Prehospital and Disaster Medicine最新文献

{"title":"From Single Impact Sites to Dispersed Corridors: A Disaster Report of Emergency Medical Services Command Adaptation to Cluster-Munition Pattern Missile Strikes in Israel.","authors":"Oren Wacht, Eli Jaffe, Noam Jaffe","doi":"10.1017/S1049023X26109182","DOIUrl":"https://doi.org/10.1017/S1049023X26109182","url":null,"abstract":"<p><p>This Disaster Report describes a series of missile impact events managed by Magen David Adom (MDA), Israel's national Emergency Medical Services (EMS) organization, during the March 2026 missile campaign. The report focuses on a recurring operational distinction between compact single-warhead impact events and dispersed cluster-munition pattern events. Unlike routine mass-casualty incident recognition, MDA dispatch did not need to infer the possibility of a dispersed event only from accumulating emergency calls. While missiles are in flight, the Home Front Command (HFC) broadcasts real-time threat alerts through multiple public channels: the official HFC app, direct cell broadcasts to all phones in the threatened area, and live overlays on all television channels. Command and dispatch personnel from MDA used this publicly available information as an early threat layer at or before the initial dispatch phase. Emergency calls, motorcycle first-responder reports, volunteer responder reports, and ambulance crew updates then refined the actual medical footprint. Across six events, cluster-munition pattern events involved four-to-six municipalities and maximum geographic spread of 6.9km to 11.5km, whereas single-warhead events remained within one municipality and had maximum geographic spread of less than 400 meters. The events suggest that dispersed missile attacks require EMS command to combine prehospital warning-system visibility with a distributed responder network that functions as a forward sensor layer for dispatch and command.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e33"},"PeriodicalIF":4.1,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231162","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":"Evaluating Classifier Derivation and Validation Beyond the Receiver Operating Characteristic Curve.","authors":"Jeffrey Michael Franc, Samuel J Stratton","doi":"10.1017/S1049023X26109170","DOIUrl":"https://doi.org/10.1017/S1049023X26109170","url":null,"abstract":"<p><p>The area under the receiver operating characteristic curve (AUROC) summarizes a classifier's discrimination across all possible thresholds, but it does not establish calibration, clinical utility, or performance at the threshold used in practice. This editorial explains the interpretation and limitations of AUROC using a hypothetical genomic enzyme test for susceptibility to symptomatic COVID-19. It emphasizes that threshold selection must be justified according to the intended use, outcome prevalence, and consequences of false-positive and false-negative results. Threshold derivation and validation should be treated as separate processes, and performance should be evaluated in independent or appropriately internally validated data. Reporting should generally include sensitivity and specificity with 95% confidence intervals and the complete confusion matrix, from a validation dataset. AUROC P-values should receive limited emphasis; effect magnitude, precision, and decision-relevant performance are more informative.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e32"},"PeriodicalIF":4.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220646","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 Drone-Integrated Artificial Intelligence-Based System for Mass-Casualty Triage and Remote Monitoring.","authors":"İsmail Tayfur, Perihan Şımşek, Mert Bal, Emine Cansu Akgül, Arda Üstübıoğlu, Burcu Bayramoğlu, Abdülkadir Gunduz","doi":"10.1017/S1049023X26109121","DOIUrl":"https://doi.org/10.1017/S1049023X26109121","url":null,"abstract":"<p><strong>Objective: </strong>Triage and data transfer are critical to the medical management of mass-casualty incidents (MCIs). However, the chaotic nature of such events makes it difficult to classify casualties according to structured triage protocols. Furthermore, even when triage is implemented effectively, communication disruptions between the incident scene and dispatch centers can hinder response operations. The aim of this study was to present a drone-integrated system that enables non-contact vital sign measurement, remote triage, and real-time data transmission during MCIs.</p><p><strong>Methods: </strong>The system development process involved three steps: (1) developing the Vital-Sign Measurement Module; (2) developing the Triage Decision Support Module; and (3) developing the User Interfaces and Data Transmission Module to enable information transmission between dispatch centers and response teams. Within the Vital-Sign Measurement Module, heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂), and body temperature (BT) measurement algorithms were developed using the following techniques, respectively: video-based photoplethysmography (vPPG), analysis of thermal temperature fluctuations around the nose, a regression-based neural network approach, and heat maps and thermal thresholding. A pilot study was conducted under controlled indoor conditions to evaluate the accuracy of these algorithms.</p><p><strong>Results: </strong>The system can measure vital signs by processing drone-captured images, can provide triage decision support, and can transmit victims' locations, vital signs, and triage categories to response teams and dispatch centers via dedicated user interfaces. A pilot evaluation of the Vital-Sign Measurement Module showed that the relative accuracy rate of the non-contact vital-sign measurement algorithms ranged from 86% to 99%.