Prehospital and Disaster Medicine最新文献

{"title":"Prehospital Care Post-Road-Crash: A Systematic Review of the Literature.","authors":"Joseph Cuthbertson, Greg Drummond","doi":"10.1017/S1049023X25000202","DOIUrl":"https://doi.org/10.1017/S1049023X25000202","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to systematically review evidence that supports best practice post-crash response emergency care.</p><p><strong>Study design: </strong>The research questions to achieve the study objective were developed using the Patient, Intervention, Control, Outcome standard following which a systematic literature review (SLR) of research related to prehospital post-road-crash was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>A total of 89 papers were included in the analysis, presented according to the PRISMA guidelines.</p><p><strong>Conclusions: </strong>This research explored and identified key insights related to emergency care post-road-crash response. The findings showed that interservice coordination and shared understanding of roles was recommended. Application of traditional practice of the \"Golden Hour\" has been explored and contested as a standard for all care. Notwithstanding this, timeliness of provision of care remains important to certain patient groups suffering certain injury types and is supported as part of a trauma system approach for patient care.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804100","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":"Paramedic Management of Non-Traumatic Back Pain in a Large Australian Ambulance Service: A Retrospective Study.","authors":"Simon P Vella, Chathurani Sigera, Jason C Bendall, Paul Simpson, Christina Abdel-Shaheed, Michael S Swain, Chris G Maher, Gustavo C Machado","doi":"10.1017/S1049023X25000251","DOIUrl":"https://doi.org/10.1017/S1049023X25000251","url":null,"abstract":"<p><strong>Introduction: </strong>Non-traumatic back pain commonly leads people to seek health care from paramedics via triple-zero (emergency phone number in Australia), yet the management approaches by providers of ambulance services remain unclear.</p><p><strong>Study objectives: </strong>This study aims to investigate paramedic management of non-traumatic back pain in New South Wales (NSW), Australia, including the call characteristics, provisional diagnoses, and the clinical care being delivered by paramedics.</p><p><strong>Methods: </strong>This study is a retrospective analysis of NSW Ambulance computer-aided dispatch and electronic medical records from January 1, 2017 through December 31, 2022. Adults who sought ambulance service with a chief complaint of back pain, were triaged as non-traumatic back pain, and subsequently received treatment by paramedics were included. Multivariable logistic regression models were used to explore factors associated with primary outcomes; ambulance transport, opioid use, and use of medication combinations were reported as odds ratios (ORs).</p><p><strong>Results: </strong>There were 73,128 calls to NSW Ambulance with a chief complaint of back pain that were triaged as non-traumatic back pain. Of these, 54,444 (74.4%) were diagnosed with spinal pain, of which 52,825 (97.1%) were categorized by the paramedic as back or neck pain, 1,573 (2.9%) as lumbar radicular pain, and 46 (0.1%) as serious spinal pathology. Eight out of ten patients with spinal pain were transported to emergency departments. The medicine most administered by a paramedic was an opioid (37.4% of patients with spinal pain). Older patients (OR = 1.36; 95% CI, 1.30 to 1.44) were more likely to be transported to an emergency department. Patients with moderate (OR = 4.39; 95% CI, 4.00 to 4.84) and severe pain (OR = 18.90; 95% CI, 17.18 to 20.79) were more likely to be administered an opioid.</p><p><strong>Conclusions: </strong>Paramedic management of non-traumatic back pain in NSW typically results in the administration of an opioid and transport to an emergency department.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796216","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 Prehospital Protocol Modification during COVID-19 on First-Pass Intubation Success Rates.","authors":"Abagayle E Bierowski, Paul C Comber, Alexander Kuc, Aman Shah, Gerard Carroll","doi":"10.1017/S1049023X25000238","DOIUrl":"https://doi.org/10.1017/S1049023X25000238","url":null,"abstract":"<p><strong>Introduction: </strong>Many Emergency Medical Services (EMS) agencies modified their protocols during the height of the COVID-19 pandemic, particularly those involving procedures that lead to an increased risk of airborne exposure, such as intubation. In 2020, local Advanced Life Support (ALS) providers' first-line airway management device was the supraglottic airway (SGA), and tracheal intubations (TIs) were rarely performed.</p><p><strong>Objective: </strong>This study's aim was to investigate the potential clinical effect of this pandemic-related protocol change on first-pass TI success rates and on overall initial advanced airway placement success.