Journal of Emergency Medicine最新文献

{"title":"A Comparison of Time to Sepsis Alert and Antibiotics in Emergency Department Patients by Language Preference","authors":"Rebecca J. Schwei PHD, MPH ,&nbsp;Christopher Shank PHD ,&nbsp;Ryan E. Tsuchida MD ,&nbsp;Franchesca Arias PHD ,&nbsp;Maichou Lor RN, PHD ,&nbsp;Manish N. Shah MD, MPH ,&nbsp;Douglas Wiegmann PHD ,&nbsp;Michael S. Pulia MD, PHD","doi":"10.1016/j.jemermed.2025.11.008","DOIUrl":"10.1016/j.jemermed.2025.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Prior studies have found increases in sepsis-related mortality among patients with non-English language preference (NELP) vs. English language preference (ELP) in the inpatient setting, even after controlling for demographic, illness severity, and clinical encounter variables. It is unclear if disparities in sepsis care extend to the emergency department.</div></div><div><h3>Objective</h3><div>We compared time to sepsis alert and antibiotics between patients with NELP vs. ELP overall and by emergency severity index (ESI) subgroup.</div></div><div><h3>Methods</h3><div>In this retrospective observational cohort study, the independent variable was preferred language, and the dependent variables were time to sepsis alert (clinician-initiated vs. automatic) and antibiotics. We developed multivariable adjusted plus inverse probability of treatment weight (IPTW) Cox proportional hazard models.</div></div><div><h3>Results</h3><div>There were no overall differences in the time to sepsis alerts or time to antibiotic administration. In the ESI 2 subgroup, NELP patients had faster time to sepsis alert than ELP patients in clinician-initiated alerts (clinician-initiated: absolute difference: 17 min; covariate +IPTW: HR: 1.76, 99.44% CI 1.22, 2.54, <em>p</em> &lt; 0.001). Within the ESI 3 to 5 subgroup, among patients with a clinician-initiated alert, NELP patients had slower time to sepsis alert than ELP patients (absolute difference: 17 min; covariate +IPTW: HR: 0.64, 99.44% CI 0.44, 0.94, <em>p</em> = 0.012).</div></div><div><h3>Conclusion</h3><div>While we found no overall differences in time to sepsis alert, there were significant differences in subgroups, suggesting that language preference may be associated with triage score assignment and sepsis recognition. The lack of differences observed in time to antibiotics underscores the potential for thoughtfully designed best practice alerts to support equitable clinical practice.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 19-29"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Approach: Ultrasound-Guided Transgluteal Sciatic Nerve Block Using D5W and Bupivacaine/Dexamethasone for Acute Sciatica in the Emergency Department","authors":"Robert Stenberg MD,&nbsp;Negin Ceraolo MD, MS,&nbsp;Ana Ritz DO,&nbsp;Brian Makowski DO,&nbsp;Erin L. Simon DO","doi":"10.1016/j.jemermed.2025.11.012","DOIUrl":"10.1016/j.jemermed.2025.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Acute sciatica can cause severe radicular pain that is often unresponsive to systemic medications in the emergency department (ED). Ultrasound-guided transgluteal sciatic nerve blocks offer a targeted, opioid-sparing method of pain.</div></div><div><h3>Case Report</h3><div>We present a case of a patient with intractable bilateral lower extremity pain secondary to sciatica, successfully treated with transgluteal nerve blocks under ultrasound guidance. The sciatic nerves were visualized in the gluteal region between the greater trochanter and ischial tuberosity. One side was anesthetized using dextrose 5% in water (D5W), and the other with a combination of bupivacaine and dexamethasone. The patient reported significant pain relief within 20 min and was safely discharged with outpatient follow-up.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>This case underscores the expanding role of regional anesthesia techniques in ED pain management and highlights a unique instance of bilateral nerve blocks producing effective analgesia despite the use of D5W alone on one side.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 5-8"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of Nitrogen Oxides Into a Triage-Based Index for Predicting Adverse Outcomes in ST-Segment Elevation Myocardial Infarction Patients","authors":"Man-Ju Ting PhD ,&nbsp;Chien-Chieh Hsieh MD, PhD ,&nbsp;Hsiao-Yu Yang MD, PhD ,&nbsp;Fu-Shan Jaw PhD ,&nbsp;Pau-Chung Chen MD, PhD","doi":"10.1016/j.jemermed.2025.12.002","DOIUrl":"10.1016/j.jemermed.