BMC Emergency Medicine最新文献

{"title":"The effect of emergency department occupancy on the revisitation rate within seven days among patients discharged by triage.","authors":"Jari Ylä-Mattila, Anna Eidstø, Jalmari Nevanlinna, Heini Huhtala, Teemu Koivistoinen, Sami Mustajoki","doi":"10.1186/s12873-025-01315-8","DOIUrl":"10.1186/s12873-025-01315-8","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED) crowding has been repeatedly shown to affect patient outcomes negatively. However, there is limited research on its impact on patients immediately discharged by the triage team. This study aimed to evaluate the effect of ED occupancy level on the rates of ED revisitation and hospitalization within seven days among patients discharged or redirected by the triage team.</p><p><strong>Methods: </strong>An observational single-center study was conducted at the Tampere University Hospital ED from January 1, 2023, to December 31, 2024. The study population consisted of patients who were discharged or redirected by the ED triage team. These patients were divided into two groups: (1) patients who revisited the ED within seven days and (2) patients who did not return within seven days. A subgroup analysis focused on revisits that resulted in hospitalization. ED occupancy at the time of triage was considered as a predicting factor for revisitation and hospitalization. Age, sex, triage shift, and the updated Charlson Comorbidity Index (uCCI) were adjusted for in a multivariable logistic regression analysis.</p><p><strong>Results: </strong>Of the 180,267 ED visitors during the study period, 8.8% (n = 15,910) were discharged by the triage team. Of these, 8.7% (n = 1392) revisited the ED within seven days, and 16.2% (n = 225) of the revisiting patients were hospitalized. In the multivariable analyses, the highest quartile of ED occupancy was associated with an increased likelihood of ED revisitation (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.06-1.57). Older age was linked to both revisitation and hospitalization (OR for a 1-year increase 1.01 [95% CI: 1.01-1.02] and 1.02 [95% CI: 1.02-1.03], respectively). The uCCI score was also associated with revisitation and hospitalization (OR for a 1-point increase 1.13 [95% CI: 1.07-1.18] and 1.23 [95% CI: 1.13-1.33], respectively).</p><p><strong>Conclusions: </strong>The highest ED occupancy quartile was associated with a modestly increased likelihood of an ED revisit but not hospitalization within seven days after being discharged by the triage team. Furthermore, age and comorbidities were associated with both revisitation and hospitalization.</p><p><strong>Trial registration: </strong>Clinical trial number: not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"157"},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulance professionals' adaptations in prehospital services: a critical incident study.","authors":"Cecilie Erga, Stephen J M Sollid, Karina Aase","doi":"10.1186/s12873-025-01309-6","DOIUrl":"10.1186/s12873-025-01309-6","url":null,"abstract":"<p><strong>Background: </strong>The working environment for ambulance professionals in prehospital services is complex, dynamic, and associated with a high degree of unpredictability. It is therefore essential that ambulance professionals adapt to provide high-quality and safe care, yet the research literature on how they successfully adapt in their everyday work remains sparse. The aim of this study is to address this knowledge gap by exploring adaptations in the context of prehospital services, through ambulance professionals' descriptions of successful missions.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted using the Critical Incident Technique methodology for data collection and analysis, the latter through the processes of re-storying and cross-incident analysis. Twenty semi-structured individual interviews were conducted between October 2023 and May 2024 with ambulance professionals, including licensed ambulance medical technicians and paramedics with dual licensing or other additional medical licenses across four ambulance stations in Norway with contrasting geographical locations.</p><p><strong>Results: </strong>A wide range of successful adaptations were described by the ambulance professionals and grouped into seven core themes: (1) Adaptations in mission planning; (2) Practical adaptations; (3) Time-critical adaptations; (4) Personal adaptations; (5) Task-focused adaptations; (6) Adaptations in stakeholder coordination; (7) Adapting to patients and informal caregivers.</p><p><strong>Conclusions: </strong>This study provides insight and new knowledge about successful adaptations in prehospital services and illuminates the variety of adaptations ambulance professionals make in different contexts. Trust is an underlying feature for successful adaptations, while communication is the overall predominant feature, especially vital in stakeholder coordination and decision-making processes impacting team efforts and mission efficiency. Further research should provide insight into cross-occupational and cross-stakeholder collaborative processes.