Journal of the American College of Emergency Physicians open最新文献

{"title":"Elderly woman with clitoral swelling and pain","authors":"Matthias Barden MD,&nbsp;Roberto Reyna MD,&nbsp;Lana Hariri MD","doi":"10.1002/emp2.13262","DOIUrl":"https://doi.org/10.1002/emp2.13262","url":null,"abstract":"<p>A 77-year-old female presented to our community-based emergency department complaining of clitoral swelling and pain (Figure 1). She reported a 2-week history of gradually increasing enlargement and discomfort of the area. One month prior to the onset of these symptoms, she had undergone a urethral bulking agent injection by a urogynecologist at a different health system to treat urinary stress incontinence with polyacrylamide hydrogel (Bulkamid).<span>¹</span></p><p>She was awaiting a follow-up appointment with her urogynecologist but decided to seek care in the emergency department instead once she felt the pain was no longer tolerable. In the emergency department, point-of-care ultrasound was performed showing a localized collection of heterogeneous nonvascular debris consistent with abscess formation, as opposed to solid or cystic mass (Figure 2 and video file supplemental data).<span>²</span></p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A young man with flank pain and dysuria","authors":"Matthew S. Wilson MD,&nbsp;Michael S. Miles MD,&nbsp;Jaysun G. Frisch DO,&nbsp;Rosalia M. Mahr MD,&nbsp;Michael I. Prats MD","doi":"10.1002/emp2.13233","DOIUrl":"https://doi.org/10.1002/emp2.13233","url":null,"abstract":"<p>A 22-year-old man with past medical history of type 1 diabetes, intravenous polysubstance use, bacterial endocarditis, and frequent urinary tract infections presented to the emergency department with left-sided flank pain and dysuria. The pain had been worsening over the last 3–4 days and associated with dysuria, foul smelling urine, and urine “clumps.” He was noted to be ill-appearing with left costovertebral angle tenderness. Vital signs were heart rate of 114 bpm, blood pressure of 122/66, temperature of 37.5°C, respiratory rate of 18 breaths per minute, and pulse oximetry of 97% on room air. Labs were notable for blood glucose 431 mg/dL, beta hydroxybutyrate 2.83 mmol/L, leukocytosis of 13.2 K/µL, creatinine 1.15 mg/dL, and normal lactate. Urinalysis was consistent with infection. Ultrasound showed a hyperechoic area in the renal pelvis with heterogenous appearing posterior acoustic shadowing (Figure 1, Video 1).</p><p>M Prats has received payments from Butterfly Network, Inc. for consulting on educational materials. Advertising payments were made to M Prats' businesses Exo Imaging, Inc. and Echonous Inc.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Association between the American Board of Emergency Medicine Oral Certifying Examination and Future State Medical Board Disciplinary Actions”","authors":"","doi":"10.1002/emp2.13312","DOIUrl":"https://doi.org/10.1002/emp2.13312","url":null,"abstract":"<p>Reisdorff EJ, Johnston MM, Kraus CK, Keim SM, Santen SA. Association between the american board of emergency medicine oral certifying examination and future state medical board disciplinary actions. <i>JACEP Open</i>. 2024; 5:e13119. 10.1002/emp2.13119</p><p>For the article titled “Association between the American Board of Emergency Medicine Oral Certifying Examination and Future State Medical Board Disciplinary Actions” published in the Journal of the American College of Emergency Physicians Open (2024):</p><p>In Section 2.2 Data Sources, the statement “The NPDB is managed by the Federal government through the U.S. Department of Health and Human Services” is incomplete.</p><p>This statement should have read “Data utilized in this study were obtained from the National Practitioner Data Bank, which is managed by the Health Resources and Services Administration (HRSA), an agency of the U.S. Government. HRSA does not endorse any specific products, services, or conclusions described in this manuscript. The views and opinions expressed are solely those of the authors and do not necessarily reflect the official policy or position of HRSA or the U.S. Government.”</p><p>We apologize for this error.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Man with severe neck pain","authors":"Sho Yamaguchi MD,&nbsp;Yuya Kitai MD,&nbsp;Tetsuya Inoue MD, PhD","doi":"10.1002/emp2.13276","DOIUrl":"https://doi.org/10.1002/emp2.13276","url":null,"abstract":"<p>A 53-year-old male presented with acute neck pain radiating to the occiput for 2 days. He had been playing golf daily before symptom onset. There was no history of recent upper respiratory infection. Examination revealed an axillary temperature of 37.4°C, with other vital signs normal. The patient was alert with no meningeal signs, and neck pain worsened with rotation. Neurological examination was normal, with no palpable lymphadenopathy, and the pharyngeal examination was normal. Computed tomography (CT) confirmed the diagnosis (Figure 1).