Journal of Emergency Nursing最新文献

{"title":"Shorter Emergency Department Boarding Times in Hospitals With Better Nurse Staffing.","authors":"K Jane Muir, Karen B Lasater, Kathy Sliwinski, Benjamin C Sun, Alexander T Janke, Matthew D McHugh, Linda H Aiken, Daniela Golinelli","doi":"10.1016/j.jen.2026.06.011","DOIUrl":"10.1016/j.jen.2026.06.011","url":null,"abstract":"<p><strong>Introduction: </strong>Boarding occurs when a patient is admitted to the hospital but remains in the emergency department until an inpatient bed is available. No previous evidence establishes a relationship between hospital nurse staffing and emergency department boarding times. This study fills this gap.</p><p><strong>Methods: </strong>This was a cross-sectional study of 335 hospitals in Florida, New Jersey, and Pennsylvania. Using staffing data from 1367 medical-surgical nurses in the RN4CAST-US 2016 survey, hospitals were categorized as having worse (≥5:1) than better (<5:1) patient-to-nurse staffing ratios. The American Hospital Association provided data on hospital characteristics. Hospital emergency department patient boarding times were derived from the Centers for Medicare and Medicaid Services Compare timely and effective care files. Hospital-level linear regression models using a doubly robust propensity score weighting approach were used to evaluate the relationship between nurse staffing and boarding times.</p><p><strong>Results: </strong>Most study hospitals had worse (n = 286) than better (n = 49) patient-to-nurse staffing ratios. Mean boarding times were longer in the worse-staffed hospitals than the better-staffed hospitals (128 vs 108 minutes; P = .01). These findings persisted in the propensity score weighted models (127 vs 108 minutes; P = .03) and the doubly robust models (128 vs 108 minutes; P = .009).</p><p><strong>Discussion: </strong>This study establishes a baseline understanding of the relationship between hospital nurse staffing levels and patient boarding times, providing a foundation for evaluating changes over time. Safe nurse staffing levels are a modifiable lever to reduce emergency department crowding through decreasing patient boarding times.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622446","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":"Not All Acute Neck Swellings Are Hematomas: A Cervical Cyst Rupture After Minor Trauma.","authors":"Mehmet Yorgun, Mahmut Şahin","doi":"10.1016/j.jen.2026.06.014","DOIUrl":"https://doi.org/10.1016/j.jen.2026.06.014","url":null,"abstract":"<p><strong>Background: </strong>Acute lateral neck swelling is an uncommon but potentially high-risk presentation in the emergency department. When symptoms occur after minor trauma, cervical hematoma is often presumed. However, rupture of a preexisting cervical cyst may closely mimic hematoma in both clinical presentation and imaging, creating a potential diagnostic pitfall and increasing the risk of misinterpretation in the emergency setting.</p><p><strong>Case presentation: </strong>A previously healthy 15-year-old male presented to the emergency department with acute right-sided neck swelling, pain, and restricted neck motion approximately 14 hours after a sudden neck-turning movement. Initial assessment revealed normal vital signs and laboratory findings. Bedside ultrasonography demonstrated a well-defined cystic lesion with dense internal content. Contrast-enhanced computed tomography revealed a solitary hypodense cervical cystic lesion extending from the right supraclavicular region into the right cervical compartment, without enhancing solid components or surrounding inflammatory change, consistent with acute cyst rupture. Bedside needle aspiration performed in the emergency department yielded approximately 50 mL of homogeneous, straw-colored, nonhemorrhagic fluid, resulting in rapid clinical improvement. The patient was discharged after a period of observation with close outpatient follow-up and experienced an uneventful recovery.</p><p><strong>Discussion: </strong>This case highlights an important diagnostic consideration in which acute neck swelling after minor trauma may represent rupture of a cervical cyst rather than traumatic hematoma. Continuous nursing assessment and effective physician-nurse collaboration are essential for airway monitoring, procedural support, safe patient disposition, and discharge education in uncommon but potentially high-risk emergency presentations.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Carotid Massage Versus Ice Bag Maneuver by Trained Nurses for Children With Paroxysmal Supraventricular Tachycardia: A Randomized Controlled Trial.","authors":"Doaa El Amrousy, Amany Shwitah, Rahma Soliman Bahgat, Nagwa Ramadan Esmail Magor","doi":"10.1016/j.jen.2026.06.013","DOIUrl":"https://doi.org/10.1016/j.jen.2026.06.013","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the efficacy of carotid sinus massage vs ice bag maneuvers by trained nurses in terminating paroxysmal supraventricular tachycardia in children in the emergency department.