Pediatric emergency care最新文献

{"title":"Suicide Prevention and Telehealth in Children's Hospital Emergency Departments.","authors":"Stephanie K Doupnik, Cadence F Bowden, Diana Worsley, Cameron Keating, Kyla Cassidy, Ashley A Foster, William Quarshie, Jungwon Min, Zachary Meisel, Steven C Marcus","doi":"10.1097/PEC.0000000000003304","DOIUrl":"10.1097/PEC.0000000000003304","url":null,"abstract":"<p><strong>Objectives: </strong>Suicide is a leading cause of death among adolescents. Emergency department (ED) visits for mental health concerns are rising, and telehealth is increasingly used to provide emergency mental health care. We conducted a national survey to describe suicide prevention practices and tele-mental health care in children's hospital EDs.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of leaders at all 52 US EDs affiliated with dedicated children's hospitals (ie, hospitals that provide care only to children) to describe use of tele-mental health care and suicide prevention practices.</p><p><strong>Results: </strong>Leaders from 41 EDs completed the survey (79% response rate). Tele-mental health care was used in 23 EDs (56%); there were no differences in ED structural characteristics between institutions with telehealth versus without telehealth. Among responding EDs, 40 (98%) reported they screen for suicide risk, and 29 (71%) reported they use a standardized approach to suicide prevention discharge planning. Risk reduction practices conducted at many but not all EDs included assessment of access to lethal means (n = 31, 86%), counseling on reduction of access to lethal means (n = 30, 73%) and providing patients with a list of professionals or agencies that they can contact in a crisis (n = 35, 85%). There were no differences in use of suicide prevention practices at EDs with versus without telehealth ( P > 0.1 for all).</p><p><strong>Conclusions: </strong>Approximately half of children's hospital EDs use tele-mental health care, and hospitals with versus without tele-mental health care report similar rates of suicide prevention practice use. Opportunities exist to increase use of discharge safety practices.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e10-e17"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Automated Finger Compression for Capillary Refill-Time Measurement in Pediatrics: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1097/PEC.0000000000003265","DOIUrl":"10.1097/PEC.0000000000003265","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e3"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982977","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 Incidence and Severity of Pediatric Injuries Sustained by Electric Bikes and Powered Scooters: The Experience of an Urban, Tertiary Pediatric Emergency Department.","authors":"Seraj Moati, Oren Tavor, Tali Capua, Igor Sukhotnik, Miguel Glatstein, Ayelet Rimon, Neta Cohen","doi":"10.1097/PEC.0000000000003258","DOIUrl":"10.1097/PEC.0000000000003258","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe the incidence and severity of electrical bicycle (E-bike)- and power scooter (P-scooter)-related injuries and their secular trends among pediatric patients presenting to a pediatric emergency department (ED).</p><p><strong>Methods: </strong>This retrospective cohort study of patients aged <18 years who sustained E-bike and P-scooter injuries was performed between 2018 and 2023. We explored trends of severe trauma cases, ED visits, hospitalizations, and surgical interventions. Severity of trauma was rated by either an injury severity score (ISS) of >15 or the patient's need for acute care as defined by intensive care unit (ICU) admission, direct disposition to the operating room, acute interventions performed in the trauma room, and in-hospital death.</p><p><strong>Results: </strong>Of the 1466 pediatric patients who presented to our pediatric ED following P-scooter and E-bike injuries, 216 (14.7%) were hospitalized, with a median age of 14.0 years (interquartile range, 10.5-16.0 years) and male predominance (69.0%). The number of ED visits increased 3.5-fold by study closure, with a parallel increase in hospitalizations, surgical interventions, and severe trauma cases. The relative percentages of severe trauma cases were not significantly different over time. Among hospitalized patients, 3 patients (1.4%) died and 9 (4.1%) required rehabilitation care.</p><p><strong>Conclusions: </strong>The incidence and severity of E-bike and P-scooter injuries and fatalities continue to increase within the pediatric population. Current personal and road safety regulations are providing inadequate in preventing these injuries, highlighting an urgent need for revision and stricter enforcement.