{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:50:36Z","timestamp":1767343836550,"version":"3.48.0"},"reference-count":50,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Late-onset sepsis (LOS) is a life-threatening complication in preterm infants, with reported incidence rates of 1%\u201330% that vary by clinical and geographical factors. Quality improvement (QI) bundles integrating infection control, nutrition, and device management show promise in reducing LOS, but evidence remains fragmented due to heterogeneous definitions and mixed study populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta-analysis of QI studies was conducted across PubMed, Embase, Cochrane Library, and Web of Science (inception to March 19th, 2025). Studies were included if they reported pre-post QI outcomes for LOS in preterm infants (gestational age\u00a0&lt;\u00a037 weeks), with effect sizes synthesized as odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity was evaluated using\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      , with random-effects models for\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2265 50%. Subgroup analyses explored LOS definition impacts (time windows: \u226548 h, \u226572 h, other) and meta-regression tested covariates (study year, sample size, quality).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 9,705 identified studies, 29 (21 for meta-analysis,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0= 29,120 infants) met criteria. QI bundles significantly reduced LOS in very low birth weight (VLBW) infants (pooled OR = 0.47, 95% CI [0.38\u20130.58],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 88.7%) and extremely low birth weight (ELBW) infants (OR = 0.49, 95% CI [0.29\u20130.83],\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 80.6%). Core components included multidisciplinary teams (25\/29), hand hygiene (21\/29), and central line management (22\/29). Subgroup analysis showed varying effects by LOS definition: OR = 0.35 (95% CI [0.19\u20130.64]) for \u2265 48 h, OR = 0.50 (95% CI [0.39\u20130.64]) for \u2265 72 h, and OR = 0.71 (95% CI [0.61\u20130.82]) for ill-defined thresholds. Meta-regression identified no significant modifiers (all\n                      <jats:italic>p<\/jats:italic>\n                      &gt;\u00a00.0), but publication bias was detected in VLBW analyses (Egger\u2019s test,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>QI bundles significantly reduce LOS in preterm infants, including VLBW and ELBW subgroups, through core components like multidisciplinary teams, hand hygiene, and central line management. Given outcome variations by diagnostic criteria, standardizing LOS definitions is crucial. These bundles should be integrated into routine care globally. Future efforts should prioritize standardized reporting, antibiotic stewardship, and equitable implementation, especially in low-resource settings, by building on existing evidence and broader healthcare principles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20530","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:47:01Z","timestamp":1767343621000},"page":"e20530","source":"Crossref","is-referenced-by-count":0,"title":["Quality improvement interventions to prevent late-onset sepsis in premature infants: a systematic review and meta-analysis"],"prefix":"10.7717","volume":"14","author":[{"given":"Xiangtong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong,  China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong,  China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kangyan","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Child Health Care, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genfeng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong,  China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhangbin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shenzhen People\u2019s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen,  Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"issue":"17","key":"10.7717\/peerj.20530\/ref-1","doi-asserted-by":"publisher","first-page":"2036","DOI":"10.1080\/14767058.2016.1236245","article-title":"Nosocomial sepsis: evaluation of the efficacy of preventive measures in a level-III neonatal intensive care unit","volume":"30","author":"Almeida","year":"2017","journal-title":"The Journal of Maternal-Fetal & Neonatal Medicine"},{"issue":"6","key":"10.7717\/peerj.20530\/ref-2","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1542\/peds.2004-1785","article-title":"Is bloodstream infection preventable among premature infants? A tale of two cities","volume":"115","author":"Aly","year":"2005","journal-title":"Pediatrics"},{"issue":"2","key":"10.7717\/peerj.20530\/ref-3","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.jhin.2005.02.002","article-title":"Prospective evaluation of a multi-factorial prevention strategy on the impact of nosocomial infection in very-low-birthweight infants","volume":"61","author":"Andersen","year":"2005","journal-title":"The Journal of Hospital Infection"},{"key":"10.7717\/peerj.20530\/ref-4","doi-asserted-by":"publisher","first-page":"m865","DOI":"10.1136\/bmj.m865","article-title":"Quality improvement into practice","volume":"368","author":"Backhouse","year":"2020","journal-title":"BMJ (Clinical Research Ed)"},{"issue":"9","key":"10.7717\/peerj.20530\/ref-5","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1007\/s13312-018-1374-5","article-title":"Decreasing