Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury
- Autores
- Rohaut, B.; Calligaris, C.; Hermann, B.; Perez, P.; Faugeras, F.; Raimondo, F.; King, J. R.; Engemann, D.; Marois, C.; Le Guennec, L.; Di Meglio, L.; Sangaré, A.; Munoz Musat, E.; Valente, M.; Ben Salah, A.; Demertzi, A.; Belloli, Laouen Mayal Louan; Manasova, D.; Jodaitis, L.; Habert, M. O.; Lambrecq, V.; Pyatigorskaya, N.; Galanaud, D.; Puybasset, L.; Weiss, N.; Demeret, S.; Lejeune, F. X.; Sitt, J. D.; Naccache, L.
- Año de publicación
- 2024
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P < 0.001; and 2.9 (1.56–5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21–0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18–6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients.
Fil: Rohaut, B.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Calligaris, C.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Hermann, B.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Perez, P.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Faugeras, F.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Raimondo, F.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: King, J. R.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Engemann, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Marois, C.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Le Guennec, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Di Meglio, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Sangaré, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Munoz Musat, E.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Valente, M.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Ben Salah, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Demertzi, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Belloli, Laouen Mayal Louan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Investigación en Ciencias de la Computación. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Investigación en Ciencias de la Computación; Argentina
Fil: Manasova, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Jodaitis, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Habert, M. O.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Lambrecq, V.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Pyatigorskaya, N.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Galanaud, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Puybasset, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Weiss, N.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Demeret, S.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Lejeune, F. X.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Sitt, J. D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia
Fil: Naccache, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia - Materia
-
Disorders of consciousness
Assesment - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by/2.5/ar/
- Repositorio
.jpg)
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/275318
Ver los metadatos del registro completo
| id |
CONICETDig_372c01c672c6270e5c2dfaee995da34c |
|---|---|
| oai_identifier_str |
oai:ri.conicet.gov.ar:11336/275318 |
| network_acronym_str |
CONICETDig |
| repository_id_str |
3498 |
| network_name_str |
CONICET Digital (CONICET) |
| spelling |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injuryRohaut, B.Calligaris, C.Hermann, B.Perez, P.Faugeras, F.Raimondo, F.King, J. R.Engemann, D.Marois, C.Le Guennec, L.Di Meglio, L.Sangaré, A.Munoz Musat, E.Valente, M.Ben Salah, A.Demertzi, A.Belloli, Laouen Mayal LouanManasova, D.Jodaitis, L.Habert, M. O.Lambrecq, V.Pyatigorskaya, N.Galanaud, D.Puybasset, L.Weiss, N.Demeret, S.Lejeune, F. X.Sitt, J. D.Naccache, L.Disorders of consciousnessAssesmenthttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P < 0.001; and 2.9 (1.56–5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21–0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18–6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients.Fil: Rohaut, B.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Calligaris, C.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Hermann, B.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Perez, P.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Faugeras, F.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Raimondo, F.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: King, J. R.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Engemann, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Marois, C.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Le Guennec, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Di Meglio, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Sangaré, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Munoz Musat, E.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Valente, M.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Ben Salah, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Demertzi, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Belloli, Laouen Mayal Louan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Investigación en Ciencias de la Computación. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Investigación en Ciencias de la Computación; ArgentinaFil: Manasova, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Jodaitis, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Habert, M. O.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Lambrecq, V.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Pyatigorskaya, N.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Galanaud, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Puybasset, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Weiss, N.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Demeret, S.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Lejeune, F. X.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Sitt, J. D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaFil: Naccache, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; FranciaNature Publishing Group2024-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/275318Rohaut, B.; Calligaris, C.; Hermann, B.; Perez, P.; Faugeras, F.; et al.; Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury; Nature Publishing Group; Nature Medicine; 30; 8; 5-2024; 2349-23551078-8956CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.nature.com/articles/s41591-024-03019-1info:eu-repo/semantics/altIdentifier/doi/10.1038/s41591-024-03019-1info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-12-03T09:15:07Zoai:ri.conicet.gov.ar:11336/275318instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-12-03 09:15:07.905CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
