African Journal of Emergency Medicine最新文献

{"title":"Vehicle extrication in road traffic crashes: a descriptive analysis of an advanced medical rescue service in South Africa","authors":"Naseef Abdullah ,&nbsp;Jaydon Rose ,&nbsp;Egnall Brown ,&nbsp;Heike Geduld","doi":"10.1016/j.afjem.2025.04.003","DOIUrl":"10.1016/j.afjem.2025.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Road Traffic Crashes (RTCs) represent a significant global health challenge, with a disproportionate burden on low- and middle-income countries. Vehicle extrication is a critical Emergency Medical Service (EMS) intervention enabling early assessment and treatment of entrapped patients but remains understudied in resource-limited settings despite its potential impact on patient outcomes. This study describes the RTC extrication burden managed by a public sector EMS in the Western Cape, South Africa.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of Computer-Aided-Dispatch (CAD) and a paper-based rescue case record data related to the extrication practises of 97 Advanced Medical Rescuers stationed across 25 rescue stations throughout the Western Cape of South Africa. Standard descriptive statistical procedures were applied to all variables.</div></div><div><h3>Results</h3><div>Of 2,587,979 EMS activations during the study period, 23,899 (0.9 %) required specialised medical rescue activations, and 11,699 (0.5 %) were for transport-related emergencies. Of these, 719 (6.1 %) cases necessitated vehicle extrication. Light motor vehicles accounted for most extrications (78.2 %, <em>n</em> = 562), while heavy motor vehicles showed higher proportional extrication rates (127.5 vs. 75.8 extrications per 1,000 RTCs). Peak rescue activations occurred between 08h00 and 20h00 (11.9 %, <em>n</em> = 1,388). The predominant extrication techniques were vehicle stabilisation (24.9 %, <em>n</em> = 501), third-door conversion (23.9 %, <em>n</em> = 482 ), and dashboard lift (13.9 %, <em>n</em> = 282). Most patients (83.1 %, <em>n</em> = 24,588) presented with routine (green) or non-urgent (yellow) acuity, though rural areas exhibited a higher proportion of high-acuity cases</div></div><div><h3>Conclusion</h3><div>This first comprehensive analysis of the RTC extrication burden in a South African province reveals significant spatial and temporal variations in rescue needs and techniques. Our findings provide valuable extrication-related data to inform targeted training programs, standardised extrication protocols, and strategic resource allocation to enhance EMS capabilities in resource-limited settings. These insights provide a foundation for workforce planning and specialised training to improve outcomes for entrapped RTC patients in similar contexts.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 621-627"},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912895","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":"Factors associated with mortality among patients with penetrating non-compressible torso hemorrhage in South Africa: A retrospective cohort study","authors":"Smitha Bhaumik ,&nbsp;Adane F. Wogu ,&nbsp;Lani Finck ,&nbsp;Maria Jamison ,&nbsp;Mengli Xiao ,&nbsp;Julia Finn ,&nbsp;Hendrick Lategan ,&nbsp;Janette Verster ,&nbsp;Shaheem de Vries ,&nbsp;Craig Wylie ,&nbsp;Lesley Hodson ,&nbsp;Mohammet Mayet ,&nbsp;Leigh Wagner ,&nbsp;L'Oreal Snyders ,&nbsp;Karlien Doubell ,&nbsp;Elaine Erasmus ,&nbsp;George Oosthuizen ,&nbsp;Christiaan Rees ,&nbsp;Steven G Schauer ,&nbsp;Julia Dixon ,&nbsp;Nee-Kofi Mould-Millman","doi":"10.1016/j.afjem.2025.02.002","DOIUrl":"10.1016/j.afjem.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-compressible torso haemorrhage (NCTH), resulting from penetrating trauma to the chest, abdomen, or pelvis, places patients at high risk of death. The objectives of this study are to characterize the injury profile of patients with penetrating NCTH who receive care within a tiered public trauma system in South Africa and to identify factors associated with mortality.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of clinical data collected from Sept-2021 through Dec-2023 across 6 hospitals, 4 ambulance bases, and 2 mortuaries in the Western Cape Province that form a cohesive trauma referral pathway. The study included patients age ≥18 years with penetrating NCTH who arrived at the hospital within 3 h and received blood products within 6 h of injury. NCTH was defined as Abbreviated Injury Scale (AIS) ≥ 2 to chest, abdomen or pelvis, with a systolic blood pressure ≤ 100 mm Hg. Data were analysed using multivariable logistic regression and Cox proportional hazards modelling.</div></div><div><h3>Results</h3><div>There were 202 patients with penetrating NCTH; median age was 29 years, 94 % male, injured by stab wounds (66 %) and gunshot wounds (31 %). Most patients (85 %) sustained injuries to the chest, 33 % to the abdomen, and 1.5 % to the bony pelvis. In a multivariable logistic regression model, elevated Triage Early Warning Score (TEWS ≥7) (OR 4.45, 95 % CI 1.58–13.90), elevated New Injury Severity Score (NISS &gt;25) (OR 4.35, 95 % CI 1.45–16.30), anatomic injury to the abdomen/pelvis (OR 2.76, 95 % CI 1.03–7.74), and receipt of acute airway intervention (OR 4.97, 95 % CI 1.94–13.20) were significantly associated with 7-day in-hospital mortality.