首页 > 最新文献

Singapore medical journal最新文献

英文 中文
Development of the modified Safety Attitude Questionnaire for the medical imaging department. 为医学影像科编制经修改的安全态度问卷。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-02-06 DOI: 10.4103/singaporemedj.SMJ-2021-254
Ravi Chanthriga Eturajulu, Maw Pin Tan, Mohd Idzwan Zakaria, Karuthan Chinna, Kwan Hoong Ng

Introduction: Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments.

Methods: Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups.

Results: A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups.

Conclusion: The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.

简介医学影像科经常发生医疗事故。这些错误经常受到患者安全文化的影响。本研究旨在为医学影像科室开发一种合适的患者安全文化评估工具:方法:邀请一家教学医院医学影像科的工作人员填写通用简版安全态度问卷(SAQ)。采用 Cronbach's α 评估内部一致性和可靠性。进行了确认性因子分析(CFA),以检查模型的拟合情况。正面回答百分比(PPR)的截止值为 60%。对不同职业组的 PPR 值进行了比较:共收到 300 份完整问卷,回复率为 75.4%。在信度分析中,最初的 32 项 SAQ 的 Cronbach's α 为 0.941。有六个分量表与 CFA 的拟合效果不佳。修改后的 5 个分量表、22 个项目的模型(SAQ-MI)显示出更好的拟合效果(拟合优度指数≥0.9,比较拟合指数≥0.9,塔克-刘易斯指数≥0.9,均方根近似误差≤0.08)。22 个项目的 Cronbach's α 为 0.921。最后五个分量表分别为安全和团队合作氛围、工作满意度、压力认可度、管理感知和工作条件,PPR 分别为 62%、68%、57%、61% 和 60%。据统计,放射技师、医生和其他职业群体之间的 PPR 存在明显差异:修改后的五因素 22 项 SAQ-MI 是评估医学影像科室患者安全文化的合适工具。不同职业群体在患者安全文化方面存在差异,这将为未来的干预研究提供参考。
{"title":"Development of the modified Safety Attitude Questionnaire for the medical imaging department.","authors":"Ravi Chanthriga Eturajulu, Maw Pin Tan, Mohd Idzwan Zakaria, Karuthan Chinna, Kwan Hoong Ng","doi":"10.4103/singaporemedj.SMJ-2021-254","DOIUrl":"10.4103/singaporemedj.SMJ-2021-254","url":null,"abstract":"<p><strong>Introduction: </strong>Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments.</p><p><strong>Methods: </strong>Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups.</p><p><strong>Results: </strong>A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups.</p><p><strong>Conclusion: </strong>The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"33-40"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222521","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}
引用次数: 0
Immune thrombocytopenia in infants: a retrospective study with comparison to toddlers. 婴儿免疫性血小板减少症:一项与幼儿比较的回顾性研究。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-03-02 DOI: 10.4103/singaporemedj.SMJ-2021-184
Anselm Chi-Wai Lee

Introduction: Immune thrombocytopenia (ITP) is the most common cause of acquired bleeding in childhood, but little is known about the clinical course and outcomes in infants with ITP.

Methods: This is a retrospective study of all infants (1-12 months of age) and toddlers (13-47 months of age) diagnosed with ITP from a single centre during a 13-year period. The following data were compared between the two patients groups: demographics, severity of bleeding, platelet counts, duration of illness, development of chronic ITP, treatment and association with recent vaccination.

Results: Twenty-two infants and 30 toddlers were diagnosed and followed up for ITP during the study period. Infants with ITP generally had minor or mild bleeding (19, 86.4%) and seldom required treatment (7, 31.8%), and their thrombocytopenia resolved at a mean of 1.90 months after diagnosis. Besides age, the sex ratio, severity of bleeding, platelet counts and proportion that required treatment were comparable between infants and toddlers. Fewer infants developed chronic ITP (1/22 vs. 9/30, P = 0.032), but more infants had a history of vaccination in the preceding 6 weeks prior to diagnosis of ITP (13/22 vs. 1/30, P < 0.001).

Conclusion: ITP in infants is almost always a self-limiting and transient illness, and the majority of cases do not require treatment.