</p><p><strong>Methods: </strong>This randomized clinical trial included 120 children with hemodynamically stable paroxysmal supraventricular tachycardia who were recruited from the pediatric emergency department. The studied children were randomly divided into 2 equal groups: group I received carotid sinus massage maneuver, and group II received ice bag maneuver. Both maneuvers were applied by trained nurses, and success was defined as return to sinus rhythm within 5 minutes of applying the maneuver.</p><p><strong>Results: </strong>A total of 26 children (43.3%) of the carotid sinus massage group returned to normal sinus rhythm, while only 14 children (23.3%) of the ice bag group returned to sinus rhythm within the first 5 minutes. The need for antiarrhythmic drugs as well as the duration of hospital stay were significantly lower in the carotid sinus massage group compared with the ice bag group. Side effects were minor with no significant difference between the 2 groups. Regression analysis revealed that older age, longer time since onset of paroxysmal supraventricular tachycardia, atrioventricular reentrant tachycardia, ice bag maneuver, history of previous cardiac diseases, and increased numbers of vagal maneuver attempts were strong independent predictors.</p><p><strong>Discussion: </strong>The carotid sinus massage maneuver was significantly more effective than the ice bag maneuver in terminating paroxysmal supraventricular tachycardia and decreasing the need for antiarrhythmic drugs and duration of hospital stay. Training nurses for such simple vagal maneuvers can help decrease the need for antiarrhythmic drugs, especially in limited-resource countries.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473882","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":"Human Bite Injury to a Nurse in the Emergency Department: A Case Report.","authors":"Pooja Jangid, Mohan Kumar Hanumanthappa, Ashish Behera, Saurabh Chandrabhan Sharda","doi":"10.1016/j.jen.2026.06.004","DOIUrl":"https://doi.org/10.1016/j.jen.2026.06.004","url":null,"abstract":"<p><strong>Introduction: </strong>Human bite injuries are an important occupational hazard in emergency departments. Our case highlights the management of human bite injuries, which may be exposed to polymicrobial infection and blood-borne pathogens.</p><p><strong>Case presentation: </strong>A 25-year-old emergency nurse sustained a human bite that penetrated the glove while inserting a nasogastric tube in a 38-year-old agitated patient with hepatic encephalopathy. Examination showed a superficial laceration on the dorsal aspect of the right fifth finger with erythema, swelling, and serosanguinous drainage, and contusion on the palmar surface. Neurovascular status and range of motion were normal.</p><p><strong>Management and outcomes: </strong>The nurse received immediate wound irrigation, tetanus prophylaxis, and a 5-day course of oral antibiotic agents. Baseline laboratory tests were normal, and protective hepatitis B antibody levels were confirmed. No postexposure prophylaxis was required. The wound healed without complications at 7-day follow-up.</p><p><strong>Conclusion: </strong>Human bite injuries pose significant clinical and occupational risks. Prompt wound care, infection prophylaxis, and timely reporting improve outcomes. This case highlights the importance of safety protocols, de-escalation strategies, and institutional preparedness for occupational exposures.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431026","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":"Diagnostic Accuracy of Nurse-Led ED Triage Using the Modified All India Institute of Medical Sciences Triage Protocol: A Cross-Sectional Study in a Tertiary-Care Center in India.","authors":"Roshan Mathew, Naman Agrawal, Kavin Duraisamy, Aniket Patel, Prakash Sabani, B Murali Krishna, Debendra K Tripathy","doi":"10.1016/j.jen.2026.06.002","DOIUrl":"https://doi.org/10.1016/j.jen.2026.06.002","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency departments in low- and middle-income settings face rising patient volumes, overcrowding, and constrained medical resources, making accurate early triage essential to prioritize lifesaving care while avoiding unnecessary use of resuscitation capacity. Although the 3-tier color-coded All India Institute of Medical Sciences triage protocol (red/yellow/green) has shown strong prognostic validity when applied by physicians, evidence on its real-world diagnostic accuracy when implemented by nurses in Indian tertiary-care centers remains limited.</p><p><strong>Methods: </strong>This retrospective cross-sectional study evaluated nurse-led triage using a modified All India Institute of Medical Sciences triage protocol in the Department of Emergency Medicine at All India Institute of Medical Sciences, Raipur (annual census, ∼54,000), including adult trauma and nontrauma presentations from June to August 2025. Using systematic random sampling (every fifth patient), 2584 records were analyzed after excluding brought-dead cases and records with incomplete documentation (n = 89) or missing outcomes (n = 43). Nurse-assigned triage served as the index test and was compared with a blinded expert physician reference standard (2 independent emergency physicians with adjudication by a senior reviewer; interrater quadratic-weighted kappa = 0.61).