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  1. AU="Clarke Aileen"
  2. AU="Aparecido Corrêa, Nivaldo"
  3. AU="Meng-Ju Wang"
  4. AU=Verrills Paul
  5. AU="Chaudhari, Amol"
  6. AU="Planagumà, Jesús"
  7. AU="de Rezende, Grazielli Rocha"
  8. AU="Mohadeseh NEZAM"
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  10. AU="Gentle, Popular"
  11. AU=Wang Jirui
  12. AU="Bielik, Martin"
  13. AU="Simon A.F. Darroch"
  14. AU="Suzuki, Kenichi G N"
  15. AU="Hu, Yizhong"
  16. AU=Sasaki Kotaro
  17. AU=Abd-Elsayed Alaa
  18. AU="Jung, Hee-Jun"
  19. AU="Struckmann, Stephan"
  20. AU=Coward Richard
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  22. AU="Rebecca A Butcher"
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  25. AU="Alzalzalah, Sayed"
  26. AU=Kaufman Jonathan J
  27. AU="Kim, Jin K"
  28. AU="Zevakov, S A"
  29. AU="Sui Phang"
  30. AU="Kolomeichuk, Lilia V"
  31. AU="Sabuj Kanti Mistry"
  32. AU="Basurto-Lozada, Daniela"
  33. AU="Takashima, Shin-Ichiro"
  34. AU="Teresinha Leal"
  35. AU="Angélique B van 't Wout"
  36. AU="Roberts, Nicholas J"
  37. AU="Chauhan, Gaurav B"
  38. AU=Hanjaya-Putra Donny
  39. AU=Powell James
  40. AU="Russell, Todd"
  41. AU=Forth Scott
  42. AU="Kreutzer, Susanne" AU="Kreutzer, Susanne"
  43. AU="St John, Maie"
  44. AU=Gerhardy A
  45. AU="Qi, Huixin"
  46. AU="Dobosiewicz, May"
  47. AU="Srivastava, Rakesh"
  48. AU="Grevtsov K.I."

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  1. Artikel ; Online: How and why are video consultations used in urgent primary care settings in the UK? A focus group study.

    Payne, Rebecca Elizabeth / Clarke, Aileen

    BJGP open

    2023  Band 7, Heft 3

    Abstract: Background: Video consulting was widely rolled out across general practice at the start of the COVID-19 pandemic. In the in-hours setting there has been a marked shift away from using the technology, but many urgent care clinicians continue to use video ...

    Abstract Background: Video consulting was widely rolled out across general practice at the start of the COVID-19 pandemic. In the in-hours setting there has been a marked shift away from using the technology, but many urgent care clinicians continue to use video consulting. Little is known about the reasons behind this discrepancy.
    Aim: To understand how and why video is used in urgent care settings.
    Design & setting: Focus groups were held via Microsoft Teams with 11 GPs working in in- and out-of-hours settings across the UK.
    Method: GPs were recruited through a convienience sampling strategy. Meetings were recorded, auto-transcribed, and checked for accuracy. A thematic analysis was performed.
    Results: Urgent care GPs used video as an adjunct to the telephone in the initial assessment of patients and felt it helped direct patients to the right service first time. They were confident using video for a broad range of presenting conditions. They felt it created additional trust and rapport with patients and was useful for bringing third parties into the consultation. They felt that it allowed them to maximise resources and use shielded colleagues effectively. They emphasised the importance of one-to-one training and this was seen as vital for effective implementation within an organisation.
    Conclusion: Video consulting is useful in the urgent care setting as an adjunct to telephone consulting. It is particularly helpful in the initial triage of patients. One-to-one training is needed for effective implementation.
    Sprache Englisch
    Erscheinungsdatum 2023-09-19
    Erscheinungsland England
    Dokumenttyp Journal Article
    ISSN 2398-3795
    ISSN (online) 2398-3795
    DOI 10.3399/BJGPO.2023.0025
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Access and triage in contemporary general practice: A novel theory of digital candidacy.

    Dakin, Francesca H / Rybczynska-Bunt, Sarah / Rosen, Rebecca / Clarke, Aileen / Greenhalgh, Trisha

    Social science & medicine (1982)

    2024  Band 349, Seite(n) 116885

    Abstract: To access contemporary healthcare, patients must find and navigate a complex socio-technical network of human and digital actors linked in multi-modal pathways. Asynchronous, digitally-mediated triage decisions have largely replaced synchronous ... ...

