Australasian Emergency Care最新文献

{"title":"Preparing undergraduate student paramedics to consider their mental health during clinical placement in Australia","authors":"Anthony Weber ,&nbsp;Briella Weber ,&nbsp;Shannon Delport","doi":"10.1016/j.auec.2023.05.002","DOIUrl":"10.1016/j.auec.2023.05.002","url":null,"abstract":"<div><h3>Introduction</h3><p>This article explores the impact of mental health issues on paramedics in Australia, particularly Post-Traumatic Stress Disorder, caused by their exposure to high levels of stress. The prevalence of Post-Traumatic Stress Disorder is higher among paramedics than any other occupation, and this could be a cause for concern, especially for undergraduate student paramedics. The article examines the need to build resilience among student paramedics to help them handle the trauma they may experience during clinical placement.</p></div><div><h3>Methods</h3><p>This study conducted a two-step process to review literature and university handbooks to determine the level of education provided to paramedic students on Post-Traumatic Stress Disorder and resilience during clinical placement, due to the lack of research in this area. The first step involved a search for relevant articles, while the second step involved a search of the Australian Health Practitioner Regulation Agency website to identify paramedicine programs and a manual evaluation of each undergraduate pre-registration paramedicine curriculum in Australia.</p></div><div><h3>Results</h3><p>This study conducted a systematic search of national and international literature and Australian undergraduate pre-registration paramedicine programs to identify any studies pertaining to the education of paramedic students in resilience and Post Traumatic Stress Disorder. The search found that only 15 (5.95 %) of the 252 reviewed subjects had reference to mental health, resilience or Post-Traumatic Stress Disorder, with only 4 (1.59 %) of them discussing these topics in preparation for clinical practice. The study highlights the lack of emphasis on student paramedic self-care as an essential underpinning for clinical placement preparation in the curriculum.</p></div><div><h3><strong>Conclusion</strong></h3><p>This literature review concludes that appropriate training and support, teaching resilience, and promoting self-care are crucial in preparing paramedic students for the emotional and psychological demands of their work. Equipping students with these tools and resources can improve their mental health and well-being and enhance their ability to provide high-quality care to patients. Promoting self-care as a core value in the profession is essential in creating a culture that supports paramedics in maintaining their own mental health and well-being.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 341-345"},"PeriodicalIF":1.8,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860739","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":"Adherence to recommended guidelines for low back pain presentations to an Australian emergency department: Barriers and enablers","authors":"Janelle Heine ,&nbsp;Peter Window ,&nbsp;Sarah Hacker ,&nbsp;Jordan Young ,&nbsp;Gary Mitchell ,&nbsp;Shea Roffey ,&nbsp;Michelle Cottrell","doi":"10.1016/j.auec.2023.04.003","DOIUrl":"10.1016/j.auec.2023.04.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study sought to evaluate the adherence to guidelines for the management of mechanical Low Back Pain within a single tertiary metropolitan Emergency Department setting. Our objectives were:</p><p></p><ul><li><span>1.</span><span><p>To identify the proportion of patients presenting to a single Emergency Department with mechanical Low Back Pain who received management in line with the guidelines; and</p></span></li><li><span>2.</span><span><p>To understand and describe factors that can influence clinicians’ (non-) adherence to the guidelines.</p></span></li></ul></div><div><h3>Methods</h3><p>A two-stage multi-methods study design was undertaken. Stage 1 involved a retrospective chart audit of patients presenting with a diagnosis of mechanical Low Back Pain to establish documented adherence to clinical guidelines. Stage 2 explored clinicians’ perspectives towards factors influencing adherence to the guidelines via a study-specific survey and follow up focus groups.</p></div><div><h3>Results</h3><p>The audit demonstrated low adherence to the following guidelines: (i) appropriate prescription of analgesia, (ii) targeted education and advice, and (iii) attempts to mobilise. Three major themes were identified as factors influencing adherence to the guidelines: (1) clinician driven influences and factors, (2) workflow processes, and (3) patient expectations and behaviours.</p></div><div><h3>Conclusion</h3><p>There was low adherence to some published guidelines and factors influencing adherence to the guidelines were multi-factorial. Understanding the factors that influence care decisions and developing strategies to address these can improve Emergency Department management of mechanical Low Back Pain.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 326-332"},"PeriodicalIF":1.8,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9847913","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 that contribute to patient length of stay in the emergency department: A time in motion observational study","authors":"Karlie Payne ,&nbsp;Dante Risi ,&nbsp;Anna O’Hare ,&nbsp;Simon Binks ,&nbsp;Kate Curtis","doi":"10.1016/j.auec.2023.04.002","DOIUrl":"10.1016/j.auec.2023.04.