Military Medicine最新文献

{"title":"Prevalence of Vision-Threatening Ocular Disease Among North Carolina Veterans.","authors":"Charles N Davis, Keith Carnes, George Richardson, William Brandon","doi":"10.1093/milmed/usaf381","DOIUrl":"https://doi.org/10.1093/milmed/usaf381","url":null,"abstract":"<p><strong>Introduction: </strong>Prevalence studies on ocular diseases among veterans are limited and underreported. In this retrospective study, we examined the prevalence of vision-threatening ocular diseases among North Carolina veterans. We assessed the prevalence of 6 serious ocular conditions among veterans receiving primary care at the Salisbury Veterans Affairs Health Care System (SVAHCS) in North Carolina to better understand ocular disease prevalence among veterans. Glaucoma, the most common ocular disease in this population, underscores the need for targeted interventions to mitigate vision loss.</p><p><strong>Materials and methods: </strong>A retrospective review of medical records from 34,530 veterans enrolled in SVAHCS primary care was conducted. Data collected included demographics such as age, gender, and race. The study focused on 6 vision-threatening diseases: glaucoma, vision-threatening diabetic retinopathy (VTDR), exudative age-related macular degeneration (AMD), retinal vein occlusions (RVO), retinal artery occlusions (RAO), and non-arteritic anterior ischemic optic neuropathy (NAION). Structured Query Language extracted disease frequency, and statistical analysis revealed prevalence rates and socio-demographic patterns.</p><p><strong>Results: </strong>The average age of veterans was 69.5 years, with 94% male and 66% White. The most prevalent ocular condition was glaucoma (9%), followed by VTDR (1.3%), exudative AMD (0.9%), RVO (0.8%), RAO (0.4%), and NAION (0.4%). Older male veterans had a disproportionate burden of most ocular conditions. Racial disparities in disease prevalence highlight areas for focused healthcare strategies.</p><p><strong>Conclusions: </strong>This study reveals the significant burden of vision-threatening ocular diseases among North Carolina veterans, with glaucoma being the most prevalent. The findings emphasize the need for targeted screening and personalized interventions to prevent vision loss and address disparities. Further research should explore systemic and behavioral contributors to these trends, guiding evidence-based strategies to improve veterans' ocular health outcomes.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753792","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":"Exploring the Protective Properties of Perceived Military and Non-Military Social Support in Relation to Perceived Substance Abuse Among Veterans With Chronic Pain.","authors":"Dorothy Dreelin, Taylor B Stanley, Sara K Blaine, David F Tharp, Jennifer L Robinson","doi":"10.1093/milmed/usaf361","DOIUrl":"https://doi.org/10.1093/milmed/usaf361","url":null,"abstract":"<p><strong>Introduction: </strong>Perceived social support serves as a protective factor in the course of chronic pain and substance use disorders in civilian populations, but the role of support from civilians versus other military personnel for combat veterans experiencing chronic pain has not yet been explored. The current study examined differences in the protective properties of perceived social support from (1) military personnel and (2) civilians, regarding substance use and perceived substance abuse for combat veterans experiencing chronic pain. We hypothesized that higher endorsement of both types of perceived social support would be associated with lower odds of self-reported, perceived substance abuse, and support from military personnel would be associated with lower odds of perceived substance abuse after controlling for the role of non-military social support.</p><p><strong>Materials and methods: </strong>The current study evaluated military personnel who were deployed to a combat zone for more than 1 month. Participants completed an online, anonymous survey including questions regarding experiences with chronic pain, cannabis, and illegal substance use, their beliefs regarding alcohol or prescription pill abuse, and their perceived military and non-military social support. We conducted a series of binary logistic regressions to evaluate whether perceived military and non-military social support predicted the odds of endorsing substance use, with several sociodemographic variables and chronic pain entered as covariates for each model. The Auburn University Institutional Review Board approved all study procedures.</p><p><strong>Results: </strong>Contrary to our hypotheses, participants reporting higher levels of non-military social support were more likely to endorse using cannabis or other illegal substances and report perceived alcohol or prescription medication abuse, even when controlling for sociodemographic and chronic pain covariates. Our hypothesis that greater support from military personnel would predict lower odds of perceived substance abuse after controlling for the role of non-military social support was not supported.</p><p><strong>Conclusions: </strong>Our results add to the mixed literature regarding the association between substance use with increased social support among combat veterans, while providing more detail on the role of specific social support sources in relation to drug use as well as alcohol use. Our findings may be because of combat veterans engaging in social drinking with members of their support system or utilizing substances for pain management purposes, but more research is needed on this topic. Results suggest researchers and clinicians should be mindful to inquire of one's social support sources, the quality of these relationships, and what adaptive or maladaptive behaviors may occur within the individual's social support network.