    Abstract To access contemporary healthcare, patients must find and navigate a complex socio-technical network of human and digital actors linked in multi-modal pathways. Asynchronous, digitally-mediated triage decisions have largely replaced synchronous conversations between humans. In this paper, we draw on a large qualitative dataset from a multi-site study of remote and digital technologies in general practice to understand widening inequities of access. We theorise our data by bringing together traditional candidacy theory (in particular, concepts of self-assessment, help-seeking, adjudication and negotiation) and socio-technical and technology structuration theories (in particular, concepts of user configuration, articulation, distanciation, disembedding, and recursivity), thus producing a novel theory of digital candidacy. We propose that both human and technological actors (in different ways) embody social structures which affect how they 'act' in social situations. Digital technologies contain inbuilt assumptions about users' capabilities, needs, rights, and skills. Patients' ability to self-assess as sick, access digital platforms, self-advocate, and navigate multiple stages in the pathway, including adapting to and compensating for limitations in the technology, vary widely and are markedly patterned by disadvantage. Not every patient can craft an accurate digital facsimile on which the subsequent adjudication decision will be made; those who create incomplete, flawed or unpersuasive digital facsimiles may be deprioritised or misdirected. Staff who know about such patients may use articulation measures to ensure a personalised and appropriate access package, but they cannot identify or fully mitigate all such cases. The decisions and actions of human and technological agents at the time of an attempt to access care can significantly influence, disrupt, and reconstitute candidacy both immediately and recursively over time, and also recursively shape the system itself. These findings underscore the need for services to be (co-)designed with attention to the exclusionary tendencies of digital technologies and technology-supported processes and pathways.
    Mesh-Begriff(e) Humans ; Triage/methods ; General Practice/methods ; Health Services Accessibility ; Qualitative Research ; Digital Technology ; Female ; Male ; Adult ; Middle Aged
    Sprache Englisch
    Erscheinungsdatum 2024-04-13
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 4766-1
    ISSN 1873-5347 ; 0037-7856 ; 0277-9536
    ISSN (online) 1873-5347
    ISSN 0037-7856 ; 0277-9536
    DOI 10.1016/j.socscimed.2024.116885
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Paragons, Mavericks and Innovators-A typology of orthopaedic surgeons' professional identities. A comparative case study of evidence-based practice.

    Grove, Amy / Pope, Catherine / Currie, Graeme / Clarke, Aileen

    Sociology of health & illness

    2021  Band 44, Heft 1, Seite(n) 59–80

    Abstract: Clinical guidelines, as vehicles for evidence-based practice (EBP) attempt to standardize health-care practice, reduce variation and increase quality. However, their use for surgery has been contested, and often resisted. This article examines ... ...

    Abstract Clinical guidelines, as vehicles for evidence-based practice (EBP) attempt to standardize health-care practice, reduce variation and increase quality. However, their use for surgery has been contested, and often resisted. This article examines professional responses to EBP in hip replacement surgery using data from case study observations and interviews in three English orthopaedic departments. A professional identity perspective is adopted to explain how standardization through EBP, represents an empirical phenomenon around which surgeons enact their identities as Paragons, Mavericks or Innovators, to enhance legitimacy and stratify themselves in their response to EBP. Attention is drawn to variation between Paragon surgeons working in university (teaching) hospitals and Maverick and Innovator types located in general hospitals, and the ways this interacts with adoption of EBP. The typology shows how practice variation is related to surgeons' tendencies to align to characteristic types, with distinct social processes, power and prestige, and which are in turn influenced by organizational context. The dynamics of EBP and professional identity continues to limit attempts to standardize surgical practice. The typology contributes to the understanding of failures to follow EBP, as associated with the identities individuals create and negotiate, and with identity narratives used to legitimize differing responses to EBP.
    Mesh-Begriff(e) Delivery of Health Care ; Evidence-Based Practice ; Humans ; Orthopedic Surgeons ; Social Identification ; Surgeons
    Sprache Englisch
    Erscheinungsdatum 2021-10-27
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 795552-2
    ISSN 1467-9566 ; 0141-9889
    ISSN (online) 1467-9566
    ISSN 0141-9889
    DOI 10.1111/1467-9566.13392
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel: The importance of understanding evidence.