</p><p><strong>Results: </strong>Nurses achieved 85.3% exact agreement (95% CI, 83.9-86.5) with good overall agreement (quadratic-weighted kappa = 0.78); most discordances were 1-step (14.3%) and severe mismatches were rare (0.4%). Undertriage (12%) substantially exceeded overtriage (3%). For identifying red cases (expert red, n = 751), the sensitivity was 0.79 and the specificity was 0.97, yielding 92% accuracy for red vs not red; 21.8% of true red patients were undertriaged (1.5% to green). Mortality increased with higher acuity, with no deaths among green by either rater; mistriage was not significantly associated with discharge mortality (relative risk, 0.52; 95% CI, 0.22-1.23; P = .113). In multivariable analysis, trauma (odds ratio, 4.41; P < .001) and alert presentation (odds ratio, 1.92; P < .01) independently predicted incorrect triage.</p><p><strong>Discussion: </strong>Nurse-led modified All India Institute of Medical Sciences triage protocol demonstrated high reliability and specificity but a clinically important undertriage tendency, particularly in trauma and alert patients, supporting targeted training on injury kinematics and mitigation of ambulatory bias, alongside system aids (eg, checklists/electronic prompts) to improve safety.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426189","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":"Implementing a Phlebotomy Training Program to Decrease Troponin Hemolysis Rates in an Emergency Department.","authors":"Mariolina Bartolomeo, Gladyris Conception, Marly Sam, Vepuka Kauari, Kasey Jackman, Carol Anne Celona","doi":"10.1016/j.jen.2026.04.029","DOIUrl":"https://doi.org/10.1016/j.jen.2026.04.029","url":null,"abstract":"<p><strong>Introduction: </strong>Hemolyzed troponin samples may delay diagnosis and treatment for patients presenting with a cardiac complaint. This project focused on decreasing hemolysis rates of troponin samples collected in the emergency department and increasing troponin sample collection by emergency room technicians in an urban academic medical center. This project aimed to evaluate the hemolysis rate of troponin samples collected by registered nurses and emergency room technicians working in the emergency department after completing a phlebotomy training program on best practices in blood specimen collection.</p><p><strong>Methods: </strong>A quality improvement design was used to assess troponin hemolysis rates during the 12 weeks before and after the project implementation. Staff knowledge of factors that lead to hemolyzed blood specimens was assessed using a pre- and post-test. Educational in-service was provided to both emergency department technicians and registered nurses, and data analysis was performed to compare pre- and postproject implementation troponin hemolysis rates.</p><p><strong>Results: </strong>Overall departmental troponin hemolysis rates declined from 7.2% to 3.4%. Samples collected by emergency room technicians after the intervention had a 56% reduction, whereas samples collected by registered nurses had a 52% reduction in blood specimen hemolysis. Our analysis demonstrated a significant reduction in hemolysis among specimens drawn by registered nurses (P<.001). In contrast, emergency room technicians did not significantly reduce the number of hemolyzed specimens (P = .33); however, their involvement did result in a doubling of the total number of specimens drawn by emergency room technicians, which increased from 41 to 91 total samples collected.</p><p><strong>Discussion: </strong>Findings from this project support the use of a phlebotomy training program to educate staff on best practices in blood collection, which may contribute to a lower incidence of hemolyzed blood specimens. The findings also support the use of emergency room technicians in collecting troponin blood specimens within the ED setting.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426180","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":"Prognostic Role of Presepsin, Proadrenomedullin, and Interleukin-6 in Sepsis.","authors":"Seyit Ali Karagöz, Yonca Senem Akdeniz, Dildar Konukoğlu, Sevil Kuşku Kıyak, Serap Biberoğlu, Afşın İpekci, Fatih Çakmak, Alp Batuhan Öztürk, İbrahim İkizceli, Seda Özkan","doi":"10.1016/j.jen.2026.06.001","DOIUrl":"https://doi.org/10.1016/j.jen.2026.06.001","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the predictive value of serum presepsin, proadrenomedullin, and interleukin-6 levels for prognosis and mortality in patients diagnosed as having sepsis in the emergency department.</p><p><strong>Methods: </strong>This prospective observational cohort study was conducted with patients diagnosed as having sepsis in the emergency department of a tertiary university hospital. The study analyzed the patients' demographic characteristics, comorbidities, source of sepsis, biomarker levels, treatments, microbial culture results, and 30-day mortality. Blood samples were collected upon the patients' admission to the emergency department.