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753791","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":"An Uncommon Reaction to a Common Medication: Stevens-Johnson Syndrome Associated With Azithromycin.","authors":"Jackson L Howell, Audra L Cochran, Brittanie I Neaves, Christopher A Coop","doi":"10.1093/milmed/usaf352","DOIUrl":"https://doi.org/10.1093/milmed/usaf352","url":null,"abstract":"<p><p>Stevens-Johnson Syndrome (SJS) is a rare but potentially fatal skin reaction characterized by extensive involvement of the epidermal and mucosal tissue. Although medications are the typical culprits, infectious diseases and chronic illnesses may also trigger SJS or toxic epidermal necrolysis (TEN). We present a rapid, severe SJS/TEN case in response to azithromycin administration, underscoring the critical need for pharmacovigilance and discontinuation of suspected medications, even if the potential causative agent is not commonly associated with these severe cutaneous adverse reactions.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742817","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 Systematic Review of Competencies for Enhancing Financial Expertise in Military Healthcare.","authors":"Alejandro Fuentes, Colleen M Cooper","doi":"10.1093/milmed/usaf353","DOIUrl":"https://doi.org/10.1093/milmed/usaf353","url":null,"abstract":"<p><strong>Introduction: </strong>The evolving demands of military healthcare require Chief Financial Officers (CFOs) in military medical treatment facilities (MTFs) to possess advanced financial competencies to ensure efficiency and compliance with federal regulations.</p><p><strong>Materials and methods: </strong>This systematic review, conducted using PRISMA guidelines, analyzed studies from PubMed, CINAHL, EMBASE, PsycINFO, and Google Scholar published between 2014 and 2024 to identify CFO competencies in military healthcare, focusing on strategic thinking, business integration, human capital management, digital literacy, and financial management.</p><p><strong>Results: </strong>Ten studies were included, revealing 5 critical competency areas: strategic thinking, business integration, human capital management, digital literacy, and financial management, which informed a unified training framework for military healthcare financial officers across all service branches.</p><p><strong>Conclusions: </strong>A standardized training pathway aligning with these competencies can enhance financial leadership in MTFs, improving resource management and operational readiness within the Defense Health Agency.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718169","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":"Simulated Aeromedical Evacuation Causes Hippocampal Neuronal Damage in Rats With Acute Lung Injury.","authors":"Chunli Yin, Jingmei He, Weiwei Li, Qiaofan Chen, Yanshu Wang, Shiqi Wang, Lei Liu","doi":"10.1093/milmed/usaf377","DOIUrl":"https://doi.org/10.1093/milmed/usaf377","url":null,"abstract":"<p><strong>Introduction: </strong>Aeromedical rescue plays an important role in the extensive evacuation of war casualties, sudden natural disasters (e.g., earthquakes, tsunamis), major public health events, and special needs across borders and regions. The most prominent environmental consideration in aeromedical evacuation (AE) is the impact of changes in barometric pressure on oxygen delivery and gas expansion. However, the hypobaric and hypoxic environment sustained by critically ill patients in flight can cause lung injury, leading to hypoxemia, which remains one of the few limiting factors for AE. Previous studies have focused primarily on secondary damage to brain and lung tissues during AE, with limited investigations into potential injuries to other organ systems. The purpose of this study was to investigate the effects of hypobaric hypoxia on the brain tissue of rats with acute lung injury (ALI).</p><p><strong>Materials and methods: </strong>Sprague-Dawley (SD) rats with lipopolysaccharide (LPS)-induced ALI were allocated to either a normoxic environment or a simulated AE environment (hypobaric hypoxic conditions). Hematoxylin-eosin staining was used to evaluate brain tissue damage, and single-cell RNA sequencing technology was used to analyze the injured brain tissue.</p><p><strong>Results: </strong>Sprague-Dawley rats with lipopolysaccharide-induced ALI presented with hippocampal neuronal damage after undergoing simulated AE. The analysis of the interaction of neurons with other hippocampal tissue cells suggested that the expression level of NRG1-ErbB4 was significant.</p><p><strong>Conclusion: </strong>This study demonstrated that ALI results in hippocampal neuronal damage after simulated aeromedical treatment in rats. In this study, single-cell RNA sequencing revealed that the NRG1/ErbB4 signaling pathway may play an important role in hippocampal neuronal injury. In contrast to previous studies on secondary injury to lung tissue, this study examined secondary injury to brain tissue caused by simulated AE.