Journal of Emergency Medicine最新文献

{"title":"Characteristics of Young Children Presenting to the Emergency Department for Psychiatric Evaluation","authors":"Muhammad Waseem MD, MS ,&nbsp;Afaf F. Moustafa MD ,&nbsp;Kathryn D. Esposito MD ,&nbsp;Rebecca Yang MD, MPH ,&nbsp;Aubrey Vinh MD ,&nbsp;Danyah Nadim MD ,&nbsp;Masood A. Shariff MD","doi":"10.1016/j.jemermed.2025.09.028","DOIUrl":"10.1016/j.jemermed.2025.09.028","url":null,"abstract":"<div><h3>Background</h3><div>The rising influx of young children in emergency departments (ED) for behavioral concerns represents a current crisis requiring immediate intervention. These children face heightened risks of emotional impairments and mood disorders.</div></div><div><h3>Objective</h3><div>This study identifies factors contributing to disruptive behavior and examines baseline characteristics associated with ED visits to highlight the urgent need for targeted action.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of ED records (2015–2021) at an inner-city hospital, focusing on pediatric patients who presented with behavioral symptoms and received psychiatric evaluations. Data included demographics, psychiatric comorbidities, social history, adverse childhood experiences (ACEs), and ED length of stay. Patients were categorized into the no-prior-ED group and the prior-ED group. Reviewed overall characteristics and statistical tests analyzed differences between subgroups.</div></div><div><h3>Results</h3><div>The records of 184 children (with an average age of 9.4 years, 65% male) revealed that 49% were Hispanic, 39% were Black, and 12% were from other racial backgrounds. Behavioral issues included aggression (51%), suicidal ideation (34%), and acting out (22%). Children were brought in to ED, mainly, from home (59%) and school (33%). Notably, 52% had no prior psychiatric diagnosis, with attention-deficit/hyperactivity disorder (40%) as the most common diagnosis. ACEs were identified in 42% of cases. Compared to the no-prior-ED group, children in the prior-ED group showed higher ACEs scores, longer ED stays, and increased rates of disabilities and suicidal thoughts (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study underscores the cyclical nature of ED visits among children with mental and behavioral health and high ACEs. These findings highlight the need for further investigation into early identification strategies and coordinated care to interrupt this cycle.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 104-111"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578329","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":"Fulminant Aortic Occlusion Causing Paraplegia and Multiorgan Ischemia in a Young Adult: A Case Report","authors":"Kriti Gupta MBBS,&nbsp;Sachin Ambure MBBS,&nbsp;Naman Agrawal MD,&nbsp;Roshan Mathew MD,&nbsp;Debendra Tripathy MD","doi":"10.1016/j.jemermed.2025.09.020","DOIUrl":"10.1016/j.jemermed.2025.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Acute aortic occlusion (AAO) is a rare and catastrophic vascular emergency, typically affecting older adults and presenting with acute limb ischemia.</div></div><div><h3>Case Report</h3><div>We report a case of a 39-year-old male chronic alcoholic and smoker who presented with severe back pain followed by sudden-onset bilateral paraplegia and multiorgan ischemia. The patient developed complete motor and sensory loss below the T10 level and urinary incontinence within an hour of symptom onset. Physical examination revealed cold, mottled lower limbs with absent femoral, tibial, and distal pulses. Computed tomography (CT) angiography showed complete occlusion of the infrarenal aorta, left renal artery occlusion with complete left kidney infarction. Despite initial consideration of spinal myelopathies, the diagnosis of AAO was made based on the vascular examination. The patient's delayed presentation and extensive ischemia precluded revascularization, and he died within hours of presentation.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>This case highlights the need for a high level of suspicion for AAO across a broader patient demographic, even in presentations dominated by neurological symptoms. Prompt recognition and immediate diagnosis via CT angiography are crucial for improving the outcomes in this time-sensitive and devastating condition.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 91-94"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578327","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":"Conservative Management of Spontaneous Posterior Mediastinal Intercostal Artery Hemorrhage: A Case Report and Literature Review","authors":"Masahiko Okada MD ,&nbsp;Hisashi Yanaihara MD ,&nbsp;Mika Misaki MD ,&nbsp;Nao Kohata MD, PhD ,&nbsp;Yusuke Suzuki MD, PhD ,&nbsp;Takanori Asakura MD, PhD","doi":"10.1016/j.jemermed.2025.11.001","DOIUrl":"10.1016/j.jemermed.