</p><p><strong>Results: </strong>Patients with septic shock had significantly higher serum interleukin-6 levels (363.2 pg/mL) than those with sepsis (140.6 pg/mL; P = .003). In contrast, proadrenomedullin levels were significantly lower in patients with septic shock (0.27 pmol/mL) than those with sepsis (0.48 pmol/mL; P = .02). Although presepsin levels were higher in the septic shock group (178.3 ng/L vs 156.9 ng/L), this difference was not statistically significant (P = .81). However, in multivariable analysis, none of the biomarkers remained independent predictors after adjustment for clinical confounders. Interleukin-6 levels were also significantly higher in nonsurvivors than survivors (363.2 pg/mL vs 195.5 pg/mL; P = .046). In receiver operating characteristic analysis, interleukin-6 (area under the curve, 0.701), proadrenomedullin (area under the curve, 0.658), and procalcitonin (area under the curve, 0.625) demonstrated moderate predictive ability for septic shock.</p><p><strong>Discussion: </strong>Interleukin-6, presepsin, and proadrenomedullin may provide supportive diagnostic and prognostic information in patients with sepsis and septic shock in the emergency department. However, none of these biomarkers remained independent prognostic predictors after adjustment for clinical confounders. Further studies are needed to better clarify their clinical utility and prognostic role.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Nurse Staffing and Outcomes for Patients and Nurses: A Scoping Review.","authors":"Yuta Imamura, Hideaki Sakuramoto, Akira Ouchi, Tomoharu Honda, Shogo Uno, Mitsuhiro Tamoto","doi":"10.1016/j.jen.2026.05.015","DOIUrl":"https://doi.org/10.1016/j.jen.2026.05.015","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department crowding compromises patient safety and quality of care. Nurse staffing is a key determinant of patient flow, treatment timeliness, and clinical outcomes. This review mapped and synthesized evidence on the relationship between emergency nurse staffing and outcomes for both patients and emergency nurses.</p><p><strong>Methods: </strong>A scoping review was conducted using the Arksey and O'Malley framework and Joanna Briggs Institute methodology, reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. MEDLINE, CINAHL, CENTRAL, Scopus, and Igaku Chuo Zasshi were searched from inception to February 25, 2025, without publication-year restriction. Eligible studies reported nurse staffing in emergency departments and patient- or nurse-related outcomes.</p><p><strong>Results: </strong>The authors retrieved 1965 studies, and 41 met eligibility criteria after full-text screening. Forty-1 studies, primarily observational and conducted in the United States, were included. Nurse-to-patient ratios varied considerably, ranging from 1:1 in resuscitation areas to 1:20 in general emergency departments. Overall, 32 of 41 studies (78%) reported positive associations between higher staffing and favorable outcomes, including shorter length of stay, reduced waiting times, fewer patients leaving without being seen, fewer errors, and lower mortality. Nurse-related outcomes such as burnout and turnover were examined in a few studies, suggesting potential benefits of adequate staffing.</p><p><strong>Discussion: </strong>This scoping review found that adequate nurse staffing in emergency departments was consistently associated with improved patient safety and quality of care. However, the predominance of observational designs and heterogeneity in staffing measures limit comparability across studies. Future research should adopt standardized staffing indicators and systematically include nurse-related outcomes to strengthen the evidence base for international policy and practice.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388434","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":"Author Response to Letter Regarding: “Survival and Neurologic Performance at 30 days and Beyond Following Out-of-Hospital Cardiac arrest comparing standard Cardiopulmonary Resuscitation Versus Chest Compression-Only Resuscitation by Bystanders: A Systematic Review and Meta-Analysis”","authors":"José Alberto Martínez-Hortelano PhD,&nbsp;Juan Manuel López-Reina Roldán PhD,&nbsp;Diana Patricia Pozuelo-Carrascosa PhD,&nbsp;Pablo Blasco-Benito MSc,&nbsp;Gema Martínez-Díaz MSc,&nbsp;Iván Ortega-Deballon PhD","doi":"10.1016/j.jen.2026.03.001","DOIUrl":"10.1016/j.jen.2026.03.001","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 4","pages":"Pages 847-849"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical and Ethical Importance of Research at the Bedside","authors":"Lisa Wolf PhD, RN, CEN, FAEN, FAAN","doi":"10.1016/j.jen.2026.04.027","DOIUrl":"10.1016/j.jen.2026.04.027","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"52 4","pages":"Pages 837-838"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370813","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}