African Journal of Emergency Medicine最新文献

{"title":"Examining the burden of unintentional injuries in Ghana: A systematic review and meta-analysis","authors":"Daniel Gyaase ,&nbsp;Deepti Beri ,&nbsp;Stacie Powell ,&nbsp;Nipuna Cooray ,&nbsp;Margie Peden ,&nbsp;Julie Brown ,&nbsp;Jagnoor Jagnoor","doi":"10.1016/j.afjem.2025.100907","DOIUrl":"10.1016/j.afjem.2025.100907","url":null,"abstract":"<div><h3>Background</h3><div>In Ghana, there is a lack of comprehensive and empirical data on injuries. In the absence of robust national datasets, systematic reviews serve as a critical tool for understanding existing evidence. Our study synthesises the available literature to estimate the pooled prevalence and mortality associated with unintentional injuries in Ghana.</div></div><div><h3>Method</h3><div>We searched and identified studies that reported on the burden (prevalence, mortality, economic and disabilities) of commonly reported unintentional injuries (road traffic injuries, falls, burns, drowning and poisoning) in Ghana. Studies were identified from PubMed, EMBASE, Global Health, and Scopus from 2000 to 2023.</div></div><div><h3>Result</h3><div>A total of 46 studies were included in the review. The prevalence and mortality of unintentional injuries were high, with a pooled estimate of 18 % (95 % CI: 11 % – 26 %) and 15 % (9 % CI: 10 % – 21 %), respectively. Road traffic injury (RTI) was found to be a major contributor to the high prevalence and mortality. Our review found limited data on the economic burden and disabilities from unintentional injuries. Despite the lack of complete data, the cost of treating unintentional injuries appears to be significantly high. The annual cost of treating RTIs was US$6730,862.89, falls were US$1645,736.50, and burns were US$464,937.11.</div></div><div><h3>Conclusion</h3><div>Our review found a high prevalence, mortality, and likely economic burden of unintentional injuries in Ghana. Prioritising road safety could significantly reduce the burden of unintentional injuries in Ghana. Due to the limited studies on the economic burden and disability from unintentional injuries, more research is needed to drive insurance policies and rehabilitation practices.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100907"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096469","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":"Magnitude and associated factors of discharge against medical advice among patients treated in the adult Emergency Department at an Ethiopian University Hospital","authors":"Getachew Worku ,&nbsp;Demelash Ataro","doi":"10.1016/j.afjem.2025.100918","DOIUrl":"10.1016/j.afjem.2025.100918","url":null,"abstract":"<div><h3>Background</h3><div>Discharge against medical advice (DAMA) is a global phenomenon in which patients voluntarily terminate their consent to medical care before the medical team declares them fit for discharge. This adversely affects the delivery of quality health care and poses serious clinical, ethical, and legal challenges to the individual physician and the hospital. This study aims to assess the magnitude and factors associated with DAMA.</div></div><div><h3>Methods</h3><div>An institution-based cross-sectional study was conducted at the adult emergency department of Hawassa University Comprehensive Specialized Hospital, Ethiopia. A systematic random sampling technique was used to select 322 patients. The data were collected using a pretested, structured checklist through chart review. Descriptive statistics, including proportions, medians, tables, and charts, were used to describe the characteristics of the study participants. Binary logistic regression analysis was used to identify factors associated with DAMA. The model's fitness was checked by the Hosmer and Lemeshow tests. The significance level was declared at a p-value &lt; 0.05.</div></div><div><h3>Results</h3><div>This study found that the magnitude of DAMA was 7.45 % (24 out of 322); 95 % CI: 4.56–10.3 %) The majority of patients with DAMA 1041.7 %) were due to a financial issue, followed by the refusal of procedure 5, 20.8 %) and poor prognosis 4, 16.7 %). Being male [AOR: 4.1; 95 % CI: 1.17–14.11] and triage levels of Red and Orange [AOR: 2.87; 95 % CI: 1.02- 8.02] were associated with DAMA.</div></div><div><h3>Conclusion</h3><div>The study identified a considerable magnitude of DAMA. Being male and the severity of the triage score were found to be independent determinants of DAMA. The majority of patients had permanently left the hospital due to financial constraints. Therefore, strengthening health insurance and ensuring the availability of the necessary resources at government health facilities could help reduce DAMA.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100918"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519757","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":"Factors contributing to extended length of stay in the emergency department and potential strategies for improving patient flow in a central hospital in the Gauteng Province, South Africa","authors":"L. Motimele ,&nbsp;V. Lalloo ,&nbsp;T. Sefala ,&nbsp;A. Engelbrecht ,&nbsp;L. Majake-Mogoba ,&nbsp;D. Basu","doi":"10.1016/j.afjem.2025.100896","DOIUrl":"10.1016/j.afjem.2025.100896","url":null,"abstract":"<div><h3>Background</h3><div>Length of stay (LOS) is an integral part of inpatient care in hospitals, particularly in Emergency Departments (EDs). It is an essential performance indicator for the National Indicator Data Set in South Africa. Multiple studies have indicated a correlation between an increased LOS and worse patient outcomes in a variety of acute medical conditions. The study aims to establish the key factors of LOS in the ED at a central hospital in the Gauteng Province of South Africa.