central line-associated bloodstream infections through quality improvement initiative","volume":"55","author":"Balla","year":"2018","journal-title":"Indian Pediatrics"},{"issue":"Suppl 1","key":"10.7717\/peerj.20530\/ref-6","doi-asserted-by":"publisher","first-page":"e001353","DOI":"10.1136\/bmjoq-2021-001353","article-title":"Reducing late-onset neonatal sepsis in very low birthweight neonates with central lines in a low-and-middle-income country setting","volume":"10","author":"Batthula","year":"2021","journal-title":"BMJ Open Quality"},{"key":"10.7717\/peerj.20530\/ref-7","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1186\/s12887-022-03310-5","article-title":"A standardized implementation of multicenter quality improvement program of very low birth weight newborns could significantly reduce admission hypothermia and improve outcomes","volume":"22","author":"Bi","year":"2022","journal-title":"BMC Pediatrics"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-8","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1086\/650448","article-title":"A quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit","volume":"31","author":"Bizzarro","year":"2010","journal-title":"Infection Control and Hospital Epidemiology"},{"issue":"6","key":"10.7717\/peerj.20530\/ref-9","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1038\/sj.jp.7210981","article-title":"Reducing acquired infections in the NICU: observing and implementing meaningful differences in process between high and low acquired infection rate centers","volume":"23","author":"Bloom","year":"2003","journal-title":"Journal of Perinatology"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-10","doi-asserted-by":"publisher","first-page":"F51","DOI":"10.1136\/archdischild-2015-310165","article-title":"Decreasing infection in neonatal intensive care units through quality improvement","volume":"102","author":"Bowen","year":"2017","journal-title":"Archives of Disease in Childhood"},{"issue":"Suppl 1","key":"10.7717\/peerj.20530\/ref-11","doi-asserted-by":"publisher","first-page":"e2022057092E","DOI":"10.1542\/peds.2022-057092E","article-title":"Early enteral feeding for preterm or low birth weight infants: a systematic review and meta-analysis","volume":"150","author":"Chitale","year":"2022","journal-title":"Pediatrics"},{"issue":"4","key":"10.7717\/peerj.20530\/ref-12","doi-asserted-by":"publisher","first-page":"F391","DOI":"10.1136\/archdischild-2017-313595","article-title":"Why are preterm newborns at increased risk of infection?","volume":"103","author":"Collins","year":"2018","journal-title":"Archives of Disease in Childhood. Fetal and Neonatal Edition"},{"issue":"5","key":"10.7717\/peerj.20530\/ref-13","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1038\/sj.jp.7211283","article-title":"Infection control practices reduce nosocomial infection and mortality in preterm infants in Bangladesh","volume":"25","author":"Darmstadt","year":"2005","journal-title":"Journal of Perinatology"},{"issue":"6","key":"10.7717\/peerj.20530\/ref-14","doi-asserted-by":"publisher","first-page":"F562","DOI":"10.1136\/archdischild-2015-309804","article-title":"The impact of a sepsis quality improvement project on neurodisability rates in very low birthweight infants","volume":"101","author":"Davis","year":"2016","journal-title":"Archives of Disease in Childhood Fetal and Neonatal Edition"},{"issue":"6","key":"10.7717\/peerj.20530\/ref-15","doi-asserted-by":"publisher","first-page":"e2022058813","DOI":"10.1542\/peds.2022-058813","article-title":"Late-onset sepsis among very preterm infants","volume":"150","author":"Flannery","year":"2022","journal-title":"Pediatrics"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-16","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/s2213-2600(18)30063-8","article-title":"The global burden of paediatric and neonatal sepsis: a systematic review","volume":"6","author":"Fleischmann-Struzek","year":"2018","journal-title":"The Lancet Respiratory Medicine"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-17","doi-asserted-by":"publisher","first-page":"fmad045","DOI":"10.1093\/tropej\/fmad045","article-title":"Antimicrobial resistance and epidemic clustering of late-onset neonatal infections in a Brazilian intensive care unit","volume":"70","author":"Freitas","year":"2023","journal-title":"Journal of Tropical Pediatrics"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-18","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.jhin.2010.12.018","article-title":"Tracking neonatal nosocomial infection: the continuous quality improvement cycle","volume":"78","author":"Gill","year":"2011","journal-title":"The Journal of Hospital Infection"},{"issue":"12","key":"10.7717\/peerj.20530\/ref-19","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1136\/bmjqs-2014-003151","article-title":"Development of the quality improvement minimum quality criteria set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications","volume":"24","author":"Hempel","year":"2015","journal-title":"BMJ Quality & Safety"},{"issue":"5","key":"10.7717\/peerj.20530\/ref-20","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1001\/jamapediatrics.2019.0241","article-title":"Racial segregation and inequality in the neonatal intensive care unit for very low-birth-weight and very preterm infants","volume":"173","author":"Horbar","year":"2019","journal-title":"JAMA Pediatrics"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-21","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1542\/peds.107.1.14","article-title":"Collaborative