Uncategorized

Scientific publication trends of emergency department of International Federation for Emergency Medicine members, 2009 to 2018

a b s t r a c t

Background: Emergency medicine (EM) is a rapidly developing specialty worldwide. The Scientific publications trend is one of the parameters to evaluate national EM developmental milestones. This study was performed to analyze the publication trends from emergency departments (EDs) of International Federation for Emergency Medicine (IFEM) full member countries from 2009 to 2018.

Methods: All data were retrieved from the SciVerse Scopus database. IFEM full member countries where EM was recognized as a specialty before 2009 and annual publication numbers exceeded 12 in 2018 were included. The EM journals list was adopted from the 2017 Journal Citation Reports. Publications with the first author affiliated with EDs were divided into EM or non-EM journal groups according to the publishing journal. The slope (?) of the linear regression was used to assess the trends of publication numbers. The correlation between the 2009 publi- cation number and the trend of publication between 2009 and 2018 was measured by Pearson’s correlation co- efficient (r). The correlation between funding numbers and publication numbers was analyzed by Spearman’s rank correlation coefficient (rs).

Results: We identified 30,130 publications with first authors from EDs in 19 countries. The numbers of publica- tions in both EM and non-EM journals showed an increasing trend in 12 countries. Fifteen of the 19 countries had a greater increasing trend in non-EM journals than in EM journals. The 2009 publication numbers were pos- itively correlated with the publication increasing trend between 2009 and 2018 in both EM and non-EM journals (r = 0.854 and 0.947, respectively, both p < 0.001). The funded publication number was positively correlated with the total national publication amount (rs = 0.748, p < 0.001).

Conclusions: The research capacity of EDs has been increasingly recognized by other medical specialties. The na- tional publication numbers from EDs may predict the academic publication increasing trends in the subsequent 10 years.

(C) 2021

  1. Introduction

Emergency medicine (EM) is a relatively young Medical specialty [1]. Over the last half a century, EM has been recognized as an indepen- dent medical specialty in many countries [2]. The developmental mile- stones of EM, including the establishment of EM societies, publication of academic journals, standardization of resident training programs, and emergence as an independent medical specialty, has marked the evolution of EM in different countries [3]. However, these milestones could not provide dynamic and continuous evaluation of EM develop- ment after these static milestones had been achieved. The national sci- entific publication trend is a dynamic and continuous parameter that

* Corresponding author at: No.222, Maijin Rd., Anle Dist., Keelung City 204, Taiwan.

E-mail address: [email protected] (C.-H. Lee).

can be used to evaluate the research capacity and development of EM [4]. Publications and academic contributions were used previously to evaluate national EM development [5]. The publication trends from emergency departments (EDs), from a national perspective, may allow long-term evaluation and comparison of the worldwide academic de- velopment of EM as a discipline.

In 1991, national EM organizations from the UK, Australia, Canada, and the USA formed the International Federation for Emergency Medi- cine (IFEM) [6], which aimed to “promote access to, and lead the devel- opment of, the highest quality of Emergency medical care for all people” [7]. The IFEM full members are national EM organizations from coun- tries in which EM is officially recognized as a medical specialty and which also have recognized training programs in EM [6]. The IFEM full members grew from four in 1991 to more than 50 in 2019, making it the largest and most representative international EM organization.

https://doi.org/10.1016/j.ajem.2021.07.022

0735-6757/(C) 2021

Image of Fig. 1

Fig. 1. The inclusion process of study countries from the International Federation for Emergency Medicine (IFEM) full member countries. The countries are listed in alphabetical order.

Being one of the full members of IFEM also remarks the national EM de- velopmental milestone.

This study was performed to analyze the trends of scientific publica- tions from EDs of IFEM full member countries from 2009 to 2018 to evaluate the national academic EM developmental milestones.

  1. Methods
    1. Study design

This was an observational study, and it qualified for a waiver from our Institutional Review Board because no human subjects were involved.

    1. Study setting and populations

All data were retrieved from the SciVerse Scopus database [8]. The EM journals list (Table A.1) was adopted from the 2017 Journal Citation Reports (JCR) category of EM [9]. Non-EM journals were journals not classified into the JCR EM category. The journals classified into the EM category in the previous version of JCR but not in the 2017 JCR were classified as non-EM journals. The study period was between 2009 and 2018. The inclusion criteria of study countries were: (1) IFEM full members [10]; (2) EM was recognized as an independent specialty be- fore 2009, the year our study period began; and (3) > 12 annual publi- cations in 2018, the year our study period ended. Publications with first authors affiliated with EDs were classified as ED originating publications.

