Journal of biomechanics最新文献

{"title":"Median nerve shape and position in response to varied wrist postures during pinch.","authors":"Trevour O Greene, David B Jordan, Zong-Ming Li","doi":"10.1016/j.jbiomech.2026.113627","DOIUrl":"https://doi.org/10.1016/j.jbiomech.2026.113627","url":null,"abstract":"<p><p>This study investigated changes in median nerve flattening ratio (FR) and transverse position in the carpal tunnel across wrist flexion-extension (FE) postures during pinch in healthy adults. We hypothesized that deviated wrist FE postures from neutral would increase FR and alter nerve transverse position, and that pinch force would increase FR and amplify postural effects on position. Eleven healthy participants underwent ultrasound transverse imaging at the distal carpal tunnel of the right hand with the wrist splinted in three 30° extension, neutral, and 30° flexion with neutral radioulnar position. Participants performed tip-to-tip pinch from 0 to 20 N using a pinch dynamometer. Nerve FR was calculated as the ratio of the major to minor axis, and nerve centroid position was tracked using optical flow analysis. Two-way repeated measures ANOVAs were used to examine the effects of wrist FE posture and pinch force on nerve FR as well as radioulnar and dorsovolar position. FR of the nerve was significantly dependent on FE (p < 0.001), force (p < 0.005), and their interaction (p < 0.001). The greatest FR (7.7 ± 3.2) was observed in wrist flexion posture at 20 N. The nerve was at different radioulnar or dorsovolar positions at varying wrist FE postures and forces (p < 0.05). Wrist FE posture and pinch force independently and interactively influence median nerve morphology and displacement in the carpal tunnel, with the most pronounced effects in the flexion posture under load. These findings advance understanding of median nerve mechanical behavior in the wrist for healthy subjects and potential pathomechanics associated with manual tasks.</p>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"208 ","pages":"113627"},"PeriodicalIF":2.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical analysis of shoulder pseudoparalysis as per the Collin classification of massive rotator cuff tears: an ex-vivo study.","authors":"David T Axford, Robert Potra, Richard Appleyard, Janos Tomka, Petra L Graham, Antonio Arenas-Miquelez, Desmond J Bokor, Louis M Ferreira, Sumit Raniga","doi":"10.1016/j.jbiomech.2026.113626","DOIUrl":"https://doi.org/10.1016/j.jbiomech.2026.113626","url":null,"abstract":"<p><p>Clinical investigations have shown strong correlations between rotator cuff tear patterns and reduced active range of motion; however, no biomechanical study has investigated the effect of tear pattern on shoulder function for all Collin classification types. The purpose of this study was to investigate the effect of rotator cuff tear pattern on joint kinematics, muscle function, and acromial strains during simulated ex-vivo shoulder elevation. An ex-vivo shoulder simulator performed four motions including scapular plane abduction, forward flexion, internal rotation, and external rotation in seven cadaveric specimens (mean age 56 ± 6 years). Each motion was performed for seven shoulder conditions: intact, supraspinatus deactivation (type S), and deactivation types A through E according to the Collin classification. Joint kinematics, muscle force, and acromial strains were reported for each motion and condition. Deactivation of three rotator cuff tendons resulted in a significant reduction in arm elevation during scapular plane abduction and forward flexion (p≤.012 for type B, C, and E) while deactivation of the entire anterior or posterior rotator cuff resulted in loss of internal or external rotation active range of motion (p<.001). All deactivation patterns led to higher anterior and lateral deltoid forces than the intact shoulder (p≤.049). Internal and external rotation stability was maintained in types A and D with significantly higher force in the inferior subscapularis and teres minor (p<.001), respectively. Finally, rotator cuff deactivation led to increased maximum principal strain in the acromion and scapular spine compared to the intact shoulder.</p>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"208 ","pages":"113626"},"PeriodicalIF":2.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greater mediolateral required coefficient of friction reflects asymmetric gait control in individuals with unilateral transfemoral amputation","authors":"Shunta Kobayashi,&nbsp;Kai Kobayashi,&nbsp;Chien-Chi Chang,&nbsp;Takeshi Yamaguchi,&nbsp;Hiroaki Hobara","doi":"10.1016/j.jbiomech.2026.113591","DOIUrl":"10.1016/j.jbiomech.2026.113591","url":null,"abstract":"<div><div>Individuals with unilateral transfemoral amputation are at greater risk of falls than individuals without amputation, with slipping being a major contributing factor. The required coefficient of friction, defined as the minimum shoe–floor friction needed to prevent slipping, has been well studied in individuals without amputation but remains poorly understood in individuals with unilateral transfemoral amputation. Especially, its association with gait parameters in this population is unclear. This study investigated differences in resultant required coefficient of friction and its mediolateral and