Journal of acute medicine最新文献

{"title":"Impact of COVID-19 Pandemic on Emergency Department Volume and Acuity in Low Incidence Area: Taiwan's Experience in Three Hospitals.","authors":"Pei-Hsien Lin,&nbsp;Hung-Yuan Su,&nbsp;I-Ting Tsai,&nbsp;Kuo-Hsin Lee,&nbsp;Yu-Han Wang,&nbsp;Chao-Sheng Chang,&nbsp;Meng-Chun Hsu,&nbsp;Jeng-Long Tsai,&nbsp;Chih-Wei Hsu","doi":"10.6705/j.jacme.202209_12(3).0003","DOIUrl":"https://doi.org/10.6705/j.jacme.202209_12(3).0003","url":null,"abstract":"<p><strong>Background: </strong>The decrease in emergency department (ED) patient visits during the COVID-19 pandemic was reported by various studies. Our study aimed to investigate whether a similar trend can be observed in a country with a low incidence of COVID-19 as well as the impact caused by the pandemic on ED patients in different triage levels and categories.</p><p><strong>Methods: </strong>This multicenter retrospective study collected data from three regional hospitals between March 2019 and December 2020. We evaluated the differences between patient volume, disease severity, and patient composition in ED before and after the COVID-19 pandemic among these hospitals.</p><p><strong>Results: </strong>There was a 23% reduction in ED patient volume in the urban hospital (hospital A) as well as a 16% reduction in suburban hospitals (hospitals B and C) during the pandemic period, respectively. The regression analysis showed a high correlation in the change in monthly patient volume among these hospitals. In terms of severity, there was a 24% reduction in ED visits with high severity levels (Taiwan Triage and Acuity Scale [TTAS] I, II) in hospital A, as well as 16% and 12% in hospitals B and C during the pandemic period, respectively. Similarly, there was a 23% reduction in ED visits with low severity levels (TTAS III, IV, V) in hospital A, as well as 20% and 16% in hospitals B and C during the pandemic period, respectively. In terms of patient types, there was a significant decline in non-traumatic adult patients (19%, 17%, and 10%), and pediatric patients (49%, 50%, and 46%) in hospitals A, B, and C, respectively.</p><p><strong>Conclusions: </strong>Despite the low incidence of COVID-19 in Taiwan, a decrease in total ED visits was still found during the pandemic, especially in non-trauma adult visits and pediatric visits. In addition, ED visits in both high and low severity levels decreased in these regional hospitals.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 3","pages":"105-112"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561484/pdf/jacme-12-3-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Rapid PCR Testing for Viral Respiratory Infections on Acute Admissions From the Emergency Department and Inpatient Length of Stay.","authors":"Jack Callum,&nbsp;Duin McDiarmid,&nbsp;Rusheng Chew","doi":"10.6705/j.jacme.202209_12(3).0002","DOIUrl":"https://doi.org/10.6705/j.jacme.202209_12(3).0002","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing influenza and respiratory syncytial virus (RSV) with conventional multiplex respiratory viral polymerase chain reaction (PCR) takes 24-72 hours compared with under two hours for recently available rapid PCR tests. We investigated the impact of rapid diagnosis of acute respiratory viral infection on admission odds from the emergency department (ED) and acute inpatient length of stay (LOS), as well as concordance between the rapid and conventional PCR tests used at our institution.</p><p><strong>Methods: </strong>Single-center retrospective cohort study of patients presenting to the ED with influenza-like illness. We compared the odds of admission and acute LOS in patients investigated with rapid PCR, those investigated with conventional PCR, and those investigated with both tests. Multivariable logistic regression was used to assess the odds of admission, while linear regression was used to assess LOS.</p><p><strong>Results: </strong>There was no significant change in the odds of admission among patients who received the rapid PCR compared to conventional PCR (odds ratio: 1.01, 95% confidence interval [CI]: 0.50-2.02; <i>p</i> = 0.96). There was also no significant difference in LOS of admitted patients who received rapid PCR testing (regression coefficient: -0.32, 95% CI: -1.75 to 1.12; <i>p</i> = 0.66). The rapid PCR test used at our institution yielded fully concordant results with conventional PCR testing.</p><p><strong>Conclusions: </strong>Rapid PCR testing is as sensitive as conventional PCR testing for the diagnosis of influenza and RSV but is neither associated with a significant impact on admission nor inpatient LOS. Further research is needed to assess the impact of rapid testing on isolation room use.