</p><p><strong>Conclusions: </strong>The system provides an innovative approach to improving medical response management in MCIs by enabling remote triage and monitoring. Its non-contact vital sign measurement, triage decision support, and near real-time data transmission capabilities provide an infrastructure that can contribute to faster response and improved operational coordination. However, further field trials and development are required to improve the robustness of the vital-sign measurement algorithms to motion, to improve their adaptability to changing environmental conditions, and to maintain high accuracy despite individual differences.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e30"},"PeriodicalIF":4.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220626","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":"Circadian and Seasonal Patterns of Recorded Emergency Medical Service Workload by Diagnostic Category: A Two-Year Retrospective Analysis with Forecasting from Türkiye.","authors":"Sefer Ozkaya, Mehmet Serkan Yurdakul","doi":"10.1017/S1049023X26109133","DOIUrl":"https://doi.org/10.1017/S1049023X26109133","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency Medical Services (EMS) demand varies across circadian, weekly, and seasonal timescales. This study is among the first such integrated analyses in the Turkish 112 EMS context.</p><p><strong>Study objective: </strong>The primary objective of this study was to characterize circadian patterns in overall EMS case-record volume and across seven clinical groups, as well as hourly, weekly, and seasonal variation in diagnostic composition across eight categories. Secondary objectives were to estimate adjusted temporal associations and evaluate frozen transfer of aggregate daily forecasts from 2024 to the immediately subsequent 2025 holdout.</p><p><strong>Methods: </strong>This retrospective study analyzed 60,811 routinely collected EMS case-record rows from Karaman Province, Türkiye over 731 days in 2024-2025. Interaction, cosinor, and negative binomial (NB) models characterized temporal patterns; aggregate daily case-record volume was forecast using weekly Fourier terms with autoregressive integrated moving average (ARIMA) errors trained on 2024 and frozen for 2025. The data represented provincial case-record workload, an operational proxy for population demand rather than a census of all inbound calls or unique patients.</p><p><strong>Results: </strong>Case-record volume peaked at 21:00 and was lowest at 06:00; adjusted volume at 21:00 was 3.53-times that at 06:00 (95% CI, 3.28-3.81). Hourly diagnostic composition differed modestly (Cramér V = 0.061). Rhythmicity was detected in all seven clinical groups (all joint-test P values < 0.001), but low full-cell R² values indicated substantial unexplained hour-date variation; acrophases ranged from 14:41 to 19:14 and relative amplitudes from 28.6% (Respiratory) to 67.9% (Trauma). Standardized Trauma share was higher in summer than winter (25.7% versus 18.1%), whereas Respiratory share was higher in winter than summer (9.7% versus 3.6%). Adjusted volume was higher on Monday than Saturday and higher in August than November (IRRs 1.11 and 1.23, respectively). In the frozen 2025 holdout, the selected model achieved mean absolute scaled error (MASE) = 0.722 and 95% prediction-interval coverage of 96.2%.</p><p><strong>Conclusion: </strong>Clinical-group rhythms and seasonal composition differences were observed. The frozen evaluation quantified aggregate daily forecast transfer only from 2024 to the immediately subsequent 2025 within one provincial series. Findings support local monitoring of recorded evening workload and seasonal diagnostic composition, particularly the higher Trauma share in summer and the higher Respiratory share in winter.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e31"},"PeriodicalIF":4.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196121","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":"Disaster Report: Military Helicopter Crash in a Deployed Environment - Providers' and Patient's Perspectives.","authors":"Jason Wilfred David, Rachel Bridwell, Steven Zesati, Shawn Cecil, Joshua Lowe, Jason Auchincloss, Max Sirkin, Andrew Schaffrinna","doi":"10.1017/S1049023X26109145","DOIUrl":"https://doi.org/10.1017/S1049023X26109145","url":null,"abstract":"<p><p>The crash of a military helicopter during a 2023 United States Army deployment produced a mass-casualty incident (MASCAL) in an austere setting. One of the casualties was an Emergency Medicine (EM) physician who oversaw point-of-injury (POI) triage and early casualty evacuation with a Special Operations Forces (SOF) medic to the nearest Role II Military Treatment Facility (MTF), followed by movement of the six most severely injured patients to Role III, and subsequent transfer to Landstuhl Regional Medical Center (LRMC) via Critical Care Air Transport Team (CCATT). This disaster report explores the EM physician's actions as the initial provider, another EM physician as a receiving provider for a multi-leg fixed-wing transport, and a practicing trauma surgeon's unique perspective as one of the significantly injured patients. The viewpoints in this report highlight operational decisions including dispersion of medical assets, dynamic triage, destination/platform selection, and significant stressors of flight. Disaster care pathways should anticipate aeromedical stressors, emphasize patient positioning and communication, and align evacuation decisions with changing resources and injury patterns. These lessons are directly relevant to prehospital/disaster systems operating in contested, austere, or resource-limited environments.