anteroposterior components between individuals with unilateral transfemoral amputation and individuals without amputation across multiple walking speeds, and examined their associations with spatial gait parameters. Thirty individuals with unilateral transfemoral amputation and 30 matched controls walked at eight fixed speeds (0.55–1.53 m/s) on an instrumented treadmill. Ground reaction forces were used to calculate required coefficient of friction and step parameters. At the time point corresponding to required coefficient of friction, the mediolateral component of required coefficient of friction was significantly greater in the intact limb than in the prosthetic limb across all walking speeds, indicating elevated mediolateral friction demand. Step width was negatively associated with mediolateral component of required coefficient of friction in the prosthetic limb, suggesting that mediolateral friction demand is modulated by base-of-support adjustments under prosthetic constraints. In contrast, associations between step parameters and the anteroposterior component were less consistent. These findings identify limb-specific mediolateral friction demands as a key feature of prosthetic gait and provide mechanistic insight into slip-related risk during human bipedal walking.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"207 ","pages":"Article 113591"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating the margin of stability and inter-limb symmetry: A before-after trial on the acute effects of a novel hybrid passive spring damper ankle-foot orthosis in hemiparetic multiple sclerosis with drop-foot","authors":"Nahid Tafti,&nbsp;Ensieh Pourhoseingholi","doi":"10.1016/j.jbiomech.2026.113586","DOIUrl":"10.1016/j.jbiomech.2026.113586","url":null,"abstract":"<div><div>People with multiple sclerosis (PwMS) are at increased fall risk due to dynamic instability. This clinical trial assessed the immediate effect of a novel hybrid passive spring-damper ankle–foot orthosis (HPSD-AFO) on dynamic stability in hemiparetic PwMS. The primary aim was to evaluate changes in the margin of stability (MoS)—an instantaneous measure of stability derived from the extrapolated center of mass (XcoM)—comparing outcomes between the affected and unaffected sides. This within-subject before-after trial evaluated gait in twelve mildly hemiparetic PwMS (three males, nine females; mean age 35.2 years) under both shod and novel HPSD-AFO conditions. Full-body kinetics and targeted kinematics were recorded along a 10-meter walkway. The analysis focused on spatial–temporal parameters (step width, stride time, step length) and dynamic stability metrics, including anteroposterior (AP MoS) and mediolateral (ML MoS) for the whole gait cycle and key phases. Gait with the HPSD-AFO resulted in significantly reduced step width and stride time. The orthosis also significantly modulated dynamic stability: the AP MoS decreased bilaterally, while ML MoS demonstrated a limb-specific response, decreasing on the non-affected side but increasing on the affected side. Consequently, the symmetry of both spatial–temporal parameters and MoS metrics improved substantially with HPSD-AFO use. The use of the novel HPSD-AFO immediately improved gait by reducing step width and stride time. It differentially modulated stability, decreasing AP MoS bilaterally while increasing ML MoS on the affected limb. This pattern led to a significant improvement in inter-limb symmetry across both spatiotemporal and dynamic stability metrics.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"207 ","pages":"Article 113586"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to “Residual strains in human versus animal aortas: a reconciliation of apparent differences” [J. Biomech. 205 (2026) 113410]","authors":"Dimitrios P. Sokolis","doi":"10.1016/j.jbiomech.2026.113518","DOIUrl":"10.1016/j.jbiomech.2026.113518","url":null,"abstract":"","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"206 ","pages":"Article 113518"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic effects on the lower limb caused by urban terrain cross-slopes","authors":"Antony J. Crossman,&nbsp;Samuel J. Kutz,&nbsp;Angela E. Kedgley","doi":"10.1016/j.jbiomech.2026.113540","DOIUrl":"10.1016/j.jbiomech.2026.113540","url":null,"abstract":"<div><div>Walking on cross-sloped surfaces is common in urban environments and can be challenging for individuals with lower limb pathologies. Walking on a cross-sloped surface places one limb (upslope limb) in a higher position relative to the other (downslope limb), causing asymmetry. The effects of sex and walking speed on gait over a cross-sloped surface and the slope angle at which gait adaptations occur is unknown.</div><div>Sixteen participants (nine female) completed walking trials on level, 2°, 4°, 6°¸ 8°, and 10° cross-slopes at a self-selected pace (1.12 ± 0.09 ms⁻¹) with the 10° condition repeated for self-selected slow (0.81 ± 0.14 ms⁻¹) and fast (1.43 ± 0.14 ms⁻¹) paces. Ankle, knee and hip joint angles were analysed at midstance.</div><div>Greater eversion for slopes over 2° and inversion for slopes over 4° were necessary for upslope and downslope limbs, respectively. Males and females exhibited different hip kinematics when walking on a cross-sloped surface. Ankle dorsi- and plantarflexion changed with walking speed on a cross-sloped surface. Thus, slope angle, speed, and sex all resulted in differences in gait pattern on a cross-sloped surface.