</p><p><strong>Methods: </strong>This study was a retrospective prehospital chart review for all ALS encounters from a single urban EMS agency that resulted in the out-of-hospital placement of at least one advanced airway per encounter from January 1, 2019 through June 30, 2021 (<i>n</i> = 452). Descriptive statistics and chi square tests were used to evaluate data. Statistical significance was defined at <i>P</i> < .05.</p><p><strong>Results: </strong>Significantly fewer TIs were attempted in 2020 (n = 16) compared to 2019 (n = 80; <i>P</i> < .001), and first-pass TI success rates significantly decreased in 2021 (n = 22; 61.1%) compared to 2019 (n = 63; 78.8%; <i>P</i> = .047). Also, SGA placement constituted 91.2% of all initial airway management attempts in 2020 (n = 165), more than both 2019 (n = 114; 58.8%; <i>P</i> < .001) and 2021 (n = 87; 70.7%; <i>P</i> < .001). Overall first-attempt advanced airway placement success, encompassing both supraglottic and TI, increased from 2019 (n = 169; 87.1%) to 2020 (n = 170; 93.9%; <i>P</i> = .025). Conversely, overall first attempt advanced airway placement success decreased from 2020 to 2021 (n = 104; 84.6%; <i>P</i> = .0072).</p><p><strong>Conclusions: </strong>Lack of exposure to TI during the COVID-19 pandemic likely contributed to this local agency's decreased first-pass TI success in 2021. Moving forward, agencies should utilize simulation labs and other continuing education efforts to help maintain prehospital providers' proficiency in performing this critical procedure, particularly when protocol changes temporarily hinder or prohibit field-based psychomotor skill development.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764724","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":"Assessing Intent: Repetitive Strikes on Ukrainian Health Care Facilities.","authors":"Dennis G Barten, Derrick Tin, Fredrik Granholm, Diana Rusnak, Frits van Osch, Gregory Ciottone","doi":"10.1017/S1049023X2500024X","DOIUrl":"https://doi.org/10.1017/S1049023X2500024X","url":null,"abstract":"<p><strong>Introduction: </strong>Attacks on health care - which are potential war crimes - are increasingly observed in contemporary armed conflicts. The full-scale Russian invasion of Ukraine is no exception to this worrisome trend. War crime prosecutions of suspected deliberate attacks on health care facilities require proof that they were the intended target, which is extremely challenging. If health care facilities are attacked more than once, this may increase the likelihood of intent. The Ukrainian Healthcare Center (UHC) began documenting attacks on health infrastructure since the start of the full-scale Russian invasion of Ukraine. In this study, the aim was to assess repetitive attacks on Ukrainian health care facilities from February 24, 2022 through October 24, 2023.</p><p><strong>Methods: </strong>The Berkeley Protocol on Digital Open Source Investigations was used to identify and document health care attacks. Data collection for this study included temporal factors, location and type of facility, attack and weapon type, the number of health care personnel and civilians killed and injured, and whether the afflicted facilities were damaged, destroyed, and/or repeatedly attacked.</p><p><strong>Results: </strong>During the study period, there were 397 attacks on 281 Ukrainian health care facilities, damaging 237 facilities and destroying another 44. Fifty-three facilities (18.9%) were attacked more than once (total: 163 attacks; mean 3.1; median 2; range 2-10 attacks), and 27.7% of all health care attacks (110/397) concerned repeat attacks. The median time between attacks was 18 days (range: 0-289 days).</p><p><strong>Conclusions: </strong>From February 24, 2022 through October 24, 2023, one-in-five targeted health care facilities in Ukraine experienced repetitive attacks. Furthermore, one-in-four attacks on health care involved recurrent attacks. This observed pattern raises the possibility that health care facilities in Ukraine are being intentionally targeted.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-5"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764721","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 Management of Earthquake-Related Thoracic Trauma After the 2023 Türkiye Earthquakes.","authors":"Ömer Taşkın, Sevcan Seçinti, İsmail C Karacaoğlu, Nezihat R Dişel, Ayça Açıkalın Akpınar","doi":"10.1017/S1049023X25000159","DOIUrl":"10.1017/S1049023X25000159","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with thoracic trauma require rapid decision making and early intervention, especially during natural disasters when the influx of patients complicates hospitalization decisions. Identifying the characteristics of these patients can improve triage protocols, optimize resource allocation, and enhance outcomes in future disaster scenarios.</p><p><strong>Study objective: </strong>The aim of this study was to determine the characteristics of hospitalized patients after the February 2023 earthquakes in Türkiye and to contribute to Disaster Medicine.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study was conducted in a university hospital's emergency department (ED) located in the earthquake area. All patients over 18 years old with earthquake-related thoracic trauma were included. Demographic information, mechanisms of injury, associated injuries, laboratory results, and treatments were recorded. Patients were divided into two groups: discharged and hospitalized.