    Clarke, Aileen

    The Health service journal

    2012  Band 122, Heft 6330, Seite(n) 18, 19

    Mesh-Begriff(e) Data Collection ; Decision Making ; Evidence-Based Practice ; Health Planning ; State Medicine ; United Kingdom
    Sprache Englisch
    Erscheinungsdatum 2012-11-22
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 632799-0
    ISSN 0952-2271 ; 0300-8347
    ISSN 0952-2271 ; 0300-8347
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Konferenzbeitrag: A workshop to co-design messages that may increase uptake of vaccines: A case study

    Schmidtke, Kelly A. / Skrybant, Magdalena / Kudrna, Laura / Russell, Samantha / Ding, Isabel L. / Clarke, Aileen

    Vaccine. 2022 July 30,

    2022  

    Abstract: The present case study describes a co-produced and theoretically informed workshop wherein messages were co-designed to increase the uptake of future COVID-19 vaccines in the United Kingdom. Co-design can enhance the legitimacy and effectiveness of ... ...

    Abstract The present case study describes a co-produced and theoretically informed workshop wherein messages were co-designed to increase the uptake of future COVID-19 vaccines in the United Kingdom. Co-design can enhance the legitimacy and effectiveness of public interventions, but many researchers, service providers, and policymakers may be uncertain where to start. This demonstrative example applies behavioural science and design thinking theory, illustrating how others can integrate theoretically informed co-design into similar and more complex projects efficiently. The workshop brought together members of the public, immunisers, and public health specialists. A narrative analysis was conducted to identify themes related to vaccine hesitancy. The workshop's supporting materials are made available as supplemental materials, which can be modified for future workshops. The discussion encourages additional workshops to be conducted, including diverse members of the public, to co-design novel solutions to improve public health more generally.
    Schlagwörter COVID-19 infection ; case studies ; public health ; vaccines ; United Kingdom
    Sprache Englisch
    Erscheinungsverlauf 2022-0730
    Erscheinungsort Elsevier Ltd
    Dokumenttyp Artikel ; Konferenzbeitrag
    Anmerkung Pre-press version
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2022.07.053
    Datenquelle NAL Katalog (AGRICOLA)

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  6. Artikel ; Online: Comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study using routine data of faecal calprotectin testing for inflammatory bowel disease.

    Freeman, Karoline / Willis, Brian H / Ryan, Ronan / Taylor-Phillips, Sian / Clarke, Aileen

    BMC medical research methodology

    2022  Band 22, Heft 1, Seite(n) 192

    Abstract: Background: Meta-analyses of test accuracy studies may provide estimates that are highly improbable in clinical practice. Tailored meta-analysis produces plausible estimates for the accuracy of a test within a specific setting by tailoring the selection ...

    Abstract Background: Meta-analyses of test accuracy studies may provide estimates that are highly improbable in clinical practice. Tailored meta-analysis produces plausible estimates for the accuracy of a test within a specific setting by tailoring the selection of included studies compatible with a specific setting using information from the target setting. The aim of this study was to validate the tailored meta-analysis approach by comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study.
    Methods: A retrospective cohort study of primary care electronic health records provided setting-specific data on the test positive rate and disease prevalence. This was used to tailor the study selection from a review of faecal calprotectin testing for inflammatory bowel disease for meta-analysis using the binomial method and the Mahalanobis distance method. Tailored estimates were compared to estimates from a study of test accuracy in primary care using the same routine dataset.
    Results: Tailoring resulted in the inclusion of 3/14 (binomial method) and 9/14 (Mahalanobis distance method) studies in meta-analysis. Sensitivity and specificity from tailored meta-analysis using the binomial method were 0.87 (95% CI 0.77 to 0.94) and 0.65 (95% CI 0.60 to 0.69) and 0.98 (95% CI 0.83 to 0.999) and 0.68 (95% CI 0.65 to 0.71), respectively using the Mahalanobis distance method. The corresponding estimates for the conventional meta-analysis were 0.94 (95% CI 0.90 to 0.97) and 0.67 (95% CI 0.57 to 0.76) and for the FC test accuracy study of primary care data 0.93 (95%CI 0.89 to 0.96) and 0.61 (95% CI 0.6 to 0.63) to detect IBD at a threshold of 50 μg/g. Although the binomial method produced a plausible estimate, the tailored estimates of sensitivity and specificity were not closer to the primary study estimates than the estimates from conventional meta-analysis including all 14 studies.
    Conclusions: Tailored meta-analysis does not always produce estimates of sensitivity and specificity that lie closer to the estimates derived from a primary study in the setting in question. Potentially, tailored meta-analysis may be improved using a constrained model approach and this requires further investigation.
    Mesh-Begriff(e) Chronic Disease ; Humans ; Inflammatory Bowel Diseases/diagnosis ; Inflammatory Bowel Diseases/epidemiology ; Leukocyte L1 Antigen Complex ; Retrospective Studies ; Sensitivity and Specificity
    Chemische Substanzen Leukocyte L1 Antigen Complex
    Sprache Englisch
    Erscheinungsdatum 2022-07-12
    Erscheinungsland England
    Dokumenttyp Journal Article ; Meta-Analysis ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041362-2
    ISSN 1471-2288 ; 1471-2288
    ISSN (online) 1471-2288
    ISSN 1471-2288
    DOI 10.1186/s12874-022-01668-9
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: A workshop to co-design messages that may increase uptake of vaccines: A case study.

