Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"Characteristics and outcomes of out-of-hospital cardiac arrest due to drowning - a nationwide registry-based study.","authors":"Christoph Hüser, Christine Eimer, Jan Wnent, Sadrija Cukoski, Matthias Johannes Hackl, Victor Suárez, Jan-Thorsten Gräsner, Stephan Seewald","doi":"10.1186/s13049-025-01469-1","DOIUrl":"10.1186/s13049-025-01469-1","url":null,"abstract":"<p><strong>Aim of the study: </strong>To describe and compare cases of resuscitation after out-of-hospital cardiac arrest (OHCA) attributed to drowning (D-OHCA) versus other causes (ND-OHCA).</p><p><strong>Methods: </strong>Retrospective, descriptive and comparative analysis of D-OHCA vs. ND-OHCA patients registered in the German Resuscitation Registry from January 2013 to December 2023 using Chi-square, Mann-Whitney U tests and regression analysis. Key variables included 10-year age groups, body temperature measured at the scene, prehospital factors (e.g., bystander CPR, initial rhythm), and outcomes such as survival and neurological status (CPC, mRS) at hospital discharge.</p><p><strong>Results: </strong>Of the 68,719 included patients 316 (0.5%) had D-OHCA with 50% of the cases occurring during the summer months (June, July and August). D-OHCA in comparison to ND-OHCA patients were younger (median age 50 years vs. 72.5 years, p < 0.001), had a higher rate of asystole as initial rhythm (73.1 vs. 54.9%, p < 0.001) and a lower initial body temperature (median of 31.1 °C vs. 35.8 °C, p < 0.001). While overall survival and favourable neurological outcomes did not differ significantly between groups, stratified analysis showed that D-OHCA patients aged 0-10 years had significantly higher survival rates (44.7% vs. 16.3%, p < 0.001) and favourable neurological outcomes at hospital discharge (34.0% vs. 7.6%, p < 0.001) compared to ND-OHCA patients under 11 years.</p><p><strong>Conclusion: </strong>Drowning was a rare cause of out-of-hospital cardiac arrest in this study, often occurring during summer months. Outcome in D-OHCA was generally comparable to ND-OHCA and only better in children aged up to 10 years. Lower body temperatures were associated with unfavourable outcomes in most D-OHCA cases.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"151"},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital management of accidental hypothermia: A nationwide survey among Italian helicopter emergency medical services.","authors":"Laura Leuci, Francesco Daminelli, Lorenzo Gamberini, Filippo Boroli, Simon Rauch, Giulia Roveri, Bruno Barcella, Claudia Dallari, Giovanni Sbrana, Luca Carenzo","doi":"10.1186/s13049-025-01474-4","DOIUrl":"10.1186/s13049-025-01474-4","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"156"},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High ratio of plasma to red cells in contemporary resuscitation of haemorrhagic shock after trauma: a secondary analysis of the PATCH-trauma trial.","authors":"Biswadev Mitra, Michael C Reade, Steve Bernard, Bridget Dicker, Marc Maegele, Russell L Gruen","doi":"10.1186/s13049-025-01476-2","DOIUrl":"10.1186/s13049-025-01476-2","url":null,"abstract":"<p><strong>Background: </strong>Plasma transfusion is recommended as an initial intervention in most major haemorrhage protocols for trauma resuscitation. With availability of newer blood components, therapeutic agents and investigations for coagulopathy, the marginal benefits of high ratios of plasma to red cells is uncertain. The aim of this study was to report the association of high ratios of plasma: red cells and 28-day mortality in patients with major trauma.</p><p><strong>Methods: </strong>The PATCH-Trauma trial enrolled critically bleeding patients at high risk of trauma induced coagulopathy and randomised them to receive prehospital tranexamic acid or placebo. The sub-group of patients who were managed with massive transfusions in hospital (> 4 units of red cells in first 4 h) were included for this post-hoc analysis. Associations of high ratios of plasma (more than 1 unit of plasma for every 2 units of red cells) and 28-day mortality were reported using multivariable logistic regression analysis after adjustment for potential confounders including age, neurological injury, injury severity, coagulopathy and administration of platelets, fibrinogen concentrates, cryoprecipitate and tranexamic acid.