</p><p><strong>Results: </strong>The study included 179 patients, with a median age of 45 years. Overall, 80.4% were trapped under debris, and 43.8% were rescued on the first day. Hospitalization rates were higher in patients trapped under debris and those rescued after the first day. Blunt thoracic trauma was observed in 95.5% of patients. One hundred and three patients (57.5%) underwent Extended Focused Assessment with Sonography in Trauma (E-FAST) in the ED, 152 patients (84.9%) underwent x-ray, and 129 patients (72.1%) underwent computed tomography (CT). Imaging studies revealed rib fractures in 49.7% and lung parenchymal injuries in 48.6% of patients. Patients with lung parenchymal injury had higher hospitalizations rates. Hospitalized patients had higher levels of white blood cells (WBCs), potassium, blood urea nitrogen (BUN), creatinine, creatinine kinase (CK), creatine kinase-myocardial band (CKMB), and troponin I.</p><p><strong>Conclusion: </strong>This study highlights the prevalence of blunt thoracic trauma and the importance of imaging in the assessment of thoracic injuries following earthquakes. While few patients needed surgery, many required hospitalizations and had abnormal laboratory results, emphasizing the need for careful monitoring for complications like muscle damage and infection.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"6-11"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567601","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":"Demographic and Injury Characteristics of Patients Injured in a Hailstorm.","authors":"Kamil Kokulu, Ekrem Taha Sert, Serdar Özdemir, Hüseyin Mutlu, İbrahim Altunok","doi":"10.1017/S1049023X25000135","DOIUrl":"10.1017/S1049023X25000135","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe the demographic characteristics, injury characteristics, and outcomes of individuals sustaining injuries during a hailstorm in Istanbul, Turkey.</p><p><strong>Methods: </strong>In this study, the medical records of 76 patients who presented to the emergency department (ED) of a tertiary hospital after incurring injuries due to hailstorms were retrospectively reviewed. Analyses were performed to identify hailstorm-associated injury profiles, injury mechanisms, patient demographics, and ED resource use.</p><p><strong>Results: </strong>Of the 76 patients, 42 (55.3%) were male and 34 (44.7%) were female, with the ages of the patients ranging from five to 79 years. Of the patients, 93.4% presented to the ED within the first eight hours after a hailstorm. The most common injury mechanisms were the direct impact of hailstones on the body surface (36.8%) and slips and falls during escape (35.6%). The most frequently injured anatomical areas were skin (60.5%), head (44.7%), and extremities (16.7%). Significant injuries occurred in only 11.8% of the patients, of whom three were treated surgically and one died. The most common injuries were soft tissue and minor head injuries.</p><p><strong>Conclusions: </strong>Severe hailstorms often strike suddenly and can be difficult to predict. In response, EDs must handle a large number of injured patients in the aftermath of a hailstorm. It is important to remember that hailstorms, like other natural disasters, can cause serious injuries.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"43-47"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483608","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 Data are Gathered in Mass-Casualty Incidents? A Scoping Review.","authors":"Michael Pallot, Sarah Alvi, Jade Hanley, Anisa Jafar","doi":"10.1017/S1049023X25000111","DOIUrl":"10.1017/S1049023X25000111","url":null,"abstract":"<p><strong>Background: </strong>Mass-casualty incidents (MCIs) are overwhelming events which generate a surge in casualties, exceeding local capacity and stressing emergency services. Significant mortality, morbidity, and economic impact is often caused. They attract responses from both local and international governmental and non-governmental medical responders. To improve professional standards and accountability, there has been much recent focus on record-keeping by teams in these contexts. This paper seeks to further understand what data are gathered and shared as a result of MCIs to outline current practice and help move towards improved minimum standards of documentation.</p><p><strong>Methods: </strong>A structured database search and abstract screening process was conducted utilizing PRISMA guidelines for scoping reviews. Data were then collected from all papers identified. To ensure all relevant data were gathered, authors of each included study were contacted to clarify their approach to data collection for their work.</p><p><strong>Results: </strong>From 154 included manuscripts, 64 data categories were found and recorded, capturing MCIs over a period of 32 years located in 42 countries from all World Health Organization (WHO) global regions. Retrospective and contemporaneous data collection was equally prevalent. In-hospital or research team data collection was most common. The ten most common data categories collected were: number of injuries (94.8%), number of deaths (89.6%), injury type (81.2%), cause of injury (79.9%), age (63.0%), sex (63.0%), treatment (62.3%), severity of injury (61.7%), outcome of injury (59.1%), and investigations/treatments given (55.8%). Of the contactable authors, only 29 responded. Sixteen reported reviewing notes retrospectively or using follow-up patient interviews.