</div></div><div><h3>Conclusion</h3><div>Among patients with penetrating injuries to the torso, high triage scores, high injury severity, early airway interventions, and penetrating abdominal trauma were associated with elevated mortality risk.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 613-620"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900330","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":"Knowledge, attitude, practice, and associated factors of physicians towards cardiopulmonary resuscitation at a tertiary hospital in Ethiopia","authors":"Natan Mulubrhan Alemseged ,&nbsp;Gobena Tesfaye ,&nbsp;Abera Admas","doi":"10.1016/j.afjem.2025.04.002","DOIUrl":"10.1016/j.afjem.2025.04.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiopulmonary resuscitation (CPR) is performed on victims of cardiac arrest. It is important for health professionals to successfully perform these lifesaving skills. This study aimed to assess the CPR knowledge, attitude, practice, and associated factors of physicians working at Hiwot Fana Comprehensive Specialized Hospital Eastern Ethiopia.</div></div><div><h3>Methods</h3><div>An institutional-based cross-sectional study was implemented. A stratified random sampling technique was used. A self-administered questionnaire and a manikin was used to assess CPR skills. The results are presented in the text, tables, and graphs. Multivariate logistic regression was used to identify factors associated with levels of competency. The adjusted odds ratio with the corresponding 95 % confidence interval was calculated to show the strength of the association.</div></div><div><h3>Results</h3><div>This study revealed that 63.7 % [95 % CI 57 % -71 %] of the physicians had good knowledge, and their overall competency in CPR was found to be 63 % [95 % CI 54 % - 72 %]. They have a positive attitude regarding the importance of CPR and a willingness to provide CPR. Physicians who took resuscitation training (adjusted odds ratio 11.8 [4.29–32.42]) and a specialist (adjusted odds ratio 7.99 [1.87–34.27]) were more competent than their counterparts.</div></div><div><h3>Discussion</h3><div>The results demonstrate suboptimal CPR competency among physicians’ representatives at a tertiary hospital in Eastern Ethiopia. Taking CPR training and being a specialist were found to have an effect on being competent in CPR. Participants reported positive attitudes toward doing CPR. A system of regular, updated refresher training for physicians should be implemented to maintain CPR competencies. Hospitals should also be equipped with materials and drugs needed for CPR.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 607-612"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving role of paramedicine educators: A scoping review","authors":"Judy Sheahan ,&nbsp;Richelle Duffy ,&nbsp;Charmaine Cunningham","doi":"10.1016/j.afjem.2025.04.001","DOIUrl":"10.1016/j.afjem.2025.04.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Growing responsibility and changes to paramedicine and prehospital care have led to rapid developments in paramedicine education. Despite educational requirements at increasingly advanced levels, it remains unclear how academia has responded to these changes and if they're developing the requisite skills and knowledge.</div></div><div><h3>Methods</h3><div>A scoping review was undertaken to understand the present role of paramedicine educators and how they've adapted to the evolution of paramedicine education worldwide. Data searches were performed across eight electronic databases, six paramedicine journals, grey literature, and included sources reference lists.</div></div><div><h3>Results</h3><div>The four-staged search strategy revealed 1,738 sources, of which 32 remained for final synthesis. In general, there was a lack of contemporary research examining the role of the paramedicine educator despite changes to Higher Education provision and function of paramedics. Noteworthy was the absence of articles from Africa, South America, and major parts of Europe, highlighting the need for development in these regions. There is a lack of clear role descriptions or definitions for paramedicine educators. Inconsistencies were highlighted in entry criteria and progression routes across paramedicine academia globally, emphasising the importance of support for transitioning and established paramedicine educators.</div></div><div><h3>Discussion</h3><div>These findings have important implications for Higher Education. Professional demands are on the rise, creating a need to introduce clearly defined roles for paramedicine educators to provide clarity in expectations and increase confidence. The changing landscape of care provision in paramedicine from the historic emergency care focussed model to a more autonomous and inclusive sphere of out-of-hospital care, provides an ideal opportunity to progress and shape the identity of the paramedicine educator.