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732259","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":"Echelon of Care at Time of External Fixation and Infection Risk in Military Combat Casualties.","authors":"Michael D Cobler-Lichter, Jessica M Delamater, Talia R Arcieri, Ana M Reyes, Jonathan D Stallings, Vincente S Nelson, Nicholas Namias, Kirby R Gross, Shawn E Boomsma, Mark D Buzzelli, Jennifer Gurney, Kenneth G Proctor, Paul J Wetstein","doi":"10.1093/milmed/usaf367","DOIUrl":"https://doi.org/10.1093/milmed/usaf367","url":null,"abstract":"<p><strong>Introduction: </strong>Role 2 (R2) U.S. military treatment facilities provide lifesaving far forward damage control resuscitation and surgery. Given the austere conditions at R2s, infection risk is a major concern. We aimed to evaluate the infection rate after external fixation (EF) in military casualties based on where in the evacuation pathway the EF was performed, hypothesizing that lower-echelon EF would be associated with increased infections.</p><p><strong>Materials and methods: </strong>The Department of Defense Trauma Registry (DoDTR) was retrospectively reviewed from 2003 to 2024. Non-U.S. military patients, deaths, and burns were excluded. Lower-echelon EF was defined as the first EF performed at R2, or Role 3 (R3) in cases of R2 bypass. Infection was defined as any one of seventeen infectious complications recorded in the DoDTR. We evaluated the independent association of lower-echelon EF on both wound infection (WI) and overall infection using multiple regression.</p><p><strong>Results: </strong>In 6,115 patients, 2,529 met inclusion criteria, of whom 646 (25.5%) developed postoperative infection. 19.0% of all EFs were placed at R2, 67.7% at R3, 5.4% at Role 4 (R4), and 7.8% at R4-Continental United States (R4c). Overall infection rate after EF was 19.2% for R2, 24.9% for R3, 19.8% for R4, and 38.8% for R4c (25.5% overall). Wound infection was the most common infectious complication at (8.6% after EF at R2, 14.5% for R3, 15.3% for R4, and 24.5% for R4C, 15.2% overall). On adjusted analysis, higher-echelon EF was independently associated with WI and overall infection: adjusted odds ratio of 1.718 (97.5% CI, 1.311-2.250), and 1.514 (97.5% CI, 1.208-1.899), respectively.</p><p><strong>Conclusions: </strong>For U.S. military casualties, lower-echelon external fixation is associated with decreased infection despite the austere setting. Although this study is unable to elucidate the specific factor(s) responsible for this association, it highlights the need to maintain orthopedic expertise close to point-of-injury and for future work to identify the specific characteristics of either the patients who receive lower-echelon EF, their injuries, or the EFs at the Role 2 and Role 3 facilities themselves that are responsible for this association.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708062","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":"Identification of Relevant Occupational Tasks Performed by the Brazilian Air Force Firefighters.","authors":"Willian C Botta, José M M P Santos, Robin M Orr, João P Borin","doi":"10.1093/milmed/usaf374","DOIUrl":"https://doi.org/10.1093/milmed/usaf374","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify content-valid occupational tasks performed by Brazilian Air Force (BAF) firefighters to support the development of Physical Employment Standards (PES).</p><p><strong>Materials and methods: </strong>A 3-step validation process was applied: (1) scenario development, (2) subject matter expert (SME) judgment, and (3) task quantification. Seven SMEs identified 5 operational scenarios and 33 critical tasks, which were rated based on importance, frequency, and physical demand. Tasks with a Content Validity Index above 0.86 were retained. In the final step, 164 active duty firefighters rated 27 tasks using a Likert scale.</p><p><strong>Results: </strong>Tasks involving victim removal and load carriage were rated among the most important and physically demanding, and forest firefighting tasks were the most frequently performed. Inter-rater reliability was high across all domains.</p><p><strong>Conclusion: </strong>This systematic approach provides a foundation for future PES development, contributing to improved readiness, safety, and targeted physical training programs for BAF firefighters.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699016","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":"Depression and Obesity in U.S. Military Service Members and Veterans: A Systematic Review.","authors":"Shawnice L Shankle, Laureen H Smith","doi":"10.1093/milmed/usaf376","DOIUrl":"https://doi.org/10.1093/milmed/usaf376","url":null,"abstract":"<p><strong>Introduction: </strong>High body mass index (BMI) and depression are significant chronic health concerns in adult populations, including in the U.S. Military. This systematic review examines the published literature on the relationship between high BMI and depressive symptoms among U. S. service members (SMs) and veterans from the most recent wars.</p><p><strong>Materials and methods: </strong>A structured literature review published from 2012 to 2022 used established systematic review guidelines. Sixteen primary research studies from the last 10 years were examined using healthcare and social sciences databases. The studies included BMI and depressive symptoms as variables. Studies measured the relationship between BMI and depressive symptoms among those with military service during the Gulf War or Post-9/11 eras.