| dc.title.none.fl_str_mv |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| title |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| spellingShingle |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury Rohaut, B. Disorders of consciousness Assesment |
| title_short |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| title_full |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| title_fullStr |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| title_full_unstemmed |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| title_sort |
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury |
| dc.creator.none.fl_str_mv |
Rohaut, B. Calligaris, C. Hermann, B. Perez, P. Faugeras, F. Raimondo, F. King, J. R. Engemann, D. Marois, C. Le Guennec, L. Di Meglio, L. Sangaré, A. Munoz Musat, E. Valente, M. Ben Salah, A. Demertzi, A. Belloli, Laouen Mayal Louan Manasova, D. Jodaitis, L. Habert, M. O. Lambrecq, V. Pyatigorskaya, N. Galanaud, D. Puybasset, L. Weiss, N. Demeret, S. Lejeune, F. X. Sitt, J. D. Naccache, L. |
| author |
Rohaut, B. |
| author_facet |
Rohaut, B. Calligaris, C. Hermann, B. Perez, P. Faugeras, F. Raimondo, F. King, J. R. Engemann, D. Marois, C. Le Guennec, L. Di Meglio, L. Sangaré, A. Munoz Musat, E. Valente, M. Ben Salah, A. Demertzi, A. Belloli, Laouen Mayal Louan Manasova, D. Jodaitis, L. Habert, M. O. Lambrecq, V. Pyatigorskaya, N. Galanaud, D. Puybasset, L. Weiss, N. Demeret, S. Lejeune, F. X. Sitt, J. D. Naccache, L. |
| author_role |
author |
| author2 |
Calligaris, C. Hermann, B. Perez, P. Faugeras, F. Raimondo, F. King, J. R. Engemann, D. Marois, C. Le Guennec, L. Di Meglio, L. Sangaré, A. Munoz Musat, E. Valente, M. Ben Salah, A. Demertzi, A. Belloli, Laouen Mayal Louan Manasova, D. Jodaitis, L. Habert, M. O. Lambrecq, V. Pyatigorskaya, N. Galanaud, D. Puybasset, L. Weiss, N. Demeret, S. Lejeune, F. X. Sitt, J. D. Naccache, L. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Disorders of consciousness Assesment |
| topic |
Disorders of consciousness Assesment |
| purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.2 https://purl.org/becyt/ford/3 |
| dc.description.none.fl_txt_mv |
Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P < 0.001; and 2.9 (1.56–5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21–0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18–6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients. Fil: Rohaut, B.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Calligaris, C.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Hermann, B.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Perez, P.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Faugeras, F.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Raimondo, F.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: King, J. R.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Engemann, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Marois, C.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Le Guennec, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Di Meglio, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Sangaré, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Munoz Musat, E.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Valente, M.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Ben Salah, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Demertzi, A.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Belloli, Laouen Mayal Louan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Investigación en Ciencias de la Computación. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Investigación en Ciencias de la Computación; Argentina Fil: Manasova, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Jodaitis, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Habert, M. O.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Lambrecq, V.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Pyatigorskaya, N.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Galanaud, D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Puybasset, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Weiss, N.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Demeret, S.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Lejeune, F. X.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Sitt, J. D.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia Fil: Naccache, L.. Centre de Recherche de I'Institut du Cerveau et de la Moelle Epinière; Francia |
| description |
Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P < 0.001; and 2.9 (1.56–5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21–0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18–6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024-05 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/275318 Rohaut, B.; Calligaris, C.; Hermann, B.; Perez, P.; Faugeras, F.; et al.; Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury; Nature Publishing Group; Nature Medicine; 30; 8; 5-2024; 2349-2355 1078-8956 CONICET Digital CONICET |
| url |
http://hdl.handle.net/11336/275318 |
| identifier_str_mv |
Rohaut, B.; Calligaris, C.; Hermann, B.; Perez, P.; Faugeras, F.; et al.; Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury; Nature Publishing Group; Nature Medicine; 30; 8; 5-2024; 2349-2355 1078-8956 CONICET Digital CONICET |
| dc.language.none.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://www.nature.com/articles/s41591-024-03019-1 info:eu-repo/semantics/altIdentifier/doi/10.1038/s41591-024-03019-1 |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/2.5/ar/ |
| eu_rights_str_mv |
openAccess |
| rights_invalid_str_mv |
https://creativecommons.org/licenses/by/2.5/ar/ |
| dc.format.none.fl_str_mv |
application/pdf application/pdf |
| dc.publisher.none.fl_str_mv |
Nature Publishing Group |
| publisher.none.fl_str_mv |
Nature Publishing Group |
| dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
| reponame_str |
CONICET Digital (CONICET) |
| collection |
CONICET Digital (CONICET) |
| instname_str |
Consejo Nacional de Investigaciones Científicas y Técnicas |
| repository.name.fl_str_mv |
CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
| repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
| _version_ |
1850505432371560448 |
| score |
13.275514 |