</p><p><strong>Results: </strong>Among 1310 patients enrolled in the PATCH-trauma trial, 372 patients were included for this analysis; 213 (57.3%) received high ratios of plasma: red cells and 116 (31.4%) deaths were recorded at 28 days. High ratios of plasma: red cells were associated with lower mortality (adjusted odds ratio; aOR 0.50; 95%CI: 0.26-0.96). Older age (aOR 1.02; 95%CI: 1.01-1.03), initial Glasgow Coma Scale 3-8 (aOR 6.57; 95%CI: 2.92-14.80) and trauma induced coagulopathy (aOR 5.64; 95%CI: 2.87-11.1) on hospital arrival were associated with higher mortality.</p><p><strong>Conclusions: </strong>Among patients with critical bleeding managed with massive transfusions, high ratios of plasma: red cells were associated with lower mortality, after controlling for potential confounders. Ongoing provision of early plasma for management of critical bleeding is indicated with consideration to prehospital plasma.</p><p><strong>Registration: </strong>ClinicalTrials.gov number, NCT02187120 (Registered 09 July 2014).</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"154"},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital analgesia for trauma-related pain by paramedics: a comparative retrospective observational study of paracetamol, nalbuphine plus paracetamol, and piritramide.","authors":"Jonas Lohmann, Martin Deicke, Marvin Deslandes, Julia Johanna Grannemann, Lydia Johnson Kolaparambil Varghese, Jochen Hinkelbein, Annika Hoyer, Matthias Kalmbach, Thomas Plappert, Bernd Strickmann, Mathini Vaseekaran, Tobias Vollmer, Gerrit Jansen","doi":"10.1186/s13049-025-01470-8","DOIUrl":"10.1186/s13049-025-01470-8","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"152"},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous vital sign monitoring for predicting hospital length of stay: a feasibility study in chronic obstructive pulmonary disease and chronic heart failure patients.","authors":"Ivan Juez-Garcia, Iván D Benítez, Gerard Torres, Jessica González, Laia Utrillo, Anna Pérez, Natalia Varvará, Irene Cuadrat, Ferran Barbé, Jordi de Batlle","doi":"10.1186/s13049-025-01458-4","DOIUrl":"10.1186/s13049-025-01458-4","url":null,"abstract":"<p><strong>Background: </strong>Vital signs monitoring provides clinicians with real-time information regarding patients' current medical condition. We hypothesize that applying comprehensive analytical methods to underutilized, routinely collected vital signs data can yield valuable insights to support clinical decision-making. In this study, we present a novel approach for vital signs time series analysis applied to hospitalization length of stay (LOS) prediction in chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients.</p><p><strong>Methods: </strong>Heart rate (HR), respiratory rate (RR) and peripheral oxygen saturation (SpO₂) were continuously monitored during the first 24 h of hospital admission in COPD and CHF patients admitted to general, non-ICU hospital wards. The resulting time series were submitted to a comprehensive analysis through a highly comparative, massive feature extraction. We identified key patterns associated with hospitalization length of stay (LOS). Finally, we developed a predictive model for hospitalization LOS combining predictive features from the three vital signs time series.</p><p><strong>Results: </strong>A total of 101 patients were enrolled in the study, 74 of whom were eligible for analysis (39 COPD and 35 CHF patients). Periodicity and self-correlation in HR and RR time series were associated to hospitalization LOS. In SpO₂ time series, short-term fluctuations and local dynamics were associated to hospitalization LOS. The predictive model for hospitalization LOS was built using nineteen predictive features and achieved an area under the curve (AUC) of 0.975, an accuracy of 0.944, a sensitivity of 0.979, and a specificity of 0.900 in 10-fold cross-validation.</p><p><strong>Conclusion: </strong>Through a comprehensive feature-based analysis, we identified key patterns in HR, RR, and SpO₂ time series associated with hospitalization LOS in COPD and CHF patients and a compact set of features that can accurately predict LOS in COPD and CHF patients using only routinely collected data from the first 24 h of admission.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"150"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning model to predict mortality in patients with skin and soft tissue infection in emergency department.","authors":"Yu-Wei Chen, Kai-Hsiang Wu, Po-Han Wu, Cheng-Ting Hsiao, Chiao-Hsuan Hsieh, Wen-Chih Fann, Leng-Chieh Lin, Chia-Peng Chang","doi":"10.1186/s13049-025-01463-7","DOIUrl":"10.1186/s13049-025-01463-7","url":null,"abstract":"<p><strong>Background: </strong>Accurately predicting mortality in patients with skin and soft-tissue infections (SSTIs) remains challenging. Machine learning models offer rapid processing, algorithmic impartiality, and strong predictive accuracy, which may improve early risk stratification in the emergency department (ED).