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Early risk stratification in ST-segment elevation myocardial infarction (STEMI) remains challenging. The Hypoxia-Age-Shock Index (HASI), incorporating SpO₂, age, heart rate, and systolic blood pressure, offers improved prediction over traditional indices but may benefit from machine learning (ML) and environmental data.</div></div><div><h3>Objectives</h3><div>To compare HASI with established shock indices for mortality prediction in STEMI triage and assess whether adding machine learning and ambient NOx data improves early risk assessment.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 711 STEMI patients. HASI was compared with the Shock Index (SI) and Age-Adjusted Shock Index (ASI) for predicting in-hospital mortality. ML models (logistic regression, random forest, support vector machine, XGBoost) were developed using HASI variables. Ambient nitrogen oxides (NOx) data were matched to emergency department arrival times. Model performance was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the precision–recall curve (AUPRC). SHapley Additive exPlanations (SHAP) analysis assessed variable importance.</div></div><div><h3>Results</h3><div>Among 711 STEMI patients, 41 (5.8%) died during hospitalization and 77 (10.8%) underwent endotracheal intubation. HASI outperformed both SI and ASI (AUC: 0.747 vs. 0.628 and 0.700; <em>p</em> &lt; 0.05). The application of machine learning further improved predictive performance, with the random forest model achieving an AUC of 0.961 and sensitivity of 0.750. Incorporating ambient NOx further enhanced prediction, increasing the AUPRC to 0.907 and the XGBoost sensitivity to 0.833. NOx ranked third in feature importance.</div></div><div><h3>Conclusions</h3><div>HASI, combined with ML and ambient NOx exposure, provides a rapid and interpretable tool based on SHAP analysis for transparent feature contribution and early mortality risk assessment in STEMI triage.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 83-92"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding “Phantom Scanning in Point-of-Care Ultrasound After Out-of-Hospital Cardiac Arrest: Impact of Clinical Presentation in a Single-Center Analysis”","authors":"Zachary Boivin MD ,&nbsp;Trent She MD","doi":"10.1016/j.jemermed.2025.12.011","DOIUrl":"10.1016/j.jemermed.2025.12.011","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 97-98"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Using a Step Stool on Chest Compressions Quality During Cardiopulmonary Resuscitation: A Systemic Review and Meta-Analysis","authors":"Sudha Chandelia MD, DM ,&nbsp;Pragati Sahu MBBS ,&nbsp;Sarthak Kaushik MBBS ,&nbsp;Neeraj Kumar MD ,&nbsp;Jyotsna Makol ,&nbsp;Deepika Tandon","doi":"10.1016/j.jemermed.2025.11.009","DOIUrl":"10.1016/j.jemermed.2025.11.009","url":null,"abstract":"<div><h3>Background</h3><div>A successful cardiopulmonary resuscitation (CPR) requires quality chest compressions (CCs). Use of a step stool during CPR might improve CC quality, though there is no consensus.</div></div><div><h3>Objectives</h3><div>To analyze the effects of a rescuer using a step stool on CC during CPR.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and searched five databases (PubMed, Embase, Cochrane, Web of Science, and Scopus). Two independent authors did screening, data extraction, risk of bias, and GRADE (Grading of Recommendations, Assessments, Development, and Evaluation) assessment. Random effects model was used for data analysis. Risk of bias was assessed using theCochrane tools (RoB 2 for randomized and ROBINS-1 V2 for nonrandomized studies.</div></div><div><h3>Results</h3><div>Six studies (four adult and two pediatric) were included in the meta-analysis. Most domains in studies were at serious risk of bias. Overall, using a step stool during CPR may slightly increase depth of CC (mm) (mean difference [MD], 95% confidence interval [CI]; 2.74, 1.26–4.21; <em>p</em> &lt; 0.0003; <em>I</em>² = 35%; low certainty); pediatric (MD 1.63, 95% CI 0.33–2.93; <em>p</em> = 0.01; <em>I</em>² = 24%; low certainty); adult (MD 4.24, 95% CI 2.18–6.31; <em>p</em> = 0.0001; <em>I</em>² = 0%; low certainty). Overall, using a step stool may slightly increase CC rates toward 120/min (MD 2.97, 95% CI 0.74–5.20; <em>p</em> = 0.009; <em>I</em>² = 49%; low certainty); adult (MD 5.61, 95% CI 3.0–8.22; <em>p</em> = 0.0001; <em>I</em>² = 0%; low certainty); but in children effects are uncertain (MD 1.30, 95% CI (−1.52–4.12; <em>p</em> = 0.37; <em>I</em>² = 69%; very low certainty). Effects on chest recoil (MD 0.18, 95% CI 0.04–0.32; <em>p</em> = 0.01; <em>I</em>² = 0%; two studies; very low certainty) and angle between rescuer and manikin (MD 10.43, 95% CI 8.14–12.72; <em>p</em> = 0.0001; <em>I</em>² = 0%; one study; very low certainty) are very uncertain. Minimized interruption and excessive ventilation were not reported in any studies.