Pub Date : 2025-10-22DOI: 10.1016/j.jemermed.2025.10.016
Zachary Miles MD, Jonathan Thornton MD
Background
Out-of-hospital cardiac arrest (OHCA) due to ST-elevation myocardial infarction (STEMI) requires immediate intervention to optimize survival and neurological outcomes. Rapid recognition and treatment are critical, especially in prehospital settings.
Case Report
A 61-year-old female with a history of coronary artery disease suffered a witnessed cardiac arrest while riding a city bus. Bystanders activated Emergency Medical Services (EMS), who promptly initiated cardiopulmonary resuscitation (CPR) and defibrillation, achieving return of spontaneous circulation (ROSC). Due to the patient’s proximity to a tertiary care STEMI center, EMS made the unconventional decision to continue resuscitative efforts en route using the city bus, bypassing traditional ambulance transport. Upon arrival, she underwent emergent percutaneous coronary intervention (PCI) and achieved full neurological recovery.
Why Should an Emergency Physician Be Aware of This?
This case illustrates the importance of flexibility and innovation in prehospital care. However, it also highlights the need to balance innovation with adherence to EMS safety protocols and statutory requirements. Uninterrupted CPR, rapid defibrillation, and expedited transport—even via unconventional means—can dramatically impact outcomes in STEMI-related cardiac arrest, but such strategies must always be weighed against provider and patient safety.
{"title":"Seconds Matter: Novel Transport Solutions in Urban Settings Reduce Transport Times","authors":"Zachary Miles MD, Jonathan Thornton MD","doi":"10.1016/j.jemermed.2025.10.016","DOIUrl":"10.1016/j.jemermed.2025.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) due to ST-elevation myocardial infarction (STEMI) requires immediate intervention to optimize survival and neurological outcomes. Rapid recognition and treatment are critical, especially in prehospital settings.</div></div><div><h3>Case Report</h3><div>A 61-year-old female with a history of coronary artery disease suffered a witnessed cardiac arrest while riding a city bus. Bystanders activated Emergency Medical Services (EMS), who promptly initiated cardiopulmonary resuscitation (CPR) and defibrillation, achieving return of spontaneous circulation (ROSC). Due to the patient’s proximity to a tertiary care STEMI center, EMS made the unconventional decision to continue resuscitative efforts en route using the city bus, bypassing traditional ambulance transport. Upon arrival, she underwent emergent percutaneous coronary intervention (PCI) and achieved full neurological recovery.</div></div><div><h3>Why Should an Emergency Physician Be Aware of This?</h3><div>This case illustrates the importance of flexibility and innovation in prehospital care. However, it also highlights the need to balance innovation with adherence to EMS safety protocols and statutory requirements. Uninterrupted CPR, rapid defibrillation, and expedited transport—even via unconventional means—can dramatically impact outcomes in STEMI-related cardiac arrest, but such strategies must always be weighed against provider and patient safety.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 20-22"},"PeriodicalIF":1.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546581","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}
Pub Date : 2025-10-22DOI: 10.1016/j.jemermed.2025.10.020
René Christian Bleeg , Ninna Rysholt Poulsen , Mona Kyndi Pedersen , Peter Skrejborg , Morten Breinholt Søvsø
Background
Emergency Medical Services (EMS) continuously document treatment and patient condition information in the electronic prehospital medical record (ePMR) during care. Only selected information is communicated via telephone to the emergency department (ED) and the waiting ED team, potentially leading to loss of valuable information.
Objectives
To pilot-test whether implementing real-time, screen-based access to prehospital medical records before patient arrival enhances the ED team’s readiness.
Methods
Pilot study of implementing wall-mounted screens connected to the ePMR system in the ED trauma rooms in the North Denmark Regional Hospital. Three months before and four months after implementation, we measured the overall self-reported readiness of the ED team by questionnaires. The readiness rating was based on a visual analogue scale (VAS 0–15) and three sub-questions.