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e29"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171594","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":"Flood Response in Rural Indonesia Implementing the World Health Organization Emergency Medical Team Minimum Data Set - Disaster Report.","authors":"Aurick Yudha Nagara, Holipah Holipah, Sri Andarini, Hikmawan Wahyu Sulistomo","doi":"10.1017/S1049023X26109078","DOIUrl":"10.1017/S1049023X26109078","url":null,"abstract":"<p><p>Indonesia experiences recurrent natural disasters that impose substantial strain on its health system, with annual flooding affecting rural communities such as Sitiarjo Sumbermanjing Wetan. Despite these recurring events, Indonesia has not systematically adopted the World Health Organization (WHO) Emergency Medical Team (EMT) Minimum Data Set (MDS) for standardized disaster medical reporting, thereby limiting data integration and evidence-based policy development. This disaster report describes the operational patterns, clinical demographics, and syndromic distribution captured by the WHO EMT MDS framework across three distinct flood responses in 2017, 2022, and 2023. The Universitas Brawijaya Emergency Medical Team (UB-EMT) prospectively collected daily surveillance data using the WHO EMT MDS reporting system. A total of 363 consultations were analyzed and stratified according to age, sex, and reporting period. Consultation volume peaked on Day 1 and declined on subsequent days. Females accounted for 62% of the cases and adults (18-64 years old) represented the majority of patients (68.87%). The most frequently reported conditions were skin diseases (33.46%), musculoskeletal problems (24.39%), and acute respiratory infections (16.64%), respectively. Age-specific patterns were evident: preschoolers and school-aged children presented with acute respiratory infections, whereas adults and older people more commonly experienced skin diseases and musculoskeletal problems. The absence of systematic implementation of the WHO EMT MDS constrains standardized surveillance and inter-team coordination in disaster settings. Therefore, the institutional adoption of the WHO EMT MDS is essential to strengthen real-time monitoring, optimize resource allocation, and enhance post-disaster evaluation in Indonesia.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e28"},"PeriodicalIF":4.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137962","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":"Quantitative Triage and Cumulative Risk in Neonatal Intensive Care Unit Evacuation: A Simulation Study Using Real-World Clinical Data.","authors":"Kazunori Imai, Chunxi Xu, Shoya Oikawa, Yuko Araki, Shinji Saitoh, Osuke Iwata","doi":"10.1017/S1049023X26109157","DOIUrl":"10.1017/S1049023X26109157","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal intensive care unit (NICU) evacuation poses distinct operational and ethical challenges because neonates often depend on continuous life-sustaining technologies and specialized care. Although several neonatal or pediatric disaster triage systems have been proposed, actual NICU evacuation cannot be ethically or practically tested under controlled disaster conditions. A reproducible framework comparing evacuation-order strategies is therefore needed.</p><p><strong>Study objective: </strong>This study aimed to develop and apply a reproducible simulation framework for NICU evacuation-order evaluation and, within that framework, to compare structured triage with evacuation without triage and quantitative with categorical neonatal triage approaches.</p><p><strong>Methods: </strong>A retrospective simulation study was conducted using routinely recorded clinical triage assessments from a tertiary NICU, comprising 1,079 patient evaluations in 162 neonates across 49 triage days. During clinical practice, clinical severity and triage status had been recorded using the Neonatal Therapeutic Intervention Scoring System (NTISS), Neonatal Extrication Triage (NEXT), and Simple Triage and Rapid Treatment for Neonates, Revised (START-Neo-R); NEXT was a quantitative six-domain resource-dependency score ranging from zero to 12, whereas START-Neo-R was a five-level categorical neonatal triage system. Three evacuation strategies were evaluated: descending-order evacuation using NEXT, descending-order evacuation using START-Neo-R, and evacuation without triage. Evacuation-order performance was quantified using the Total Evacuation Score (TES), defined as the time integral of cumulative NTISS scores among patients remaining in the NICU across sequential evacuation steps. The TES distributions were compared descriptively across strategies rather than inferentially.</p><p><strong>Results: </strong>Within the 49 observed triage days, both structured triage strategies generated TES distributions shifted lower than those from evacuation without triage. In the direct comparison between NEXT and START-Neo-R, the worst-case TES under NEXT was lower than more than one-half of the START-Neo-R TES distribution on 34 of the 49 observed triage days (69.4%).</p><p><strong>Conclusion: </strong>In this simulation study using real-world NICU data, TES provided a reproducible framework for comparing neonatal evacuation-order strategies under explicit assumptions. Within this TES-based framework, structured triage generated TES distributions shifted lower than those from evacuation without triage, and NEXT showed a more favorable distribution-based pattern than START-Neo-R on most observed days. These findings suggest that TES-based evaluation may help identify triage strategies that support more transparent and testable NICU evacuation planning.