African Journal of Emergency Medicine最新文献

{"title":"Pelvic sheet binders: Are doctors placing them in the correct position?","authors":"Marcus William Kruger ,&nbsp;Jana du Plessis ,&nbsp;Pravani Moodley","doi":"10.1016/j.afjem.2024.12.001","DOIUrl":"10.1016/j.afjem.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Unstable pelvic fractures cause significant bleeding, morbidity, and mortality. Commercially available Pelvic Circumferential Compression Devices (PCCDs) are used in the initial resuscitation and management of these cases. In the trauma-burdened, resource limited setting of Southern Africa, the available alternative is a pelvic sheet binder (PSB). For optimal results placement should be at the greater trochanters (GTs). Prior studies have shown that practitioners are inaccurate in their placement. This study aimed to describe placement of PSBs by doctors and factors influencing placement.</div></div><div><h3>Methods</h3><div>This was a multicentre, prospective, observational, simulation-based study. Doctors working in Emergency Departments (EDs) and Trauma Emergency Units (TEUs) in Johannesburg were asked to place a PSB on two healthy male models of differing body mass index (BMI), as simulated patients (SPs). Outcomes were based on PSB position relative to the GTs, marked using an ultraviolet pen, and photographed under ultraviolet light. Data on techniques of placement, as well as practitioner factors, were also collected to investigate their influence on accuracy.</div></div><div><h3>Results</h3><div>In this study 147/176 (83.5 %) of the PSBs placed were correct (trochanteric). Of those placed on the normal BMI SP 71/88 (81 %) were correct and 76/88 (86 %) of those on the increased BMI SP. BMI did not appear to influence accuracy of placement. Practitioner factors that had statistically significant association with accurate placement included the following: Working in the TEU, work experience of ≥6 years, a diploma in primary emergency care (DipPEC, College of emergency medicine, South Africa), all methods of placing the PSB and inspecting to find the GTs.</div></div><div><h3>Conclusion</h3><div>The overall accuracy of PSBs placement was high (83.5 %). Additional postgraduate training (DipPEC) and work experience improved placement accuracy. This study highlighted the importance of additional trauma training and areas of possible future research, such as optimal binder width and method of securing PSBs.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 512-517"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985120","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":"Editorial—AfJEM Dec 2024","authors":"Peter Hodkinson (Editor in Chief, African Journal of Emergency Medicine (AfJEM))","doi":"10.1016/j.afjem.2024.12.002","DOIUrl":"10.1016/j.afjem.2024.12.002","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 518-519"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985115","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":"Triage implementation audit at the adult emergency department of Debre Tabor Comprehensive Specialized Hospital in Ethiopia","authors":"Belayneh Dessie Kassa ,&nbsp;Mebratu Libanos ,&nbsp;Kumlachew Geta ,&nbsp;Natnael Moges","doi":"10.1016/j.afjem.2024.10.001","DOIUrl":"10.1016/j.afjem.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>In an emergency room, triage is a crucial element that determines the clinical urgency of patients. Triage can dictate important decisions on the use of resources and the treatment that patients need. Many patients are seen later than necessary, wasting resources and time, and some may even be discharged without being seen, risking their lives. This study aimed to determine whether the triage tool was fully completed, properly measured, and documented, the triage early warning score (TEWS) was calculated, and whether patients were examined, distributed, and managed in appropriate areas.</div></div><div><h3>Methods</h3><div>An institution-based cross-sectional study with a retrospective chart review was conducted at Debre Tabor Comprehensive Specialized Hospital by selecting patients’ charts using simple random sampling among patients who visited the adult Emergency Department from January 1, 2021, to December 31, 2023. The descriptive statistics were presented to characterize individual variables, and cross-tabulation was used to see the relationship between individual patient-related factors and their final triage status.</div></div><div><h3>Results</h3><div>From the randomly selected 345 patients’ charts, 67 (19.4 %) didn't contain a triage sheet. The total triage early warning score was correctly calculated for only 21 (7.6 %) patients and properly triaged. Most of the patients were improperly triaged (92.4 %, <em>n</em> = 257), of which 253 (91 %) were under-triaged and four (1.4 %) were over-triaged. Fischer's exact test revealed a statistically significant relationship between patients’ color-coding category, triage early warning score documentation, and the use of clinical discriminators and final triage assessment (p = 0.007, p = 0.000, and p = 0.000 respectively).</div></div><div><h3>Conclusion</h3><div>The status of our triage implementation is alarming and specifically the level of under-triage. There is a significant gap regarding the application of clinical discriminators and TEWS calculations.