Australasian Emergency Care最新文献

{"title":"The Clinical Frailty Scale offers little utility as part of a prediction model for community-dwelling older fallers at risk of re-presenting to the emergency department.","authors":"Loren Barton ,&nbsp;Mark Nelson ,&nbsp;Kirsten Strudwick ,&nbsp;Corey Scholes","doi":"10.1016/j.auec.2024.11.004","DOIUrl":"10.1016/j.auec.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>There is no published literature on the predictive ability of the Clinical Frailty Scale (CFS) for falls risk specific to the Emergency Department (ED) population. This study aims to develop a prognostic model to determine the predictive ability of the CFS for ED falls’ re-presentation in community-dwelling older people.</div></div><div><h3>Methods</h3><div>A retrospective observational cohort study was completed from July 2019 to July 2022 on community dwelling people aged 75 years and over who presented to the ED with an extrinsic fall and had a CFS score recorded. The primary outcome was fall-related re-presentation to ED; the secondary outcome was mortality. A flexible parametric survival model was applied with time to falls re-presentation, and post-estimation, used to predict the probability of another fall re-presentation within 6 months. Calibration was assessed and a decision support curve generated.</div></div><div><h3>Results</h3><div>The model demonstrated reasonable calibration-in-the-large (Slope = 0.999) and fit between CFS and probability of fall re-presentation. The CFS model displayed negligible discriminant ability (C-statistic = 0.534) for identifying older people at risk of falls-related ED re-presentations within 6 months of index presentation.</div></div><div><h3>Conclusions</h3><div>The CFS cannot be used to prognosticate an individual’s risk of ED re-presentation within 6 months of an index extrinsic fall.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 110-115"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774992","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":"Consumer experiences of emergency department pre-triage waiting period: A mixed-methods study","authors":"Rebecca Sedgman ,&nbsp;Noah Pallot ,&nbsp;Annette Peart ,&nbsp;Sebastian Wrobel ,&nbsp;Joseph Miller ,&nbsp;Liam Hackett ,&nbsp;Katrina Maybury ,&nbsp;Emogene Aldridge ,&nbsp;Patrick J. Owen ,&nbsp;Paul Buntine","doi":"10.1016/j.auec.2025.01.001","DOIUrl":"10.1016/j.auec.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Emergency department pre-triage waiting periods have received limited attention. We aimed to explore the pre-triage experiences and perspectives of consumers attending emergency departments.</div></div><div><h3>Methods</h3><div>This mixed-methods cross-sectional study included 92 participants (patients, carers, and guardians) who attended one of three public hospital emergency departments in metropolitan Melbourne (Victoria, Australia). Quantitative self-report outcomes were waiting time (minutes) and number of previous emergency department visits. Qualitative outcomes (explored through content analysis) were consumer experiences and perspectives of emergency departments in general and the pre-triage waiting period specifically.</div></div><div><h3>Results</h3><div>Participants reported a median (IQR) waiting time since triage of 45 (100) minutes and 65 % (n = 60) experienced a pre-triage waiting time of 3–90 minutes. The most common perception of the pre-triage waiting period was an expectation to wait (n = 16, 17 %), yet 46 % (n = 42) reported difficulties during this period, such as other patients cutting in queue (n = 6, 6.5 %). Few positives were associated with the pre-triage waiting period and suggestions to improve this period tended to focus on facilitating a queuing system (n = 18, 20 %).</div></div><div><h3>Conclusion</h3><div>Consumers expected and understood triage, yet reported various difficulties and few positives during the pre-triage waiting period and suggested improvements to the current system, warranting investigation of interventions to improve queuing.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 136-141"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030364","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":"RESCUE - Rapid, Effective, Safe Communication in Emergency Departments: A cross-sectional e-survey","authors":"Amy Freeman-Sanderson ,&nbsp;Nicola Clayton ,&nbsp;Margaret Fry ,&nbsp;Rebecca Sullivan ,&nbsp;Bronwyn Hemsley","doi":"10.1016/j.auec.2024.12.002","DOIUrl":"10.1016/j.auec.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Effective staff-to-staff and patient-provider communication in the Emergency Department (ED) is essential for safe, quality care. Routine wearing of Personal-Protective-Equipment (PPE) has introduced new challenges to communication. We aimed to understand the perspectives of ED staff about communicating while wearing PPE, and to identify factors contributing to communication success, breakdown, and repair.</div></div><div><h3>Methods</h3><div>Study design was a descriptive cross-sectional online survey with convenience sampling. Categorical data were analysed using descriptive statistics and qualitative data analysed using content thematic analysis.