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 3","pages":"96-104"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561482/pdf/jacme-12-3-02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who Is at Risk? A Critical Case of Japanese Encephalitis.","authors":"Yu-Hsiang Chen,&nbsp;Ko-Ying Huang,&nbsp;Chia-Chen Liu,&nbsp;Yi-Ming Weng","doi":"10.6705/j.jacme.202209_12(3).0005","DOIUrl":"https://doi.org/10.6705/j.jacme.202209_12(3).0005","url":null,"abstract":"<p><p>Japanese encephalitis (JE) is critical epidemic encephalitis caused by the JE virus (JEV) in Southeast Asia. The World Health Organization defined \"acute encephalitis syndrome\" (AES) as an acute onset of fever with a change of mental status and/or new-onset seizure, mainly for the surveillance of JE. The key clues for the diagnosis include the patient age group of unvaccinated era or waning vaccine-induced immunity and the history of possible mosquito bites in epidemic areas. We report a 47-year old man who is in an unvaccinated era with potential waning immunity. The patient presented with fever and altered mental status for 2 days. He was speechless and could not follow commands. The patient had gone camping in the countryside a week before the visit. At the emergency department, neck stiffness was noted. There was a leukocytosis with a left shift by blood cell count. The brain computed tomography was essentially normal. The cerebrospinal fluid (CSF) sample via lumbar puncture showed leukocytosis, a high protein level, and a low sugar level in comparison to serum tests. Further antibody test of CSF confirmed the diagnosis. Magnetic resonance imaging (MRI) of the brain revealed a high signal in the right thalamus and a mildly swollen left caudate nucleus 4 days after admission. He was extubated and finally discharged with partial dependency on activities of daily living. This case reminds us of the JE in AES. Emergency physicians should be aware of the suspicious case of unvaccinated age or waning immunity and possible mosquito bites in epidemic areas. The role of MRI on JE was also discussed in this article.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 3","pages":"122-125"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561487/pdf/jacme-12-3-05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Cardiopulmonary Arrest in the Emergency Department: The First Case With Successful Return of Spontaneous Circulation in Taiwan.","authors":"Shuo-Ting Hsu,&nbsp;Yi-Kai Fu,&nbsp;Hao-Yang Lin,&nbsp;Wen-Chu Chiang,&nbsp;Yu-Chen Chiu,&nbsp;Jen-Tang Sun,&nbsp;Matthew Huei-Ming Ma","doi":"10.6705/j.jacme.202209_12(3).0006","DOIUrl":"https://doi.org/10.6705/j.jacme.202209_12(3).0006","url":null,"abstract":"<p><p>Exsanguinating torso hemorrhage is a leading cause of death in trauma patients. Bleeding leads to hypothermia, acidosis, and coagulopathy, the so-called \"lethal triad,\" and creates a vicious cycle. Therefore, bleeding control tops the priority list in the management of trauma patients. Placement of resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with traumatic non-compressible torso hemorrhage is a developing technique in the emergency departments (EDs) in Taiwan, and it is a possible solution for abdominal and pelvic trauma patients with hemodynamic instability. It not only temporarily controls bleeding below the inflation site but also increases cerebral and coronary circulation. It can create a bridge for definitive care such as an operation or an embolization, possibly preventing death. Compared to thoracotomy followed by an aortic cross clamp, REBOA is a less invasive and possibly, a more efficient way to control the hemorrhage and may lead to better overall survival. The use of REBOA has been proven to be associated with improved survival-to-discharge in severely injured trauma patients. We report a case of out-of-hospital cardiac arrest caused by penetrating injury wherein return of spontaneous circulation was successfully achieved after 39-minute cardiopulmonary resuscitation and REBOA placement in the ED. The REBOA balloon was deflated after bleeding was stopped during the laparotomy operation. The patient was then transferred to the intensive care unit for postoperative care. Unfortunately, the patient passed away approximately 12 hours after the surgery.