Results
We included 393 questionnaires (traumas N = 199, medical emergencies N = 194) corresponding to capture of 46% (141/307) of all events. For all questionnaires combined, overall readiness increased from a median of 7.1 (IQR 6.5–12.9) to 12.8 (IQR 9.7–14), p < 0.001. Stratified by event type, results persisted. Trauma: 7.1 (6.8–12.7) to 13.4 (9–14), p < 0.001; medical emergency: 7.1 (5.7–12.9) to 12.2 (9.7–13.9), p < 0.001.
Conclusions
Measured by questionnaires, we found that easy access to real-time EMS patient data, visualized on a screen in the trauma room before receiving patients with traumas or medical emergencies, significantly increases the overall self-reported readiness of the ED team members.
{"title":"Can Real-Time Prehospital Medical Record Data Presented on A Screen Enhance Team Readiness in the Emergency Department? A Pilot Study","authors":"René Christian Bleeg , Ninna Rysholt Poulsen , Mona Kyndi Pedersen , Peter Skrejborg , Morten Breinholt Søvsø","doi":"10.1016/j.jemermed.2025.10.020","DOIUrl":"10.1016/j.jemermed.2025.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Emergency Medical Services (EMS) continuously document treatment and patient condition information in the electronic prehospital medical record (ePMR) during care. Only selected information is communicated via telephone to the emergency department (ED) and the waiting ED team, potentially leading to loss of valuable information.</div></div><div><h3>Objectives</h3><div>To pilot-test whether implementing real-time, screen-based access to prehospital medical records before patient arrival enhances the ED team’s readiness.</div></div><div><h3>Methods</h3><div>Pilot study of implementing wall-mounted screens connected to the ePMR system in the ED trauma rooms in the North Denmark Regional Hospital. Three months before and four months after implementation, we measured the overall self-reported readiness of the ED team by questionnaires. The readiness rating was based on a visual analogue scale (VAS 0–15) and three sub-questions.</div></div><div><h3>Results</h3><div>We included 393 questionnaires (traumas N = 199, medical emergencies N = 194) corresponding to capture of 46% (141/307) of all events. For all questionnaires combined, overall readiness increased from a median of 7.1 (IQR 6.5–12.9) to 12.8 (IQR 9.7–14), <em>p</em> < 0.001. Stratified by event type, results persisted. Trauma: 7.1 (6.8–12.7) to 13.4 (9–14), <em>p</em> < 0.001; medical emergency: 7.1 (5.7–12.9) to 12.2 (9.7–13.9), <em>p</em> < 0.001.</div></div><div><h3>Conclusions</h3><div>Measured by questionnaires, we found that easy access to real-time EMS patient data, visualized on a screen in the trauma room before receiving patients with traumas or medical emergencies, significantly increases the overall self-reported readiness of the ED team members.</div></div><div><h3>Trial registration</h3><div>None.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 199-210"},"PeriodicalIF":1.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621941","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}
Pub Date : 2025-10-22DOI: 10.1016/j.jemermed.2025.10.025
Young Woo Um MD, MSC , You Hwan Jo MD, PHD , Jae Hyuk Lee MD, PHD , Inwon Park MD, PHD , Ji Eun Hwang MD, MSC , Seung Hyun Kang MD , Narae Kim MD
Background
As populations age, emergency department (ED) visits by older patients are rising, many of whom present in critically ill state. This trend necessitates frailty assessment in clinical decision-making to guide appropriate goals of care.
Objectives
This study aims to evaluate the prognostic value of the Clinical Frailty Scale (CFS) among critically ill older ED patients.
Methods
In this prospective cohort study at a South Korean tertiary hospital, patients aged ≥65 years with Korean Triage and Acuity Scale levels 1 or 2 were included and grouped by CFS scores: nonfrail (1–3), mildly frail (4–5), moderately frail (6), severely frail (7), and very severely frail (8). The primary outcome was 3-month mortality. Data were analyzed using the Cox proportional hazards model and area under the receiver operating characteristic curve (AUROC).