</div></div><div><h3>Conclusion</h3><div>Low certainty evidence suggests rescuer use of a step stool may slightly increase depth and rate of CCs in simulation set-up, with unclear clinical implications. Effects of using a step stool on chest recoil, angle between the rescuer and manikin, duty cycle, minimized interruption, and excessive ventilation are very uncertain in view of very low certainty/no evidence.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 48-60"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Academy of Emergency Medicine","authors":"","doi":"10.1016/S0736-4679(26)00025-9","DOIUrl":"10.1016/S0736-4679(26)00025-9","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 99-100"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black Clouds in Emergency Medicine: Perception vs. Reality in Clinical Workload","authors":"Busra Bildik MD,&nbsp;Bora Cekmen MD,&nbsp;Burcu Simge Eroglu MD,&nbsp;Buse Betul Kucukkaya Gundogdu MD,&nbsp;Dicle Bulak MD,&nbsp;Damla Anbarlı Metin MD","doi":"10.1016/j.jemermed.2025.11.010","DOIUrl":"10.1016/j.jemermed.2025.11.010","url":null,"abstract":"<div><h3>Background</h3><div>In emergency medicine, the belief that some physicians are “Black Clouds” consistently facing heavier workloads, while others are “White Clouds” experiencing lighter shifts, persists despite limited scientific validation.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate whether these reputational labels correspond to measurable differences in clinical workload.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted in a tertiary emergency department with an average of 830 daily visits. Physicians with at least 6 months of service were surveyed to identify peers as “luckiest” (White Clouds) and “unluckiest” (Black Clouds), resulting in four physicians per group. Duty rosters over 6 months were classified as black, white, or gray days depending on on-duty combinations. Objective parameters—including patient volume, red triage cases, admissions, cardiopulmonary resuscitations, trauma cases, and deaths—were extracted from electronic records and statistically compared.</div></div><div><h3>Results</h3><div>A total of 156 shifts were analyzed: 57 white, 51 gray, and 48 black days. Mean daily patient volume was slightly lower on black days (814.31 ± 8.90) compared to white (825.91 ± 9.10) and gray (829.09 ± 10.24), though not statistically significant (<em>p</em> = 0.429). No significant differences were found in red triage patients, admissions, intensive care unit (ICU) admissions, resuscitations, trauma cases, or deaths across groups.</div></div><div><h3>Conclusion</h3><div>The study found no statistically significant differences between Black Cloud and White Cloud shifts. These labels appear to reflect subjective perception rather than objective workload, underscoring the need to address cultural superstitions in emergency medicine to reduce stigma and support physician well-being.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 61-67"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10% Lidocaine Versus 1% Diclofenac Spray in Radial Arterial Blood Gas Sampling: A Randomized, Double-Blind, Placebo-Controlled Trial using Perfusion Index","authors":"Ibrahim Altundağ MD,&nbsp;Sinem Doğruyol MD ,&nbsp;Burcu Genç Yavuz MD ,&nbsp;Mustafa Ahmet Afacan MD ,&nbsp;Şahin Çolak MD","doi":"10.1016/j.jemermed.2025.12.015","DOIUrl":"10.1016/j.jemermed.2025.12.015","url":null,"abstract":"<div><h3>Background</h3><div>Radial arterial blood gas (ABG) sampling is a common but painful procedure essential for assessing critically ill patients. Effective pain control is vital for patient comfort and procedural success.</div></div><div><h3>Objective</h3><div>This study aimed to compare the analgesic efficacy of topical 10% lidocaine and 1% diclofenac sprays versus placebo in alleviating pain during radial ABG sampling. We also explored perfusion index (PI) as an objective pain assessment tool.