</div><div>People use the end range of motion of their ankles when walking in commonplace urban settings. This may be an impediment to mobility for populations with reduced ankle mobility. As the cross-slope conditions tested in this paper are encountered every day in urban environments, the findings suggest that ambulation over cross-sloped surfaces may be an important task to consider in future designs of interventions for the lower limb.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"206 ","pages":"Article 113540"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic insights into the synergistic Determinants of bone Biomechanics: Multi-level characterization and multi-parameter composite factor model in immature murine tibiae","authors":"Zhentao Li,&nbsp;Qi Tong,&nbsp;Guanjun Zhang,&nbsp;Canhui Gui,&nbsp;Han Yang,&nbsp;Dun Li,&nbsp;Jiali Peng,&nbsp;Houzheng Liu","doi":"10.1016/j.jbiomech.2026.113547","DOIUrl":"10.1016/j.jbiomech.2026.113547","url":null,"abstract":"<div><div>The chemical composition, structure, and mechanical properties of mature bone are well established. However, predictive models for the mechanical properties of developing bone—characterized by active mineralization and structural remodeling—remain incomplete. This study integrated high-resolution Micro-CT, high-throughput nanoindentation, and confocal Raman spectroscopy to systematically map the spatial heterogeneity of structure, chemical composition, and mechanical properties in tibiae from 6-week-old female C57BL/6J mice. Multi-parameter composite factor models were proposed to predict the elastic modulus and hardness. The results indicated that single structural or chemical composition parameters exhibited limited explanatory power for elastic modulus (R² ≤ 0.346) and hardness (R² ≤ 0.37). In contrast, integrating structural and chemical descriptors significantly improved model performance, achieving R² values of 0.746 for elastic modulus and 0.814 for hardness, underscoring a coordinated structure–chemistry interplay during bone development. Notably, significant gradients in the circumferential direction of mineralized matrix ratio and carbonate substitution degree (<em>p</em> &lt; 0.01) did not result in heterogeneous mechanical properties, reflecting a dynamic balance mechanism that supports structural growth while maintaining mechanical integrity. This work provides mechanistic insight into the developmental adaptation of immature bone and establishes a theoretical foundation for advanced fracture treatment strategies and biomimetic bone repair materials.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"206 ","pages":"Article 113547"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148854479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture initiation in heterogeneous human cortical bone tissues predicted by an AT1 phase field model","authors":"Maxime Levy,&nbsp;Zohar Yosibash","doi":"10.1016/j.jbiomech.2026.113521","DOIUrl":"10.1016/j.jbiomech.2026.113521","url":null,"abstract":"<div><div>Predicting fracture initiation in human femurs by computed tomography-based finite element analysis (FEA) is of high interest. Newly introduced phase-field models (PFMs), when combined with FEA, may offer a promising tool for predicting fracture initiation and crack paths.</div><div>PFMs require a material length parameter, <span><math><msub><mi>ℓ</mi><mn>0</mn></msub></math></span>, which remains undetermined for heterogeneous cortical bone tissue. This parameter depends on the critical strain and may vary with bone density. Here, <span><math><msub><mi>ℓ</mi><mn>0</mn></msub></math></span> is investigated within the <span>AT1</span> PFM framework by comparing PF-FEA predictions with experimental observations from macroscopic three-point bending (3PB) tests on cortical bone specimens.</div><div>A literature-based critical strain value of <span><math><msub><mi>ε</mi><mi>c</mi></msub><mo>=</mo><mn>7300</mn><mstyle><mspace></mspace></mstyle><mi>μ</mi><mrow><mtext>strain</mtext></mrow></math></span> provided good agreement with the experimentally measured yield forces when used within the <span>AT1</span> PFM framework. This value is lower than the yield strain measured from the 3PB experiments (as documented in past experiments on cortical bone tissues). Combining this critical strain with experimentally determined fracture toughness and Young’s modulus correlations yields <span><math><msub><mi>ℓ</mi><mn>0</mn></msub></math></span> values in the range <span><math><mn>0.20</mn><mo>−</mo><mn>0.22</mn></math></span> mm. The resulting nearly constant <span><math><msub><mi>ℓ</mi><mn>0</mn></msub></math></span> values over the investigated ash density range, <span><math><msub><mi>ρ</mi><mrow><mi>a</mi><mi>s</mi><mi>h</mi></mrow></msub><mo>=</mo><mn>0.85</mn></math></span>–<span><math><mn>1.40</mn><mspace></mspace><mrow><mi>g</mi><mrow><mo>/</mo></mrow><msup><mi>cm</mi><mn>3</mn></msup></mrow></math></span>, led to PF-FEA predictions of the experimental yield forces within approximately <span><math><mo>±</mo><mn>10</mn><mi>%</mi></math></span>.