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"154"},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and mortality of patients categorised with non-specific symptoms when dialling the emergency medical number: a register-based cohort study.","authors":"Vilde Fosso Smievoll, Helene Monsen Folkedal, Lars Myrmel, Guttorm Brattebø","doi":"10.1186/s12873-025-01311-y","DOIUrl":"10.1186/s12873-025-01311-y","url":null,"abstract":"<p><strong>Background: </strong>Medical communication centre operators of the 1-1-3 medical emergency number in Norway use the decision support tool, the Norwegian Index for Medical Emergency, to categorise the problem and determine the correct handling and urgency level of the situation. The index comprises 42 chapters, one of which is titled 'Non-specific problem'. Studies in Denmark frequently use this chapter; however, there are no published Norwegian studies on the demographics of this patient group. Thus, we investigated the characteristics of the patients assigned to this chapter and their 1- and 30-day mortality outcomes.</p><p><strong>Methods: </strong>This was a registry-based, retrospective cohort study. Descriptive statistics were used to compare the two groups; t-tests were performed for continuous variables, and data were presented with corresponding 95% confidence intervals. Categorical data were compared using the chi-square test. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Out of the 25,474 included calls to the emergency medical communication centre in 2022, 1,860 (7.3%) were categorised as 'Non-specific problem'. Patients in this group had a higher mean age, were more often men, had a shorter hospital stay, and showed more comorbidities than the control group. The use of this chapter was associated with the allocation of a higher urgency level, and a reduction in the use of these criteria was observed during nighttime. Significantly higher 1- and 30-day mortality rates were observed in patients with non-specific symptoms (1.40% and 6.94%, respectively; p < 0.05).</p><p><strong>Conclusions: </strong>The group presenting symptoms categorised as non-specific comprised older patients, more men, and a higher number of patients showing comorbidities than the control group. Patients presenting symptoms categorised as non-specific typically perceived a high level of urgency. Most of these patients had a non-specific main diagnosis after hospital admission and a significantly higher mortality rate than those presenting with symptoms categorised as specific.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"156"},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of compassion fatigue among emergency department nurses: a systematic review and meta-analysis.","authors":"Yunyun Pan, Xiaoyou Wang, Wanglu Jin","doi":"10.1186/s12873-025-01314-9","DOIUrl":"10.1186/s12873-025-01314-9","url":null,"abstract":"<p><strong>Background: </strong>Emergency nurses face heightened vulnerability to compassion fatigue due to chronic exposure to trauma and high-stress environments, potentially compromising both their well-being and patient care quality. However, comprehensive syntheses of its prevalence and modifiable factors remain limited.</p><p><strong>Methods: </strong>Observational studies on the risk and factors influencing the occurrence of compassion fatigue among emergency department nurses were included by searching the CNKI, Wanfang, Vip, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of science databases from inception to December 2024. Data were statistically analysed using RevMan 5. 2 software.</p><p><strong>Results: </strong>Eleven cross-sectional studies were included, with seven (n = 2,385 nurses) reporting risk estimates. Random-effects meta-analysis indicated significantly elevated compassion fatigue risk (OR = 3.48, 95%CI:1.66-7.30, P = 0.001). Subgroup analysis indicated numerically higher risk among Chinese nurses (OR = 4.33, 95%CI:2.12-8.86, P < 0.0001) versus US nurses (OR = 1.73, 95%CI:0.16-19.11, P = 0.65), though without significant subgroup differences (P = 0.47). Descriptive analysis showed that factors such as personal characteristics and work-related factors were associated with compassion fatigue.</p><p><strong>Conclusion: </strong>There is a high risk of developing compassion fatigue among emergency department nurses. While point estimates suggested higher risk in China than the US, this difference lacked statistical significance. Factors such as personal characteristics and work-related factors were associated with compassion fatigue.