免疫性血小板减少症(ITP)是儿童期获得性出血的最常见原因,但对ITP患儿的临床病程和结局知之甚少。方法:这是一项回顾性研究,对13年间来自单一中心诊断为ITP的所有婴儿(1-12个月大)和幼儿(13-47个月大)进行研究。比较两组患者的以下数据:人口统计学、出血严重程度、血小板计数、病程、慢性ITP的发展、治疗以及与近期疫苗接种的关系。结果:22名婴儿和30名幼儿在研究期间被诊断并随访ITP。ITP患儿一般有轻微或轻度出血(19.86.4%),很少需要治疗(7.31.8%),其血小板减少症在诊断后平均1.90个月消退。除了年龄,性别比例、出血严重程度、血小板计数和需要治疗的比例在婴幼儿之间是相似的。发生慢性ITP的婴儿较少(1/22比9/30,P = 0.032),但更多的婴儿在ITP诊断前6周有疫苗接种史(13/22比1/30,P < 0.001)。结论:婴幼儿ITP多为一过性自限性疾病,多数不需要治疗。
{"title":"Immune thrombocytopenia in infants: a retrospective study with comparison to toddlers.","authors":"Anselm Chi-Wai Lee","doi":"10.4103/singaporemedj.SMJ-2021-184","DOIUrl":"10.4103/singaporemedj.SMJ-2021-184","url":null,"abstract":"<p><strong>Introduction: </strong>Immune thrombocytopenia (ITP) is the most common cause of acquired bleeding in childhood, but little is known about the clinical course and outcomes in infants with ITP.</p><p><strong>Methods: </strong>This is a retrospective study of all infants (1-12 months of age) and toddlers (13-47 months of age) diagnosed with ITP from a single centre during a 13-year period. The following data were compared between the two patients groups: demographics, severity of bleeding, platelet counts, duration of illness, development of chronic ITP, treatment and association with recent vaccination.</p><p><strong>Results: </strong>Twenty-two infants and 30 toddlers were diagnosed and followed up for ITP during the study period. Infants with ITP generally had minor or mild bleeding (19, 86.4%) and seldom required treatment (7, 31.8%), and their thrombocytopenia resolved at a mean of 1.90 months after diagnosis. Besides age, the sex ratio, severity of bleeding, platelet counts and proportion that required treatment were comparable between infants and toddlers. Fewer infants developed chronic ITP (1/22 vs. 9/30, P = 0.032), but more infants had a history of vaccination in the preceding 6 weeks prior to diagnosis of ITP (13/22 vs. 1/30, P < 0.001).</p><p><strong>Conclusion: </strong>ITP in infants is almost always a self-limiting and transient illness, and the majority of cases do not require treatment.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"20-23"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9180495","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}
引用次数: 0
Risk and protective factors associated with adolescent depression in Singapore: a systematic review. 新加坡青少年抑郁症的相关风险和保护因素:系统回顾。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-04-26 DOI: 10.4103/singaporemedj.SMJ-2021-192
Wei Sheng Goh, Jun Hao Norman Tan, Yang Luo, Sok Hui Ng, Mohamed Sufyan Bin Mohamed Sulaiman, John Chee Meng Wong, Victor Weng Keong Loh

Introduction: Adolescent depression is prevalent, and teen suicide rates are on the rise locally. A systemic review to understand associated risk and protective factors is important to strengthen measures for the prevention and early detection of adolescent depression and suicide in Singapore. This systematic review aims to identify the factors associated with adolescent depression in Singapore.

Methods: A systematic search on the following databases was performed on 21 May 2020: PubMed, EMBASE and PsycINFO. Full texts were reviewed for eligibility, and the included studies were appraised for quality using the Newcastle Ottawa Scale. Narrative synthesis of the finalised articles was performed through thematic analysis.

Results: In total, eight studies were included in this review. The four factors associated with adolescent depression identified were: (1) sociodemographic factors (gender, ethnicity); (2) psychological factors, including childhood maltreatment exposure and psychological constructs (hope, optimism); (3) coexisting chronic medical conditions (asthma); and (4) lifestyle factors (sleep inadequacy, excessive internet use and pathological gaming).

Conclusion: The identified factors were largely similar to those reported in the global literature, except for sleep inadequacy along with conspicuously absent factors such as academic stress and strict parenting, which should prompt further research in these areas. Further research should focus on current and prospective interventions to improve mental health literacy, targeting sleep duration, internet use and gaming, and mitigating the risk of depression in patients with chronic disease in the primary care and community setting.