Results
A cohort of 502 patients was analyzed (median age 78 years). The median CFS score was 5, with 73.8% classified as frail (CFS ≥ 4). The 3-month mortality rate was 29.0%. Hazard ratios (95% confidence intervals [CIs]) for 3-month mortality were 1.97 (1.14–3.39) for CFS 6, 2.56 (1.51–4.32) for CFS 7, and 3.99 (2.03–7.86) for CFS 8. Adding CFS categories significantly improved 3-month mortality prediction (AUROC [95% CI] with CFS: 0.74 [0.69–0.79], without CFS: 0.70 [0.65–0.75], p = 0.003), although the overall predictive performance remained similar.
Conclusion
Higher CFS scores were significantly associated with increased 3-month mortality among critically ill older ED patients, highlighting the prognostic value of the CFS.
{"title":"The Prognostic Value of the Clinical Frailty Scale in Critically Ill Older Adult Patients in the Emergency Department","authors":"Young Woo Um MD, MSC , You Hwan Jo MD, PHD , Jae Hyuk Lee MD, PHD , Inwon Park MD, PHD , Ji Eun Hwang MD, MSC , Seung Hyun Kang MD , Narae Kim MD","doi":"10.1016/j.jemermed.2025.10.025","DOIUrl":"10.1016/j.jemermed.2025.10.025","url":null,"abstract":"<div><h3>Background</h3><div>As populations age, emergency department (ED) visits by older patients are rising, many of whom present in critically ill state. This trend necessitates frailty assessment in clinical decision-making to guide appropriate goals of care.</div></div><div><h3>Objectives</h3><div>This study aims to evaluate the prognostic value of the Clinical Frailty Scale (CFS) among critically ill older ED patients.</div></div><div><h3>Methods</h3><div>In this prospective cohort study at a South Korean tertiary hospital, patients aged ≥65 years with Korean Triage and Acuity Scale levels 1 or 2 were included and grouped by CFS scores: nonfrail (1–3), mildly frail (4–5), moderately frail (6), severely frail (7), and very severely frail (8). The primary outcome was 3-month mortality. Data were analyzed using the Cox proportional hazards model and area under the receiver operating characteristic curve (AUROC).</div></div><div><h3>Results</h3><div>A cohort of 502 patients was analyzed (median age 78 years). The median CFS score was 5, with 73.8% classified as frail (CFS ≥ 4). The 3-month mortality rate was 29.0%. Hazard ratios (95% confidence intervals [CIs]) for 3-month mortality were 1.97 (1.14–3.39) for CFS 6, 2.56 (1.51–4.32) for CFS 7, and 3.99 (2.03–7.86) for CFS 8. Adding CFS categories significantly improved 3-month mortality prediction (AUROC [95% CI] with CFS: 0.74 [0.69–0.79], without CFS: 0.70 [0.65–0.75], <em>p</em> = 0.003), although the overall predictive performance remained similar.</div></div><div><h3>Conclusion</h3><div>Higher CFS scores were significantly associated with increased 3-month mortality among critically ill older ED patients, highlighting the prognostic value of the CFS.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 33-43"},"PeriodicalIF":1.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573053","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}
Pub Date : 2025-10-14DOI: 10.1016/j.jemermed.2025.10.003
Michael N. Megafu DO, MPH , Noelle Nerenberg BS , Hirshal Pandya MS , Omar Guerrero BS , Jacob Speechley DO , Samuelson E. Osifo MD , Paul Tornetta III MD , Robert L. Parisien MD , Antonio Cusano MD , Investigation performed by the Scientific Collaborative for Orthopaedic Research and Education (SCORE) Group
Background
The epidemiology of boxing-related upper extremity injuries in the United States (US) has been minimally described, with only one prior study examining data up to 2016.
Objective
To update and extend national estimates of these injuries through 2023, highlighting post-2016 trends and the impact of the COVID-19 pandemic.
Methods
The National Electronic Surveillance System database was queried for upper extremity boxing-related injuries presenting to US emergency departments from January 1, 2014, to December 31, 2023. Injuries were categorized by body part, diagnosis, and disposition. National estimates (NE) were calculated based on each hospital's assigned statistical sample weight. Linear regression assessed trends over time.