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"155"},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Emergency and critical care services in Somalia: a cross-sectional nationwide hospital assessment using the WHO Hospital Emergency Unit assessment tool.","authors":"Haron Ndwiga Njiru, Pryanka Relan, Sk Md Mamunur Rahman Malik, Azad Abdullah, Mukhtar Shube, Ali Haji Adam Abubakar, Ibrahim Nur, Abdinasir Yusuf Osman, Paul Sonenthal, Shada Rouhani, Bernard Olayo, Naoko Ohno, Ireneaus Sebit Sindani, Ali Abdirahman Osman, Md Shajib Hossain, Ndithia James, Monther Alabesat, Mohamed Derow","doi":"10.1186/s12873-025-01318-5","DOIUrl":"10.1186/s12873-025-01318-5","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"153"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation status of European guidelines on trauma management of prehospital bleeding control: a national survey in Austria.","authors":"Julia Doescher, Sibylle Langenecker","doi":"10.1186/s12873-025-01312-x","DOIUrl":"10.1186/s12873-025-01312-x","url":null,"abstract":"<p><strong>Background: </strong>Trauma, particularly injuries involving massive bleeding, is a leading cause of preventable death worldwide. Prehospital setting plays a critical role, with bleeding control being a primary focus. While guidelines like the European and German Bleeding Guidelines provide evidence-based recommendations for bleeding management, the extent to which these guidelines are implemented by emergency physicians in the prehospital setting remains unclear.</p><p><strong>Methods: </strong>A nationwide online survey was conducted in Austria to assess emergency physicians' familiarity with and implementation of the European and German Bleeding Guidelines on bleeding control in prehospital settings. The survey was distributed through emergency medical organizations in Austria, gathering 116 responses.</p><p><strong>Results: </strong>Despite high awareness of the Bleeding Guidelines (81%), only 41% of new recommendations were implemented. Moreover, only 50% adhere to recommendations that were already included in previous versions. A questionnaire assessing knowledge about the Bleeding Guidelines' content revealed a mean score of 13.5 ± 4.37 (maximum score of 26 points), indicating a gap in knowledge application.</p><p><strong>Conclusions: </strong>This study highlights the potential for improving the implementation of trauma and bleeding management Guidelines in the prehospital setting. The findings indicate that, despite a strong awareness of the Bleeding Guidelines, a gap exists between knowledge and practical application. This gap underscores the need for enhanced training, regular continuing education, and the use of algorithms and checklists to support Bleeding Guideline adherence. Further studies are needed to explore the reasons for this non-adherence, and additional qualitative research in this field is essential.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"152"},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing medical care at mass gathering sporting events: the 2023 Ryder Cup experience.","authors":"Cesare Mercalli, Federico Emiliano Ghio, Sara Bonizzato, Barbara Mantellini, Carlo Serini, Paolo Pallavicini, Maria Rosaria Squeo, Andrea Ferretti, Andrew Murray, Luca Carenzo","doi":"10.1186/s12873-025-01316-7","DOIUrl":"10.1186/s12873-025-01316-7","url":null,"abstract":"<p><strong>Background: </strong>The Ryder Cup is a men's golf competition and one of the most high-profile sporting events worldwide, presenting significant challenges for healthcare providers, especially when hosted in non-urban areas. Medical professionals must address sport-related illness and injuries in elite athletes, exacerbations of pre-existing conditions in spectators, and occupational health issues among staff and volunteers. Proper healthcare planning and infrastructure are crucial to reduce the burden on local hospitals and ensure timely care for everyone involved. Aim of the study is to describe the medical plan and assess its effectiveness, along with patient care records to report the epidemiology of illnesses and injuries at the 2023 Ryder Cup.</p><p><strong>Methods: </strong>The Medical Emergency Services at the 2023 Ryder Cup required careful planning including communication, infrastructures, a field hospital and multiple first aid stations. On-field resources such as patrol crews and transport vehicles ensured rapid response. A multidisciplinary team - including specialized physicians, nurses, and technicians - provided medical care. This retrospective observational study evaluates the medical plan and electronic patient care records.