</div></div><div><h3>Results</h3><div>Across nursing, medical and allied health, 78 staff responded with mean age= 38.8 years and mean ED clinical experience= 8.8 years). Respondents reported PPE impacted communication with patients/family members (81 %) and staff (61 %), with almost three-quarters of patient interactions rated as “somewhat difficult” or “extremely difficult”. Content themes were: (i) impacts of mask-wearing on communication, (ii) impacts of mask-wearing on patient care quality and safety, and (iii) strategies for repairing communication breakdown. Health impacts of communicating in PPE (50 %) included voice fatigue, skin irritation, and throat dryness.</div></div><div><h3>Conclusion</h3><div>ED staff perceived that wearing PPE impacted communication and compromised safe and efficient quality care delivery. Staff reported using increased voice volume, repetition, gestures, increased proximity, and emphasised facial movements to enhance their communication.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 123-128"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900684","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 experiences of trans (binary and non-binary) people accessing emergency department care in Australia: A grounded theory study","authors":"Jake A. Muller,&nbsp;Elizabeth M. Forster,&nbsp;Katina Corones-Watkins,&nbsp;Belinda Chaplin","doi":"10.1016/j.auec.2024.11.001","DOIUrl":"10.1016/j.auec.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore the experiences of trans (binary and non-binary) people accessing emergency department care in Australia.</div></div><div><h3>Method</h3><div>This qualitative descriptive study utilised a grounded theory approach. Seven people who identified as trans were recruited through social media and trans support groups. Individuals participated in an in-depth narrative interview. Interview transcriptions were analysed using a constant comparative approach.</div></div><div><h3>Results</h3><div>Following thematic analysis, four key themes were identified: <em>1. identity; 2. clinical care; 3. communication; and 4. perceptions of health professional education, beliefs and experience in caring for trans people.</em></div></div><div><h3>Conclusion</h3><div>This study is the first in Australia to explore the experiences of trans people utilising emergency department services. The findings of this study are similar to international data whereby the delivery of gender affirming care in emergency departments is inconsistent, health professionals are perceived as poorly educated and gender identity is inadequately recognised.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 96-102"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781961","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":"Enhancing end-of-life care for advanced heart failure patients in Saudi Arabian emergency departments (EDs): Perspectives of ED staff on challenges","authors":"Ali Jaber Alqahtani ,&nbsp;Geoffrey Keith Mitchell ,&nbsp;Lisa Crossland ,&nbsp;Hanan Mesfer Alyami","doi":"10.1016/j.auec.2025.01.004","DOIUrl":"10.1016/j.auec.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Providing care for patients nearing the end of life who have advanced heart failure presents significant challenges, especially in emergency settings where the primary focus is on life-saving interventions. Exploring the perceptions of emergency department staff is essential for identifying barriers and improving care delivery in this critical context.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted in two hospitals in Saudi Arabia. Semi-structured interviews were completed with thirty emergency staff. A thematic analysis was used to identify the challenges in delivering care for patients nearing the end of life.</div></div><div><h3>Results</h3><div>Seven themes were identified: current practices for advanced heart failure patients, communication barriers, inadequate training in end-of-life care, limitations in emergency department design, heavy workloads, the influence of cultural and religious factors, and the importance of psychological and emotional support for patients and families. The findings highlight the need for structured training, cultural sensitivity, and improved environments to address these challenges.</div></div><div><h3>Conclusions</h3><div>This study emphasizes the complexities of providing care for patients nearing the end of life in emergency settings. Addressing gaps in communication, training, and cultural competence is critical. Tailored strategies for Saudi Arabia’s unique context are essential to enhance care for advanced heart failure patients.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 150-156"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366895","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":"First Nations women’s experiences of out-of-hospital childbirth: Insights for enhancing paramedic practice – A scoping review","authors":"Arwen Wilkinson ,&nbsp;Haley Findlay ,&nbsp;Jayne Lawrence ,&nbsp;Linda Deravin","doi":"10.1016/j.auec.2024.11.002","DOIUrl":"10.1016/j.auec.