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"77-85"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546702","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":"Oral Ketamine and Midazolam for Procedural Sedation in the Pediatric Emergency Department: A Retrospective Study.","authors":"Jeannine Del Pizzo, Joel A Fein","doi":"10.1097/PEC.0000000000003291","DOIUrl":"10.1097/PEC.0000000000003291","url":null,"abstract":"<p><strong>Introduction: </strong>Needle-free procedural sedation (PS) is an attractive option for children presenting to the emergency department (ED) who require a painful procedure, as it avoids inflicting additional pain either with intravenous line placement or intramuscular injection. While use of oral (PO) ketamine has been reported in the literature, limited information is available to guide ED-based use in children.</p><p><strong>Methods: </strong>This is a descriptive study of the patient experience receiving PS with the following regimen: PO ketamine 6 mg/kg (max of 200 mg) with or without PO midazolam 0.5 mg/kg (max 15 mg) approximately 30 minutes before a procedure. We performed a retrospective chart review of children younger than 18 years receiving this PS regimen at a tertiary care children's hospital ED and an affiliated community hospital ED from January 1 through September 30, 2023.</p><p><strong>Results: </strong>Fifty-eight children were sedated with PO ketamine during the study period. The most common procedure performed was laceration repair (46.5%), followed by incision and drainage (17.3%). All but 2 children received PO midazolam along with PO ketamine. Eight patients received additional medications due to inadequate sedation. Sedation depth was clinician-reported as moderate in 74.1% (43), mild in 15.5% (9), and deep in 10.3% (6). Procedures were completed in 98.3% (57) cases. 93.1% (54) of patients had no adverse event (AE) of any kind and no patient had a significant adverse event (SAE).</p><p><strong>Discussion: </strong>PO ketamine with or without midazolam resulted in procedure completion of a variety of procedures in the pediatric ED with minimal AE, no SAE, and without need for additional sedative medications in 86.2% (50). This regimen is an option for needle-free moderate PS in this setting. Further study is needed to clarify the benefit of the addition of midazolam to PO ketamine, rates of AE and SAE, sedation duration, and recovery times.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"122-126"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668607","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":"Emergency Medical Services and Police Utilization for Pediatric Mental and Behavioral Health Concerns Within a Large Hospital System.","authors":"Victoria Hartwell, Lauren Riney, Alexandra Cheetham, Wendy J Pomerantz, Sang Hoon Lee, Rachel Bensman, Hamilton Schwartz, Yin Zhang, Lynn Babcock","doi":"10.1097/PEC.0000000000003287","DOIUrl":"10.1097/PEC.0000000000003287","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare emergency medical services (EMS) and police utilization trends, epidemiology, and emergency department (ED) outcomes between pediatric patients with mental or behavioral health (MBH) emergencies and those with non-MBH concerns transported to a large children's hospital system.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients aged 5 to 18 years transported via EMS and police to two EDs affiliated with a children's hospital from January 2012 through December 2020. Data were abstracted from electronic hospital records. Encounters for MBH emergencies were identified using diagnostic codes and chief complaints. Trends of EMS and police transports of patients with MBH emergencies were examined. Patient demographics and ED outcomes were compared between children presenting with MBH emergencies and those with non-MBH concerns.</p><p><strong>Results: </strong>During the 9-year study period, out of 40,663 transports to the EDs, 36,137 (89%) arrived via EMS, and 4,526 (11%) arrived via police. A total of 10,250 (28.4%) EMS transports were for MBH emergencies. The volume of patients transported by EMS for MBH emergencies increased by 1.4% per year ( P < 0.01) with no significant change in total EMS patient volumes. Patients with MBH emergencies transported by EMS were more likely to be older, female, of White race, and publicly insured; require restraint in the ED; and be admitted ( P < 0.001). Of police transports, 4153 (91.8%) were for MBH emergencies, with no statistical change in the proportion of police transports that were for MBH emergencies. Police-transported MBH patients compared to non-MBH police-transported patients were more likely to be younger, female, and of White race ( P < 0.001); 8.7% required mechanical/physical restraints in ED, 6.7% required pharmacologic restraint medications in ED, and 53% were admitted.</p><p><strong>Conclusions: </strong>The proportion of pediatric transports for MBH emergencies by EMS is rising and comprises the majority of police transports. Distinct from non-MBH pediatric patients transported, MBH patients necessitate significant ED resources, including ED-administered restraints and admission, highlighting their unique burden on the prehospital and ED systems.