</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the feasibility of prehospital point-of-care EEG: The prehospital implementation of rapid EEG (PHIRE) study","authors":"Elan L. Guterman MD, MAS,&nbsp;Mary P. Mercer MD, MPH,&nbsp;Andrew J. Wood MPH,&nbsp;Edilberto Amorim MD,&nbsp;Jonathan K. Kleen MD, PhD,&nbsp;Daniel Gerard MS, NRP,&nbsp;Colleen Kellison EMT-P,&nbsp;Scott Yamashita BA,&nbsp;Benjamin Auerbach,&nbsp;Nikita Joshi MD,&nbsp;Karl A. Sporer MD","doi":"10.1002/emp2.13303","DOIUrl":"https://doi.org/10.1002/emp2.13303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Point-of-care electroencephalography (EEG) devices can be rapidly applied and do not require specialized technologists, creating new opportunities to use EEG during prehospital care. We evaluated the feasibility of point-of-care EEG during ambulance transport for 911 calls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This mixed-methods study was conducted between May 28, 2022 and October 28, 2023. Emergency Medical Services (EMS) clinicians identified eligible individuals, provided emergent treatment, applied EEG, and obtained an EEG recording during ambulance transport. Eligible patients were aged 6 years or older and evaluated for seizure, stroke, or altered mental status. EMS clinicians completed a survey and a brief phone interview following every enrollment. Two epileptologists reviewed EEG recordings for interpretability and artifact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 34 prehospital encounters in which EEG was applied. Patients had a mean age of 69 years, and 15 (44%) were female. EEG recordings had a median duration of 10 min 30 s. It took EMS clinicians an average of 2.5 min to apply the device and begin EEG recording. There were 14 (47%) recordings where clinicians achieved a high-quality connection for all 10 electrodes and 32 (94%) recordings that were sufficient in quality to interpret. There were 24 (71%) recordings with six or more channels free of artifact for 5 min or more. All clinicians agreed or strongly agreed that the device was easy to use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among real-world prehospital encounters for patients with neurologic symptoms, point-of-care EEG was rapidly applied and yielded EEG recordings that could be used for clinical interpretation, demonstrating the feasibility of point-of-care EEG in future prehospital care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Images of venipuncture injuries","authors":"Li Jiazhao PhD,&nbsp;Jiang Wenxin MD,&nbsp;Shen Yelin","doi":"10.1002/emp2.13278","DOIUrl":"https://doi.org/10.1002/emp2.13278","url":null,"abstract":"<p>A 57-year-old female was admitted to the intensive care unit (ICU) following brain surgery. The process of deep venipuncture was challenging, as indicated by her lung computed tomography (CT) scans (Figures 1-3). Previously, she had a catheter in her left internal jugular vein, which was not functioning properly and was subsequently removed, leaving a retrosternal air leak shadow, as indicated by the red arrow in Figure 1. An attempt to puncture the right subclavian vein failed, resulting in residual gas trapped between the muscle layers (Figure 2) with a radius of 2 mm and an area of 13.21 mm². Eventually, catheterization of the right internal jugular vein was successful after two failed attempts (Figure 3); some gas was observed near the catheter, with a maximum area of approximately 32 mm × 10 mm.</p><p>The patient's vital signs remained stable during and after the procedure. A follow-up lung CT performed 4 days later showed that all gas had been absorbed. However, deep venipuncture failures are common in clinical settings and can lead to complications,<span>¹</span> such as mediastinal emphysema, peripheral nerve injury,<span>²</span> and pneumothorax, which in turn can result in economic burdens, prolonged hospitalization, and even fatalities—fortunately, this patient did not experience significant complications. However, the CT scan revealed past injuries, serving as a reminder for clinicians to exercise caution and rigor during invasive procedures.</p><p>The authors declare no conflict of interest.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending emergency care beyond discharge: Piloting a virtual after care clinic","authors":"John Adam Oostema MD, MS,&nbsp;Stephanie Mullennix MSN, RN,&nbsp;Todd Chassee MD,&nbsp;Christopher Port MD,&nbsp;John Deveau DO, MPH,&nbsp;John Throop MD, MBA,&nbsp;Joshua C. Reynolds MD, MS","doi":"10.1002/emp2.13302","DOIUrl":"https://doi.org/10.1002/emp2.13302","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Many unscheduled return visits to the emergency department (ED) stem from insufficient access to outpatient follow-up. We piloted an emergency medicine-staffed, on-demand, virtual after care clinic (VACC) as an alternative for discharged ED patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective cohort study of discharged ED patients who scheduled VACC appointments within 72 hours of index ED visit. We performed descriptive analyses and compared risks of ED return at 72 hours and 30 days between patients who did/did not attend their appointment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From March to December 2022, 309 patients scheduled VACC appointments and 210 (68%) attended them. Patients who scheduled appointments were young (median 37 years), non-Hispanic white (80%), females (75%) with a primary care physicians (PCP) (90%), and commercial insurance (72%).  Most VACC visits reinforced ED testing and/or treatment (64%) or adjusted medications (26%). VACC attendees were less likely to return to the ED within 72 h (3.3% vs. 13.1%; risk difference 9.3% [95% confidence interval, CI 2.7%‒19.8%]) and 30 days (16.2% vs. 30.3%; risk difference 14.1% [95% CI 3.8%‒24.4%]) compared to those who scheduled but did not attend a VACC appointment. VACC attendance was associated with lower odds of 72-h (adjusted odds ratio [aOR] 0.0; 95% CI 0.0‒0.4) and 30-day (aOR 0.4; 95% CI 0.2‒0.7) return ED visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this pilot study, younger, white, female, commercially insured patients with a PCP preferentially scheduled VACC appointments. Among patients who scheduled VACC appointments, those who attended their appointments were less likely to return to the ED within 72 hours and 30 days than those who did not.