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Intercostal artery hemorrhage (ICAH) is an extremely rare, potentially life-threatening condition. The etiology of ICAH includes trauma, anticoagulation therapy, bleeding disorders, infections, and underlying diseases such as neurofibromatosis type 1, systemic lupus erythematosus, and hypertension. Due to the rarity of this condition, standardized treatment strategies remain undefined. We report a rare case of spontaneous ICAH successfully managed with conservative therapy and review relevant literature.</div></div><div><h3>Case Report</h3><div>A 49-year-old male presented with sudden and progressively worsening abdominal and back pain. He had no history of trauma or underlying diseases, except for previously undiagnosed and uncontrolled hypertension. Imaging revealed a hemorrhage from the intercostal artery in the posterior mediastinum, which was considered to be the likely source of bleeding. Given the patient’s hemodynamic stability and location of the hematoma, conservative management was selected. Blood pressure was initially controlled with intravenous nicardipine, followed by oral sacubitril/valsartan and nifedipine administration. The hematoma did not increase in size, and the patient was discharged on day 15, without complications. Follow-up imaging confirmed complete resolution of the hematoma, and the patient’s blood pressure remained stable without further antihypertensive medication use.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>Although ICAH is extremely rare, it can cause life-threatening bleeding. Prompt recognition is essential, especially when imaging reveals a posterior mediastinal hematoma without trauma or anticoagulation therapy. Conservative management may be feasible in hemodynamically stable patients with natural tamponade; however, careful patient selection and close monitoring are crucial. Awareness of this condition can help avoid unnecessary invasive procedures.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 181-186"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604552","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":"“Is My Face Swollen?”—Utilizing Point-of-Care Ultrasound to Diagnose Odontogenic Infections","authors":"Joshua T. Hoffer MD,&nbsp;Reena Park MD,&nbsp;Daniel S. Brenner MD, PHD","doi":"10.1016/j.jemermed.2025.10.032","DOIUrl":"10.1016/j.jemermed.2025.10.032","url":null,"abstract":"<div><h3>Background</h3><div>Odontogenic infections are a common presentation in the emergency department. Most odontogenic infections can be managed with oral antibiotics, analgesia, and outpatient dentistry referrals, but cases of odontogenic perimandibular or perimaxillary abscess often require drainage and more acute specialist referral. Computed tomography is commonly utilized to differentiate simple odontogenic infections from more complex pathology. Point-of-care ultrasound has emerged as a primary imaging modality to differentiate simple cellulitis from abscess in most parts of the body, but has not historically been utilized for odontogenic infections. This case series utilizes multiple examples to demonstrate how to utilize point-of-care ultrasound to diagnose simple or complex odontogenic infections and describes the relevant sonographic anatomy for interested users.</div></div><div><h3>Case Reports</h3><div>We present the cases of 10 patients where point-of-care ultrasound successfully diagnosed odontogenic infections, in some cases allowing proper treatment without computed tomography.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>Point-of-care ultrasound can be utilized to diagnose odontogenic infections and reduce computed tomography utilization in otherwise healthy, uncomplicated patients.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 165-176"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596657","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":"What Echocardiographic Findings Suggest Acute Type A Aortic Dissection?","authors":"Stephen Alerhand MD ,&nbsp;Linda Qiu MD ,&nbsp;Robert James Adrian MD","doi":"10.1016/j.jemermed.2025.10.012","DOIUrl":"10.1016/j.jemermed.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>An acute Stanford Type A aortic dissection (ATAAD) carries a high in-hospital mortality rate that increases with delays to surgical intervention. Early diagnosis is therefore critical for improving outcomes. Unfortunately, ATAAD is often misdiagnosed initially. Moreover, definitive diagnosis with computed tomography angiography (CTA) requires time to obtain and may not be feasible in an unstable patient. Fortunately, emergency physicians can use transthoracic cardiac point-of-care ultrasound (POCUS) to make a quicker diagnosis, prompt earlier CTA, initiate goal-directed therapy, and reduce time-to-operative intervention.</div></div><div><h3>Objective</h3><div>This narrative review reports four echocardiographic findings that suggest the presence of ATAAD. For each finding, we describe the associated pathophysiology and summarize the literature evaluating diagnostic utility. We also use high-quality media to provide step-by-step tutorials and advanced pearls and pitfalls for translation to the bedside.