</div></div><div><h3>Methods</h3><div>This randomized, double-blind, placebo-controlled study was conducted in the emergency department. A total of 150 patients undergoing radial ABG sampling were randomly assigned to three groups: placebo (n = 50), 10% lidocaine (n = 50), and 1% diclofenac (n = 50). Baseline perfusion index (PI₀) was recorded, sprays applied, and a 10-min waiting period followed. After ABG sampling, post-procedure measurements were obtained, including PI₁ and pain intensity assessed using the Visual Analog Scale (VAS). Analgesic effects were compared based on VAS scores and changes in PI (ΔPI and %ΔPI).</div></div><div><h3>Results</h3><div>The mean post-procedure VAS scores were 4.18 ± 2.09 (lidocaine), 4.80 ± 2.70 (diclofenac), and 4.90 ± 2.59 (placebo), with no significant differences between groups (<em>p</em> = 0.292). As a secondary finding, a moderate positive correlation was observed between VAS scores and %ΔPI (<em>r</em> = 0.379, <em>p</em> &lt; 0.001). PI significantly decreased in all groups after ABG sampling, but no significant differences were observed among groups.</div></div><div><h3>Conclusion</h3><div>Topical 10% lidocaine and 1% diclofenac sprays did not provide significant pain relief compared to placebo. Although a moderate correlation between VAS and PI was observed, further research is needed to establish PI’s clinical utility.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov (NCT06918340).</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 39-47"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Appraisal of “Comparative Efficacy and Safety of Intravenous Vasopressors in Pre-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis”","authors":"Raihan Mohammed Mohiuddin,&nbsp;Mohammed Misbah Ul Haq","doi":"10.1016/j.jemermed.2025.10.038","DOIUrl":"10.1016/j.jemermed.2025.10.038","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 93-94"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Ultrasound Image Quality Between Users on a Novel Automated Device for Extremity Injury","authors":"Christopher Thom MD, RDMS ,&nbsp;Vietvuong Vo MD ,&nbsp;Jakob Ottenhoff DO ,&nbsp;Colleen Mullins BA ,&nbsp;Ashley Simpson MS, CCRC ,&nbsp;Sarah Homan BS ,&nbsp;Lauren Kerich BS ,&nbsp;Laura Vargas Ortiz BS ,&nbsp;Diana Hamza MS ,&nbsp;Philip Jarrett MD, MBA","doi":"10.1016/j.jemermed.2025.11.011","DOIUrl":"10.1016/j.jemermed.2025.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Plain radiography traditionally serves as the first-line imaging modality for extremity injuries. However, x-rays have limitations in subtle fracture detection and soft tissue visualization. Ultrasound represents an alternative modality with potential diagnostic benefit but requires substantial operator expertise.</div></div><div><h3>Objective</h3><div>We sought to evaluate the image quality and patient comfort associated with a novel volumetric ultrasound system (Accuro XV) that intends to automate imaging acquisition. Scans obtained by clinical research assistants (CRAs) were compared to those obtained by board-certified emergency physicians.</div></div><div><h3>Methods</h3><div>This was a prospective, multi-site study of patients aged 5 and older presenting with acute ankle or wrist trauma. 205 subjects were enrolled, each undergoing x-ray and Accuro XV imaging. Pain levels were assessed using a Numerical Rating Scale. Fifty CRA and 50 physician-acquired studies were randomly selected for blinded image quality analysis.</div></div><div><h3>Results</h3><div>There was no significant difference in image quality between CRA and physician groups (mean scores 3.6 vs. 3.7; <em>p</em> = 0.24), with over 90% of studies rated as diagnostically adequate. Interrater reliability amongst reviewers was moderate (intraclass correlation coefficient 0.53–0.56). Pain scores were similar with both showing minimal discomfort (median pain increase during imaging of 0; interquartile range 0–1).</div></div><div><h3>Conclusion</h3><div>This study demonstrates the feasibility of high-quality extremity ultrasound imaging using the Accuro XV device, including by nonphysician operators with minimal training. The technology shows potential for broader adoption in acute care with nonphysician operators. Further studies are warranted to evaluate diagnostic accuracy and clinical impact.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"81 ","pages":"Pages 9-18"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}