</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data from 1,294 ED patients diagnosed with SSTIs between March 2015 and December 2020. Five machine learning algorithms-logistic regression (LR), k-nearest neighbours (KNN), support vector machine (SVM), random forest (RF), and Extreme Gradient Boosting (XGBoost)-were developed using 20 candidate variables, with model performance evaluated in independent runs. A simplified XGBoost model using only the six most influential predictors was also derived for bedside application.</p><p><strong>Results: </strong>Among the five models, XGBoost achieved the highest performance (AUC = 0.892, sensitivity = 86.9%, specificity = 93.4%). The streamlined six-variable XGBoost model further improved predictive metrics (AUC = 0.922, sensitivity = 88.5%, specificity = 95.4%), matching or slightly surpassing the full model while reducing data requirements.</p><p><strong>Conclusions: </strong>XGBoost outperformed LR, KNN, SVM, and RF in predicting SSTI mortality, offering both higher accuracy and operational efficiency. Its sequential tree-building, regularization, and robust handling of missing data enable superior discrimination in tabular clinical datasets. The simplified model, requiring only standard admission variables, provides a fast, cost-effective, and highly accurate tool for early identification of high-risk patients in the ED.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"148"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triage limitations in geriatric trauma: the need for tailored criteria.","authors":"Mücahide Samli Helvaci, Eda Tagriverdi, Adem Az","doi":"10.1186/s13049-025-01465-5","DOIUrl":"10.1186/s13049-025-01465-5","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"149"},"PeriodicalIF":3.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of specialized outpatient palliative care in emergency advance directives: fewer hospitalizations, greater alignment with patient wishes.","authors":"Yann-Nicolas Batzler, Jannis Wetzlar, Dirk Wildner, Manuela Schallenburger, Theresa Tenge, Marc Stefaniak, Miguel Angel Méndez Delgado, Jacqueline Schwartz, Lennert Böhm, Michael Bernhard, Martin Neukirchen","doi":"10.1186/s13049-025-01468-2","DOIUrl":"10.1186/s13049-025-01468-2","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"147"},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation of gastrointestinal bleeding in patients with antithrombotic therapy, results from a consecutive retrospective cohort.","authors":"Aipi Forsberg-Puckett, Gabriele Wurm Johansson, Sara Regnér","doi":"10.1186/s13049-025-01431-1","DOIUrl":"10.1186/s13049-025-01431-1","url":null,"abstract":"<p><strong>Background: </strong>Antithrombotic treatment might affect bleeding symptoms, identification of bleeding source and treatment for patients with acute gastrointestinal bleeding. This study aims to investigate possible differences in initial bleeding symptoms, identified bleeding site and treatment of patients with or without antithrombotic medication admitted for gastrointestinal bleeding.</p><p><strong>Methods: </strong>All consecutive adult patients primarily admitted for gastrointestinal bleeding at Skane University Hospital between 2018-01-01 and 2019-06-31, were included in this study. Data was retrospectively extracted from medical files. Patients were stratified according to antithrombotic therapy (antiplatelet or oral anticoagulants) on admittance or not. Groups were compared using Fisher's exact test, Mann Whitney U-test, Kruskal-Wallis test and logistic regression analysis, including interaction models.