青少年抑郁症很普遍,青少年自杀率在当地呈上升趋势。系统性回顾了解相关的风险和保护因素对于加强新加坡青少年抑郁症和自杀的预防和早期发现措施非常重要。本系统综述旨在确定新加坡青少年抑郁症的相关因素。方法:于2020年5月21日对PubMed、EMBASE和PsycINFO数据库进行系统检索。对全文进行审查以确定其合格性,并使用纽卡斯尔渥太华量表对纳入的研究进行质量评价。通过主题分析对定稿文章进行叙事综合。结果:本综述共纳入8项研究。与青少年抑郁相关的四个因素是:(1)社会人口因素(性别、种族);(2)心理因素,包括童年虐待暴露和心理构念(希望、乐观);(3)患有慢性疾病(哮喘)的;(4)生活方式因素(睡眠不足、过度上网、病态游戏)。结论:所确定的因素与国际文献报道的基本相似,除了睡眠不足,以及明显缺失的因素,如学业压力和严格的父母教育,这些因素应促使这些领域的进一步研究。进一步的研究应侧重于当前和未来的干预措施,以提高心理健康素养,针对睡眠时间、互联网使用和游戏,并在初级保健和社区环境中减轻慢性疾病患者的抑郁风险。
{"title":"Risk and protective factors associated with adolescent depression in Singapore: a systematic review.","authors":"Wei Sheng Goh, Jun Hao Norman Tan, Yang Luo, Sok Hui Ng, Mohamed Sufyan Bin Mohamed Sulaiman, John Chee Meng Wong, Victor Weng Keong Loh","doi":"10.4103/singaporemedj.SMJ-2021-192","DOIUrl":"10.4103/singaporemedj.SMJ-2021-192","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent depression is prevalent, and teen suicide rates are on the rise locally. A systemic review to understand associated risk and protective factors is important to strengthen measures for the prevention and early detection of adolescent depression and suicide in Singapore. This systematic review aims to identify the factors associated with adolescent depression in Singapore.</p><p><strong>Methods: </strong>A systematic search on the following databases was performed on 21 May 2020: PubMed, EMBASE and PsycINFO. Full texts were reviewed for eligibility, and the included studies were appraised for quality using the Newcastle Ottawa Scale. Narrative synthesis of the finalised articles was performed through thematic analysis.</p><p><strong>Results: </strong>In total, eight studies were included in this review. The four factors associated with adolescent depression identified were: (1) sociodemographic factors (gender, ethnicity); (2) psychological factors, including childhood maltreatment exposure and psychological constructs (hope, optimism); (3) coexisting chronic medical conditions (asthma); and (4) lifestyle factors (sleep inadequacy, excessive internet use and pathological gaming).</p><p><strong>Conclusion: </strong>The identified factors were largely similar to those reported in the global literature, except for sleep inadequacy along with conspicuously absent factors such as academic stress and strict parenting, which should prompt further research in these areas. Further research should focus on current and prospective interventions to improve mental health literacy, targeting sleep duration, internet use and gaming, and mitigating the risk of depression in patients with chronic disease in the primary care and community setting.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"2-14"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447018","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}
引用次数: 0
Paediatric one-day admission: why and is it necessary? 儿科一日入院:为什么需要?
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-02-15 DOI: 10.4103/singaporemedj.SMJ-2021-117
Jing Zhan Lock, Zi Xean Khoo, Jen Heng Pek

Introduction: Paediatric patients admitted to the inpatient units from the emergency department (ED) are increasing, but the mean length of stay has fallen significantly. We aimed to determine the reasons behind paediatric one-day admissions in Singapore and to assess their necessity.

Methods: A retrospective study involving paediatric patients who were admitted from a general ED of an adult tertiary hospital to a paediatric tertiary hospital between 1 August 2018 and 30 April 2020. One-day admission was defined as an inpatient stay of less than 24 h from the time of admission to discharge. An unnecessary admission was defined as one with no diagnostic test ordered, intravenous medication administered, therapeutic procedure performed or specialty review made in the inpatient unit. Data were captured in a standardised form and analysed.

Results: There were 13,944 paediatric attendances - 1,160 (8.3%) paediatric patients were admitted. Among these, 481 (41.4%) were one-day admissions. Upper respiratory tract infection (62, 12.9%), gastroenteritis (60, 12.5%) and head injury (52, 10.8%) were the three most common conditions. The three most common reasons for ED admissions were inpatient treatment (203, 42.2%), inpatient monitoring (185, 38.5%) and inpatient diagnostic investigations (32, 12.3%). Ninety-six (20.0%) one-day admissions were unnecessary.

Conclusion: Paediatric one-day admissions present an opportunity to develop and implement interventions targeted at the healthcare system, the ED, the paediatric patient and their caregiver, in order to safely slow down and perhaps reverse the trend of increased hospital admissions.