    Schmidtke, Kelly A / Skrybant, Magdalena / Kudrna, Laura / Russell, Samantha / Ding, Isabel L / Clarke, Aileen

    Vaccine

    2022  Band 40, Heft 37, Seite(n) 5407–5412

    Abstract: The present case study describes a co-produced and theoretically informed workshop wherein messages were co-designed to increase the uptake of future COVID-19 vaccines in the United Kingdom. Co-design can enhance the legitimacy and effectiveness of ... ...

    Abstract The present case study describes a co-produced and theoretically informed workshop wherein messages were co-designed to increase the uptake of future COVID-19 vaccines in the United Kingdom. Co-design can enhance the legitimacy and effectiveness of public interventions, but many researchers, service providers, and policymakers may be uncertain where to start. This demonstrative example applies behavioural science and design thinking theory, illustrating how others can integrate theoretically informed co-design into similar and more complex projects efficiently. The workshop brought together members of the public, immunisers, and public health specialists. A narrative analysis was conducted to identify themes related to vaccine hesitancy. The workshop's supporting materials are made available as supplemental materials, which can be modified for future workshops. The discussion encourages additional workshops to be conducted, including diverse members of the public, to co-design novel solutions to improve public health more generally.
    Mesh-Begriff(e) COVID-19/prevention & control ; COVID-19 Vaccines ; Humans ; United Kingdom ; Vaccines
    Chemische Substanzen COVID-19 Vaccines ; Vaccines
    Sprache Englisch
    Erscheinungsdatum 2022-08-13
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2022.07.053
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare.

    Gauly, Julia / Court, Rachel / Currie, Graeme / Seers, Kate / Clarke, Aileen / Metcalfe, Andy / Wilson, Anna / Hazell, Matthew / Grove, Amy Louise

    Implementation science : IS

    2023  Band 18, Heft 1, Seite(n) 15

    Abstract: Background: Healthcare systems invest in leadership development of surgeons, surgical trainees, and teams. However, there is no agreement on how interventions should be designed, or what components they must contain to be successful. The objective of ... ...

    Abstract Background: Healthcare systems invest in leadership development of surgeons, surgical trainees, and teams. However, there is no agreement on how interventions should be designed, or what components they must contain to be successful. The objective of this realist review was to generate a programme theory explaining in which context and for whom surgical leadership interventions work and why.
    Methods: Five databases were systematically searched, and articles screened against inclusion considering their relevance. Context-mechanism-outcome configurations (CMOCs) and fragments of CMOCs were identified. Gaps in the CMOCs were filled through deliberation with the research team and stakeholder feedback. We identified patterns between CMOCs and causal relationships to create a programme theory.
    Results: Thirty-three studies were included and 19 CMOCs were developed. Findings suggests that interventions for surgeons and surgical teams improve leadership if timely feedback is delivered on multiple occasions and by trusted and respected people. Negative feedback is best provided privately. Feedback from senior-to-junior or peer-to-peer should be delivered directly, whereas feedback from junior-to-senior is preferred when delivered anonymously. Leadership interventions were shown to be most effective for those with awareness of the importance of leadership, those with confidence in their technical surgical skills, and those with identified leadership deficits. For interventions to improve leadership in surgery, they need to be delivered in an intimate learning environment, consider implementing a speak-up culture, provide a variety of interactive learning activities, show a genuine investment in the intervention, and be customised to the needs of surgeons. Leadership of surgical teams can be best developed by enabling surgical teams to train together.
    Conclusions: The programme theory provides evidence-based guidance for those who are designing, developing and implementing leadership interventions in surgery. Adopting the recommendations will help to ensure interventions are acceptable to the surgical community and successful in improving surgical leadership.
    Trial registration: The review protocol is registered with PROSPERO (CRD42021230709).
    Mesh-Begriff(e) Humans ; Leadership ; Delivery of Health Care ; Health Facilities ; Learning
    Sprache Englisch
    Erscheinungsdatum 2023-05-13
    Erscheinungsland England
    Dokumenttyp Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2225822-X
    ISSN 1748-5908 ; 1748-5908
    ISSN (online) 1748-5908
    ISSN 1748-5908
    DOI 10.1186/s13012-023-01274-3
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: What is the best way to evaluate social prescribing? A qualitative feasibility assessment for a national impact evaluation study in England.