</div></div><div><h3>Discussion</h3><div>The echocardiographic findings that suggest ATAAD are: aortic intimal flap, aortic root enlargement, aortic regurgitation, and pericardial effusion.</div></div><div><h3>Conclusion</h3><div>The use of cardiac POCUS can rule in or strongly suggest the diagnosis of ATAAD. Although cardiac POCUS on its own should not be used to rule out ATAAD, the lack of any suggestive echocardiographic findings may lower suspicion for this diagnosis.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 224-240"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621948","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":"Cooling-Seeking Behavior and Hot Sensation as Hallmark Toxidromes in Chlorfenapyr Intoxication: A Case Report","authors":"Jiun-Hao Yu MD ,&nbsp;Chih-Huang Hsieh MD ,&nbsp;Chi-Syuan Pan MD ,&nbsp;Han-Wei Mu MD","doi":"10.1016/j.jemermed.2025.10.018","DOIUrl":"10.1016/j.jemermed.2025.10.018","url":null,"abstract":"<div><h3>Background</h3><div>Chlorfenapyr is a pyrrole-based insecticide that disrupts mitochondrial oxidative phosphorylation, leading to delayed toxicity marked by hyperthermia and multiorgan failure. While early stages are often described as asymptomatic, recognizing early subtle clinical signs is crucial to improve patient monitoring and management. This report highlights thermogenic symptoms, such as persistent hot sensations and cooling-seeking behaviors, as early warning signs of Chlorfenapyr intoxication, reconsidering existing assumptions of an asymptomatic latent phase.</div></div><div><h3>Case report</h3><div>A 78-year-old woman presented to the emergency department two hours after ingesting several mouthfuls of a pesticide. She was initially stable, with only mild gastrointestinal symptoms. Despite normothermia, she persistently reported feeling hot and demonstrated active cooling-seeking behaviors—kicking off blankets, removing clothing, and using fans—documented in a supplemental video. Laboratory tests showed mild lactic acidosis without early organ dysfunction. On day four, she developed agitation, respiratory distress, hyperthermia (39°C), and generalized muscle rigidity, followed by cardiac arrest unresponsive to resuscitation. Serum obtained at the initial emergency department visit demonstrated a Chlorfenapyr concentration of 0.97µg/mL, measured by gas chromatography–mass spectrometry.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>This case underscores the importance of recognizing hot sensations and cooling-seeking behaviors as potential early markers of Chlorfenapyr poisoning. Awareness of these subtle but distinctive symptoms can facilitate early confirmatory testing and timely clinical monitoring.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 60-63"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573810","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":"Response to Early Ultrasound-Guided Nerve Blocks for Sickle Cell Pain Crisis: A Novel Approach to Pain Management","authors":"Chitta Ranjan Mohanty MD ,&nbsp;Subhasree Das MD ,&nbsp;Rakesh Vadakkethil Radhakrishnan MSN ,&nbsp;Reshmitha Boyana MD ,&nbsp;Pearl S Konikkara MBBS","doi":"10.1016/j.jemermed.2025.10.037","DOIUrl":"10.1016/j.jemermed.2025.10.037","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 338-339"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976203","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":"Mitigating Post-Traumatic Stress Disorder Risk Through Gender-Sensitive Trauma-Informed Care in the Emergency Department—A Narrative Review","authors":"Sydney E. Larsen BS ,&nbsp;JeTaury I.M. Davis BS ,&nbsp;Nicholas Murphy PhD ,&nbsp;Nidal J. Moukaddam MD, PhD ,&nbsp;Alan C. Swann MD ,&nbsp;Thomas R. Kosten MD ,&nbsp;Natalie E. Hundt PhD ,&nbsp;Christopher D. Verrico PhD ,&nbsp;Ola Elechi MD ,&nbsp;Ynhi T. Thomas MD, MPH, MSc","doi":"10.1016/j.jemermed.2025.10.035","DOIUrl":"10.1016/j.jemermed.2025.10.035","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic stress disorder (PTSD) is a psychiatric condition that can develop after trauma and imposes substantial, long-term morbidity. Emergency departments (EDs), as the initial point of healthcare contact, can reduce patients’ risk of developing PTSD following trauma exposure through trauma-informed care (TIC). Women face a two- to threefold higher PTSD incidence than men and show distinct symptom patterns, indicating that clinical approaches should be adapted to reflect these differences in trauma response.</div></div><div><h3>Objectives</h3><div>To present a narrative review that summarizes current evidence on gender-related differences in early posttraumatic responses, TIC practices feasible in the ED, and pathways that connect ED care to psychiatric and outpatient follow-up.