    1. Study protocol

A computer-assisted literature search was conducted using the SciVerse Scopus database in December 2019. Publications with authors affiliated with EDs were retrieved using the search terms “AFFILCOUNTRY(Country) AND AFFIL(emergency) AND PUBYEAR AFT

2009 AND PUBYEAR BEF 2019″. The search term “Country” referred to the included country names of IFEM full members. One of the authors reviewed the results to retrieve publications with first authors affiliated with EDs according to the protocol listed below. The downloaded re- sults were documented in a spreadsheet. The column with author affil- iations and the first author’s affiliation were identified. The first author affiliated with the following affiliations, “emergency department”, “de- partment of emergency medicine”, “Dept Emergency Med”, “accident and emergency department” or “department of accident and emer- gency medicine” was defined as first author affiliated with EDs. A computer-assisted text search was conducted to facilitate the process and eliminate bias. Using this search string, we identified publications with first authors affiliated with EDs. The remaining publications were classified into EM and non-EM journal groups. We collected data re- garding publications, including journal name, Publication year, and funding for further analysis.

    1. Measurements

The primary outcome measure was the correlation between the na- tional publication numbers in 2009 and the increasing trend of publica- tion numbers between 2009 and 2018 to evaluate the relationship between publication number and the increasing trend of publication in the subsequent 10 years.

The secondary outcome measures were: (1) the annual national publication number in EM, non-EM journals, and total publication num- bers; (2) the increasing trends of national publication number in EM, non-EM journals, and total publications between 2009 and 2018; and

(3) the correlation between funding numbers and publication numbers of study countries.

    1. Data analysis

Linear regression was used for trend analysis and the slope (?) of lin- ear regression was used to represent the trend. The correlation between

Table 1

Publication numbers in EM journals, non-EM journals, and total publications group. (EM: emergency medicine)