Results
A total of 106,903 boxing-related upper extremity injuries were identified. The hand (48.3%), wrist (18.9%), and shoulder (14.2%) were the most commonly affected areas. Fractures were the most frequent diagnosis (26.4%), followed by strains/sprains (24.1%), other injuries (21.3%), and contusions/abrasions (17.9%). Only 3.3% of cases required hospital admission. Injury counts dropped sharply in 2020 during the COVID-19 pandemic (NE = 7282; p < 0.01 compared to pre-COVID years of 2014–2019), followed by a rebound in subsequent years, peaking in 2023 (NE = 13,258). Linear regression showed a nonsignificant annual decrease of 76 injuries over 10 years (p = 0.70; coefficient = −75.6; 95% CI: −508.7 to 357.5).
Conclusion
Boxing-related upper extremities most commonly involve the hand, with fractures representing the most common diagnosis. In conclusion, the rebound in injury rates in 2023, which diverges from the pre-COVID trend of gradual decline, warrants attention.
{"title":"Epidemiology of Boxing-Related Upper Extremity Injuries Presenting to Emergency Departments in the United States from 2014 to 2023","authors":"Michael N. Megafu DO, MPH , Noelle Nerenberg BS , Hirshal Pandya MS , Omar Guerrero BS , Jacob Speechley DO , Samuelson E. Osifo MD , Paul Tornetta III MD , Robert L. Parisien MD , Antonio Cusano MD , Investigation performed by the Scientific Collaborative for Orthopaedic Research and Education (SCORE) Group","doi":"10.1016/j.jemermed.2025.10.003","DOIUrl":"10.1016/j.jemermed.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>The epidemiology of boxing-related upper extremity injuries in the United States (US) has been minimally described, with only one prior study examining data up to 2016.</div></div><div><h3>Objective</h3><div>To update and extend national estimates of these injuries through 2023, highlighting post-2016 trends and the impact of the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>The National Electronic Surveillance System database was queried for upper extremity boxing-related injuries presenting to US emergency departments from January 1, 2014, to December 31, 2023. Injuries were categorized by body part, diagnosis, and disposition. National estimates (NE) were calculated based on each hospital's assigned statistical sample weight. Linear regression assessed trends over time.</div></div><div><h3>Results</h3><div>A total of 106,903 boxing-related upper extremity injuries were identified. The hand (48.3%), wrist (18.9%), and shoulder (14.2%) were the most commonly affected areas. Fractures were the most frequent diagnosis (26.4%), followed by strains/sprains (24.1%), other injuries (21.3%), and contusions/abrasions (17.9%). Only 3.3% of cases required hospital admission. Injury counts dropped sharply in 2020 during the COVID-19 pandemic (NE = 7282; <em>p</em> < 0.01 compared to pre-COVID years of 2014–2019), followed by a rebound in subsequent years, peaking in 2023 (NE = 13,258). Linear regression showed a nonsignificant annual decrease of 76 injuries over 10 years (<em>p</em> = 0.70; coefficient = −75.6; 95% CI: −508.7 to 357.5).</div></div><div><h3>Conclusion</h3><div>Boxing-related upper extremities most commonly involve the hand, with fractures representing the most common diagnosis. In conclusion, the rebound in injury rates in 2023, which diverges from the pre-COVID trend of gradual decline, warrants attention.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 44-50"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573106","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}
Pub Date : 2025-10-12DOI: 10.1016/j.jemermed.2025.10.014
Alexander S. Finch MD , Samuel M. Keim MD, MS , Venkatesh R. Bellamkonda MD , Tobias Kummer MD , Larissa T. Shiue MD , Christopher R. Carpenter MD, MSC , Srikar R. Adhikari MD, MS
Background
Geriatric hip fractures are a commonly encountered in the emergency department (ED) with significant associated morbidity and mortality. Providing appropriate analgesia has many challenges, and the majority of patients require opioid medications for adequate pain control. Complications of opioids include delirium, respiratory depression, and constipation, among others. Ultrasound-guided nerve blocks for hip fractures have emerged as an additional modality to utilize as part of a multimodal approach to analgesia.