简介从急诊科(ED)转入住院部的儿科病人越来越多,但平均住院时间却大幅缩短。我们旨在确定新加坡儿科一日入院的原因,并评估其必要性:这是一项回顾性研究,涉及 2018 年 8 月 1 日至 2020 年 4 月 30 日期间从成人三级医院普通急诊室收治到儿科三级医院的儿科患者。入院一天定义为从入院到出院的住院时间少于24小时。不必要的入院定义为在住院部未开具诊断检测单、未进行静脉用药、未执行治疗程序或未进行专科复查的入院。数据以标准化表格采集并进行分析:共有 13,944 名儿科就诊者,其中 1,160 名(8.3%)儿科患者入院。其中,481 人(41.4%)住院一天。上呼吸道感染(62 人,12.9%)、肠胃炎(60 人,12.5%)和头部受伤(52 人,10.8%)是最常见的三种疾病。急诊室收治病人的三个最常见原因是住院治疗(203 人,42.2%)、住院监测(185 人,38.5%)和住院诊断检查(32 人,12.3%)。96人(20.0%)的单日入院是不必要的:儿科单日入院为制定和实施针对医疗系统、急诊室、儿科患者及其护理人员的干预措施提供了机会,从而安全地减缓甚至扭转入院人数增加的趋势。
{"title":"Paediatric one-day admission: why and is it necessary?","authors":"Jing Zhan Lock, Zi Xean Khoo, Jen Heng Pek","doi":"10.4103/singaporemedj.SMJ-2021-117","DOIUrl":"10.4103/singaporemedj.SMJ-2021-117","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric patients admitted to the inpatient units from the emergency department (ED) are increasing, but the mean length of stay has fallen significantly. We aimed to determine the reasons behind paediatric one-day admissions in Singapore and to assess their necessity.</p><p><strong>Methods: </strong>A retrospective study involving paediatric patients who were admitted from a general ED of an adult tertiary hospital to a paediatric tertiary hospital between 1 August 2018 and 30 April 2020. One-day admission was defined as an inpatient stay of less than 24 h from the time of admission to discharge. An unnecessary admission was defined as one with no diagnostic test ordered, intravenous medication administered, therapeutic procedure performed or specialty review made in the inpatient unit. Data were captured in a standardised form and analysed.</p><p><strong>Results: </strong>There were 13,944 paediatric attendances - 1,160 (8.3%) paediatric patients were admitted. Among these, 481 (41.4%) were one-day admissions. Upper respiratory tract infection (62, 12.9%), gastroenteritis (60, 12.5%) and head injury (52, 10.8%) were the three most common conditions. The three most common reasons for ED admissions were inpatient treatment (203, 42.2%), inpatient monitoring (185, 38.5%) and inpatient diagnostic investigations (32, 12.3%). Ninety-six (20.0%) one-day admissions were unnecessary.</p><p><strong>Conclusion: </strong>Paediatric one-day admissions present an opportunity to develop and implement interventions targeted at the healthcare system, the ED, the paediatric patient and their caregiver, in order to safely slow down and perhaps reverse the trend of increased hospital admissions.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"15-19"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363620","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}
引用次数: 0
Gastrointestinal transit time of radiopaque ingested foreign bodies in children: experience of two paediatric tertiary centres. 儿童摄入不透射线的异物的胃肠道传递时间:两个儿科三级中心的经验。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-04-25 DOI: 10.4103/singaporemedj.SMJ-2021-408
Chen Xiang Ang, Win Kai Mun, Marion Margaret Aw, Diana Lin, Shu-Ling Chong, Lin Yin Ong, Shireen Anne Nah

Introduction: Foreign body (FB) ingestion is a common paediatric emergency. While guidelines exist for urgent intervention, less is known of the natural progress of FBs passing through the gastrointestinal tract (GIT). We reviewed these FB transit times in an outpatient cohort.

Methods: A retrospective review was performed on all children (≤18 years) treated for radiopaque FB ingestion at two major tertiary paediatric centres from 2015 to 2016. Demographic data, FB types, outcomes and hospital visits (emergency department [ED] and outpatient) were recorded. All cases discharged from the ED with outpatient follow-up were included. We excluded those who were not given follow-up appointments and those admitted to inpatient wards. We categorised the outcomes into confirmed passage (ascertained via abdominal X-ray or reported direct stool visualisation by patients/caregivers) and assumed passage (if patients did not attend follow-up appointments).