Country

Field

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

Total

Australia

EM

69

68

77

74

96

81

85

88

87

105

830

Non-EM

58

78

60

45

61

74

73

60

65

53

627

Total

127

146

137

119

157

155

158

148

152

158

1457

Canada

EM

66

70

78

76

60

92

93

90

105

167

897

Non-EM

65

60

60

75

85

87

115

105

125

148

925

Total

131

130

138

151

145

179

208

195

230

315

1822

Hong Kong

EM

52

32

37

18

22

18

15

24

20

14

252

Non-EM

10

12

9

15

10

9

10

14

7

13

109

Total

62

44

46

33

32

27

25

38

27

27

361

India

EM

0

0

1

3

11

14

8

4

4

5

50

Non-EM

13

15

13

23

32

42

38

67

41

45

329

Total

13

15

14

26

43

56

46

71

45

50

379

Iran

EM

0

9

9

11

14

17

15

11

10

14

110

Non-EM

1

7

20

34

40

65

46

66

62

62

403

Total

1

16

29

45

54

82

61

77

72

76

513

Ireland

EM

7

11

4

4

10

7

6

4

2

4

59

Non-EM

6

10

12

13

12

8

7

18

13

20

119

Total

13

21

16

17

22

15

13

22

15

24

178

Israel

EM

9

4

5

7

7

7

9

5

3

9

65

Non-EM

13

14

9

11

9

13

15

24

21

21

150

Total

22

18

14

18

16

20

24

29

24

30

215

Poland

EM

0

0

1

0

1

2

14

44

23

7

92

Non-EM

8

6

7

12

17

18

21

28

19

33

169

Total

8

6

8

12

18

20

35

72

42

40

261

Saudi Arabia

EM

3

1

1

1

1

1

0

0

5

1

14

Non-EM

9

11

10

2

6

7

10

11

8

14

88

Total

12

12

11

3

7

8

10

11

13

15

102

Singapore

EM

10

10

13

9

15

10

11

14

10

10

112

Non-EM

24

15

27

10

15

20

16

19

28

25

199

Total

34

25

40

19

30

30

27

33

38

35

311

South Africa

EM

3

5

4

1

6

5

2

6

9

8

49

Non-EM

3

8

22

18

15

18

18

26

28

42

198

Total

6

13

26

19

21

23

20

32

37

50

247

South Korea

EM

29

33

53

74

77

64

74

68

87

91

650

Non-EM

30

46

60

68

80

72

110

130

123

180

899

Total

59

79

113

142

157

136

184

198

210

271

1549

Sweden

EM

1

0

9

5

5

1

3

6

9

13

52

Non-EM

26

21

17

17

15

8

14

15

12

12

157

Total

27

21

26

22

20

9

17

21

21

25

209

Taiwan

EM

50

50

46

61

67

49

47

39

43

44

496

Non-EM

117

96

123

120

134

112

135

148

147

149

1281

Total

167

146

169

181

201

161

182

187

190

193

1777

Thailand

EM

0

0

0

0

1

0

0

3

4

3

11

Non-EM

0

3

3

6

7

8

9

16

17

13

82

Total

0

3

3

6

8

8

9

19

21

16

93

The Netherlands

EM

3

2

3

6

7

6

9

16

12

15

79

Non-EM

13

12

23

21

22

24

19

30

25

26

215

Total

16

14

26

27

29

30

28

46

37

41

294

Turkey

EM

50

55

53

57

69

74

84

94

52

61

649

Non-EM

57

74

70

97

136

180

181

156

123

121

1195

Total

107

129

123

154

205

254

265

250

175

182

1844

United Kingdom

EM

78

68

66

57

51

54

45

43

41

52

555

Non-EM

56

69

74

79

73

73

60

66

71

93

714

Total

134

137

140

136

124

127

105

109

112

145

1269

United States

EM

750

731

899

1048

948

860

891

968

980

962

9037

Non-EM

483

612

729

743

727

747

874

1005

1093

1199

8212

Total

1233

1343

1628

1791

1675

1607

1765

1973

2073

2161

17,249

the 2009 publication numbers and the trend of publication between 2009 and 2018 was evaluated by Pearson’s correlation coefficient (r). Spearman’s rank correlation coefficient (rs) was calculated to analyze the correlation between funding numbers and publication numbers. All analyses were performed by IBM SPSS Statistics (version 22; IBM Corp., Armonk, NY, USA).

  1. Results

Of the 52 IFEM full members (Table A.2), seven countries were ex- cluded because EM was not recognized as a medical specialty before 2009 [11-17], and 26 countries were excluded because the annual

publication number in 2018 was less than 12 (Fig. 1). Of the remaining 19 countries, a total of 30,130 publications between 2009 and 2018 had first authors affiliated with EDs. These publications were classified into the EM journals group or non-EM journals group according to the pub- lishing journals shown in Table 1. The national annual total publication numbers are shown in Fig. 2. Between 2009 and 2018, the publication numbers in non-EM journals exceeded those in EM journals in 16 of the 19 study countries.

The publication trends (?) of the EM journals group, non-EM journals group, and total publications group are shown in Table 2. Four- teen countries showed positive increasing trends in EM journal publica- tions, and they were statistically significant in six of these countries. The

Image of Fig. 2

Fig. 2. a and b. Annual total publication numbers between 2009 and 2018.

Image of Fig. 2

Fig. 2 (continued).

leading five countries with increasing publication trends in EM journals were the USA, Canada, South Korea, Australia, and Poland. Seventeen countries showed positive increasing trends in non-EM journal publica- tions, 12 of which were statistically significant. The leading five coun- tries with increasing publication trends in non-EM journals were the USA, South Korea, Turkey, Canada, and Iran. Sixteen countries showed positive increasing trends in total journal publications, 13 of which were statistically significant. The leading five countries with increasing publication trends in total journals were the same as for non-EM journals, i.e., the USA, South Korea, Canada, Turkey, and Iran. Canada, South Korea, Thailand, and the Netherlands showed significant positive publication trends in both EM and non-EM journals. The trends of pub- lication in EM and non-EM journals between 2009 and 2018 are plotted in Fig. 3. Fifteen countries showed greater increasing trends in non-EM journals than in EM journals. In nine of these 15 countries, the 95% con- fidence interval (95% CI) of increasing trends in EM and non-EM journals did not overlap.

The correlation between the publication numbers in 2009 and the increasing publication trends between 2009 and 2018 in EM and non- EM journals are shown in Fig. 4 and Fig. 5, respectively. The Pearson’s Correlation coefficients (r) were 0.854 for EM journals and 0.947 for non-EM journals (both p < 0.001).

