Journal of Emergency Nursing最新文献

{"title":"Evaluating the Canadian Triage and Acuity Scale as a Predictor of Emergency Nursing Workloads in an Emergency Department Ambulatory Care Setting.","authors":"Aaron Penciner, Rachael Iseman, Hassan Sheikh, Kolan Gilmour, Scott Odorizzi","doi":"10.1016/j.jen.2025.07.007","DOIUrl":"10.1016/j.jen.2025.07.007","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency departments face unpredictable workloads owing to diverse patient presentations, often leading to crowding and increased waiting times. Current staffing models in Canadian emergency departments lack evidence-based methods to predict emergency nursing needs, potentially affecting patient safety and outcomes. Other triage systems, such as the Emergency Severity Index and Manchester Triage System, have been shown to have some predictive impact on emergency nursing workload. This study explores the relationship between patient acuity, as determined by the Canadian Emergency Department Triage and Acuity Scale, and emergency nursing workload in an ambulatory care area of an emergency department.</p><p><strong>Methods: </strong>A prospective observational time-motion study was conducted in the ambulatory care area of a tertiary care academic emergency department. Research assistants used a custom application to observe emergency nurses and track patient presentations and the time emergency nurses spent on predefined tasks related to patient care.</p><p><strong>Results: </strong>Data from 40 shifts, encompassing 557 patient encounters and 719 patient-care tasks, were analyzed. Emergency nurses spent approximately 80% of their shift on patient-care activities and 20% on breaks. Regression analysis showed no significant correlation between the Canadian Emergency Department Triage and Acuity Scale and time spent on \"Orders - Investigations\" tasks. However, there was a mild yet significant correlation between the Canadian Emergency Department Triage and Acuity Scale and \"Orders - Treatments\" tasks (r = 0.17; P = .003) and care coordination (r = 0.21; P = .005), indicating that higher-acuity patients required more emergency nursing time for treatments and care coordination.</p><p><strong>Discussion: </strong>The Canadian Emergency Department Triage and Acuity Scale triage level is a weak predictor of emergency nursing workload in an emergency department ambulatory care setting. Further research is required to fully understand the relationship between the Canadian Emergency Department Triage and Acuity Scale and emergency nursing workload in emergency department ambulatory and nonambulatory settings.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856986","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":"Exploring Differences in Blood Product Administration by Patient Age and Injury Severity.","authors":"Madison Finch, Russell Griffin, David E Vance, Allison R Jones","doi":"10.1016/j.jen.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.jen.2025.06.009","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma-related hemorrhage is the leading cause of preventable death in the United States. Current resuscitation guidelines are based largely on data from younger and middle-aged adults, while influencing practice for adults of all ages. We examined age-related differences in blood product administration among individuals predicted to receive massive transfusions for the treatment of trauma-related hemorrhage.</p><p><strong>Methods: </strong>A secondary analysis was performed using data from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial, including 640 critically injured adult patients from 12 level I trauma centers across North America. We included patients aged ≥18 years, with an injury severity score of ≥9, and who had data available for packed red blood cells transfused in the first 24 hours of hospitalization. Patients were categorized based on both injury severity score (moderate, 9-15; severe, 16-24; profound, 25+) and age (young, 18-39; middle aged, 40-59; older, 60+). Descriptive statistics were used to analyze injury severity, mechanism of injury, comorbid conditions, and preinjury medication use. A negative binomial regression was used to evaluate the relationship between the quantity of packed red blood cells administered and age and injury severity categories.</p><p><strong>Results: </strong>Patients (N = 640) were primarily male (80.5%) and white (64.5%) who experienced either blunt (51.7%) or penetrating injuries (47%). Older adults with severe injury severity score were transfused 33% fewer units of packed red blood cells than young adults with severe injury severity score (count ratio, 0.67; 95% CI, 0.47-0.96; P = .031).</p><p><strong>Discussion: </strong>Our findings support a potential difference in the quantity of blood products administered among patients based on age. Further investigation is required to better understand age-related treatment considerations for trauma-related hemorrhage.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785906","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 Influencing Patient Safety Activities Among Emergency Nurses.","authors":"WonJin Kwak, Gyuli Baek, EunJu Lee","doi":"10.1016/j.jen.