</p><p><strong>Results: </strong>585 patients were included. Median age was 75 years and a majority (58%) were male. In total, 269 (46%) patients had no antithrombotic medication and 316 (54%) had some kind of antithrombotic medication. Patients with antithrombotic therapy had a higher age and Charlson comorbidity index than those without antithrombotic therapy. However, comparing patients with anticoagulants, antiplatelet medication and no antithrombotics, hemoglobin at arrival (median (interquartile range (IQR)) 99(75-130), 103(85-125) and 100(80-128) respectively, p = 0.851) and Shock index (0.65 (0.50-0.83), 0.67(0.53-0.81) and 0.66 (0.57-0.80) respectively, p = 0.529) did not differ between the groups. Patients with antithrombotic therapy more often presented with hematochezia alone (35.3% and 32.2% for anticoagulant and antiplatelet medications, respectively, 23% for those with no antithrombotics p = 0.017) and less frequently with hematemesis compared to patients with no antithrombotic therapy (14.7% and 24.6%, respectively, 33.1% in those with no antithrombotics, p < 0.001). Predicted probabilities of receiving endoscopic treatment, need for transfusion, and number of units transfused did not differ between groups.</p><p><strong>Conclusions: </strong>Patients with anticoagulant therapy more often present with a lower source of Gastrointestinal (GI) bleeding than both those on antiplatelet medications and those with no antithrombotics. However, the presentation of bleeding is similar regardless of any antithrombotic medication or not.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT05195697), 19/01/2022.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"146"},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing prehospital invasive arterial blood pressure monitoring in critically ill patients-a prospective observational first year analysis.","authors":"Jakob Ule, Tobias Hüppe, Julian Thiel, Ulrich Berwanger, Thomas Schlechtriemen, David Conrad, Benedikt Merscher","doi":"10.1186/s13049-025-01461-9","DOIUrl":"10.1186/s13049-025-01461-9","url":null,"abstract":"<p><strong>Background: </strong>Exposure to hypotension is linked to increased morbidity and mortality. Invasive blood pressure (IBP) measurement might be superior to non-invasive blood pressure measurement in detecting hypotension. The feasibility of IBP in prehospital care for selected patients by specialized rescue teams has been demonstrated. Therefore, we tested the hypothesis that the implementation of prehospital IBP measurement is feasible in a German emergency system by emergency teams with limited exposure to critically ill patients.</p><p><strong>Methods: </strong>This single center study was conducted with two emergency physicians vehicles. Indications for IBP measurement were adults requiring airway management, catecholamine therapy or fluid resuscitation. IBP was performed using either direct or Seldinger technique. Physicians recorded the puncture attempts, cannulation sites, and techniques. Patients with IBP attempt were visited the first three days to report complications. Emergency physicians documented a reason if they decided not to perform IBP. Data were analyzed to find operational differences between IBP attempts and no IBP attempts and IBP success and failure. Multiple linear regression was used to measure the influence of prehospital IBP attempts on the on-scene time.</p><p><strong>Results: </strong>During the study period, 3887 emergency responses occurred, with 2.8% (n = 108) meeting IBP criteria. Reasons for an IBP were catecholamine therapy (74%), airway management (73%) and fluid resuscitation (51%). 68 (63%) of the patients meeting IBP criteria received an IBP attempt with a success rate of 88%. While difficult extrication (p = 0.002) and longer transportation time (p = 0.009) were associated with a high IBP attempt rate, IBP attempts in nursing homes were less often performed (p = 0.002). Most common reason for not performing IBP was a transport priority and poor puncturing condition. Multiple regression analysis showed IBP attempts prolonged the on-scene time by 7.4 min (p = 0.013).</p><p><strong>Conclusions: </strong>Prehospital IBP can be performed safely even by teams with limited exposure to critically ill patients, with low failure and complication rates across a wide range of indications. Based on these data, IBP measurement prolonged the on-scene time by 7.5 min. Even though exposure to critically ill patients is rare, teams should consider performing an IBP if indicated.</p><p><strong>Trial registration: </strong>Study was a part of the PHINIABP (PreHospital Invasive vs. Non-Invasive Blood Pressure) study and was registered with German Clinical Trials (ID DRKS00030477) and approved by the regional ethics committee (Ärztekammer Saarland, Saarbrücken, Germany, Identification Number 158/22, September 13, 2022). Written informed consent was obtained from patients or their legal representatives.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"145"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}