Among the total of 30,130 publications, 4189 were funded re- searches. The USA was found to have the greatest number of funded publications (3165), followed by Taiwan (276), South Korea (210), Canada (171), and Australia (107). The leading five countries with the highest proportion of funded publications were Sweden (48/209, 22.97%), followed by Thailand (20/93, 21.51%), the USA (3165/17249, 18.35%), Taiwan (276/1777, 15.53%), and South Korea (210/1549, 13.56%). The Spearman’s rank correlation coefficient (rs) between pub- lication numbers and funded publication numbers for the 19 study countries was 0.748 (p < 0.001).

  1. Discussion

The numbers of EM journals increased more rapidly than in other medical specialties between 2000 and 2009 [18]. Publications by

emergency physicians in 24 EM journals increased from 1124 in 2008 to 1650 in 2017 [19]. These results indicating the rapid global develop- ment of academic EM. Emergency medicine is a cross-disciplinary spe- cialty. Therefore, researches originated from EDs may also be published in non-EM journals. In the present study, we analyzed scien- tific publications originating in EDs from IFEM full member countries in which EM was recognized as an independent specialty before 2009 to determine the evolution of academic EM performance from an interna- tional perspective.

A previous study reported that the publication numbers and increas- ing trend of ED originating research were higher in non-EM journals than in EM journals in Taiwan [5]. This may have been because EM is a cross-disciplinary medical specialty. As the quality and quantity of ED originating research increase, the publications from EDs will be ac- cepted by journals in other specialties that are related to EM. It was un- clear whether this situation was unique to Taiwan or a common characteristic of the evolution of EM in other countries. The present study showed that in several IFEM full member countries, the publica- tion numbers and increasing trend of ED originating research in non- EM journals also exceeded those in EM journals. The results indicated that, in these countries, the academic contributions of EDs have been recognized not only in the field of EM but are also rapidly increasing in other medical specialties. The trend can be rationalized from both in- dividual and national perspectives. From individual perspective, the phenomenon of “publish-or-perish” forced the researchers to publish and pursue citations. More publication number, citations, and high im- pact factor of publishing journals lead to more funding to the institute and also personal Academic promotion [20,21]. The category aggregate impact factor in JCR referred to the average publication citations in cer- tain category [9]. The aggregate impact factor of category of EM rank last among 12 categories of clinical medicine [18]. Publications in non-EM journals might have a higher chance of being cited, which is helpful in promotion and applying for funding. Therefore, EM researchers may tend to submit their researches to non-EM journals prior than EM journals in order to obtain higher chance to be cited. The similar mindset had been discussed in previous study on ED researchers’ pref- erence to submit to international or domestic journals in order to get

Image of Fig. 3

Fig. 3. Correlation between the trends of publications in EM and non-EM journals between 2009 and 2018. (EM: emergency medicine).

Image of Fig. 4

Fig. 4. Correlations between publication numbers in 2009 and publication trends between 2009 and 2018 in EM journals. (EM: emergency medicine).

Image of Fig. 5

Fig. 5. Correlations between publication numbers in 2009 and publication trends between 2009 and 2018 in non-EM journals. (EM: emergency medicine).

Table 2

National publication trends (?) in EM journals, non-EM journals, and total publications from 2008 to 2019. (EM: emergency medicine; CI: confidence interval) Country EM journals Non-EM journals Total

Trend (?)

p-value

95% CI

Trend (?)

p-value

95% CI

Trend (?)