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.jen.2025.06.006","url":null,"abstract":"<p><strong>Introduction: </strong>With the rise in chronic diseases and an aging population, the complexity of hospital environments has increased, leading to a higher incidence of patient safety events. Improving patient safety and minimizing safety-related issues have become essential responsibilities for emergency department health care professionals. This study, using a cross-sectional survey design, aimed to explore the factors influencing emergency nurses' patient safety nursing activities, focusing on safety control, patient safety knowledge and attitude (key components of patient safety competency), patient safety culture, and demographic and educational factors.</p><p><strong>Methods: </strong>This study analyzed data from 165 emergency nurses across 8 hospitals in South Korea, including 3 regional emergency medical centers, 3 local emergency medical centers, and 2 local emergency medical facilities. The data collection took place between February 22 and August 28, 2021.</p><p><strong>Results: </strong>Stepwise multiple regression analysis identified several key factors that influence patient safety nursing activities among emergency nurses. These factors include safety control and patient safety knowledge and attitude, both of which are components of patient safety competency. Other influential factors were receiving 11 or more sessions of patient safety-related education, maintaining a strong patient safety culture, engaging in monthly or biannual patient safety education, and being married. Together, these factors explained 69% of the variance in patient safety nursing activities.</p><p><strong>Discussion: </strong>To improve patient safety nursing activities among emergency nurses, targeted strategies should focus on enhancing safety control and patient safety knowledge. Raising awareness of patient safety is also essential. In addition, organizational-level efforts-such as policies and procedures aimed at fostering a culture of patient safety-are crucial for sustained improvement.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719109","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 Impact of Emergency Department Geriatric Nurse Practitioners on Patient Length of Stay.","authors":"Kenneth M Forte, Andriana M Foiles Sifuentes, Adam Chess, Cheryl Green, Anna Clabby","doi":"10.1016/j.jen.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.jen.2025.06.003","url":null,"abstract":"<p><strong>Introduction: </strong>Limited research exists that examines the impact of geriatric-focused nurse practitioners practicing within United States emergency departments on the reduction of inpatient admission length of stay for older patients. This represents a significant gap in the provision of care. Our study aimed to assess the efficacy of geriatric-focused nurse practitioners' integration into an emergency department setting and the subsequent effect on the length of stay of inpatient hospital admissions.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of medical records for patients aged ≥65 years from a large, private, not-for-profit, urban hospital emergency department. Data on ED encounters were collected from the year 2023 and aggregated based on patients' age, inpatient hospital admission, and whether they were assigned to a geriatric-focused nurse practitioner while in the emergency department. To investigate the differences in inpatient admission length of stay between geriatric patients assessed and treated by geriatric-focused nurse practitioners and those who were not, we needed to establish confounders that could contribute to the patient's length of stay. We conducted a causal effect identification model and identified 4 confounding variables, which were adjusted for during our analysis.</p><p><strong>Results: </strong>Findings indicated that patients receiving consultations by geriatric-focused nurse practitioners in the emergency department had a statistically significant reduction in their inpatient length of stay. The unadjusted mean admission length of stay reduced to 5.86 days from 7.28 days, with an unadjusted median reduced to 4.63 days from 4.95 days. We used a multivariable linear regression model using log-transformed length of stay adjusted for confusion assessment method score, mobility score, polypharmacy status, and triage acuity. Data showed that geriatric-focused nurse practitioners' consultations with older patients within the emergency department resulted in a 10.3% reduction in admission length of stay (95% CI, 1.95-17.93).</p><p><strong>Discussion: </strong>Geriatric-focused nurse practitioners in the emergency department led to a substantial decrease in inpatient lengths of stay.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692340","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":"TEMPORARY REMOVAL: Intentional Coingestion of RisperiDONE and Ethylene Glycol in a 35-Year-Old: A Case Review.","authors":"Robert Asselta","doi":"10.1016/j.jen.2025.06.004","DOIUrl":"10.1016/j.jen.2025.06.004","url":null,"abstract":"<p><p>The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies-and-standards/article-withdrawal.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660953","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":"Utility of Triage Nurses' Quick-Look Assessments of Adults in the Emergency Department for Predicting Hospital Admission.","authors":"Ryuji Suzuki, Toshihiko Takada, Jun Miyashita, Shunichi Fukuhara","doi":"10.1016/j.jen.