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Birthing on Country principles in Australia have seen a revitalisation in midwifery care over the last decade with it being seen as a metaphor for the best start to life for First Nations peoples. This scoping review aimed to explore the extent of evidence of Australian First Nations women's experiences of out-of-hospital childbirth and the alignment with Birthing on Country principles to inform paramedic practice.</div></div><div><h3>Methods</h3><div>Four databases were searched including MEDLINE, CINAHL, EBSCOhost Health and Scopus utilising the Joanna Briggs Institute (JBI) methodology for Scoping Reviews. Inclusion and exclusion criteria were identified. All articles were reviewed in a two stage process.</div></div><div><h3>Results</h3><div>Fifty two papers were yielded with 6 meeting the inclusion criteria. Using reflective thematic analysis four key themes were generated; Birthing on Country and identity, inequitable access to healthcare, trusting relationships and medicalisation of birth.</div></div><div><h3>Conclusions</h3><div>There is a large gap in the literature surrounding delivery of care by paramedics to First Nations women birthing out-of-hospital in Australia. This review proposes supports and actions required to implement Birthing on Country principles into paramedicine. Further, standard maternity care has been found to be insufficient for First Nations women due to a lack of culturally safe care.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 89-95"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808741","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":"'It’s only a matter of time' - Lessons learnt and recommendations from COVID-19 to inform emergency nursing for future pandemics: An integrated literature review","authors":"Megan R. Simic ,&nbsp;Joanne E. Porter ,&nbsp;Blake Peck ,&nbsp;Christopher Mesagno","doi":"10.1016/j.auec.2024.10.004","DOIUrl":"10.1016/j.auec.2024.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>In the recovery phase of COVID-19 disaster management, Emergency Department (ED) nurses are attempting to return to normal workforce operations, despite significant impacts on personal and professional lives. This review aims to examine and synthesise current literature for the learnings and recommendations from the lived experiences of ED nurses during the COVID-19 pandemic.</div></div><div><h3>Procedures</h3><div>Electronic databases CINAHL Complete, Web of Science, Scopus (Elsevier) and PubMed were utilised using a 5-year timeframe that aligned with COVID-19 in Australia. Final date of accepted papers was 28th February 2024. A JBI Mixed Methods Convergent Integrated Approach was used.</div></div><div><h3>Findings</h3><div>A total of 15 studies were included in the final review, representing seven countries of origin and included 649 ED nurses. Seven major themes related to learnings and recommendations were generated from data synthesis including (1) professional identity, (2) wellbeing support, (3) camaraderie, (4) effective communication, (5) working conditions and professional boundaries, (6) education and training, and (7) external support.</div></div><div><h3>Conclusion</h3><div>With the likelihood of future epidemic and pandemic events globally, it is vital to explore and collate evidence on the learnings and recommendations from ED during the COVID-19 pandemic to continue to build a sustainable, resilient, and supported workforce.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 2","pages":"Pages 76-88"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741534","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":"Managing non-traumatic musculoskeletal conditions presenting to emergency departments: Do patient profiles vary between a physiotherapy-led 'Diversion' pathway and routine care?","authors":"Robert Waller ,&nbsp;Mathew McLaughlin ,&nbsp;Sarah King ,&nbsp;Jessica Lai ,&nbsp;Reuben Holt ,&nbsp;Pippa Flanagan ,&nbsp;Ivan Lin ,&nbsp;Karen Richards ,&nbsp;Piers Truter","doi":"10.1016/j.auec.2024.08.001","DOIUrl":"10.1016/j.auec.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Low urgency, non-traumatic musculoskeletal presentations are common in emergency departments. Although care is safe, it is expensive, and low priority. Pathways diverting these patients from emergency departments to physiotherapy care may improve hospital outcomes. Identifying the suitable patient profile for these pathways is important.</div></div><div><h3>Methods</h3><div>A mixed prospective and retrospective, descriptive, cross-sectional study investigated adults aged 18–65 presenting to two emergency departments. Suitable patients were diverted directly to a physiotherapy outpatient diversion pathway. Three groups were compared, diverted patients, patients suitable but not diverted, and patients unsuitable for diversion.</div></div><div><h3>Results</h3><div>Diverted patients were aged 43 (median, inter-quartile range 34–53.5) years, triaged as low-urgency, self-referred, self-transported, and had few concerning features of serious pathology. Diverted patients had a 113-minute shorter emergency stay at 79 (median) minutes compared to suitable but not diverted patients, and both groups had a similar profile. Most (93.4 %) diverted patients were discharged within 4- hours, compared to suitable but not diverted patients (72.9 %). Key factors preventing diversion were concern for serious pathology or diversion capacity restraints.