</p><p><strong>Results: </strong>Four studies used SMs alone, 11 used veterans, and 1 used both. Nine studies found a relationship between high BMI and depressive symptoms, with 3 reporting the relationship only in specific sub-groups (e.g., specific BMI categories). Seven studies found no relationship. Mixed findings and varied study quality indicate a nuanced relationship. SMs and veterans have high BMIs and depressive symptoms at rates comparable to their civilian counterparts.</p><p><strong>Conclusion: </strong>High BMI and depressive symptoms among SM and veterans could have consequences for personal health, healthcare systems, and national security. Little is understood about the complexity of relationship between high BMIs and depressive symptoms among military and veteran populations. Delivering evidence-based tailored care for SMs and veterans experiencing these conditions requires more research, especially intervention-based studies. Effective policies to ensure the holistic health of SMs and veterans are needed to secure the health and fitness of the warfighters in the U.S. Military.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699013","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":"Exploring Impostor Phenomenon During Pre-Clerkship Period in Military Medical School.","authors":"Eungjae Kim, Jinbum Dupont, Steven J Durning, Jezreelyn Bulaklak, Abigail Crosier, Michael Soh","doi":"10.1093/milmed/usaf373","DOIUrl":"https://doi.org/10.1093/milmed/usaf373","url":null,"abstract":"<p><strong>Purpose: </strong>impostor phenomenon (IP) is defined as an experience where individuals attribute their success to chance or luck and not to their mastery of skills, which is commonly experienced within competitive environments such as medical school. Building on a prior study on IP during onboarding, the purpose of this study is to examine IP experiences throughout the pre-clerkship curriculum and provide insights into the possible evolution of IP during the initial 16 months of a military medical school.</p><p><strong>Materials and methods: </strong>The study participants were second-year medical students at a military medical school who had previously participated in an initial IP study at the beginning of their first year of medical school. Researchers conducted semi-structured interviews in December 2023 to explore how students' experience with the IP changed after their pre-clerkship education, and qualitative thematic analysis was conducted. Scores from the Clance Impostor Phenomenon Scale (CIPS) during onboarding and at the end of the pre-clerkship period were compared.</p><p><strong>Results: </strong>Researchers interviewed 21 of the original 29 matriculated military medical students who completed the initial study. Fifteen students (71.4%) reported frequent or intense IP experiences on the CIPS indicating that IP remained present in the study sample. Average CIPS scores from onboarding and end of pre-clerkship were 68.3 and 68.1, respectively, suggesting that the intensity of IP remained stable. Thematic analysis of interview transcripts identified 6 themes that influenced students' experience with IP: academic progress, military medical expectations, self-comparison, relationship dynamics and building relationships, extracurricular engagement and roles, and navigating uncertainty. Theme saturation was reached at n = 15.</p><p><strong>Conclusion: </strong>Although the intensity of IP remained relatively stable from onboarding to the end of pre-clerkship, the underlying themes driving IP evolved as students transitioned into active participation in undergraduate medical training. Similar to the initial IP study, situated learning theory continued to offer a valuable framework for understanding these shifts, particularly through relationships with peers and upperclassmen. Future research incorporating mixed methods could further clarify how qualitative shifts in IP correspond to variations in CIPS scores. As participants advance into clerkship rotations, we anticipate continued evolution in IP experiences, warranting further longitudinal exploration.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699015","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":"Diagnosis and Treatment of a Sports-Related Morel Lavallée Lesion With Point-of-Care Ultrasound: A Case Study.","authors":"Ellis Bronstein, Savannah Kounelis-Wuillaume, Colby MaGill, Jeffrey C Leggit","doi":"10.1093/milmed/usaf378","DOIUrl":"https://doi.org/10.1093/milmed/usaf378","url":null,"abstract":"<p><p>Morel-Lavallée lesions (MLLs) are closed degloving injuries that result in inter-fascial hemolymphatic collections. These lesions develop as a result of shearing forces in the deep fascial planes and often arise in the context of significant high-velocity traumas. However, they are often underdiagnosed, especially in the case of atypical presentations such as sports or low-impact injuries. Here we present a case of MLL following a fall from a bike at low speed that resulted in a large area of soft-tissue ecchymosis and swelling that would not resolve following conservative treatment. Point-of-care ultrasound (POCUS) was used to diagnose and guide interventional treatment via ultrasound-guided drainage of the fluid collection. This case is informative as it serves as a reminder for providers to always consider MLL in the differential diagnosis of soft tissue injuries. It additionally demonstrates how POCUS can help identify and assist in management of MLLs in the primary care setting.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699014","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}