p-value

95% CI

Australia

3.212

0.003

1.442 to 4.982

-0.236

0.846

-2.952 to 2.480

2.976

0.040

0.181 to 5.771

Canada

7.861

0.008

2.716 to 13.005

9.388

0.000

6.866 to 11.910

17.248

0.000

10.370 to 24.127

Hong Kong

-3.055

0.008

-5.073 to -1.036

0.006

0.984

-0.671 to 0.683

-3.048

0.007

-4.987 to -1.110

India

0.642

0.233

-0.507 to 1.792

4.818

0.002

2.312 to 7.325

5.461

0.003

2.472 to 8.450

Iran

0.958

0.058

-0.043 to 1.959

7.424

0.000

4.881 to 9.967

8.382

0.000

5.196 to 11.568

Ireland

-0.527

0.097

-1.174 to 0.120

0.939

0.050

-0.002 to 1.881

0.412

0.390

-0.633 to 1.457

Israel

-0.006

0.982

-0.591 to 0.579

1.285

0.015

0.327 to 2.242

1.279

0.017

0.297 to 2.260

Poland

2.921

0.059

-0.143 to 5.986

2.721

0.000

1.763 to 3.680

5.642

0.004

2.324 to 8.960

Saudi Arabia

0.012

0.947

-0.393 to 0.417

0.327

0.398

-0.518 to 1.173

0.339

0.400

-0.541 to 1.219

Singapore

0.036

0.883

-0.513 to 0.586

0.503

0.477

-1.052 to 2.058

0.539

0.469

-1.098 to 2.177

South Africa

0.515

0.056

-0.016 to 1.046

3.115

0.001

1.676 to 4.554

3.630

0.001

2.033 to 5.228

South Korea

6.048

0.001

3.323 to 8.774

14.285

0.000

10.586 to 17.984

20.333

0.000

15.980 to 24.686

Sweden

0.885

0.046

0.019 to 1.751

-1.303

0.007

-2.145 to -0.461

-0.418

0.494

-1.763 to 0.927

Taiwan

-1.200

0.214

-3.250 to 0.850

4.806

0.003

2.157 to 7.456

3.606

0.041

0.194 to 7.019

Thailand

0.418

0.006

0.157 to 0.679

1.758

0.000

1.228 to 2.287

2.176

0.000

1.449 to 2.902

The Netherlands

1.521

0.000

0.998 to 2.045

1.448

0.007

0.510 to 2.387

2.970

0.000

1.776 to 4.163

Turkey

2.236

0.189

-1.359 to 5.832

9.970

0.032

1.086 to 18.853

12.206

0.046

0.289 to 24.123

United Kingdom

-3.461

0.001

-5.011 to -1.910

1.515

0.193

-0.941 to 3.972

-1.945

0.226

-5.367 to 1.476

United States

20.830

0.053

-0.389 to 42.050

70.327

0.000

54.201 to 86.454

91.158

0.000

61.806 to 120.510

more citations [22]. When the theme and quality of EM research can be recognized by both EM and non-EM journals, this consideration leads to research been published more in non-EM journals than in EM journals. From the national perspective, the national ED originating research in non-EM journals exceeded those in EM journals indicated that most of the theme and quality of EM research were recognized by not only EM field but also other specialties. Therefore, we propose that the differ- ences between publication numbers and trends in EM and non-EM journals may be a benchmark of academic EM development and could be adopted as a dynamic developmental milestone of national academic EM. Further studies over longer periods and in more countries are needed to confirm and validate this inference. On the other hand, fur- ther research is needed to determine whether the observation that in- creasing trends in publication number in non-Specialty journals outweigh those in specialty journals is unique to EM or is also the case in other medical specialties.

Our analysis demonstrated a positive correlation between publica- tion numbers in 2009 and publication increasing trends between 2009 and 2018 in both EM and non-EM journals. This indicated that the pub- lication numbers in a specific year may predict the academic EM devel- opmental trend in the subsequent 10 years. A similar prediction has also been made in the academic performance of EM journals [18]. The phe- nomenon in EM journals was considered to be the result of a positive feedback effect in which high impact factor journals attract more high-quality research, leading to a more Rapid increase in impact factors in subsequent years. The phenomenon in national ED originating publi- cations demonstrated in our study may also have resulted from positive feedback between research infrastructure and research outcome. The performance of medical research is reliant on multiple types of infra- structure, including funding, research labs, quality and quantity of re- searchers, and health care systems [23]. Our study disclosed that in academic EM, funded publication number was positively correlated with the total amount of national publications. More robust research en- vironments resulted in more publications, and more publications attract more resources that make the environment more robust in the future. This positive feedback may explain why the publication numbers in a specific year may predict the publication increasing trend in the subse- quent 10 years. Scientific publication numbers increase faster in leading countries results in an increasing gap between leading and other coun- tries. Further studies and international collaborations are required to develop interventions to reduce the academic gap between leading

and other countries, to improve global EM development regardless of current academic performance.