</div></div><div><h3>Conclusion</h3><div>A group of patients with non-traumatic musculoskeletal conditions who can be safely diverted to physiotherapy outpatients are described. Diversion impact was high quality care and improved emergency department metrics.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 1","pages":"Pages 24-30"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689724","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":"What assessment, intervention and diagnostics should women with early pregnancy bleeding receive in the emergency department and when? A scoping review and synthesis of evidence","authors":"Baylie Trostian ,&nbsp;Andrea McCloughen ,&nbsp;Ramon Z. Shaban ,&nbsp;Kate Curtis","doi":"10.1016/j.auec.2024.09.006","DOIUrl":"10.1016/j.auec.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Vaginal bleeding is a frequent complication in early pregnancy, care that women receive, or lack thereof, can have immediate and long-term consequences. There is a lack of cogent, synthesised evidence on the assessment, interventions, and diagnostics for the management of early pregnancy bleeding in the emergency department (ED). This paper reports the results of a scoping review that identified that examined the literature to clarify concepts and generate a synthesis of the evidence for the assessment, interventions, diagnostics and management of early pregnancy bleeding in the ED.</div></div><div><h3>Methods</h3><div>Five databases were searched. Practice guidelines and statements were sourced from professional organisations, and online repositories. Three types of data were included: practice guidelines, reviews, and primary research. Data were extracted and collated, and findings were synthesised into a clinical guideline.</div></div><div><h3>Results</h3><div>A total 122 (of 3602) papers from database searching, and six (of 46) practice guidelines were included. Seventy-seven publications reported on assessment including performing vital observations. Thirty-six reported on interventions including administration of analgesia, and 114 reported on diagnostics, which most (n = 93) recommended use of ultrasound. Few (12 %) of practice statements and guidelines recommended care not based in current evidence. The study yielded an evidence-based practice guideline to be used for initial management of early pregnancy bleeding.</div></div><div><h3>Conclusions</h3><div>The practice guideline generated by this examination and synthesis of the evidence offers comprehensive, evidence informed recommendations for the initial management of early pregnancy bleeding. Continued research and knowledge translation for initial management of early pregnancy bleeding is needed to reduce variation in emergency care and improve outcomes for women.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 1","pages":"Pages 1-11"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481785","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":"Evaluation of the Australian Triage Scale in patients who present to the emergency department with upper gastrointestinal bleeding","authors":"Kimberley Ryan ,&nbsp;Lee Jones ,&nbsp;Sherry Cass ,&nbsp;Jacob Christensen ,&nbsp;Mark Appleyard ,&nbsp;Anthony FT Brown ,&nbsp;Florian Grimpen","doi":"10.1016/j.auec.2024.10.001","DOIUrl":"10.1016/j.auec.2024.10.001","url":null,"abstract":"<div><div>Evaluation of the Australian Triage Scale in patients who present to the emergency department with upper gastrointestinal bleeding</div></div><div><h3>Background</h3><div>Upper gastrointestinal bleeding (UGIB) is a common presentation to the emergency department (ED). Study aims were to evaluate the utility of the Australasian Triage Score (ATS) in patients presenting to the ED with UGIB.</div></div><div><h3>Methods</h3><div>This retrospective observational study included 356 patients over a 2-year period who presented to a metropolitan hospital ED. The ATS was categorised into three groups, ATS 1/2, ATS 3 and ATS 4/5. Primary outcomes explored the relationship between ATS and haemodynamic parameters. Secondary outcomes evaluated the proportion of patients with suspected variceal bleeding and allocated a non-life-threatening ATS category.</div></div><div><h3>Results</h3><div>The study population were distributed by ATS 1/2 (28.7 %), ATS 3 (46.6 %) and ATS 4/5 (24.7 %). Over half of patients with some haemodynamic compromise were allocated an ATS 3 or 4/5. Additionally, 56 % with suspected variceal bleeding and 51 % with syncope were also allocated an ATS category (3 or 4/5).</div></div><div><h3>Conclusions</h3><div>The utility of the ATS recognises most patients presenting with UGIB at high-risk of adverse outcomes. Additional screening at triage maybe beneficial for those patients with a history of cirrhosis or varices, and UGIB-related syncope. Consideration of an ATS category of 2 for these patients may enable them to access earlier time-critical therapies.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 1","pages":"Pages 57-62"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513557","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}