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 506-511"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886428","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":"Exploring trauma surgeons' views on trauma care in Nigeria: A qualitative study","authors":"Oluwafunmilayo Akinlade ,&nbsp;Adebisi Adeyeye ,&nbsp;Brandon L. Ellsworth ,&nbsp;Christopher W. Reynolds ,&nbsp;Chiamaka Eneh ,&nbsp;Ayobami Olufadeji","doi":"10.1016/j.afjem.2024.03.001","DOIUrl":"10.1016/j.afjem.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><div>In Nigeria, trauma care faces challenges due to high injury and death rates from road traffic accidents and violence. Improvements are underway, but gaps in service availability, training, and coordination persist, necessitating evidence-based interventions.</div></div><div><h3>Purpose</h3><div>To evaluate trauma care practices in Nigeria, focusing on practitioners' perceptions of training, resources, and care quality to inform policy and practice enhancements.</div></div><div><h3>Methods</h3><div>An exploratory qualitative study was conducted with seven trauma surgeons across Nigeria, using semi-structured interviews and an Interpretive Description analysis approach, adhering to SRQR standards.</div></div><div><h3>Results</h3><div>Analysis of interviews with seven Nigerian trauma surgeons highlighted a trauma care system burdened by high incidences of traffic-related injuries. Despite varying caseloads—from 20 cases per month to 65 weekly—common challenges included delayed care, leading to complications like infection and misaligned wound healing. Surgeons noted strengths in motivated staff and sub-specialization but stressed barriers such as underdeveloped prehospital care, financial constraints, and resource shortages, which hindered effective trauma management and outcomes.</div></div><div><h3>Conclusions</h3><div>Effective trauma care in Nigeria is crucial and achievable through policy reforms, better resource distribution, and enhanced training. Systematic data collection and a national trauma care protocol are recommended to improve patient outcomes and guide future research and policymaking.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 520-526"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706841","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":"Barriers to accessing appendectomy in the public sector health system in the Western Cape Province, South Africa","authors":"Johnelize Louw ,&nbsp;Kathryn M. Chu ,&nbsp;Peter S. Nyasulu ,&nbsp;Réne English","doi":"10.1016/j.afjem.2024.10.221","DOIUrl":"10.1016/j.afjem.2024.10.221","url":null,"abstract":"<div><h3>Background</h3><div>Appendectomy is the surgical treatment for acute appendicitis and barriers to timely care can lead to morbidity and mortality. In South Africa, patients experience delays during the stages of seeking, reaching, and receiving care. This study explored the perceptions and experiences of barriers to accessing appendectomy among patients, caregivers, and surgeons employed at selected public hospitals in the Western Cape, South Africa.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted through semi-structured in-depth interviews. Study sites comprised four public hospitals. The interviews were audio recorded, transcribed, and translated verbatim. Excerpts in the qualitative data were systematically categorised and themes were generated using inductive thematic analysis according to Braun and Clarke's methodology.</div></div><div><h3>Findings</h3><div>The following themes were generated from the analysis 1) barriers related to late presentation to a healthcare facility and 2) barriers related to healthcare facility delays. Identified barriers were perceptions of appendicitis-like symptoms, the influence of beliefs, customs and culture on healthcare-seeking behaviour, personal and social positions and values, lack of knowledge of the health system, transport accessibility and affordability, delayed ambulance response time, and proximity of healthcare facilities. Key barriers experienced after presentation to a healthcare facility related to inter-facility transfers, surgical capacity, and the diagnostic and management capabilities of facilities.</div></div><div><h3>Conclusion</h3><div>Participants in the study experienced, and perceived similar delays to accessing appendectomy to that reported in other African countries. Improved health literacy in communities could lead to timely healthcare-seeking behaviour for appendicitis and other emergency conditions. Efforts are needed to ensure access to affordable and available transport options, and healthcare facilities need to be better equipped to diagnose and treat appendicitis. This can be achieved through upskilling and augmenting human and other resources, which will require the support of the government and other relevant stakeholders.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 499-505"},"PeriodicalIF":1.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656375","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":"Abstracts from African Conference of Emergency Care 2024. Gaborone, Botswana November 2024","authors":"","doi":"10.1016/j.afjem.2024.10.002","DOIUrl":"10.1016/j.afjem.2024.10.002","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 277-498"},"PeriodicalIF":1.