Clinical Question
In older adults diagnosed with hip fractures in the ED, do ultrasound-guided nerve blocks improve patient-centered outcomes when compared with standard interventions, such as opioid analgesia?
Evidence Review
Three studies were reviewed: a systematic review and meta-analysis, a randomized controlled trial, and a prospective feasibility study.
Conclusion
Compared with standard ED management strategies for analgesia after hip fractures in adults, fascia iliaca compartment blocks do not reduce mortality. Single injection fascia iliaca compartment blocks appeared to improve delirium rates, though this effect was not seen on the included randomized controlled trial. Hospital length-of-stay and opioid use were decreased in patients who received nerve blocks for hip fractures. Some ED literature also supports using femoral nerve blocks as the blocks are feasible, effective, and safe.
{"title":"Does Point-of-Care Ultrasound-Guided Nerve Block for Geriatric Hip Fracture Analgesia in the Emergency Department Improve Outcomes?","authors":"Alexander S. Finch MD , Samuel M. Keim MD, MS , Venkatesh R. Bellamkonda MD , Tobias Kummer MD , Larissa T. Shiue MD , Christopher R. Carpenter MD, MSC , Srikar R. Adhikari MD, MS","doi":"10.1016/j.jemermed.2025.10.014","DOIUrl":"10.1016/j.jemermed.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Geriatric hip fractures are a commonly encountered in the emergency department (ED) with significant associated morbidity and mortality. Providing appropriate analgesia has many challenges, and the majority of patients require opioid medications for adequate pain control. Complications of opioids include delirium, respiratory depression, and constipation, among others. Ultrasound-guided nerve blocks for hip fractures have emerged as an additional modality to utilize as part of a multimodal approach to analgesia.</div></div><div><h3>Clinical Question</h3><div>In older adults diagnosed with hip fractures in the ED, do ultrasound-guided nerve blocks improve patient-centered outcomes when compared with standard interventions, such as opioid analgesia?</div></div><div><h3>Evidence Review</h3><div>Three studies were reviewed: a systematic review and meta-analysis, a randomized controlled trial, and a prospective feasibility study.</div></div><div><h3>Conclusion</h3><div>Compared with standard ED management strategies for analgesia after hip fractures in adults, fascia iliaca compartment blocks do not reduce mortality. Single injection fascia iliaca compartment blocks appeared to improve delirium rates, though this effect was not seen on the included randomized controlled trial. Hospital length-of-stay and opioid use were decreased in patients who received nerve blocks for hip fractures. Some ED literature also supports using femoral nerve blocks as the blocks are feasible, effective, and safe.</div></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"80 ","pages":"Pages 81-90"},"PeriodicalIF":1.3,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573039","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":"If Depression Leads to the Emergency Department, the Pathway is Broken: Rethinking Integrated Care For Mental Health","authors":"Waseem Jerjes MBBS MSc MDres PhD MRCGP FHEA FAcadMed","doi":"10.1016/j.jemermed.2025.07.043","DOIUrl":"10.1016/j.jemermed.2025.07.043","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 421-422"},"PeriodicalIF":1.3,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268522","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}
Pub Date : 2025-10-11DOI: 10.1016/j.jemermed.2025.08.006
Drew Castleberry MD , Michael P. Wilson MD, PhD , Kimberly Nordstrom MD, JD
{"title":"Reply to Letter to the Editor","authors":"Drew Castleberry MD , Michael P. Wilson MD, PhD , Kimberly Nordstrom MD, JD","doi":"10.1016/j.jemermed.2025.08.006","DOIUrl":"10.1016/j.jemermed.2025.08.006","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 402-403"},"PeriodicalIF":1.3,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268535","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}
Pub Date : 2025-10-11DOI: 10.1016/S0736-4679(25)00398-1
{"title":"American Academy of Emergency Medicine","authors":"","doi":"10.1016/S0736-4679(25)00398-1","DOIUrl":"10.1016/S0736-4679(25)00398-1","url":null,"abstract":"","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":"78 ","pages":"Pages 425-426"},"PeriodicalIF":1.3,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262840","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}