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e27"},"PeriodicalIF":4.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114163","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":"Multi-Country Human-to-Human Andes Virus Outbreak on a Cruise Ship: A Disaster Report on Prehospital, Health Care Facility, and Public Health System Challenges - Essential Knowledge for Frontline Clinicians.","authors":"Aileen M Marty, Christian K Beÿ, Kristi L Koenig","doi":"10.1017/S1049023X26109108","DOIUrl":"10.1017/S1049023X26109108","url":null,"abstract":"<p><p>The Andes Virus (ANDV) outbreak reported on May 2, 2026, aboard a luxury vessel departing from Ushuaia, Patagonia, Argentina, was caused by an <i>Orthohantavirus</i> unique in its person-to-person transmissibility in contrast to zoonotic transmission characteristic of better-known hantaviruses. Containment required coordinated international management because passengers and crew embarked and disembarked at several international ports-of-call prior to outbreak recognition, resulting in cross-border transmission potential. Among those who disembarked, several traveled on flights to various destinations. Cases subsequently manifested in multiple countries, including Tristan da Cunha, Spain, France, Switzerland, South Africa, Canada, and The Netherlands. Upon notification, international health authorities implemented containment measures, such as contact tracing, quarantine, and isolation. Uniquely, ANDV poses distinctive risks due to its immediately prodromal presymptomatic transmission potential, initial non-specific flu-like symptoms, prolonged incubation period, conceivable long-term neurologic and endocrinologic sequalae, high case fatality rates (CFRs), and possibility of international dissemination. This report describes the successful management of a multi-national outbreak associated with cruise-ship travel, a setting with unique challenges. It also examines implications and challenges for prehospital, health care facility, and public health systems for future ANDV outbreaks. The event was characterized by delayed recognition, international spread, and complex coordination across multiple jurisdictions and sectors, including medical and public health authorities, policy- and decision-makers, crisis and emergency risk-communication experts, media, logistics, transportation, and security. Rapid implementation of public health measures coupled with clinician implementation of the Identify-Isolate-Inform (3I) model, a clinical framework to detect and prevent the spread of infectious disease, at the prehospital and health care facility levels are critical actions that can contain future ANDV outbreaks.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e25"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114170","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":"Multi-Victim Assault with a Penetrating Weapon and an Alkaline Agent: Disaster Report.","authors":"Youichi Yanagawa, Hiroki Nagasawa, Hiromichi Ohsaka, Kazuhiko Omori, Seigo Yamada, Mutsumi Sakurada","doi":"10.1017/S1049023X26109054","DOIUrl":"10.1017/S1049023X26109054","url":null,"abstract":"<p><p>At a factory in eastern Shizuoka Prefecture, Japan, a man clad in protective gear and wielding a spear-like knife attached to a pole attacked employees at a plant with a blade while spraying alkaline chlorine bleach from a backpack. This resulted in eight cases of torso stab wounds and seven cases of alkaline damage to the cornea, skin, and pharynx. Eight patients were transported to one hospital, the nearest emergency center equipped to handle critical cases, while the other seven were transported to another hospital. Of the eight patients transported to the first hospital, six received blood transfusions for hemorrhagic shock. Four patients required endotracheal intubation, two underwent emergency surgery, two underwent emergency interventional radiology (IVR) procedures, and two had chest drains placed. All patients survived and were discharged.This paper introduces the basic concept for managing mass casualties in eastern Shizuoka Prefecture with limited medical resources during localized disasters. It outlines the overall situation of a mass-casualty incident involving puncture wounds and alkaline corneal and skin injuries, and it discusses evaluation and issues.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e24"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114152","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":"Marvin L. Birnbaum, MD, PhD.","authors":"Samuel J Stratton","doi":"10.1017/S1049023X26109091","DOIUrl":"10.1017/S1049023X26109091","url":null,"abstract":"<p><p>Marvin L. Birnbaum, MD, PhD passed away in May 2026. He was a pioneer and leader in both Emergency Medical Services (EMS) and Disaster Medicine. He was dedicated to developing EMS and Disaster Medicine as professions and academic disciplines. Dr. Birnbaum was Editor-in-Chief of Prehospital and Disaster Medicine (PDM) for 23 years and served terms as the World Association for Disaster and Emergency Medicine (WADEM) President and was a member of the WADEM Board of Directors for 35 Years. This editorial is a tribute to Dr. Birnbaum.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"41 1","pages":"e26"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081912","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}