Results: Of the 2,122 ED visits for FB ingestion, 350 patients who were given outpatient follow-up appointments were reviewed (median age 4.35 years [range: 0.5-14.7], 196 [56%] male). The largest proportion (16%) was aged 1-2 years. Coins were the most common ingested FB, followed by toys. High-risk FB (magnets or batteries) formed 9% of cases ( n =33). The 50 th centile for FB retention was 8, 4 and 7 days for coins, batteries and other radiopaque FBs, respectively; all confirmed passages occurred at 37, 7 and 23 days, respectively. Overall, 197 (68%) patients defaulted on their last given follow-up.

Conclusion: This study provides insight into the transit times of FB ingested by children, which helps medical professionals to decide on the optimal time for follow-up visits and provide appropriate counsel to caregivers.

简介:异物(FB)摄入是一种常见的儿科急症。虽然存在紧急干预的指南,但对FBs通过胃肠道(GIT)的自然过程知之甚少。我们在门诊队列中回顾了这些FB转运时间。方法:回顾性分析2015年至2016年在两家主要三级儿科中心接受不透明FB摄入治疗的所有儿童(≤18岁)。记录人口统计数据、FB类型、结局和医院就诊(急诊科[ED]和门诊)。所有从急诊科出院并接受门诊随访的病例均包括在内。我们排除了那些没有给予随访预约和住院病房的患者。我们将结果分为确认通过(通过腹部x光或患者/护理人员报告的直接粪便可视化)和假设通过(如果患者没有参加随访预约)。结果:在2122例因摄入FB就诊的ED患者中,有350例患者接受了门诊随访预约(中位年龄4.35岁[范围:0.5-14.7],196例[56%]男性)。1 ~ 2岁占比最大(16%)。硬币是最常见的FB,其次是玩具。高风险FB(磁铁或电池)占9% (n =33)。硬币、电池和其他不透射线的FBs的第50百分位保留率分别为8、4和7天;所有确认的传代分别发生在37、7和23天。总体而言,197例(68%)患者在最后一次随访中违约。结论:本研究提供了儿童摄入FB的转运时间,有助于医疗专业人员确定最佳随访时间,并为护理人员提供适当的咨询。
{"title":"Gastrointestinal transit time of radiopaque ingested foreign bodies in children: experience of two paediatric tertiary centres.","authors":"Chen Xiang Ang, Win Kai Mun, Marion Margaret Aw, Diana Lin, Shu-Ling Chong, Lin Yin Ong, Shireen Anne Nah","doi":"10.4103/singaporemedj.SMJ-2021-408","DOIUrl":"10.4103/singaporemedj.SMJ-2021-408","url":null,"abstract":"<p><strong>Introduction: </strong>Foreign body (FB) ingestion is a common paediatric emergency. While guidelines exist for urgent intervention, less is known of the natural progress of FBs passing through the gastrointestinal tract (GIT). We reviewed these FB transit times in an outpatient cohort.</p><p><strong>Methods: </strong>A retrospective review was performed on all children (≤18 years) treated for radiopaque FB ingestion at two major tertiary paediatric centres from 2015 to 2016. Demographic data, FB types, outcomes and hospital visits (emergency department [ED] and outpatient) were recorded. All cases discharged from the ED with outpatient follow-up were included. We excluded those who were not given follow-up appointments and those admitted to inpatient wards. We categorised the outcomes into confirmed passage (ascertained via abdominal X-ray or reported direct stool visualisation by patients/caregivers) and assumed passage (if patients did not attend follow-up appointments).</p><p><strong>Results: </strong>Of the 2,122 ED visits for FB ingestion, 350 patients who were given outpatient follow-up appointments were reviewed (median age 4.35 years [range: 0.5-14.7], 196 [56%] male). The largest proportion (16%) was aged 1-2 years. Coins were the most common ingested FB, followed by toys. High-risk FB (magnets or batteries) formed 9% of cases ( n =33). The 50 th centile for FB retention was 8, 4 and 7 days for coins, batteries and other radiopaque FBs, respectively; all confirmed passages occurred at 37, 7 and 23 days, respectively. Overall, 197 (68%) patients defaulted on their last given follow-up.</p><p><strong>Conclusion: </strong>This study provides insight into the transit times of FB ingested by children, which helps medical professionals to decide on the optimal time for follow-up visits and provide appropriate counsel to caregivers.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"24-27"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9439943","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}
引用次数: 0
Use of metallic ureteric stents for chronic ureteric obstruction and its association with value-based care. 使用金属输尿管支架治疗慢性输尿管梗阻及其与价值导向型护理的关系。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-02-01 DOI: 10.4103/singaporemedj.SMJ-2021-418
Yu Xi Terence Law, Ang Zhou, David Terrence Consigliere, Benjamin Yen Seow Goh, Ho Yee Tiong

Introduction: We aimed to compare the real-world data and our clinical experience with metallic stents (MSs) and conventional polymeric stents (PSs) in the management of both malignant and benign chronic ureteric obstruction (CUO), in terms of clinical outcomes and costs.