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656376","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":"Impact of COVID-19 pandemic on the utilization of emergency medical services in Nairobi, Kenya","authors":"Maurine Mumo Mutua ,&nbsp;Benjamin Wachira ,&nbsp;Nancy Chege ,&nbsp;Sammy Simiyu ,&nbsp;Moses Masika","doi":"10.1016/j.afjem.2024.10.220","DOIUrl":"10.1016/j.afjem.2024.10.220","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency medical services (EMS) are vital for providing immediate medical or trauma care to patients and stabilizing them for transportation to hospitals. Following the confirmation of the first case of coronavirus disease 2019 (COVID-19) in Kenya on March 13th, 2020, the government announced several measures to curb its spread, including movement restrictions and the use of ambulance services for confirmed or suspected COVID-19 patients. This study aimed to determine the utilization of EMS in Kenya the year before and one year into the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>This retrospective study collected data on all calls received from two dispatch centers in Nairobi City County from March 2019 to February 2021, encompassing the period both before and during the COVID-19 pandemic. Data collected was analyzed based on the number of calls, sex, call timing and call type.</div></div><div><h3>Results</h3><div>The two dispatch centers received 3,477 calls during the study period. The total number of calls made during the first year of the pandemic was 1,376, compared to 2,014 the year before, a decrease of 31.7%. The proportion of trauma-related calls increased from 15% (293/2014) to 22% (303/1376) while the proportion of nighttime calls increased from 20% (410/2014) to 35% (479/1376) during the pandemic.</div></div><div><h3>Conclusion</h3><div>EMS utilization decreased during the pandemic, and trauma calls increased. While most calls were made during the day, there was a notable increase in calls made during night shifts.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 273-276"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573067","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":"The impact of the COVID-19 pandemic on presentations with suicidal behaviour in a tertiary hospital Emergency Centre in the Eastern Cape, South Africa–A cross-sectional analysis","authors":"Johnré Retief Els ,&nbsp;Luan Taljaard ,&nbsp;Clint Hendrikse","doi":"10.1016/j.afjem.2024.08.005","DOIUrl":"10.1016/j.afjem.2024.08.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Suicidal behaviour is a public health emergency, causing an estimated one million deaths globally each year. The impact of the COVID-19 pandemic on suicidal behaviour is not fully understood. This study aimed to describe the impact of the COVID-19 pandemic on presentations with suicidal behaviour at a tertiary hospital in the Eastern Cape, South Africa.</p></div><div><h3>Method</h3><p>This study was a retrospective cross-sectional analysis of patients with fatal and nonfatal suicidal behaviour who presented to Frere Hospital Emergency Centre in the Eastern Cape, South Africa. The analysis included three study periods: August to October 2019 (pre-COVID-19), August to October 2020 (wave 1), and August to October 2021(wave 3).</p></div><div><h3>Results</h3><p>A total of 16 419 patients presented to the Frere Hospital Emergency Centre during the study period, with 6 204 in 2019, 4 909 in 2020, and 5 306 in 2021. These correspond to the research periods from August to October for each successive year. The overall prevalence of suicidal behaviour was 1.6 % but decreased marginally during the pandemic (1.8 % in 2019 vs. 1.4 % in 2021) – contrary to what occurred in high-income countries. The prevalence demonstrated a clinically insignificant stepwise decline as the pandemic progressed and was inversely associated with the number of daily new COVID-19 cases nationally. A significant increase in the emergency centre's total length of stay was however observed during the COVID-19 period (143 vs. 80 min, <em>p</em> &lt; 0.001). The high proportion (66 %) of patients with suicidal behaviour requiring admissions increased further during the COVID-19 study period, placing an additional burden on inpatient disciplines. The proportion of social worker consultations increased significantly during the COVID-19 period (65% vs. 44 %, <em>p</em>&lt;.05).</p></div><div><h3>Conclusion</h3><p>The COVID-19 pandemic marginally reduced the prevalence of presentations with suicidal behaviour to the Emergency Centre, contrary to what was observed in high-income countries.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 268-272"},"PeriodicalIF":1.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X2400034X/pdfft?md5=1b1fe98a16db754170fb404a560b8393&pid=1-s2.0-S2211419X2400034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270731","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":"From vocational to graduation: A mixed methods study of support needs for vocational learners pursuing post-graduate education in South Africa","authors":"Debbi Groome ,&nbsp;Charmaine Cunningham","doi":"10.1016/j.afjem.2024.08.008","DOIUrl":"10.1016/j.afjem.2024.08.