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Increased Emergency Department length of stay impacts access to emergency care and is associated with increased patient morbidity, overcrowding, reduced patient and staff satisfaction. We sought to determine the contributing factors to increased length of stay in our mixed ED.</p></div><div><h3>Methods</h3><p>A real-time observational study was conducted at Wollongong Hospital over a continuous 72-h period. Times of intervention, assessment and treatment were recorded by dedicated emergency medical or nurse observers. The time from triage to each event was calculated and descriptive analyses performed. Free text comments were analysed using inductive content analysis.</p></div><div><h3>Results</h3><p>Data were collected on 381 of 389 eligible patients. The largest time delays were experienced by patients who required a CT, specialist review and/or an inpatient bed. Registrars and nurse practitioners were the most efficient in reaching a decision to admit or discharge. The time from triage to specialist review increased with the number requested (148 min for one, 224 min for two and 285 min for three). The longest length of stay was experienced by mental health and paediatric patients.</p></div><div><h3>Conclusions</h3><p>The main delays contributing to ED length of stay were CT imaging and specialist reviews. Overcrowding in ED need targeted, site-specific interventions.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 321-325"},"PeriodicalIF":1.8,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9780309","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":"Epidemiology and management of traumatic brain injury in a regional Queensland Emergency Department","authors":"Matthew I. Hiskens ,&nbsp;Tesfaye S. Mengistu ,&nbsp;Bauke Hovinga ,&nbsp;Neale Thornton ,&nbsp;Karen B. Smith ,&nbsp;Gary Mitchell","doi":"10.1016/j.auec.2023.04.001","DOIUrl":"10.1016/j.auec.2023.04.001","url":null,"abstract":"<div><h3>Background</h3><p>There is a paucity of traumatic brain injury<span> (TBI) data in Australia in the regional and rural context. This study aimed to investigate the epidemiology, severity, causes, and management of TBI in a regional north Queensland population to plan acute care, follow up, and prevention strategies.</span></p></div><div><h3>Methods</h3><p><span>This retrospective study analysed TBI patients presenting to Mackay Base Hospital Emergency Department (ED) in 2021. We identified patients using head injury </span>SNOMED<span> codes, and analysed patient characteristics with descriptive and multivariable regression analysis.</span></p></div><div><h3>Results</h3><p>There were 1120 head injury presentations, with an overall incidence of 909 per 100,000 people per year. The median (IQR) age was 18 (6−46) years. Falls were the most common injury mechanism (52.4% of presentations). 41.1% of patients had a Computed Tomography (CT) scan, while 16.5% of patients who met criteria had post traumatic amnesia (PTA) testing. Age, being male and Indigenous status were associated with higher odds of moderate to severe TBI.</p></div><div><h3>Conclusion</h3><p>TBI incidence in this regional population was higher than metropolitan locations. CT scan was undertaken less frequently than in comparative literature, and low rates of PTA testing were undertaken. These data provide insight to assist in planning prevention and TBI-care services.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 314-320"},"PeriodicalIF":1.8,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9475684","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 associated with willingness to perform basic life support in the community setting in Yogyakarta, Indonesia","authors":"Happy Indah Kusumawati ,&nbsp;Sutono ,&nbsp;Syahirul Alim ,&nbsp;Bayu Fandhi Achmad ,&nbsp;Arcellia Farosyah Putri","doi":"10.1016/j.auec.2023.03.003","DOIUrl":"10.1016/j.auec.2023.03.003","url":null,"abstract":"<div><h3>Background</h3><p>Cardiac arrest is one of the fatal medical emergencies which need to be treated immediately. Poor survival rates in the community settings are common because of limited and ineffective bystander basic life support (BLS). This study aimed to identify factors that are associated with the willingness to perform BLS in communities in Yogyakarta, Indonesia</p></div><div><h3>Methods</h3><p>A descriptive study was conducted with a cross-sectional design. Participants (n = 251) were enrolled from the general population consisting of teachers, security personnel, and police officers recruited through cluster random sampling. Data were gathered using both digital or printed questionnaires. Ordinal logistic regression with adjusted odds ratio (AOR) was used to analyze the association between BLS predictors and willingness to perform BLS.