</div></div><div><h3>Methodology</h3><div>A cross-sectional study was conducted over seventeen months (Aug 2023 to Dec 2024) based on 2927 entries of patients admitted at the ED for more than 48 hours. No intervention was done as part of this study.</div></div><div><h3>Results</h3><div>The median LOS was 2.81 days (IQR: 2-3) with a minimum of 2 days and a maximum of 12 days. A regression analysis demonstrated that the most significant determinants for prolonged LOS were gender and disease group of boarded patients awaiting ward transfer.Significant differences (p &lt; 0.001) in the LOS between clinical disciplines were noted, with medical (45%) and surgical departments (46%) accounting for most boarding patients compared to all other clinical disciplines.</div></div><div><h3>Conclusions</h3><div>Data demonstrated that 80% of patients in the ED wait an average of 3 days before transfer into the wards. This extended ALOS in the ED has consequences for patient outcomes and the quality of healthcare provided. Based on the findings of this study, strategies to improve patient flow are essential in facilitating timeous discharge from wards and to prioritise the forward flow of patients waiting in ED.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100896"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908580","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":"Critical care transfers of ventilator-dependent patients from operating theatres to Critical Care Units in a South African Metropole","authors":"Esther Cloete ,&nbsp;Jacobus J Badenhorst ,&nbsp;Anthony R Reed","doi":"10.1016/j.afjem.2025.100908","DOIUrl":"10.1016/j.afjem.2025.100908","url":null,"abstract":"<div><h3>Background</h3><div>Ventilated patients in the operating theatre who need transfer to other facilities, can contribute to delays and inefficencies in surgical and theatre resources. In 2018, an interhospital retrieval service was established to provide transfers between state hospitals in the Cape Town Metropole exclusively for intubated, post-operative patients. This study aims to describe the utilisation of the retrieval system and gain insights into retrieval patterns.</div></div><div><h3>Methods</h3><div>This retrospective observational study analysed all post-operative patients using the retrieval system between state hospitals in the Cape Town Metropole from July 2018 – December 2021, as recorded in an existing SPRINTT-OR registry.</div></div><div><h3>Results</h3><div>A total of 291 patients were included. Most patients retrieved were male (<em>n</em> = 186, 63.9 %), with a mean age of 34.95 (<em>S</em> ± 13.59). The median time interval from request to ambulance arrival was 61 min. Most patients (<em>n</em> = 184, 63.2 %) were transferred from a single Large Metro District Hospital (LMDH). Trauma surgery was the most common diagnostic category (<em>n</em> = 123, 42.3 %), followed by infective causes (<em>n</em> = 79, 27.1 %) and Obstetrics &amp; Gynaecology (<em>n</em> = 52, 17.9 %).</div></div><div><h3>Conclusion</h3><div>This study provides insight into the retrieval needs of ventilated, post-operative patients across different healthcare facilities in an African metropolitan area who are transferred with a dedicated, specialised transfer service. It describes the system's use and provides insight into patient demographics, diagnoses, and transfer timing, as well as the role of Emergency Medical Services (EMS) in optimising the functioning of a healthcare system.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100908"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096434","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":"Global Health research abstracts: August ‘25","authors":"","doi":"10.1016/j.afjem.2025.100919","DOIUrl":"10.1016/j.afjem.2025.100919","url":null,"abstract":"","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 4","pages":"Article 100919"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579054","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":"Perceived support needs of novice nurses working in emergency departments of selected public hospitals in Tshwane, South Africa","authors":"Kapari Mashao,&nbsp;Celia Filmalter,&nbsp;Tanya Heyns","doi":"10.1016/j.afjem.2025.100889","DOIUrl":"10.1016/j.afjem.2025.100889","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients present with diverse healthcare needs in emergency departments, necessitating nurses to have diverse clinical competencies to function effectively. Novice nurses in emergency departments may be ill-equipped to handle responsibilities and workload, necessitating adequate support for a smooth transition. However, providing practical support requires a comprehensive understanding of support needs.</div></div><div><h3>Methods</h3><div>This descriptive qualitative study investigated the perceived support needs of novice nurses working in emergency departments. Fifteen participants were purposively selected from three selected public hospitals in Tshwane, South Africa. Semi structured, face-to-face interviews were conducted between September and November 2023. The interviews were audio-recorded, and the transcripts were thematically analysed via ATLASti Version 24.