    Ayorinde, Abimbola / Grove, Amy / Ghosh, Iman / Harlock, Jenny / Meehan, Edward / Tyldesley-Marshall, Natalie / Briggs, Adam / Clarke, Aileen / Al-Khudairy, Lena

    Journal of health services research & policy

    2023  Band 29, Heft 2, Seite(n) 111–121

    Abstract: Objectives: Despite significant investment in social prescribing in England over the last decade, we still do not know if it works, or how models of social prescribing fit within wider health and care policy and practice. This study explores current ... ...

    Abstract Objectives: Despite significant investment in social prescribing in England over the last decade, we still do not know if it works, or how models of social prescribing fit within wider health and care policy and practice. This study explores current service delivery structures and assesses the feasibility of a national evaluation of the link worker model.
    Methods: Semi-structured interviews were conducted between May and September 2020, with 25 key informants from across social prescribing services in England. Participants included link workers, voluntary, community and social enterprise staff, and those involved in policy and decision-making for social prescribing services. Interview and workshop transcripts were analysed thematically, adopting a framework approach.
    Results: We found differences in how services are provided, including by individual link workers, and between organisations and regions. Standards, referral pathways, reporting, and monitoring structures differ or are lacking in voluntary services as compared to clinical services. People can self-refer to a link worker or be referred by a third party, but the lack of standardised processes generated confusion in both public and professional perceptions of the link worker model. We identified challenges in determining the appropriate outcomes and outcome measures needed to assess the impact of the link worker model.
    Conclusions: The current varied service delivery structures in England poses major challenges for a national impact evaluation. Any future rigorous evaluation needs to be underpinned with national standardised outcomes and process measures which promote uniform data collection.
    Mesh-Begriff(e) Humans ; Qualitative Research ; Feasibility Studies ; Social Work ; England ; Social Welfare
    Sprache Englisch
    Erscheinungsdatum 2023-12-15
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1330668-6
    ISSN 1758-1060 ; 1355-8196
    ISSN (online) 1758-1060
    ISSN 1355-8196
    DOI 10.1177/13558196231212854
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Fatigue and vigilance in medical experts detecting breast cancer.

    Taylor-Phillips, Sian / Jenkinson, David / Stinton, Chris / Kunar, Melina A / Watson, Derrick G / Freeman, Karoline / Mansbridge, Alice / Wallis, Matthew G / Kearins, Olive / Hudson, Sue / Clarke, Aileen

    Proceedings of the National Academy of Sciences of the United States of America

    2024  Band 121, Heft 11, Seite(n) e2309576121

    Abstract: An abundance of laboratory-based experiments has described a vigilance decrement of reducing accuracy to detect targets with time on task, but there are few real-world studies, none of which have previously controlled the environment to control for bias. ...

    Abstract An abundance of laboratory-based experiments has described a vigilance decrement of reducing accuracy to detect targets with time on task, but there are few real-world studies, none of which have previously controlled the environment to control for bias. We describe accuracy in clinical practice for 360 experts who examined >1 million women's mammograms for signs of cancer, whilst controlling for potential biases. The vigilance decrement pattern was not observed. Instead, test accuracy improved over time, through a reduction in false alarms and an increase in speed, with no significant change in sensitivity. The multiple-decision model explains why experts miss targets in low prevalence settings through a change in decision threshold and search quit threshold and propose it should be adapted to explain these observed patterns of accuracy with time on task. What is typically thought of as standard and robust research findings in controlled laboratory settings may not directly apply to real-world environments and instead large, controlled studies in relevant environments are needed.
    Mesh-Begriff(e) Female ; Humans ; Breast Neoplasms/diagnostic imaging ; Mammography ; Fatigue ; Laboratories ; Research Design
    Sprache Englisch
    Erscheinungsdatum 2024-03-04
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.2309576121
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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