</p></div><div><h3>Results</h3><p>Most participants were willing to perform BLS for all genders (55.55%). The inability to perform BLS and fear of causing harm were the main barriers to performing BLS accounting for 61.35% and 43.82%, respectively. Compared to other independent predictors, ages 40–59 were found to be the highest predictors of willingness to perform BLS (AOR:1.44) followed by experience of seeing real or simulation of the emergency case (AOR:1.38)</p></div><div><h3>Conclusions</h3><p>More than half of the respondents were eager to perform BLS although some barriers were also found. This study provides some understanding of the predictor factors associated with BLS performance and shows respondents with some training or experience were more likely to perform BLS. The results inform policymakers to develop a strategic plan for increasing willingness to apply BLS in the community. WC:250</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 303-307"},"PeriodicalIF":1.8,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9179380","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":"Major traumatic pedestrian injury in Australia: Characteristics and in-hospital outcomes from the Australia New Zealand Trauma Registry","authors":"Kate Curtis ,&nbsp;Anna Devlin ,&nbsp;Emily McKie ,&nbsp;Humaira Haider Mahin ,&nbsp;Soni Putnis ,&nbsp;Kate Hunter","doi":"10.1016/j.auec.2023.03.004","DOIUrl":"10.1016/j.auec.2023.03.004","url":null,"abstract":"<div><h3>Background</h3><p>The leading global cause of death for people aged 5–29 years is road traffic injury, a quarter of which is borne by pedestrians. The epidemiology of major hospitalised pedestrian injury across Australia is not reported. This study aims to address this gap using data from the Australia New Zealand Trauma Registry.</p></div><div><h3>Methods</h3><p>The registry hosts information on patients admitted to 25 major trauma centres across Australia who sustain a major injury (ISS &gt; 12) or die following injury. Patients were included if they were injured due to pedestrian injury from 1st July 2015–30 th June 2019. Analysis included patient and injury characteristics, injury patterns and in-hospital outcomes. Primary endpoints included risk-adjusted mortality and length of stay.</p></div><div><h3>Results</h3><p>There were 2159 injured pedestrians; of these, 327 died. Young adults (20–25 years) were the largest group, especially on weekends. Older adults (70 + years) were the largest cohort in pedestrian deaths. The most common injuries were head (42.2 %). One-third of patients were intubated prior to or on ED arrival (n = 731, 34.3 %).</p></div><div><h3>Conclusion</h3><p>Emergency clinicians should have a high index for severe pedestrian injury. Further reduction in road speed in residential areas could reduce all-age pedestrian injury in Australia.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 308-313"},"PeriodicalIF":1.8,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9133016","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":"Shaping the future design of paramedicine: A knowledge to action framework to support paramedic system modernization","authors":"Timothy Makrides ,&nbsp;Madelyn P. Law ,&nbsp;Linda Ross ,&nbsp;Cameron Gosling ,&nbsp;Joseph Acker ,&nbsp;Peter O’Meara","doi":"10.1016/j.auec.2023.03.002","DOIUrl":"10.1016/j.auec.2023.03.002","url":null,"abstract":"<div><h3>Background</h3><p>Over the past two decades, the demands placed on modern paramedic systems has changed. Paramedic services can no longer continue to operate on a traditional response model where more ambulances are deployed to meet the rising demand of patients calling for their health needs. Recent research has explored system design in paramedicine and its relationship with organizational performance. Two subsequent paramedic systems have been identified with one, the Professionally Autonomous paramedic system, being linked to higher performance. Yet, how to operationalize this model for system modernization continues to be a gap in practice.</p></div><div><h3>Objective</h3><p>To provide health leaders and policy makers with a framework from which to drive paramedic system modernization.</p></div><div><h3>Methods</h3><p>This study uses the Knowledge to Action framework to develop an implementation plan for systems that seek to modernize their service delivery model toward that of a Professionally Autonomous paramedic system.</p></div><div><h3>Results</h3><p>A detailed plan of the steps required to undertake system transformation are outlined. Whilst this framework outlines the components required for system modernization, it does not propose an in-depth outline of each of the steps required to achieve each component. Rather, end users are encouraged to develop individual implementation plans tailored to the local context using the comprehensive tools outlined within.</p></div><div><h3>Conclusion</h3><p>This knowledge to action framework provides health leaders and policy makers with a uniform roadmap for paramedic system modernization intended to improve health (clinical) outcomes as well as health system outcomes through the Professional Autonomous paramedicine model.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 296-302"},"PeriodicalIF":1.8,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9188439","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":"Gender-based differences in assessment and management of acute abdominal pain in the emergency department: A retrospective audit","authors":"Megan Hayes ,&nbsp;Ana Hutchinson ,&nbsp;Debra Kerr","doi":"10.1016/j.auec.2023.03.001","DOIUrl":"10.1016/j.auec.2023.03.001","url":null,"abstract":"<div><h3>Background</h3><p><span>Previous research has identified gender-based differences in acute pain management in the </span>emergency department<span> [ED]. The aim of this study was to compare pharmacological management of acute abdominal pain in the ED by gender.