</div></div><div><h3>Results</h3><div>Three key themes emerged to support the transition of novice nurses in emergency departments: a dedicated orientation programme, a dedicated preceptor, and a supportive culture to facilitate the transition to emergency departments. A dedicated orientation programme encompasses essential components, including emergency equipment, triage, basic life support skills, admission and treatment protocols, and specific competencies. The participants emphasised the value of dedicated preceptors, trained and experienced professionals who offer guidance, feedback and remedial support. Additionally, the importance of a supportive culture, particularly one that fosters a positive learning environment and provides emotional support to ease the transition process, was highlighted.</div></div><div><h3>Conclusion</h3><div>The successful transition of novice nurses in emergency departments is a cost-effective way of improving job satisfaction and retention. However, novice nurses working in emergency departments have diverse support needs. Thus, ensuring a successful transition requires understanding these nurses’ support needs. This study revealed that establishing a structured orientation programme, assigning trained preceptors and fostering a supportive culture are critical in facilitating the successful transition of novice nurses to emergency departments. These strategies can address novice nurses’ support needs by improving competence and patient care outcomes and promoting confidence, emotional well-being, job satisfaction and retention. Realising the support needs of novice nurses may inform the development of evidence-based transition interventions that offer support in specific ED contexts.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100889"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687301","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":"Differences in quality indicators of emergency care between on- and off-hours at Ghanaian district hospitals","authors":"Paa Forson ,&nbsp;Richard Owusu ,&nbsp;George Oduro ,&nbsp;Peter Donkor ,&nbsp;Charles Mock","doi":"10.1016/j.afjem.2025.05.004","DOIUrl":"10.1016/j.afjem.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Quality of off-hours care (nights, weekends) for many emergency conditions frequently proves inadequate. Most studies on this topic are from high-income countries. Given existing resource restrictions in low- and middle-income countries, it is especially relevant to know how care is impacted during off-hours, when resources are usually less. We assessed differences in quality indicators of emergency care between on- and off-hours at two district hospitals.</div></div><div><h3>Methods</h3><div>In this prospective cohort study conducted from June 2021 to May 2023, patients presenting to the emergency unit between 8 AM and 8 PM on weekdays were categorized as presenting during on-hours. Those presenting between 8 PM and 8 AM or anytime on weekends were considered off-hours. Completion of 16 quality indicators was compared between patients who received care during on- and off-hours.</div></div><div><h3>Results</h3><div>Data were gathered on 7831 patients: 5019 (64.1 %) presenting during on-hours and 2812 (35.9 %) during off-hours. Overall achievement of quality indicators ranged from 27.1 % (recording GCS) to 98.3 % (documentation of diagnosis). Twelve indicators were performed in &lt;80 % of patients. Four indicators were performed more often during on-hours: primary survey for trauma patients; blood glucose; documentation of diagnosis; and Glasgow Coma Scale. Three indicators were performed more often during off-hours: splinting of long-bone fractures; analgesics given to patients reporting pain; and recording of complete initial vital signs. Although there were significant differences in seven indicators, differences were small (&lt;10 %) in six.</div></div><div><h3>Conclusion</h3><div>There were limited differences in performance of quality indicators between on- and off-hours, indicating a general consistency of quality of care across daily and weekly cycles. However, most indicators were performed in &lt;80 % of patients. Monitoring of quality indicators of emergency care should be done more consistently as a way to standardise care and improve patient outcomes.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100880"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204916","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":"Characteristics and outcomes of children initiated on high flow nasal cannula and continuous positive airway pressure at the emergency centre of a district hospital in South Africa","authors":"Jessica Head ,&nbsp;Andrew Redfern ,&nbsp;Jana Hoole ,&nbsp;Liezl Ulbrich ,&nbsp;Refilwe More ,&nbsp;Daniël J. van Hoving ,&nbsp;Eric D. McCollum ,&nbsp;Shubhada Hooli","doi":"10.1016/j.afjem.2025.100884","DOIUrl":"10.1016/j.afjem.2025.100884","url":null,"abstract":"<div><h3>Introduction</h3><div>High-flow nasal cannula (HFNC) and continuous positive airway pressure delivered via a nasal interface (nCPAP) are increasingly used for paediatric emergency care in South Africa. In Cape Town, initiation of HFNC/nCPAP at a district hospital, in most instances, necessitates transfer to a paediatric high-care facility. We sought to describe the population of children initiated on HFNC/nCPAP and their short-term hospital outcomes post interfacility transfer.