</p><p><strong>Discussion & conclusions: </strong>There was significant variety in what data were collected, who collected it, and how it was done. The most common data categories were descriptive pieces of information or related to demographics. Only one-half of papers discussed treatments given. Information on both prehospital care and longer-term rehabilitation was much less prevalent.Terrorism and shooting related MCIs were the largest by paper number. Predominantly made up of more recent MCIs in higher income countries, these findings potentially reflect more organized health care systems.Overall, data collection in MCIs is challenging and heavily reliant on retrospective analysis. Current practice lacks standardization. If professionalism and accountability for health care delivery in MCIs is to be improved, so must the methods of data collection and minimum standards of documentation.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"21-32"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567852","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":"WADEM Position Statement: Disaster Medicine Education in Health Care Profession Training.","authors":"Andrew Shanes, Ilana Shecter, Morgan Davis","doi":"10.1017/S1049023X2500010X","DOIUrl":"10.1017/S1049023X2500010X","url":null,"abstract":"<p><p>Disaster Medicine is a critical and often neglected component of health care. The World Association for Disaster and Emergency Medicine (WADEM) Board of Directors, as well as the WADEM Student and Young Professional Special Interest Group, recognize the importance of introducing Disaster Medicine concepts early in health care education and have put forth a position statement emphasizing this importance. As leaders in Disaster Medicine, we aim to highlight the need for the integration of Disaster Medicine education into health care profession training. By acknowledging this educational need and by providing recommendations to appropriate stakeholders, we anticipate that this investment in Disaster Medicine education will assist in developing well-prepared health care professionals who will improve prehospital and emergency medicine, public health, and day-to-day health care throughout local and global communities.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"4-5"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468780","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":"Rapid Ultrasonography for Shock and Hypotension Protocol Performed using Handheld Ultrasound Devices by Paramedics in a Moving Ambulance: Evaluation of Image Accuracy and Time in Motion-RETRACTION.","authors":"Burcu Azapoglu Kaymak, Merve Eksioglu","doi":"10.1017/S1049023X25000147","DOIUrl":"https://doi.org/10.1017/S1049023X25000147","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"40 1","pages":"59"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701357","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":"Health Needs of Ukrainian Refugees Displaced in Moldova: A Report from an Italian Emergency Medical Team.","authors":"Emanuela Parotto, Valentina Isidoris, Anna Cavestro, Andrea Atzori","doi":"10.1017/S1049023X25000160","DOIUrl":"10.1017/S1049023X25000160","url":null,"abstract":"<p><strong>Introduction: </strong>The escalation of the armed Ukrainian conflict forced millions of refugees to cross borders into neighboring countries, such as Poland, Czech Republic, Republic of Moldova, and Romania. The objective of this manuscript is to report the mission of an Italian Emergency Medical Team (EMT), named CUAMM EMT, deployed to assist Ukrainian refugees sheltered in the Republic of Moldova.</p><p><strong>Observations: </strong>A total of 1,173 patients were admitted to the CUAMM EMT during the period of observation covered in this report (June - December 2022). The majority of patients (88.7%; n = 1,040) had health problems not directly related to the conflicts, while only 3.2% (n = 38) of patients presented diseases directly related to the event. With reference to the World Health Organization (WHO) Minimum Data Set (MDS), the most prevalent diagnosis (66.8%; n = 783) referred to \"other diseases, not specified above\" (Code 29). Among this group, the majority of diagnosis were attributable to non-communicable diseases (NCDs) such as cardiovascular diseases (23.4%; n = 177), gastrointestinal diseases (7.4%; n = 56), chronic musculoskeletal diseases (6.1%; n = 46), and cancer (4.7%; n = 36).</p><p><strong>Analysis: </strong>The most prevalent diagnoses faced by CUAMM EMT during its deployment referred to health problems not directly related to the conflict. Among them, the majority of cases registered were attributable to NCDs, raising interesting points of discussion concerning the management of these conditions during EMTs disaster deployment.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"37-42"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658352","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}