quality improvement for neonatal intensive care","volume":"107","author":"Horbar","year":"2001","journal-title":"Pediatrics"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-22","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1097\/MOP.0b013e32834ebdc3","article-title":"Quality improvement interventions to prevent healthcare-associated infections in neonates and children","volume":"24","author":"Huskins","year":"2012","journal-title":"Current Opinion in Pediatrics"},{"issue":"11","key":"10.7717\/peerj.20530\/ref-23","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1056\/NEJMoa2406295","article-title":"Out-comes of a program to reduce birth-related mortality in Tanzania","volume":"392","author":"Kamala","year":"2025","journal-title":"The New England Journal of Medicine"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-24","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1542\/peds.2010-2141","article-title":"Ohio statewide quality-improvement collaborative to reduce late-onset sepsis in preterm infants","volume":"127","author":"Kaplan","year":"2011","journal-title":"Pediatrics"},{"issue":"4 Pt 2","key":"10.7717\/peerj.20530\/ref-25","doi-asserted-by":"publisher","first-page":"e519","DOI":"10.1542\/peds.111.SE1.e519","article-title":"Implementation of evidence-based potentially better practices to decrease nosocomial infections","volume":"111","author":"Kilbride","year":"2003","journal-title":"Pediatrics"},{"issue":"6","key":"10.7717\/peerj.20530\/ref-26","doi-asserted-by":"publisher","first-page":"2026","DOI":"10.1038\/s41390-023-02742-8","article-title":"Inflammation, sepsis severity and neurodevelopmental outcomes of late-onset sepsis in preterm neonates","volume":"94","author":"Kurul","year":"2023","journal-title":"Pediatric Research"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-27","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/pch\/20.1.e1","article-title":"The evidence-based practice for improving quality method has greater impact on improvement of outcomes than dissemination of practice change guidelines and quality improvement training in neonatal intensive care units","volume":"20","author":"Lee","year":"2015","journal-title":"Paediatrics & Child Health"},{"issue":"8","key":"10.7717\/peerj.20530\/ref-28","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1503\/cmaj.081727","article-title":"Improving the quality of care for infants: a cluster randomized controlled trial","volume":"181","author":"Lee","year":"2009","journal-title":"CMAJ: Canadian Medical Association Journal"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-29","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1038\/s41390-021-01411-y","article-title":"Cause of preterm birth and late-onset sepsis in very preterm infants: the EPIPAGE-2 cohort study","volume":"90","author":"Letouzey","year":"2021","journal-title":"Pediatric Research"},{"issue":"4","key":"10.7717\/peerj.20530\/ref-30","doi-asserted-by":"publisher","first-page":"e1007","DOI":"10.1542\/peds.2014-3918","article-title":"Small baby unit improves quality and outcomes in extremely low birth weight infants","volume":"136","author":"Morris","year":"2015","journal-title":"Pediatrics"},{"issue":"8","key":"10.7717\/peerj.20530\/ref-31","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1093\/cid\/ciy1114","article-title":"Preventing bloodstream infections and death in zambian neonates: impact of a low-cost infection control bundle","volume":"69","author":"Mwananyanda","year":"2019","journal-title":"Clinical Infectious Diseases"},{"issue":"4","key":"10.7717\/peerj.20530\/ref-32","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1586\/14787210.2015.1008450","article-title":"Late-onset sepsis in preterm infants: update on strategies for therapy and prevention","volume":"13","author":"Pammi","year":"2015","journal-title":"Expert Review of Anti-Infective Therapy"},{"issue":"1","key":"10.7717\/peerj.20530\/ref-33","doi-asserted-by":"publisher","first-page":"e165","DOI":"10.1542\/peds.2011-0566","article-title":"Sustained reduction in neonatal nosocomial infections through quality improvement efforts","volume":"129","author":"Payne","year":"2012","journal-title":"Pediatrics"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-34","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1542\/peds.2009-1272","article-title":"NICU practices and outcomes associated with 9 years of quality improvement collaboratives","volume":"125","author":"Payne","year":"2010","journal-title":"Pediatrics"},{"issue":"5","key":"10.7717\/peerj.20530\/ref-35","doi-asserted-by":"publisher","first-page":"F422","DOI":"10.1136\/archdischild-2017-313362","article-title":"Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: a systematic review and meta-analysis","volume":"103","author":"Payne","year":"2018","journal-title":"Archives of Disease in Childhood Fetal and Neonatal Edition"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-36","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1038\/s41372-018-0254-0","article-title":"Golden Hour quality improvement intervention and short-term outcome among preterm infants","volume":"39","author":"Peleg","year":"2019","journal-title":"Journal of Perinatology"},{"issue":"7","key":"10.7717\/peerj.20530\/ref-37","doi-asserted-by":"publisher","DOI":"10.3390\/nu17071138","article-title":"Impact of enteral nutrition on clinical outcomes in very low birth weight infants in the NICU: a single-center