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An adult male presenting with left buccal mass","authors":"Anthony Liimatta DO,&nbsp;J. Taylor Adams DO","doi":"10.1002/emp2.13261","DOIUrl":"https://doi.org/10.1002/emp2.13261","url":null,"abstract":"<p>The patient is a 52-year-old male with a 30-year history of human immunodeficiency virus (HIV), not compliant with antiretroviral therapy (although his last viral load was undetectable 1 year prior), presenting with 3 months of worsening left facial mass (Figures 1-5), generalized weakness, and a 30-pound weight loss. He came into the emergency department (ED) because the mass started causing changes in his speech.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What explains differences in average wait time in the emergency department among different racial and ethnic populations: A linear decomposition approach","authors":"Hao Wang MD, PhD,&nbsp;Nethra Sambamoorthi PhD,&nbsp;Richard D. Robinson MD,&nbsp;Heidi Knowles MD,&nbsp;Jessica J. Kirby DO,&nbsp;Amy F. Ho MD,&nbsp;Trevor Takami MD,&nbsp;Usha Sambamoorthi PhD","doi":"10.1002/emp2.13293","DOIUrl":"https://doi.org/10.1002/emp2.13293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Non-Hispanic Black (NHB) and Hispanic/Latino (Hispanic) patients wait longer in the emergency department (ED) to see practitioners when compared with non-Hispanic White (NHW) patients. We investigate factors contributing to longer wait times for NHB and Hispanic patients using a linear decomposition approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included patients presenting to one tertiary hospital ED from 2019 to 2021. Median wait times among NHW, NHB, and Hispanic were calculated with multivariable linear regressions. The extent to which demographic, clinical, and hospital factors explained the differences in average wait time among the three groups were analyzed with Blinder‒Oaxaca post-linear decomposition model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 310,253 total patients including 34.7% of NHW, 34.7% of NHB, and 30.6% of Hispanic patients. The median wait time in NHW was 9 min (interquartile range [IQR] 4‒47 min), in NHB was 13 min (IQR 4‒59 min), and in Hispanic was 19 min (IQR 5‒78 min, <i>p</i> &lt; 0.001). The top two contributors of average wait time difference were mode of arrival and triage acuity level. Post-linear decomposition analysis showed that 72.96% of the NHB‒NHW and 87.77% of the Hispanic‒NHW average wait time difference were explained by variables analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to NHW patients, NHB and Hispanic patients typically experience longer ED wait times, primarily influenced by their mode of arrival and triaged acuity levels. Despite these recognized factors, there remains 12%‒27% unexplained factors at work, such as social determinants of health (including implicit bias and systemic racism) and many other unmeasured confounders, yet to be discovered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young woman with a headache","authors":"Megan Hoffer DO,&nbsp;Keith Boniface MD, RDMS","doi":"10.1002/emp2.13287","DOIUrl":"https://doi.org/10.1002/emp2.13287","url":null,"abstract":"<p>A 42-year-old female presented to the emergency department (ED) with a headache of 2 days’ duration. She reported a low mechanism headstrike without loss of consciousness 2 days prior, as well as a history of idiopathic intracranial hypertension (IIH). She endorsed blurred vision but denied nausea, vomiting, fever, or use of anticoagulation. Point-of-care ultrasound revealed elevated optic discs with crescent signs bilaterally (Figure 1).</p><p> </p><p>A computed tomography scan of the brain was negative for intracranial hemorrhage or mass, but did show sequelae of IIH, including prominent optic nerve sheaths and an empty sella, which had been previously demonstrated on neuroimaging in the medical record. She was offered therapeutic lumbar puncture and neurology evaluation but declined as she was scheduled for ventriculoperitoneal shunt placement with neurosurgery for management.</p><p>Ocular ultrasound is an accessible and noninvasive tool for measuring intracranial pressure (ICP) in the ED, and has been shown to be 90% sensitive in detection of papilledema.<span>¹</span> The optic nerve sheath is contiguous with the subarachnoid space and therefore the optic nerve sheath diameter fluctuates with changes in ICP.<span>^2-4</span> Crescent sign on point-of-care ultrasound is a hypoechoic ring of subarachnoid fluid surrounding the optic nerve and the presence of a crescent sign has been found to be 92% sensitive for papilledema.<span>^{5, 6}</span> When present, the crescent sign is highly indicative of elevated ICP and warrants neuroimaging and specialty consult to rule out space-occupying lesions or other emergent etiologies of elevated ICP Video 1</p><p>The authors declare no conflicts of interest.</p><p>This is a non-funded study, with no compensation or honoraria for conducting the study.</p>","PeriodicalId":73967,"journal":{"name":"Journal of the American College of Emergency Physicians open","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.13287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142169826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}