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 3","pages":"126-130"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561488/pdf/jacme-12-3-06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Geriatric Assessment in the Emergency Department for Identifying Elderly Individuals at Risk of Hip Fracture.","authors":"Pei-Ying Lin,&nbsp;Hsien-Hao Huang,&nbsp;David Hung-Tsang Yen","doi":"10.6705/j.jacme.202209_12(3).0004","DOIUrl":"https://doi.org/10.6705/j.jacme.202209_12(3).0004","url":null,"abstract":"<p><strong>Background: </strong>Hip fracture (HF) is a major challenge for healthcare systems in terms of increased costs and lengths of stay, and it has been estimated that by 2050, half of the projected 6.26 million global HFs will occur in Asia. Owing to the high morbidity and mortality associated with HF in elderly individuals, it is crucial to recognize at-risk elderly patients in the ED so that special precautions and preventive measures can be taken. While comprehensive geriatric assessment (CGA) has been shown to improve outcomes and prevent secondary fractures in elderly individuals with HF in outpatient settings, there is a lack of data to identify elderly Asian patients who are at risk of HF via using CGA in the emergency department (ED). The aim of this study is to identify the characteristics of elderly Asian patients in the ED who have an increased risk of HF via CGA.</p><p><strong>Methods: </strong>A case-control study was conducted in the ED at Taipei Veterans General Hospital, a medical center located in Taipei, Taiwan, from October 2018 to December 2019. Patients > 75 years old with and without HF were compared using data obtained from CGAs conducted by trained nurses.</p><p><strong>Results: </strong>A total of 85 HF patients (cases) and 680 non-HF patients were enrolled, among whom 340 non-HF control individuals (controls) were selected by simple random sampling. HF occurred more frequently in women and in patients with depressive symptoms. An association between decreased handgrip strength and HF risk, especially in men, was also identified ( <i>p</i> = 0.011). The variables independently associated with the presence of HF in the multivariate analysis were female sex (odds ratio [OR]: 2.229; 95% confidence interval [CI]: 1.332-3.728) and decreased handgrip strength (OR: 2.462; 95% CI: 1.155-5.247).</p><p><strong>Conclusions: </strong>By performing CGAs in the ED, we found that female sex and decreased handgrip strength were associated with HF risk. Therefore, we propose that targeted assessment of handgrip strength in female patients aged > 75 years in the ED may identify those at greatest risk of HF, resulting in improved emergency care for geriatric patients.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 3","pages":"113-121"},"PeriodicalIF":0.6,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561485/pdf/jacme-12-3-04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40438603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Clinical Presentation of Toad Venom-Induced Cardiac Intoxication.","authors":"Chia-Yi Lu,&nbsp;Yung-Yih Chang,&nbsp;Tzu-Heng Hsu,&nbsp;Chih-Yun Yeh,&nbsp;Pei-Fang Lai","doi":"10.6705/j.jacme.202206_12(2).0005","DOIUrl":"https://doi.org/10.6705/j.jacme.202206_12(2).0005","url":null,"abstract":"<p><p>Six people made the mistake of eating toad soup, and one of them died before arriving hospital. Five patients presented conscious change, gastrointestinal upset, or bradycardia. We checked their blood and electrocardiography to monitor the cardiac intoxication from toad venom. This experience revealed that the serum level of digoxin does not indicate the severity of intoxication but has the diagnostic value. And, serum potassium level is useful to provide valuable therapeutic information.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 2","pages":"75-78"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283113/pdf/jacme-12-2-05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for COVID-19 Laboratory Testing for Emergency Departments From the New Diagnostic Technology Team of the Taiwan Society of Emergency Medicine.","authors":"Chien-Chang Lee,&nbsp;Yi-Tzu Lee,&nbsp;Chih-Hung Wang,&nbsp;I-Min Chiu,&nbsp;Weide Tsai,&nbsp;Yan-Ren Lin,&nbsp;Chih-Huang Li,&nbsp;Chin Wang Hsu,&nbsp;Pei-Fang Lai,&nbsp;Jiann-Hwa Chen,&nbsp;Jeffrey Che-Hung Tsai,&nbsp;Shih-Hung Tsai,&nbsp;Chorng-Kuang How","doi":"10.6705/j.jacme.202206_12(2).0001","DOIUrl":"https://doi.org/10.6705/j.jacme.202206_12(2).0001","url":null,"abstract":"<p><p>COVID-19 tests have different turnaround times (TATs), accuracy levels, and limitations, which emergency physicians should be aware of. Nucleic acid amplification tests (NAATs) can be divided into standard high throughput tests and rapid