</div></div><div><h3>Methods</h3><div>We conducted a narrative literature review to explore current evidence on mitigating PTSD risk through gender-sensitive, TIC approaches in ED settings. Searches were conducted in PubMed, Web of Science, Science Direct, and Open Evidence using terms such as “PTSD,” “acute stress disorder,” “emergency department,” “trauma-informed care,” “gender differences,” “sex differences,” and “trauma patients.” Articles in English published primarily in the last 15 years that focused on adult trauma patients in ED settings and gender-specific outcome or interventions were included. Studies that focused exclusively on military or chronic PTSD were excluded.</div></div><div><h3>Discussion</h3><div>Women more often present with hyperarousal, intrusive re-experiencing, and interpersonal violence-related trauma, whereas men commonly exhibit dissociation and delayed help seeking. Universal micro practices, such as explicit introductions, consent before contact, plain language explanations, and privacy protection, enhance psychological safety and are particularly protective for women. Brief, validated PTSD risk screeners, electronic health record prompts, concise clinician TIC training, and on demand psychiatric consultation streamline early detection for vulnerable patients without impacting ED workflow.</div></div><div><h3>Conclusions</h3><div>Embedding gender-sensitive TIC into routine ED workflows enables PTSD risk identification, reduces re-traumatization, and facilitates prompt linkage to mental health services. Practical communication techniques, efficient screening, and structured referral pathways can empower emergency medicine clinicians to mitigate long-term PTSD sequelae across diverse trauma populations.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 241-251"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621995","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":"Letter to the Editor: “Comparison of Elastic Tourniquet and Blood Pressure Cuff for Peripheral Intravenous Access in Hypotensive Patients: A Randomized Single-Blind Study”","authors":"Savannah Higgins DO,&nbsp;Justin C Stowens MD, FACEP, FPD-AEMUS","doi":"10.1016/j.jemermed.2025.10.028","DOIUrl":"10.1016/j.jemermed.2025.10.028","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 332-333"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781440","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":"Prognostic Value of Point-of-Care Blood Gas Values to Predict Cardiopulmonary Resuscitation Outcome in Out-of-Hospital Cardiac Arrest Patients: A Systematic Review","authors":"Mohamed Ghazala MBBS ,&nbsp;Lamia Alkodami MBBS ,&nbsp;Nada Mohamad Nabih Farhat MBBS ,&nbsp;Sali Talaat Alkhabour MBBS ,&nbsp;Maha Saad Zain Al-Abeden MBBS ,&nbsp;Muhammad Candragupta Jihwaprani MBBS ,&nbsp;Idris Sula BMLS ,&nbsp;Nazmus Saquib PhD","doi":"10.1016/j.jemermed.2025.09.024","DOIUrl":"10.1016/j.jemermed.2025.09.024","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is associated with high mortality. Point of care (POC) blood gas analysis can aid in early risk stratification of OHCA patients by providing insights on metabolic derangements during resuscitation and post-arrest care.</div></div><div><h3>Objective</h3><div>To assess the role of blood gas analysis in predicting OHCA outcomes.</div></div><div><h3>Methods</h3><div>Four electronic databases (i.e., ProQuest, PubMed/MEDLINE, ScienceDirect, and Web of Science) were searched in this systematic review (PROSPERO: CRD42024552025). Eligible studies were those that included patients who had experienced OHCA, reported blood gas values, and reported any of the following outcomes: return of spontaneous circulation [ROSC], survival to hospital discharge, or good neurological outcomes.</div></div><div><h3>Results</h3><div>Thirteen studies were included in the review, with a pooled sample of 14,584 patients; 57% were male. Sampling time differed between studies: either at the beginning of or after 2 cycles of resuscitation, upon arrival, or 10 minutes after arrival to the emergency department. Blood gas values (i.e., pH, pO₂ and pCO₂) varied across studies for patients with ROSC. Some studies reported higher values in ROSC patients compared to non-ROSC patients, and vice versa. Blood gas values were generally higher among patients who survived or had favorable neurological outcomes; however, their mean values varied and were often contradictory across studies, which constrained the pooling of these estimates into a meta-analysis.</div></div><div><h3>Conclusion</h3><div>At present, POC blood gas analysis cannot reliably be used for prognosis among OHCA patients. Future studies should improve the methodology by considering factors like sampling time and source (i.e., venous or arterial).</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 266-275"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714660","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}