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"104-108"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558468","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":"Development of a Scoring Model to Predict Severe Dengue in Children at Admission to Emergency Care: An Observational Study.","authors":"Ranjini Srinivasan, Chaitra Govardhan, Sushma Krishna, Sumithra Selvam","doi":"10.1097/PEC.0000000000003288","DOIUrl":"10.1097/PEC.0000000000003288","url":null,"abstract":"<p><strong>Objective: </strong>Dengue has emerged as the most widely spread mosquito-borne disease, hyperendemic in India. Although severe dengue occurs only in a small proportion of cases, delays in the recognition and management can result in significant morbidity and mortality. Risk stratification of children in the emergency care and identifying those at risk for worsening during hospital stay facilitates optimum utilization of health care resources. The objective of our study was to develop and validate a scoring model to predict the development of severe dengue in hospitalized children by identifying risk factors present in them at the time of admission to the emergency department.</p><p><strong>Methods: </strong>A retrospective study of consecutive children aged 1 month to 18 years admitted with serologically confirmed dengue from January 2019 through December 2021 was conducted. Analysis of clinical and laboratory parameters of children resulted in the development of a comprehensive predictive scoring model. This model was internally validated prospectively on 107 children presenting with nonsevere dengue to emergency care.</p><p><strong>Results: </strong>A total of 743 children with confirmed dengue were studied out of which 216 (29.1%) had severe dengue. Presence of third spacing (odds ratio [OR] 3.74, 95% confidence interval [CI] 1.088-7.42, P < 0.001), tender hepatomegaly (OR 1.62, 95% CI 1.04-2.52, P < 0.032), respiratory distress (OR 3.50, 95% CI 1.89-6.51, P < 0.001), and moderate (OR 3.51, 95% CI 1.82-6.74, P < 0.001) to severe (OR 4.76, 95% CI 2.59-8.76, P < 0.001) elevation of aspartate aminotransferase were independent risk factors found to be associated with development of severe dengue. A score ≥7 had a specificity of 87%, negative predictive value of 86%, and overall diagnostic accuracy of 78.5% for predicting severe dengue.</p><p><strong>Conclusions: </strong>The dengue severity scoring model was found to have reasonable diagnostic accuracy in predicting severe disease prior to hospitalization. However, more studies are required to validate the score in different emergency care settings with varied pediatric populations.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"109-115"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668594","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":"Current Evidence on the Care of Young Infants With Hypothermia in the Emergency Department.","authors":"","doi":"10.1097/01.pec.0001098628.60769.58","DOIUrl":"https://doi.org/10.1097/01.pec.0001098628.60769.58","url":null,"abstract":"","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":"41 2","pages":"152-153"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067145","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 National Emergency Department Overcrowding Scale and Perceived Staff Workload: Evidence for Construct Validity in a Pediatric Setting.","authors":"Kenneth W McKinley, Joan S Bregstein, Rimma Perotte, Daniel Fenster, Maria Kwok, Jake Rose, Megan Nye, Meridith Sonnett, David O Kessler","doi":"10.1097/PEC.0000000000003300","DOIUrl":"10.1097/PEC.0000000000003300","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to determine if there is a correlation between perceived staff workload, measured by the NASA Task Load Index (TLX), and the National Emergency Department Overcrowding Scale (NEDOCS) in a pediatric ED.</p><p><strong>Methods: </strong>We collected staff questionnaires in a large, urban pediatric ED to assess perceived workload on each of six different TLX subscales, which we weighted evenly to create an overall estimate of workload. We evaluated the correlation between individual TLX responses and NEDOCS overall and by staff subgroup. Additionally, we analyzed: (1) the correlation between mean TLX responses and NEDOCS within a given hour and (2) the performance of a logistic regression model, using TLX as a predictor for \"severely overcrowded,\" as measured by NEDOCS.</p><p><strong>Results: </strong>Four hundred one questionnaires between 6/2018 and 1/2019 demonstrated significant variation between concurrently collected TLX responses and an overall poor correlation between perceived workload and NEDOCS ( R2 0.096 [95% confidence interval, 0.048-0.16]). TLX responses by subgroups of fellows (n = 4, R2 0.96) and patient financial advisors (n = 15, R2 0.58) demonstrated the highest correlation with NEDOCS. Taking mean TLX responses within a given hour, during periods with NEDOCS >60 (extremely busy or overcrowded), a polynomial trend line matched the data best ( R2 0.638). On logistic regression, the TLX predicts \"severely overcrowded\" with an area under the curve of the receiver operating characteristic of 0.731.</p><p><strong>Conclusions: </strong>NEDOCS does not have a strong correlation with individual responses on questionnaires of perceived workload for staff in a pediatric ED. NEDOCS, as a measure of overcrowding, may be better correlated with perceived workload during periods with elevated crowding or when interpreted categorically as yes/no \"severely overcrowded\".