Methods: Clinical data from our institution, including outcomes for all ureteric stents inserted for long-term management of CUO from all causes from 2014 to 2017, were retrospectively reviewed and compared between the MS and PS episodes.

Results: A total of 247 stents were placed in 63 patients with CUO over the 4-year study period. Of these, 45 stents were MSs. There was no significant difference in all baseline characteristics between the MS and PS groups, except for the aetiology of obstructive cause. Mean indwelling stent duration was significantly greater for MS than for PS (228.6 ± 147.0 vs. 146.1 ± 66.0 days, P < 0.001), thereby leading to lower average number of stent changes per year in the MS group compared to the PS group (1.4 vs. 6.3 times, respectively). Despite the higher unit cost of MS compared to PS, there was no significant mean cost difference overall (cost per dwelling day SGD 7.82 ± SGD 10.44 vs. SGD 8.23 ± SGD 20.50, P = 0.888).

Conclusion: Resonance MS is a better option than PS to manage CUO from malignant and benign causes because its significantly longer indwelling time mitigates the higher unit cost of the stent. It potentially reduces the number of procedures and operations in patients. Thus, it should be considered for all patients with CUO requiring long-term ureteric drainage.

导言:我们的目的是比较真实世界的数据和我们在治疗恶性和良性慢性输尿管梗阻(CUO)时使用金属支架(MS)和传统聚合物支架(PS)在临床结果和成本方面的临床经验:回顾性审查本院的临床数据,包括2014年至2017年为长期治疗各种原因引起的慢性输尿管梗阻而植入的所有输尿管支架的疗效,并比较MS和PS两种支架的疗效:在4年的研究期间,共为63名CUO患者植入了247个支架。其中,45 个支架为 MS。除阻塞性病因外,MS 组和 PS 组的所有基线特征均无明显差异。MS 组的平均留置支架时间明显长于 PS 组(228.6 ± 147.0 对 146.1 ± 66.0 天,P < 0.001),因此 MS 组每年更换支架的平均次数低于 PS 组(分别为 1.4 对 6.3 次)。尽管与 PS 相比,MS 的单位成本较高,但总体平均成本差异并不明显(每居住日成本 7.82 新元± 10.44 新元 vs. 8.23 新元± 20.50 新元,P = 0.888):与 PS 相比,共振 MS 是治疗恶性和良性 CUO 的更好选择,因为共振 MS 的留置时间明显更长,从而降低了支架较高的单位成本。它有可能减少患者的手术和操作次数。因此,所有需要长期输尿管引流的 CUO 患者都应考虑使用这种方法。
{"title":"Use of metallic ureteric stents for chronic ureteric obstruction and its association with value-based care.","authors":"Yu Xi Terence Law, Ang Zhou, David Terrence Consigliere, Benjamin Yen Seow Goh, Ho Yee Tiong","doi":"10.4103/singaporemedj.SMJ-2021-418","DOIUrl":"10.4103/singaporemedj.SMJ-2021-418","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to compare the real-world data and our clinical experience with metallic stents (MSs) and conventional polymeric stents (PSs) in the management of both malignant and benign chronic ureteric obstruction (CUO), in terms of clinical outcomes and costs.</p><p><strong>Methods: </strong>Clinical data from our institution, including outcomes for all ureteric stents inserted for long-term management of CUO from all causes from 2014 to 2017, were retrospectively reviewed and compared between the MS and PS episodes.</p><p><strong>Results: </strong>A total of 247 stents were placed in 63 patients with CUO over the 4-year study period. Of these, 45 stents were MSs. There was no significant difference in all baseline characteristics between the MS and PS groups, except for the aetiology of obstructive cause. Mean indwelling stent duration was significantly greater for MS than for PS (228.6 ± 147.0 vs. 146.1 ± 66.0 days, P < 0.001), thereby leading to lower average number of stent changes per year in the MS group compared to the PS group (1.4 vs. 6.3 times, respectively). Despite the higher unit cost of MS compared to PS, there was no significant mean cost difference overall (cost per dwelling day SGD 7.82 ± SGD 10.44 vs. SGD 8.23 ± SGD 20.50, P = 0.888).</p><p><strong>Conclusion: </strong>Resonance MS is a better option than PS to manage CUO from malignant and benign causes because its significantly longer indwelling time mitigates the higher unit cost of the stent. It potentially reduces the number of procedures and operations in patients. Thus, it should be considered for all patients with CUO requiring long-term ureteric drainage.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"28-32"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237884","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}
引用次数: 0
Clinical predictors of acute kidney injury in children with acute post-streptococcal glomerulonephritis: a tertiary centre experience. 链球菌感染后急性肾小球肾炎患儿急性肾损伤的临床预测因素:一家三级中心的经验。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-01-06 DOI: 10.4103/singaporemedj.SMJ-2021-092
Wan Adlina Wan Yusof, Najib Majdi Yaacob, Ariffin Nasir, Surini Yusoff, Mohamad Ikram Ilias
{"title":"Clinical predictors of acute kidney injury in children with acute post-streptococcal glomerulonephritis: a tertiary centre experience.","authors":"Wan Adlina Wan Yusof, Najib Majdi Yaacob, Ariffin Nasir, Surini Yusoff, Mohamad Ikram Ilias","doi":"10.4103/singaporemedj.SMJ-2021-092","DOIUrl":"10.4103/singaporemedj.SMJ-2021-092","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"54-57"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183271","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}
引用次数: 0
Efficacy and safety of echinocandins versus triazoles or amphotericin B in the treatment of invasive fungal infections in paediatric patients: a systematic review. 棘白菌素与三唑或两性霉素B治疗儿科患者侵袭性真菌感染的疗效和安全性:一项系统综述。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-01 Epub Date: 2023-08-23 DOI: 10.4103/singaporemedj.SMJ-2021-173
Lu Lu Htet, Lay Nee Wang, Yi Xin Liew
{"title":"Efficacy and safety of echinocandins versus triazoles or amphotericin B in the treatment of invasive fungal infections in paediatric patients: a systematic review.","authors":"Lu Lu Htet, Lay Nee Wang, Yi Xin Liew","doi":"10.4103/singaporemedj.SMJ-2021-173","DOIUrl":"10.4103/singaporemedj.SMJ-2021-173","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"58-62"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168028","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}
引用次数: 0
Does the COVID-19 XBB Omicron subvariant signal the beginning of the end of the pandemic? COVID-19 XBB Omicron 子变体是否预示着大流行开始结束?
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 Epub Date: 2022-12-01 DOI: 10.4103/singaporemedj.SMJ-2022-180
Jinghao Nicholas Ngiam, Abdurrahmaan Al-Mubaarak, Sebastian Maurer-Stroh, Paul Anantharajah Tambyah