</span></p></div><div><h3>Methods</h3><p>A retrospective chart audit<span> was conducted at one private metropolitan ED including adult patients (18–80 years) who presented with acute abdominal pain in 2019. Exclusion criteria included: pregnancy, repeat presentation within the study period, pain-free at initial medical review or documented refusal of analgesia, and oligo-analgesia. Comparisons by gender included: (1) analgesia type and (2) time to analgesia. Bivariate analysis was undertaken using SPSS.</span></p></div><div><h3>Results</h3><p>There were 192 participants: 61 (31.6 %) men and 131 (67.9 %) women. Men were more likely to get combined opioid and non-opioid medication as first line analgesia (men: 26.2 % n = 16; women: 14.5 % n = 19, <em>p</em> = .049). Median time from ED presentation to analgesia was 80 min for men (IQR: 60) versus 94 min for women (IQR: 58), (<em>p</em><span> = .119). Women (25.2 % n = 33) were more likely to receive their first analgesic after 90 min from ED presentation compared to men versus men (11.5 %, n = 7 </span><em>p</em> = .029). In addition, women waited longer before receiving second analgesia (women: 94, men: 30 min, <em>p</em> = .032).</p></div><div><h3>Conclusion</h3><p>Findings confirm there are differences in pharmacological management of acute abdominal pain in the ED. Larger studies are required to further explore differences observed in this study.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 290-295"},"PeriodicalIF":1.8,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9104746","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":"Public health messaging during disasters: A qualitative study of emergency department key informants","authors":"Nicole M. Coombs,&nbsp;Joanne E. Porter,&nbsp;Michael Barbagallo","doi":"10.1016/j.auec.2023.02.005","DOIUrl":"10.1016/j.auec.2023.02.005","url":null,"abstract":"<div><h3>Background</h3><p>Patient education is a professional obligation for all nurses. Public health messaging in emergency departments during disasters can help prevent further risk or illness for affected communities. In this study, Australian emergency nurse Key Informants share their perceptions and experiences of preventative messaging provided in their departments during disasters and the governance and processes in place to support this practice.</p></div><div><h3>Methods</h3><p>The qualitative phase of a mixed methods study, where semi structured interviews were utilised, and data analysed using a six step Thematic analysis.</p></div><div><h3>Results</h3><p>Three themes were identified: (1) Part of the Job; (2) It’s all in the delivery; and (3) Preparation is the key. These themes include concepts involving the confidence and competence of nurses providing messages, what, when and how messages are being given and how prepared both the department and staff are regarding patient education during disaster events.</p></div><div><h3>Conclusions</h3><p>Nurse confidence is a key factor in the delivery of preventative messages during disasters, potentially resulting from a lack of exposure, a junior workforce and minimal training. Leaders agree that departments are not preparing or supporting messaging practice, with an absence of specific training, formal guidelines, and patient education resources; and that improvement is needed.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 4","pages":"Pages 284-289"},"PeriodicalIF":1.8,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10837822","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":"Improving care for older patients visiting emergency departments. Are they receiving falls prevention guideline care?","authors":"Melinda Williamson ,&nbsp;Annette Barton ,&nbsp;Deborah Edwards ,&nbsp;Claire Morrisby ,&nbsp;Angela Jacques ,&nbsp;Kristie J. Harper","doi":"10.1016/j.auec.2022.08.003","DOIUrl":"10.1016/j.auec.2022.08.003","url":null,"abstract":"<div><h3>Background</h3><p>The primary objective was to examine whether the Emergency Department<span><span> (ED) treatment of older adults who fall in Australia is concordant with </span>falls prevention and management clinical guideline care recommendations.</span></p></div><div><h3>Methods</h3><p><span>A retrospective medical records </span>audit was completed for patients 65years and older, who attended the ED with a fall and were discharged home. An audit tool was developed from local, national, and international falls clinical guidelines.</p></div><div><h3>Results</h3><p>One thousand and twenty-seven patients presented following a fall throughout 2020. One hundred and seven patient medical records were audited. Assessment of cognition (94%), medication review (76%) and use of a falls risk screen (76%) were commonly completed. Under half of the patients had a documented gait evaluation (40%) and review of vision (18%). Concordance with guideline care was more likely for older patients (p = 0.042), with higher levels of comorbidity (p = 0.013), who required care assistance (p = 0.008) and received treatment from a multidisciplinary team (p &lt; 0.001) in an observation ward (p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Older patients with increased comorbidities and higher care needs had more falls guideline care recommendations documented. This was likely to occur when patients were moved to the observation ward where more comprehensive care by a multidisciplinary team could occur.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"26 1","pages":"Pages 84-89"},"PeriodicalIF":1.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9344396","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}