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.jen.2025.06.002","url":null,"abstract":"<p><strong>Introduction: </strong>Nurses use quick-look assessments, vital signs, and interviews to predict hospital admission, but evidence for the predictive accuracy of quick-look assessments remains limited. This study aimed to evaluate the accuracy of quick-look assessments in predicting hospital admission for adult patients, compare their performance with the National Early Warning Score, and assess the added value of combining quick-look assessments and the National Early Warning Score.</p><p><strong>Methods: </strong>This prospective, single-center, observational study was conducted in the emergency department of an acute care hospital. During triage, nurses predicted admission likelihood based only on quick-look assessments, without any other data such as vital signs or history of illness, with higher quick-look assessment scores indicating greater admission likelihood. The National Early Warning Score was calculated from vital sign data. Three predictive models (quick-look assessment alone, National Early Warning Score alone, and quick-look assessment + National Early Warning Score) were developed using logistic regression modeling. Model performance was assessed using the area under the curve and calibration plots.</p><p><strong>Results: </strong>Of 1588 patients, 144 (9.1%) were admitted. Higher quick-look assessment scores were associated with admission, with odds ratios of 83.8 (95% CI, 26.6-263.8) and 145.2 (95% CI, 21.4-986.4) for quick-look assessment scores of 4 and 5, respectively. The quick-look assessment model had an area under the curve of 0.85 (95% CI, 0.81-0.88), outperforming the National Early Warning Score (area under the curve, 0.67; 95% CI, 0.62-0.73). Adding the National Early Warning Score to quick-look assessments led to minimal improvement (area under the curve, 0.87; 95% CI, 0.83-0.90). Calibration showed that quick-look assessments underestimated moderate-to-high-risk predictions.</p><p><strong>Discussion: </strong>Quick-look assessments allow nurses to make accurate predictions of hospital admissions during ED triage, outperform the National Early Warning Score, and support better patient prioritization.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660954","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":"Flail Chest as a Rare Manifestation of Single Rib Fracture: A Case Report.","authors":"Harun Yildirim, Ertan Sonmez, Murtaza Kaya","doi":"10.1016/j.jen.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.jen.2025.06.005","url":null,"abstract":"<p><strong>Introduction: </strong>Flail chest is defined by the fracture of 3 or more ribs at 2 or more sites, resulting in a segment of the chest wall that loses its mechanical integrity, creating a \"floating\" segment. It occurs in 5% to 13% of patients with chest wall injuries. A very rare form of flail chest, sternal flail, refers to the separation of the sternum from the hemithoraxes and is usually associated with multiple anterior cartilage or rib fractures. Contrary to common impression, it has more than 1 form and each varies in severity.</p><p><strong>Case presentation: </strong>A 44-year-old male patient presented to the emergency department with blunt trauma. Imaging studies revealed a third rib fracture with flail chest on the right side, along with multiple rib fractures and a pneumothorax on the left. The lungs showed bilateral contusions. The patient also sustained compression fractures of the third and fifth thoracic vertebrae, a sternal fracture, and a nondisplaced distal radius fracture on the right. The clinical team inserted a chest tube into the left hemithorax to manage the pneumothorax. The patient remained stable and did not require mechanical ventilation. Oxygen therapy was administered via nasal cannula, accompanied by the administration of normal saline and analgesic treatment. Arterial blood gas analysis demonstrated mild lactic acidosis, whereas serial hemogram assessments revealed no clinically significant decline in hemoglobin levels. The patient was subsequently admitted to the department of thoracic surgery for conservative management and close observation, with no immediate indication for surgical intervention. Clinical course remained uneventful, and the patient was discharged on the seventh day in stable condition without complications.</p><p><strong>Conclusion: </strong>Flail chest may result from a single rib fracture in combination with a sternal fracture. Patients presenting with atypical manifestations of flail chest can be discharged without complications within a short period when early diagnosis, appropriate supportive care, and timely treatment are provided.</p>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cognitive Task Analysis for Developing a Clinical Decision Support System for Emergency Triage.","authors":"Steve Agius, Caroline Magri, Vincent Cassar","doi":"10.1016/j.jen.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.jen.2025.05.013","url":null,"abstract":"<p><strong>Introduction: </strong>The Emergency Department (ED) serves as a vital gateway to acute care, where timely and accurate triage decisions are essential to ensure appropriate patient prioritisation and efficient use of limited resources. Triage nurses operate in high-pressure environments and must make rapid decisions, often under conditions of uncertainty, relying on a blend of analytical reasoning and intuitive judgement. However, this complex decision-making process is susceptible to a range of challenges, including cognitive biases, communication breakdowns, procedural inconsistencies, fatigue, and stress, all of which can compromise patient safety and care quality. This study explores the multifaceted nature of triage decision-making, focusing on the influencing factors, cognitive processes, and real-world challenges experienced by nurses. By deepening our understanding of these elements, the paper lays the groundwork for the development of effective Clinical Decision Support Systems (CDSS) that can enhance clinical judgement and support nurses in delivering safe, timely, and efficient emergency care.