</p><p><strong>Results: </strong>During the six-day event, medical teams treated 513 patients, with a Patient Presentation Rate of 16.5 per 10,000 attendees. Among them, 43% required care at the Main Hospital, while mobile first aid teams (37%) and fixed first aid stations (21%) managed the remaining cases. At the Main Hospital, the most common reasons for assessment included trauma (35%), cardiovascular symptoms (14%), and heat-related illnesses (11%). Minor cases were treated with wound care, cryotherapy, and basic medical assessments.Diagnostic procedures were performed as needed, with 13% of patients undergoing electrocardiogram, 5% receiving point-of-care blood tests, and 4% undergoing ultrasound examinations. The median length of stay at the Main Hospital was 28 min, with 13% of patients requiring extended observation.Most patients (81%) were discharged on-site, while 14% were referred to local ED or specialized medical facilities. The hospital admission rate was 1.0 per 10,000 attendees, with primary reasons for referral including the need for advanced imaging or prolonged observation.</p><p><strong>Conclusion: </strong>The 2023 Ryder Cup medical response system demonstrated the effectiveness of a well-organized on-site healthcare infrastructure in managing mass-gathering emergencies. Future events can benefit from refining medical protocols, enhancing data collection, and strengthening collaboration with local healthcare institutions to optimize patient care and resource utilization.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"151"},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of traumatic pregnant patients admitted to the emergency department: a retrospective study.","authors":"Mustafa Alpaslan, Necmi Baykan, Ömer Salt, Fatma Ünlü, Serhat Koyuncu, Oğuzhan Bol, Mükerrem Altuntaş, Hakan Güner","doi":"10.1186/s12873-025-01313-w","DOIUrl":"10.1186/s12873-025-01313-w","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"150"},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and outcome of extracorporeal cardiopulmonary resuscitation patients with out-of-hospital cardiac arrest and in-hospital cardiac arrest: a nationwide prospective and observational study of 939 hospitals in China.","authors":"Di Shi, Bo Li, Wei Pan, Fuping Guo, Hui Jiang, Liu Chengxi, Huadong Zhu, Jihai Liu, Jieqing Chen, Liang Zong, Xiao Song, Chen Lin, Xin Ding, Xiang Zhou, Chang Yin, Bin Du","doi":"10.1186/s12873-025-01275-z","DOIUrl":"10.1186/s12873-025-01275-z","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac arrest represents a global health challenge characterized by high mortality and morbidity rates. Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly considered as an effective treatment for cardiac arrest; however, its application remains a subject of debate. Furthermore, limited studies have analysed out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) populations within the same context.</p><p><strong>Methods: </strong>This study involved the selection of patients who experienced cardiac arrests and were supported by ECPR in 939 tertiary hospitals across 31 provinces between 2016 and 2021. The data was derived from the ECMO Quality Improvement Project.</p><p><strong>Results: </strong>Among the 939 tertiary hospitals, a total of 6374 patients who had cardiac arrest events were identified, categorized as OHCA (1465) and IHCA (4909). Survivors in the IHCA group were comparatively younger (50 [IQR: 33-62] vs. 53 [IQR: 38-64], p < 0.001) and more likely to be female (34.2% vs. 29.8%, p < 0.05), while in the OHCA group, survivor characteristics remained similar. Multivariable modelling indicated that in the IHCA group, age ≥ 60, regions with lower GDP, acute respiratory distress syndrome (ARDS), sepsis, electrolyte disturbance, hypertension, acute renal failure, and disseminated intravascular coagulation (DIC) were identified as independent risk factors associated with hospital mortality. Conversely, being female, experiencing arrhythmia, myocarditis, and acute heart failure were identified as protective factors. In the OHCA group, independent risk factors included regions with lower GDP, hypertension, and DIC, while arrhythmia, myocarditis, ARDS, and acute heart failure were protective factors.</p><p><strong>Conclusions: </strong>This nationwide prospective observational study provides insights into the utilization of ECPR among patients experiencing OHCA and IHCA. It also underscores the disparity in risk factors and outcomes between OHCA and IHCA populations, indicating differences in clinical practices. Notably, DIC is recognized as a risk factor associated with mortality. Although the exact mechanism remains unclear, it is recommended as a screening indicator for risk stratification.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"149"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 emergency medical responses to nursing homes in a local area of Germany.","authors":"Christine Gaik, Hinnerk Wulf, Valesco Mann, Dennis Humburg, Benjamin Vojnar","doi":"10.1186/s12873-025-01306-9","DOIUrl":"10.1186/s12873-025-01306-9","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"148"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}