retrospective cohort study","volume":"17","author":"Quitadamo","year":"2025","journal-title":"Nutrients"},{"key":"10.7717\/peerj.20530\/ref-38","doi-asserted-by":"publisher","first-page":"100369","DOI":"10.1016\/j.ijmmb.2023.100369","article-title":"Effects of implementation of healthcare associated infection surveillance and interventional measures in the neonatal intensive care unit: small steps matter","volume":"44","author":"Rakshit","year":"2023","journal-title":"Indian Journal of Medical Microbiology"},{"key":"10.7717\/peerj.20530\/ref-39","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s10096-022-04522-4","article-title":"Reduction of antibiotic use and multi-drug resistance bacteria infection in neonates after improvement of antibiotics use strategy in a level 4 neonatal intensive care unit in southern China","volume":"42","author":"Ren","year":"2023","journal-title":"European Journal of Clinical Microbiology & Infectious Diseases"},{"issue":"7","key":"10.7717\/peerj.20530\/ref-40","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1017\/ice.2016.72","article-title":"The implementation of an evidence-based bundle for bloodstream infections in neonatal intensive care units in germany: a controlled intervention study to improve patient safety","volume":"37","author":"Salm","year":"2016","journal-title":"Infection Control and Hospital Epidemiology"},{"key":"10.7717\/peerj.20530\/ref-41","doi-asserted-by":"publisher","first-page":"101622","DOI":"10.1016\/j.smrv.2022.101622","article-title":"Hospital-based inpatient quality improvement initiatives on safe infant sleep: systematic review and narrative synthesis","volume":"63","author":"Salm\u00a0Ward","year":"2022","journal-title":"Sleep Medicine Reviews"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-42","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1139\/cjpp-2018-0439","article-title":"Sustained quality improvement in outcomes of preterm neonates with a gestational age less than 29 weeks: results from the evidence-based practice for improving quality phase 31","volume":"97","author":"Shah","year":"2019","journal-title":"Canadian Journal of Physiology and Pharmacology"},{"key":"10.7717\/peerj.20530\/ref-43","doi-asserted-by":"publisher","first-page":"3854","DOI":"10.1038\/s41598-024-53163-4","article-title":"The effect of minimizing central line days for very low birth weight infants through quality improvement","volume":"14","author":"Shin","year":"2024","journal-title":"Scientific Reports"},{"issue":"4","key":"10.7717\/peerj.20530\/ref-44","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/inf.0000000000001019","article-title":"Prevention of late onset sepsis and central-line associated blood stream infection in preterm infants","volume":"35","author":"Sinha","year":"2016","journal-title":"The Pediatric Infectious Disease Journal"},{"issue":"7","key":"10.7717\/peerj.20530\/ref-45","doi-asserted-by":"publisher","first-page":"151158","DOI":"10.1053\/j.semperi.2019.06.006","article-title":"Solely human milk diets for preterm infants","volume":"43","author":"Taylor","year":"2019","journal-title":"Seminars in Perinatology"},{"issue":"11","key":"10.7717\/peerj.20530\/ref-46","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1136\/bmjqs-2019-010310","article-title":"Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events","volume":"29","author":"Vaisman","year":"2020","journal-title":"BMJ Quality & Safety"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-47","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1055\/s-0030-1268237","article-title":"The effect of comprehensive infection control measures on the rate of late-onset bloodstream infections in very low-birth-weight infants","volume":"28","author":"Wicker","year":"2011","journal-title":"American Journal of Perinatology"},{"issue":"3","key":"10.7717\/peerj.20530\/ref-48","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1542\/peds.2010-1449","article-title":"Nosocomial infection reduction in VLBW infants with a statewide quality-improvement model","volume":"127","author":"Wirtschafter","year":"2011","journal-title":"Pediatrics"},{"issue":"10","key":"10.7717\/peerj.20530\/ref-49","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.3390\/jcm8101750","article-title":"Neonate bloodstream infections in organization for economic cooperation and development countries: an update on epidemiology and prevention","volume":"8","author":"W\u00f3jkowska-Mach","year":"2019","journal-title":"Journal of Clinical Medicine"},{"key":"10.7717\/peerj.20530\/ref-50","doi-asserted-by":"publisher","first-page":"e1842","DOI":"10.7717\/peerj.18425","article-title":"Quality improvement bundles to decrease hypothermia in very low\/extremely low birth weight infants at birth: a systematic review and meta-analysis","volume":"12","author":"Zhong","year":"2024","journal-title":"PeerJ"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/20530.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/20530.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/20530.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/20530.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T08:47:04Z","timestamp":1767343624000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/20530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,2]]},"references-count":50,"alternative-id":["10.7717\/peerj.20530"],"URL":"https:\/\/doi.org\/10.7717\/peerj.20530","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,2]]},"article-number":"e20530"}}