Abstract: All pandemic viruses have eventually adapted to human hosts so that they become more transmissible and less virulent. The XBB Omicron subvariant is rapidly becoming the dominant strain of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Singapore from October 2022 and is one of several variants circulating globally with the potential to dominate autumn/winter waves in different countries. The XBB Omicron subvariant has demonstrated increased transmissibility through an apparent propensity for immune evasion. This is to be expected in the natural evolution of a virus in a population highly vaccinated with a vaccine targeting the spike protein of the original Wuhan strain of the virus. This review explores the important implications of the rising prevalence of the SARS-CoV-2 Omicron subvariant for public health in Singapore and beyond.

所有大流行病毒最终都会适应人类宿主,从而变得更易传播、毒性更弱。从 2022 年 10 月起,XBB Omicron 亚变种正迅速成为新加坡严重急性呼吸系统综合症冠状病毒-2(SARS-CoV-2)的优势毒株,也是全球流行的几个变种之一,有可能在不同国家的秋冬季流行中占主导地位。XBB Omicron 亚变异体因具有明显的免疫逃避倾向而显示出更强的传播性。在接种了针对武汉病毒原始毒株尖峰蛋白疫苗的高度接种人群中,病毒的自然进化过程中出现这种情况是意料之中的。本综述探讨了 SARS-CoV-2 Omicron 亚变异株流行率上升对新加坡及其他地区公共卫生的重要影响。
{"title":"Does the COVID-19 XBB Omicron subvariant signal the beginning of the end of the pandemic?","authors":"Jinghao Nicholas Ngiam, Abdurrahmaan Al-Mubaarak, Sebastian Maurer-Stroh, Paul Anantharajah Tambyah","doi":"10.4103/singaporemedj.SMJ-2022-180","DOIUrl":"10.4103/singaporemedj.SMJ-2022-180","url":null,"abstract":"<p><strong>Abstract: </strong>All pandemic viruses have eventually adapted to human hosts so that they become more transmissible and less virulent. The XBB Omicron subvariant is rapidly becoming the dominant strain of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Singapore from October 2022 and is one of several variants circulating globally with the potential to dominate autumn/winter waves in different countries. The XBB Omicron subvariant has demonstrated increased transmissibility through an apparent propensity for immune evasion. This is to be expected in the natural evolution of a virus in a population highly vaccinated with a vaccine targeting the spike protein of the original Wuhan strain of the virus. This review explores the important implications of the rising prevalence of the SARS-CoV-2 Omicron subvariant for public health in Singapore and beyond.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"658-664"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540990","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}
引用次数: 0
Localised swelling at sites of dermal filler injections following administration of Covid-19 vaccines: a systematic review. 注射Covid-19疫苗后皮肤填充物部位局部肿胀:一项系统综述
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-01 Epub Date: 2023-04-13 DOI: 10.4103/singaporemedj.SMJ-2021-157
Chew Lip Ng, Evelyn Yuxin Tay, Alwyn Ray D'Souza