molecular diagnostic tests at the point of care (POC). The standard NAAT has the advantages of high throughput and high accuracy with a TAT of 3-4 hours. The POC molecular test has the same advantages of high accuracy as standard high throughput PCR, but can be done in 13-45 minutes. Roche cobas Liat is the most commonly used machine in Taiwan, displaying 99%-100% sensitivity and 100% specificity, respectively. Abbott ID NOW is an isothermal PCR-based POC machine with a sensitivity of 79% and a specificity of 100%. A high rate of false positives and false negatives is associated with rapid antigen testing. Antibody testing is mostly used as part of public health surveys and for testing for immunity.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 2","pages":"45-52"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283118/pdf/jacme-12-2-01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of NEWS2 + Lactate + D-Dimer in Predicting Intensive Care Unit Admission and In-Hospital Mortality of COVID-19 Patients.","authors":"Kadir Küçükceran, Mustafa Kürşat Ayrancı, Zerrin Defne Dündar, Muhammed İdris Keklik, Hülya Vatansev","doi":"10.6705/j.jacme.202206_12(2).0003","DOIUrl":"10.6705/j.jacme.202206_12(2).0003","url":null,"abstract":"<p><strong>Background: </strong>We investigated the parameters of National Early Warning Score 2 (NEWS2) + lactate + D-dimer in predicting the intensive care unit (ICU) admission and in-hospital mortality in patients hospitalized with COVID-19.</p><p><strong>Methods: </strong>Patients, who applied to the emergency department of a tertiary university hospital and were taken to the COVID-19 zone with suspected COVID-19 between March 2020 and June 2020, were retrospectively examined. In this study, 244 patients, who were hospitalized and had positive polymerase chain reaction test results, were included. NEWS2, lactate, and D-dimer levels of the patients were recorded. Patients were grouped by the states of in-hospital mortality and ICU admission.</p><p><strong>Results: </strong>Of 244 patients who were included in the study, 122 (50%) were male, while their mean age was 53.76 ± 17.36 years. 28 (11.5%) patients were admitted to the ICU, while in-hospital mortality was seen in 14 (5.7%) patients. The levels of D-dimer, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer were statistically significantly higher in patients with in-hospital mortality and admitted to ICU ( <i>p</i> < 0.05). The area under the curve (AUC) values of D-dimer, lactate, NEWS2, NEWS2 + lactate, NEWS2 + D-dimer, NEWS2 + lactate + D-dimer in predicting ICU admission were as 0.745 (0.658-0.832), 0.589 (0.469-0.710), 0.760 (0.675-0.845), 0.774 (0.690-0.859), 0.776 (0.692-0.860), and 0.778 (0.694-0.862), respectively; while the AUC values of these parameters in predicting in-hospital mortality were found to be as 0.768 (0.671-0.865), 0.695 (0.563-0.827), 0.735 (0.634-0.836), 0.757 (0.647-0.867), 0.752 (0.656-0.848), and 0.764 (0.655-0.873), respectively.</p><p><strong>Conclusions: </strong>Compared to using the NEWS2 value alone, a combination of NEWS2, lactate, and D-dimer was found to be more valuable in predicting in-hospital mortality and ICU admission.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 2","pages":"60-70"},"PeriodicalIF":0.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283119/pdf/jacme-12-2-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not-So-Simple Wrist Injury After Fall On Outstretched Hand: Dorsal Intercalated Segment Instability.","authors":"James Siu Ki Lau,&nbsp;Stephanie Dorothy Pui Ming Yu,&nbsp;Chi Kit Yuen","doi":"10.6705/j.jacme.202206_12(2).0006","DOIUrl":"https://doi.org/10.6705/j.jacme.202206_12(2).0006","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 2","pages":"79-80"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283117/pdf/jacme-12-2-06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40609984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Stigmatization and Mental Health Between Physicians and Nurses in the Early COVID-19 Pandemic Outbreak.","authors":"Cheng-Yi Fan,&nbsp;Chih-Wei Sung,&nbsp;James Chien-Tai Huang,&nbsp;Cheng-Heng Liu,&nbsp;Chi-Hsin Chen,&nbsp;Jia-How Chang,&nbsp;Jiun-Wei Chen,&nbsp;Shou-Kuen Huang,&nbsp;Tony Szu-Hsien Lee,&nbsp;Edward Pei-Chuan Huang","doi":"10.6705/j.jacme.202206_12(2).0007","DOIUrl":"https://doi.org/10.6705/j.jacme.202206_12(2).0007","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"12 2","pages":"81-83"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283114/pdf/jacme-12-2-07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}