</p><p><strong>Methods: </strong>The study used cognitive task analysis through interviews and observations to capture the cognitive strategies used by nurses during triage. This approach provided detailed insights into how nurses assess patient acuity, handle uncertainty, verify decisions, and manage challenges.</p><p><strong>Results: </strong>This study identified 26 themes from interviews and observations, illustrating how nurses use experience and protocols such as the Emergency Severity Index to manage patient flow. Key challenges encountered in triage included overcrowding, staff shortages, high patient acuity, communication barriers, frequent interruptions, and multitasking demands. Despite these hurdles, nurses adapted through prioritization and collaboration.</p><p><strong>Discussion: </strong>The findings highlight significant implications for emergency health care, mainly the need for improvements in triage decision making, resource utilization, and patient safety. Data-driven clinical decision support systems can enhance decision making, streamline assessments, reduce delays, and improve safety and equity in triage, particularly in high-stress, resource-constrained environments.</p><p><strong>Relevance to clinical practice: </strong>This study has significant implications for clinical practice, particularly in emergency care settings where effective triage is critical for patient outcomes. By exploring the cognitive processes and challenges faced by triage nurses, the research provides valuable insights into the complexities of decision making under pressure. The findings emphasize the importance of clinical decision support systems to enhance decision accuracy, reduce cognitive load, and mitigate the risk of errors. Implementing data-driven technologies and refining triage protocols can lead to more efficient resource alloc","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585564","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 Registered Nurse Staffing, Workload, and the Practice Environment on Burnout in Emergency Nurses","authors":"Sharmine Brassington PhD, RN,&nbsp;Charlotte Thomas-Hawkins PhD, RN, FAAN,&nbsp;Mary L. Johansen PhD, RN, NE-BC, FAAN,&nbsp;Pamela B. de Cordova PhD, RN-BC,&nbsp;Jeannie P. Cimiotti PhD, RN, FAAN,&nbsp;Peijia Zha PhD","doi":"10.1016/j.jen.2025.01.007","DOIUrl":"10.1016/j.jen.2025.01.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Burnout among registered nurses is an ongoing nurse workforce issue, yet there is no quantified evidence on the factors that contribute to burnout among registered nurses in emergency departments. We examined different aspects of the nurse practice environment in hospital-based emergency departments across New Jersey.</div></div><div><h3>Methods</h3><div>This cross-sectional study included a survey of emergency nurses. Using a publicly available list, an email invitation with a survey link was used to recruit potential study participants. Four self-reported measures were used. Burnout was a single-item measure, and registered nurse staffing was assessed as the number of patients assigned to a nurse on the last day worked. Additional measures included the perceived workload subscale of the Individual Workload Perception Scale and the Practice Environment Scale of the Nursing Work Index. Logistic regression models were used to estimate the odds of burnout.</div></div><div><h3>Results</h3><div>A total of 188 emergency registered nurses completed the survey. Seventy-two percent of registered nurses reported moderate to complete burnout and 34% reported sustained or complete burnout. Perceptions of high workloads (odds ratio, 2.89; <em>P</em> = .04) and unsupportive practice environments (odds ratio, 8.02; <em>P</em>&lt;.001) were associated with an increase in the odds of high burnout. An unsupportive practice environment significantly mediated the relationship between high perceived workload and high burnout.</div></div><div><h3>Discussion</h3><div>There’s an urgent need to reduce burnout among emergency registered nurses. Study findings point to a pressing need for hospital and emergency department leadership to implement strategies to improve the practice environment and decrease nurse workloads.</div></div>","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 684-691"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588058","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":"From Scholarship to Practice: Supporting Emergency Nurse Authors","authors":"Anna Valdez PhD, RN, PHN, CEN, CFRN, FAEN, FAADN","doi":"10.1016/j.jen.2025.04.015","DOIUrl":"10.1016/j.jen.2025.04.015","url":null,"abstract":"","PeriodicalId":51082,"journal":{"name":"Journal of Emergency Nursing","volume":"51 4","pages":"Pages 509-510.e1"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517315","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}