Introduction: Localised swelling at sites of filler injections has been reported in the Moderna mRNA-1273 coronavirus disease 2019 (COVID-19) vaccine trial.

Methods: We conducted a review of the existing data and literature on the potential pathophysiology for this adverse event and its potential management.

Results: Data from the Moderna and Pfizer COVID-19 vaccine Phase 3 trial and one case series were available. Three out of 30,400 subjects developed possible filler reaction in the Moderna trial. Two other cases were reported after emergency use authorisation. Reactions occurred at a mean of 1.4 days post-vaccination. Fillers were injected at a mean of 14.1 months before vaccination. Areas involved included lips, infraorbital areas and tear troughs. Treatment included observation, corticosteroids, antihistamine, hyaluronidase and 5-fluorouracil.

Conclusion: Rare, self-limiting adverse reactions to dermal fillers have been reported following COVID-19 vaccination. Clinicians should be aware of this clinical phenomenon and its management, as vaccination is carried out globally.

在2019年Moderna mRNA-1273冠状病毒病(COVID-19)疫苗试验中,报告了填充剂注射部位的局部肿胀。方法:我们对现有的关于该不良事件的潜在病理生理学及其潜在处理的资料和文献进行了回顾。结果:Moderna和辉瑞公司的COVID-19疫苗3期试验和一个病例系列的数据可用。在Moderna试验中,30400名受试者中有3人出现了可能的填充物反应。在获得紧急使用授权后报告了另外两起案件。疫苗接种后平均1.4天发生反应。填充物在接种前平均14.1个月注射。涉及的区域包括嘴唇、眶下区域和泪沟。治疗包括观察、皮质类固醇、抗组胺药、透明质酸酶和5-氟尿嘧啶。结论:COVID-19疫苗接种后皮肤填充物出现了罕见的自限性不良反应。临床医生应意识到这一临床现象及其管理,因为疫苗接种是在全球开展的。
{"title":"Localised swelling at sites of dermal filler injections following administration of Covid-19 vaccines: a systematic review.","authors":"Chew Lip Ng, Evelyn Yuxin Tay, Alwyn Ray D'Souza","doi":"10.4103/singaporemedj.SMJ-2021-157","DOIUrl":"10.4103/singaporemedj.SMJ-2021-157","url":null,"abstract":"<p><strong>Introduction: </strong>Localised swelling at sites of filler injections has been reported in the Moderna mRNA-1273 coronavirus disease 2019 (COVID-19) vaccine trial.</p><p><strong>Methods: </strong>We conducted a review of the existing data and literature on the potential pathophysiology for this adverse event and its potential management.</p><p><strong>Results: </strong>Data from the Moderna and Pfizer COVID-19 vaccine Phase 3 trial and one case series were available. Three out of 30,400 subjects developed possible filler reaction in the Moderna trial. Two other cases were reported after emergency use authorisation. Reactions occurred at a mean of 1.4 days post-vaccination. Fillers were injected at a mean of 14.1 months before vaccination. Areas involved included lips, infraorbital areas and tear troughs. Treatment included observation, corticosteroids, antihistamine, hyaluronidase and 5-fluorouracil.</p><p><strong>Conclusion: </strong>Rare, self-limiting adverse reactions to dermal fillers have been reported following COVID-19 vaccination. Clinicians should be aware of this clinical phenomenon and its management, as vaccination is carried out globally.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"665-668"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383468","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}
引用次数: 0
期刊
Singapore medical journal
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1