</div><div>The small magnitude of <span><math><msub><mi>ℓ</mi><mn>0</mn></msub></math></span> relative to the specimen dimensions, and even more so at the organ level, suggests that it may be approximated as a constant (homogeneous) parameter for fracture initiation and crack propagation analyses. These results provide, to our knowledge, the first tissue-level experimental framework for evaluating <span><math><msub><mi>ℓ</mi><mn>0</mn></msub></math></span> in cortical bone and establish a basis for future organ-level validation studies of fracture initiation in human long bones using PFMs.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"206 ","pages":"Article 113521"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fiber dispersion in the right ventricle: A comparison of constitutive neural network predictions with experimental data","authors":"Parag S. Ingalkar,&nbsp;Sotirios Kakaletsis,&nbsp;Manuel K. Rausch,&nbsp;Ellen Kuhl,&nbsp;Denisa Martonová","doi":"10.1016/j.jbiomech.2026.113532","DOIUrl":"10.1016/j.jbiomech.2026.113532","url":null,"abstract":"<div><div>The mechanical behavior of right ventricular (RV) myocardium is governed by its anisotropic microstructure, yet constitutive models that account for fiber dispersion and enable reliable parameter identification remain limited. In this study, we propose a physics-embedded constitutive neural network framework for automated discovery of strain energy functions and microstructural parameters from experimental data. The model is formulated within an incompressible, orthotropic hyperelastic setting using invariant-based representations. Fiber, sheet, and normal directions are incorporated through a rotated structural basis, and dispersion effects are modeled using a generalized structure tensor approach. The framework is trained on multi-axial mechanical data from ovine RV myocardium, including uniaxial tension-compression and simple shear tests. We investigate two training scenarios: (i) full datasets containing both tensile and compressive regimes and (ii) datasets restricted to tensile loading. In both cases, the model accurately reproduces the measured stress-strain responses and identifies sparse, interpretable constitutive models which involve isotropic, anisotropic, and coupling invariants. However, the identifiability of microstructural parameters strongly depends on the available loading conditions. While tensile-only data yield higher predictive accuracy, they result in non-unique or biased estimates of fiber dispersion. In contrast, inclusion of compressive data enables consistent identification of dispersion parameters by separating fiber and matrix contributions. These results highlight the importance of multi-axial loading data for robust parameter identification and demonstrate the capability of constitutive neural network-based approaches for data-driven modeling of anisotropic soft tissues.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"206 ","pages":"Article 113532"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing postural stability after trunk perturbation is related to altered muscle activity in patients with chronic ankle instability","authors":"Shinshiro Mineta,&nbsp;Minori Mitsui,&nbsp;Takashi Sudo,&nbsp;Tomoki Ebato","doi":"10.1016/j.jbiomech.2026.113524","DOIUrl":"10.1016/j.jbiomech.2026.113524","url":null,"abstract":"<div><div>Approximately 47% of lateral ankle sprains (LASs) occur via indirect contact; therefore, clarifying postural control after external contact to the trunk may provide valuable insights into LAS prevention. In the present study, kinematics, kinetics, and muscle activity were measured during a stepping task following trunk perturbation. Kinematics and muscle activity were analyzed before and after both perturbation and initial contact (IC), whereas kinetics were analyzed only before and after IC. The anterior–posterior stability index, medial–lateral stability index (MLSI), and maximum lateral center of pressure (COP) displacement were calculated as stability outcomes. Co-contraction indices (CCIs) were calculated to assess muscle coactivation. Group differences were analyzed using independent t-tests, Mann–Whitney U tests, or statistical parametric mapping for time-series data. Relationships between stability outcomes and muscle activity were examined using multiple regression analysis. The CAI group exhibited significantly higher MLSI and COP lateral displacement, and significantly lower tibialis anterior (TA)/TA + gastrocnemius medialis (GasM) and TA/TA + gastrocnemius lateralis (GasL) co-contraction indices. The analyses revealed several significant group differences and associations. GasM root mean square (RMS) before IC was also significantly higher. Increased MLSI was associated with delayed peroneus longus (PL) onset; COP displacement was related to PL/PL + TA CCI, PL RMS before IC, and delayed GasL onset. These findings indicate that individuals with CAI exhibit impaired postural stability during post-perturbation stepping responses following external contact to the trunk, accompanied by altered ankle muscle activation. Perturbation-based training targeting foot stability and coordinated ankle muscle activation may be important for LAS prevention and rehabilitation.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"206 ","pages":"Article 113524"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}