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 595-601"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839122","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":"Acute trauma care training in undergraduate medical education programs in Uganda; A cross-sectional survey of final year medical students","authors":"Nankabirwa Victoria ,&nbsp;Guma Isaac ,&nbsp;Kabunga Jonathan ,&nbsp;Bigogo H Charles ,&nbsp;Navume Deborah Esther ,&nbsp;Mwanje T Kintu ,&nbsp;Nakiwere Elizabeth ,&nbsp;Chelimo Gerald ,&nbsp;Lemi Edward Nelson ,&nbsp;Kanyike A Marvin ,&nbsp;Francis M. Mwaka ,&nbsp;Law J Tyler ,&nbsp;Annet N. Alenyo ,&nbsp;Bulamba Fred","doi":"10.1016/j.afjem.2025.01.003","DOIUrl":"10.1016/j.afjem.2025.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma is one of the leading causes of death and long-term disability globally. In sub-Saharan Africa, the number of specialist emergency care personnel is inadequate and task shifting is common. We aimed to assess the variation in knowledge on acute trauma care, and self-perceived confidence in performing lifesaving skills amongst final year medical students in Uganda.</div></div><div><h3>Methods</h3><div>We conducted a multi-institutional, cross-sectional survey among final year medical students who had just completed their training from eight medical schools in Uganda. We assessed knowledge using a 25 standardized multiple-choice question test adopted from a previous study, and self-reported confidence in perfuming lifesaving skills, scored on a 5-Point Likert scale.</div></div><div><h3>Results</h3><div>Some 246 (88.5 %) participants responded to the survey and 241 provided complete data. The mean knowledge score was 58.9 % (SD; 12.4) with a mean variation ratio of 0.36 (SD; 0.17). The mean self-perceived confidence score of the participants was 3.8 (SD; 1.0) with relatively high scores in interpretation of radiological investigations (mean 4.2, SD; 0.9) and patient assessment (mean 4.1, SD; 0.9), and lower scores in management of different categories of trauma patients (mean 3.8, SD; 1.0) and performing life-saving procedures (mean 3.5, SD; 0.9). Only three institutions had emergency medicine physicians, with one at each institution, and 146 (60.6 %) of participants received no dedicated trauma training.</div></div><div><h3>Conclusion</h3><div>Final year medical students exiting training in Uganda had variable knowledge in acute trauma care and intermediate self-perceived confidence in performing lifesaving skills. Training programs need to standardize and strengthen acute trauma training and provide specialists and resources essential for trauma training at undergraduate level.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 602-606"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844774","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":"Global health research abstracts: January ‘25","authors":"Jonathan Kajjimu","doi":"10.1016/j.afjem.2025.02.003","DOIUrl":"10.1016/j.afjem.2025.02.003","url":null,"abstract":"<div><div>The African Journal of Emergency Medicine, in partnership with several other regional emergency medicine journals, publishes abstracts from each respective journal. Abstracts are not necessarily linked to open access papers however, all abstracts are accessible without subscription.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 592-594"},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815725","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":"Global health research abstracts: April ‘25","authors":"Jonathan Kajjimu","doi":"10.1016/j.afjem.2025.03.001","DOIUrl":"10.1016/j.afjem.2025.03.001","url":null,"abstract":"<div><div>The African Journal of Emergency Medicine, in partnership with several other regional emergency medicine journals, publishes abstracts from each respective journal. Abstracts are not necessarily linked to open access papers however, all abstracts are accessible without subscription.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 589-591"},"PeriodicalIF":1.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of smartphones and mobile apps in Egyptian Emergency Departments: A cross-sectional study","authors":"Mohamed Hassan ,&nbsp;Roeya Aboelnasr ,&nbsp;Aya Farag Attia Elsebaey ,&nbsp;Sherif Shawky Elabd ,&nbsp;Alaa H. Ewida ,&nbsp;Waleed M. Taha","doi":"10.1016/j.afjem.2025.02.001","DOIUrl":"10.1016/j.afjem.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of mobile devices in healthcare environments has steeply increased the creation of medical software applications, or apps, for these platforms. It can enhance the provided healthcare services.</div></div><div><h3>Aim</h3><div>This study aimed to assess the prevalence of smartphone use among health care professionals (HCPs) in Egypt and detect the possible benefits and challenges identified by HCPs in the emergency department associated with the use of smartphones and mobile apps.