The study by Kokulu et al. [19], which focused on the publications by emergency physicians in 24 EM journals between 2007 and 2018 is comparable to our study. The leading five countries with publication numbers in Kokulu’s study were the USA, Canada, Australia, Turkey, and the UK. In our study, the leading five countries in 26 EM journals were the USA, Canada, Australia, South Korea, and Turkey. The rank of leading countries was similar regardless of whether the inclusion criteria in Kokulu’s study were “emergency physicians in the main pro- ductive countries which had produced at least 1% of the overall publica- tions from 2008 to 2017”, or “EDs of IFEM member countries which EM was recognized as an independent specialty before 2009” in our study. This indicated that the ranks of leading countries in publication num- bers in EM journals did not vary significantly with different inclusion criteria. The leading five countries in non-EM journals in our study were the USA, Taiwan, Turkey, Canada, and South Korea. The variation in ranking indicated that viewpoints from non-EM journals provided a different and comprehensive perspectives on publications from EDs. The national publication number increasing rate in Kokulu’s study was evaluated by average annual growth rate and the leading five countries were South Korea, Turkey, Spain, Germany, and Canada. In our study, linear regression was used to evaluate increasing rate and the leading five countries were the USA, Canada, South Korea, Australia, and Poland. The methods for evaluating an increase in publications deserve discussion. First, the average annual growth rate was determined by publication numbers in 2008 and 2017. The publication numbers in- between did not contribute to the average annual growth rate. The trend of linear regression was determined by all the annual publication numbers which reflected the influence of every year in the study period. Second, growth rate may be influenced by base period. The same incre- ment in lower base period results in higher growth rate. Countries with relatively small base period are favored in the calculation of average an- nual growth rate.

  1. Limitations

This study has some limitations. First, 33 of the 52 IFEM full member countries with low publication numbers or in which EM was not an independent specialty before 2009 were not included within the scope of this study. Countries with few publications or where EM is

not an independent specialty require other measurements to continu- ously evaluate their evolution. Second, this study evaluated academic performance according to the number of publications with first authors affiliated with EDs. The themes of these publications, study design, indi- cators of impact including Citation numbers, journal impact factor, H index, and publications with co-authors affiliated with EDs were not evaluated. Qualitative analysis of research and collaborations between emergency physicians and other medical specialties may demonstrate academic performance from different perspectives. Future studies should focus on these fields to achieve a more comprehensive evalua- tion of academic EM performance.

  1. Conclusions

EM is a continuous growing specialty worldwide from the perspec- tive of scientific publications. The research capacities of EDs of the lead- ing countries have also been increasingly accepted and acknowledged by other medical specialties. The publication numbers may predict the publication trends for the subsequent 10 years.

Financial support

This study was unfunded.

Declaration of Competing Interest

HHC, CWC and CHL report no conflict of interest.

Appendix A. Appendices

Table A.1 List of journals in the 2017 Journal Citation Reports category of emergency medicine. Rank according to 2017 journal impact factor. (*ISSN: International Standard Serial Number)

Full Journal Title ISSN*

Resuscitation 0300-9572

Annals of Emergency Medicine 0196-0644

Emergencias 1137-6821

World Journal of Emergency Surgery 1749-7922

Academic Emergency Medicine 1069-6563

Scandinavian Journal of Trauma Resuscitation & Emergency Medicine 1757-7241 prehospital emergency care 1090-3127

Injury-International Journal of The Care of The Injured 0020-1383

Emergency Medicine Journal 1472-0205

European Journal of Emergency Medicine 0969-9546

European Journal of Trauma and Emergency Surgery 1863-9933

Canadian Journal of Emergency Medicine 1481-8035

Emergency Medicine Clinics of North America 0733-8627

Emergency Medicine Australasia 1742-6731

American Journal of Emergency Medicine 0735-6757

Journal of Emergency Medicine 0736-4679

Pediatric Emergency Care 0749-5161

Prehospital and Disaster Medicine 1049-023x

Unfallchirurg 0177-5537

Journal of Emergency Nursing 0099-1767

Notfall & Rettungsmedizin 1434-6222

Ulusal Travma ve Acil Cerrahi Dergisi-Turkish Journal of Trauma & Emer- 1306-696x gency Surgery

Emergency Medicine International 2090-2840

Notarzt 0177-2309

Hong Kong Journal of Emergency Medicine 1024-9079

Signa Vitae 1334-5605

Table A.2

International Federation for Emergency Medicine full member countries in alphabetical order.

Argentina

Hungary

Oman

Sudan

Australia

Iceland

Pakistan

Sweden

Bahrain

India

Papua New Guinea

Taiwan

Canada

Iran

Paraguay

Tanzania

Chile

Iraq

Panama

Thailand

Colombia

Ireland

Peru

The Netherlands

Costa Rica

Israel

Philippines

Trinidad and Tobago

Denmark

Japan

Poland

Turkey

Dominican

Libya

Rwanda

United Arab Emirates

Finland

Malaysia

Saudi Arabia

United Kingdom

Georgia

Mexico

Singapore

United States

Ghana

Nepal

South Africa

Vietnam

Hong Kong

Norway

South Korea

Yemen

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