</div></div><div><h3>Methods</h3><div>The authors conducted a one-year retrospective observational study between August 1st 2021, to July 31st^, 2022 of children initiated on HFNC or nCPAP in the emergency centre (EC) of Khayelitsha district Hospital and transferred by ambulance to Tygerberg Hospital paediatric emergency centre. Children were excluded from the study if they were &lt;10 days or &gt;13 years of age, if they had an advanced care plan that restricted the escalation of respiratory support or if their medical records were incomplete.</div></div><div><h3>Results</h3><div>At Khayelitsha Hospital, 117 patients were initiated on HFNC (<em>n</em> = 58) or nCPAP (<em>n</em> = 59). Participants had a median age of 6.8 months. There were no major adverse events reported during inter-facility transfer. Respiratory support was weaned to low flow oxygen or room air within 24 h of transfer in 23.9 % and escalated in 9.4 %. During hospital stay 14.5 % were admitted to intensive care, 6.0 % ultimately required mechanical ventilation, and the in-hospital mortality rate was 1.7 %.</div></div><div><h3>Conclusion</h3><div>Roughly a quarter of patients were weaned from respiratory support within 24 h of transfer. Short term outcomes were good overall, demonstrating safe interfacility transfer and low mortality. Further research is needed to inform practice on best use of HFNC and nCPAP in the emergency care of children presenting with acute respiratory illness in South Africa.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100884"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297726","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":"Global Health research abstracts: May '25","authors":"Jonathan Kajjimu","doi":"10.1016/j.afjem.2025.100885","DOIUrl":"10.1016/j.afjem.2025.100885","url":null,"abstract":"<div><div>The African Journal of Emergency Medicine, in partnership with several other regional emergency medicine journals, publishes abstracts from each respective journal. Abstracts are not necessarily linked to open access papers however, all abstracts are accessible without subscription.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100885"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535044","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":"Impact of the WHO/ICRC Basic Emergency Care (BEC) course on nurses’ knowledge, confidence, and competence in Primary Health Care facilities in Gauteng, South Africa","authors":"Meghan Botes ,&nbsp;Lauren Lai King ,&nbsp;Robert Holliman ,&nbsp;Santel de Lange ,&nbsp;Simon Isabwe Tumusiime ,&nbsp;Mahlomola Kutoane ,&nbsp;Dylan Quiroga ,&nbsp;Petra Brysiewicz","doi":"10.1016/j.afjem.2025.100890","DOIUrl":"10.1016/j.afjem.2025.100890","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary health care (PHC) nurses handle preventative care and emergencies, despite the latter not being their focus. Upskilling in basic emergency care is essential as PHC facilities serve as the first point of care. The World Health Organization and International Committee of the Red Cross developed a Basic Emergency Care (BEC) course, but its suitability for Gauteng PHC nursing staff remains unknown. This study assessed the BEC course's impact on nurses' knowledge, confidence, and competence in emergency care at selected Gauteng PHC facilities.</div></div><div><h3>Methods</h3><div>A pre-post intervention design was used with purposive sampling of eighty-six nurses who completed the BEC course from three emergency departments. Data collection occurred April-June 2024. Knowledge, confidence and competence were assessed using pre- and post-course surveys and knowledge tests, plus a final evaluation with 6 open-ended questions. Data analysis included descriptive statistics, correlational analyses, and inferential methods to determine statistical significance of observed variations.</div></div><div><h3>Results</h3><div>The study included <em>N</em> = 86 nurses across various categories. Knowledge scores significantly increased from 55.1% pre-test to 78.8% post-test. Self-perceived competence and confidence improved from 2.72 to 3.54 post-course. ANOVA revealed significant relationships between nurse categories and scores in pre-tests (<em>p</em> = 0.004) and post-tests (<em>p</em> &lt; 0.001). Post-test confidence also varied significantly between categories (<em>p</em> = 0.046). Content analysis of open-ended responses identified four themes: \"Correcting wrongs\", \"Extremely congested course\", \"Contextual relevance\" and \"Skills update.\"</div></div><div><h3>Discussion</h3><div>The results highlight significant knowledge gains for all nurses who received BEC training. However, differences in performance between nurse categories suggest a need for further exploration and consideration of how to accommodate different categories of nurses. While nurses found the course highly useful and relevant, content loading and course duration should be considered.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 3","pages":"Article 100890"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680314","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}