</div></div><div><h3>Methods</h3><div>A cross-sectional 23-question structured survey-based study was conducted and distributed electronically via GoogleForms. The survey targeted all healthcare professionals working in emergency departments in Egypt either from University hospitals or the Ministry of Health.</div></div><div><h3>Results</h3><div>Among 130 responders, almost 89 % were physicians, while the rest were nurses. In addition, 53.1 % had one to four years of experience. Our study revealed that 62.3 % of the responders used medical apps daily with 61.5 % using smartphones during their work shifts. Though, about 81.5 % demonstrated limited or no availability of necessary technology infrastructure in ED. Furthermore, peer-reviewed evidence use was detected among 80 % of the responders using Google and other search engines for health-related information, and about 23 % of them used WikiEM and Wikipedia. Nevertheless, Medscape, MedCalc, and Up-to-date were among the most used medical apps with 69.2 %, 44.6 %, and 33.1 % respectively. Most of the responders were confident that smartphones could improve patient safety. In addition, satisfaction with current mobile apps was detected by more than 60 %, and most of the HCPs agreed that smartphones and mobile apps are crucial for future emergency healthcare delivery.</div></div><div><h3>Conclusion</h3><div>The use of smartphone apps in Egyptian ED is critical and is widespread among health providers; however, proper training on peer-reviewed resources can serve in improving medical health services.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 584-588"},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychoactive substance use among psychiatric in-patients presenting to the Emergency Centre of a district hospital in Cape Town, South Africa. A retrospective descriptive study","authors":"Nardus Droomer,&nbsp;Paul Xafis,&nbsp;Philip Cloete","doi":"10.1016/j.afjem.2025.02.006","DOIUrl":"10.1016/j.afjem.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Mental illness and substance use are major global challenges, with their impact on Emergency Centres becoming evident, especially in South Africa. Patients facing these issues require significant resources from both hospital and community services. However, there is a lack of local data regarding the prevalence of concurrent mental health and substance use disorders. This study aims to evaluate the extent of psychoactive substance use within the psychiatric population at a District Hospital in Cape Town, South Africa.</div></div><div><h3>Methods</h3><div>This study is a single-centre, retrospective descriptive analysis. It includes all patients referred to the inpatient psychiatric service over six months, recorded in an electronic database. Data were statistically analysed, considering the following variables: urine drug test results to identify specific substance (s) used, sex, age, diagnosis, and repeat visits.</div></div><div><h3>Results</h3><div>A total of 597 patient visits were analysed. Fifty-nine percent tested positive for at least one substance. The patients’ average age was 34 years. A greater percentage of visits were for males (58 %), with males exhibiting a higher rate of positive test results (64 %) than females (51 %). Among the 146 repeat visits, a significant association was found between the number of visits and positive test results, with 73 % of patients with ≥2 repeat visits testing positive for substances (<em>p</em> &lt; 0.001). Cannabis (60 %), methamphetamines (47 %), benzodiazepines (26 %), opioids (7 %), and cocaine (1 %) were the substances most frequently reported.</div></div><div><h3>Conclusions</h3><div>Emergency Centres in South Africa are impacted by individuals seeking mental health care, and substance use significantly exacerbates these challenges. Substance use creates serious physical, mental, and social implications for patients. As emergency care practitioners and members of the broader healthcare system, we play vital roles in addressing these issues. This study provides valuable insights into the complexities of the situation and suggests potential approaches for intervention.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 577-583"},"PeriodicalIF":1.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global health research abstracts: February ‘25","authors":"Jonathan Kajjimu","doi":"10.1016/j.afjem.2025.02.004","DOIUrl":"10.1016/j.afjem.2025.02.004","url":null,"abstract":"<div><div>The African Journal of Emergency Medicine, in partnership with several other regional emergency medicine journals, publishes abstracts from each respective journal. Abstracts are not necessarily linked to open access papers however, all abstracts are accessible without subscription.</div></div>","PeriodicalId":48515,"journal":{"name":"African Journal of Emergency Medicine","volume":"15 2","pages":"Pages 574-576"},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687701","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}