</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"e5-e9"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subconjunctival Hemorrhages Are Rare Among Infants With Cough and Gastrointestinal Conditions.","authors":"Ajay S Koti, Emily C B Brown, Kristine A Campbell","doi":"10.1097/PEC.0000000000003293","DOIUrl":"10.1097/PEC.0000000000003293","url":null,"abstract":"<p><strong>Objective: </strong>Subconjunctival hemorrhages (SCHs) are uncommon injuries in young children beyond the neonatal period and have been associated with abuse. In otherwise well infants, they are sometimes attributed to commonly observed symptoms that invoke Valsalva maneuvers, such as cough, vomiting, and constipation. Our study aims to ascertain the prevalence of SCH among children presenting to emergency care with cough, vomiting, and constipation.</p><p><strong>Methods: </strong>We conducted a cross-sectional secondary analysis of a prospectively collected dataset of children aged 1 month to 3 years presenting to a tertiary pediatric emergency department (ED). Children with and without SCH were identified at the time of their examination by ED providers. Children were assigned to Valsalva symptom groups of cough, vomiting, and/or constipation based on review of the ICD-10 codes associated with the ED encounter. Descriptive statistics and prevalence were calculated for each group. Chi-square testing of proportions was used to compare the prevalence of SCH based on the presence or absence of the 3 symptoms of interest.</p><p><strong>Results: </strong>Four thousand seven hundred seventeen qualifying ED encounters were captured, with 2 total cases of SCH identified (0.4 per 1000). SCHs were uncommonly observed in patients with cough (0.5 per 1000), vomiting (0 per 1000), and constipation (0 per 1000). We found no significant differences in the prevalence of SCH based on the presence or absence of cough ( P = 0.87), vomiting ( P = 0.52), or constipation ( P = 0.82).</p><p><strong>Conclusion: </strong>SCH is an uncommon finding in children under 3 years and is similarly uncommon among children with cough, vomiting, or constipation. It should not be attributed to uncomplicated presentations of cough, vomiting, or constipation, and alternative diagnoses, including abuse, should be carefully considered in the differential diagnosis of SCH.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"127-130"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minor Head Trauma in Children Younger Than 3 Months and Clinical Predictors of Clinically Important Traumatic Brain Injuries.","authors":"Marco Vajna de Pava, Martina Samperi, Ilia Bresesti, Lorenza Bertù, Anna Maria Plebani, Massimo Agosti","doi":"10.1097/PEC.0000000000003295","DOIUrl":"10.1097/PEC.0000000000003295","url":null,"abstract":"<p><strong>Objectives: </strong>Major studies have defined clinical rules to regulate the use of computed tomography in children after head trauma. Infants younger than 3 months are considered at higher risk of brain injuries than older children and at the same time at higher risk of radiation-induced damage. Hence, it would be desirable to have clinical decision rules more adapted to this subset of patients. The objectives of this study are to compare the rate of brain injuries in children younger than 3 months or 3 to 24 months and to assess predictors of clinically important traumatic brain injuries (ciTBIs) (the ones causing death, neurosurgical intervention, long intubation, or hospitalization for 2 days or more) in the former group.</p><p><strong>Methods: </strong>Records of children younger than 24 months evaluated in a single emergency department for minor head trauma during a 3 years period were retrospectively reviewed. The rates of brain injuries were compared in children younger or older than 3 months. Variables associated with severe lesions were assessed in younger children.</p><p><strong>Results: </strong>The study included 744 patients, 86 (11.6%) aged 0 to 90 days and 658 (88.4%) aged 91 to 730 days. Within the young group, we found higher rates of traumatic brain injuries (14.0% vs 4.1%, P = 0.0008) and ciTBI (8.1% vs 1.5%, P = 0.002) compared with the old group. A significant correlation with ciTBI in the young group was observed for heart rate (odds ratio [OR], 12.3; 95% confidence interval [CI], 2.4-62.4), nonfrontal scalp hematoma (OR, 9.2; 95% CI, 1.8-46.1), severe mechanism (OR, 5.6; 95% CI, 1.1-27.6), presence of hematoma (OR, 6.1; 95% CI, 1.2-30.0), hematoma size >3 cm (OR, 23.8; 95% CI, 4.2-135.6), and hematoma location (OR, 9.2; 95% CI, 1.8-46.1).</p><p><strong>Conclusions: </strong>Children younger than 3 months presenting after minor head trauma constitute a relevant population. Available clinical predictors well correlate with ciTBIs in this age group.</p>","PeriodicalId":19996,"journal":{"name":"Pediatric emergency care","volume":" ","pages":"131-134"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668596","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}