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Vocational learning has been critical in shaping South Africa's workforce, especially for paramedicine. The introduction of the National Qualification Framework (NQF) in 1995 phased out previous short course learning systems and redesigned qualifications within the framework. While recognition of prior learning is well advocated in the NQF, the predominant focus is undergraduate studies. The leap from vocational to Higher Education can be significant, especially for non-seasoned learners, and additional support may be required to ensure a successful transition. This study describes the support needs of vocational paramedics transitioning to post-graduate education.</p></div><div><h3>Methods</h3><p>The study used a two-phase sequential design to achieve the aims. The first phase was conducted in 2021 and involved an analysis of grades followed by semi-structured interviews to obtain qualitative insights. The second phase, conducted in 2022, focused exclusively on collecting quantitative data to validate and expand upon the initial findings from phase one.</p></div><div><h3>Results</h3><p>Analysis of the academic results over two years between Recognition of Prior Learning (RPL) and non-RPL candidates showed a difference of 4 % in the aggregated mark. This indicates that the RPL candidates have the academic acumen to succeed in a post-graduate diploma education program. Interview analysis revealed the support requirements were not academic but rather technological and institutional, with navigation of the university's learning management system being a common challenge. Hesitancy to access formal support services was noted as a university barrier.</p></div><div><h3>Conclusion</h3><p>This study highlights the academic ability of students from vocational backgrounds to succeed in post-graduate programs. These learners demonstrated strong academic performance despite entering higher education through a non-traditional pathway. Whilst advocating for consideration and refinement of the role of RPL within the NQF, this research suggests a re-evaluation of current support systems for vocational learners transitioning to post-graduate studies.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 263-267"},"PeriodicalIF":1.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X24000375/pdfft?md5=b71e68c05425b4b6ad69fa372f77c950&pid=1-s2.0-S2211419X24000375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172808","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":"Improving pain management for trauma patients at two Rwandan emergency departments","authors":"Jean Pierre Hagenimana ,&nbsp;Paulin Ruhato Banguti ,&nbsp;Rebecca Lynn Churchill Anderson ,&nbsp;Jean de Dieu Tuyishime ,&nbsp;Gaston Nyirigira ,&nbsp;Eugene Tuyishime","doi":"10.1016/j.afjem.2024.08.009","DOIUrl":"10.1016/j.afjem.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><p>Little is known regarding the effectiveness of pain protocols and guideline use in Emergency Departments (ED) in Sub-Saharan Africa. Therefore, to shed light on this research gap, this study had the following objectives: 1) to evaluate if the implementation of the Essential Pain Management (EPM) course combined with mentorship to use the World Health Organization (WHO) pain ladder-based protocol improves the quality of pain management among trauma patients at the ED of two teaching hospitals in Rwanda; and 2) to determine barriers to implementing the WHO pain ladder-based protocol among trauma patients in the same settings.</p></div><div><h3>Methods</h3><p>This was a pre- and post-intervention study. The intervention was 1-day essential pain management training for ED clinical staff followed by 1 week mentorship on the use of the WHO pain ladder-based protocol.</p></div><div><h3>Results</h3><p>We enrolled 261 patients (47.5% pre versus 52.5% post intervention), most of them were aged between 21 and 40 (60% pre versus 33% post intervention), and male (76% pre versus 73% post intervention). The quality of pain management at the ED improved as shown by the decrease of the number of patients with undocumented pain scores from 58% to 24% after the intervention (p-value &gt; 0.001) and the increase of the number of patients with mild pain from 37% to 62% (p-value &gt; 0.001). In addition, patients who were satisfied with the quality of pain management increased significantly from 42% before the intervention to 80% (p-value &gt; 0.001). Barriers to the implementation of the WHO pain ladder-based protocol were identified related to staff (i.e. inadequate experience), to the hospital (i.e. poor documentation), and to patients (i.e. reluctance to report pain).</p></div><div><h3>Conclusion</h3><p>The implementation of the EPM course along with mentorship to use the WHO pain ladder-based protocol significantly improved the quality of pain management for trauma patients in EDs of both referral hospitals. Despite this, some barriers remain unfixed such as inadequate staff experience, poor documentation, and patient's reluctance to report pain. Appropriate interventions should be implemented to address the identified barriers and ensure adequate pain management for patients admitted at EDs in public hospitals in Rwanda.</p></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"14 4","pages":"Pages 258-262"},"PeriodicalIF":1.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211419X24000387/pdfft?md5=602c8e513a76185e9c5f0722f5ace2d0&pid=1-s2.0-S2211419X24000387-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166773","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}