Robbert Van Amstel , Andreas Brandl , Guido Weide , Katja Bartsch , Richard T Jaspers , Annelies Pool-Goudzwaard , Robert Schleip
{"title":"Validation of speckle tracking analysis for assessing fascia sliding mobility","authors":"Robbert Van Amstel , Andreas Brandl , Guido Weide , Katja Bartsch , Richard T Jaspers , Annelies Pool-Goudzwaard , Robert Schleip","doi":"10.1016/j.jbiomech.2025.112580","DOIUrl":"10.1016/j.jbiomech.2025.112580","url":null,"abstract":"<div><div>Fascia sliding mobility and deformation magnitude are potential biomarkers for musculoskeletal disorders, particularly in the thoracolumbar fascia over the erector spinae muscles, which are associated with low back pain. The use of speckle tracking analysis of ultrasound images through open-source software has been proposed for assessing fascia sliding mobility and deformation of the fascia. However, little is known about the validity and reliability of speckle tracking analysis. Since open-source projects for speckle tracking analysis have made great progress, an assessment of validity and reliability is required. Therefore, this study aimed to test the metric quality of speckle tracking analysis using an open-source software program. A custom-made tissue sliding device was developed to slide two gel pad phantoms over each other at a constant speed. The shear displacement was documented in real-time as the ground truth, while ultrasound videos were recorded. The ground truth data were then compared with the speckle tracking analysis data extracted from the ultrasound videos. Speckle tracking analysis for assessing tissue displacement using free and open-source software achieved excellent test–retest reliability and showed very high validity and reliability with low measurement errors. The presented open-source ultrasound-based speckle tracking analysis method can be recommended for research and clinical use in various environments.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112580"},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437364","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":"Quantifying shoulder motion in the free-living environment using wearable inertial measurement units: Challenges and recommendations","authors":"Stephen M. Cain , Melissa M.B. Morrow","doi":"10.1016/j.jbiomech.2025.112589","DOIUrl":"10.1016/j.jbiomech.2025.112589","url":null,"abstract":"<div><div>Understanding function and dysfunction of the shoulder may be best addressed by capturing the motion of the shoulder in the unstructured, free-living environment where the magnitudes and frequencies of required daily motion can be quantified. Miniaturized wearable inertial measurement units (IMUs) enable measurement of shoulder motion in the free-living environment; however, there are challenges in using IMU-based data to estimate traditionally used measures of shoulder motion from lab-based motion capture. There are limited options for IMU placement/fixation that minimize soft tissue effects and there are significant challenges in developing the algorithms that can accurately estimate shoulder joint angles from IMU measurements of acceleration and angular velocity. In an effort to collate current knowledge and highlight solutions to addressable challenges, in this paper, we report the results of a focused search of research articles using IMUS for kinematic measurements of the shoulder in the free-living environment, discuss the basic steps required for quantifying shoulder motion in the non-laboratory field-based setting using wearable IMUs, and we discuss the challenges that must be overcome in the context of the shoulder joint and the literature review. Finally, we suggest some IMU-based measures that are less sensitive to experimental design and algorithm choices, make recommendations for the information documented in manuscripts describing studies that use IMUs to quantify shoulder motion, and propose directions for future research.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112589"},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465450","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":"Thumb motion is not the same as first carpometacarpal joint motion","authors":"Joseph J. Crisco, Amy M. Morton, Douglas C. Moore","doi":"10.1016/j.jbiomech.2025.112590","DOIUrl":"10.1016/j.jbiomech.2025.112590","url":null,"abstract":"<div><div>Thumb motion is a key outcome metric for assessing disease progression or treatment efficacy. A literature review found nearly 25 % of recent papers incorrectly described their motion measurements as those of the first carpometacarpal (CMC) joint, when in fact their technology was only capable of measuring thumb motion. The aim of this manuscript is to clarify the importance of the accurate terminology and to rigorously examine the potential error by comparing thumb motion and CMC joint motion. Computed tomography (CT) images from 46 healthy subjects were analyzed using 3D markerless bone registration techniques to compute thumb rotation (first metacarpal (MC1) relative to the radius) and CMC joint rotation (MC1 relative to trapezium). We found thumb rotation was a poor measure of CMC joint rotation. For example, at thumb rotations of 20°, the true CMC joint rotations ranged from 3° to 30°. On average, thumb rotation over predicted CMC rotation by approximately 10°, with 95 % Limits of Agreement ranging from 30° (over estimating CMC joint motion) to −11° (underestimating CMC joint motion). Importantly, the character of the data demonstrated that CMC motion cannot be predicted from thumb motion. 3D CMC joint motion can only be assessed with skeletal imaging technologies; goniometers and skin-based markers can, at best, only measure thumb motion. Referring to goniometer and skin marker measurements as CMC joint motion is incorrect. It is critical that investigators be precise in their reporting of thumb motion versus CMC joint motion, especially when reporting interventions for thumb pathologies.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112590"},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453754","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}
Anna Fändriks, Roland Zügner, Bita Shareghi, Johan Kärrholm, Roy Tranberg
{"title":"Skin and cluster markers underestimate knee flexion during controlled motions. Evaluation of 12 patients with knee arthroplasty using radiosterometric analysis as reference","authors":"Anna Fändriks, Roland Zügner, Bita Shareghi, Johan Kärrholm, Roy Tranberg","doi":"10.1016/j.jbiomech.2025.112591","DOIUrl":"10.1016/j.jbiomech.2025.112591","url":null,"abstract":"<div><div>Diverse marker sets and validation techniques have previously been utilized, posing challenges in comparing studies when assessing soft tissue artefacts in knee joint kinematics from motion analysis. This study aimed to analyse the data obtained from three different marker sets with the results derived from radiostereometric analysis (RSA) in measuring angular movements of the knee joint. Twelve post-knee replacement participants performed a one-leg step-down movement. Knee joint angular movements were analysed in flexion–extension, adduction-abduction, and internal-external rotation across all marker sets. The results were subsequently compared with those obtained from the RSA system using simple linear regression, a linear mixed-effects model, mean values and mean differences. All marker sets were found to systematically underestimate flexion–extension compared to RSA, with differences intensifying at higher knee flexion angles. The mean differences in the sagittal plane between RSA and the IOR marker set, progressively increased from approximately 5° (95% CI 4.3–4.9) to 15° (95% CI 11.6–17.9), reaching a maximum difference of 20° (95% CI 13.8–25.7) at 40° of knee flexion. Transverse and frontal plane data from all marker sets exhibited erratic errors compared to RSA. In summary, knee flexion–extension motions were consistent between marker sets, indicating minimal impact on results based on the marker set choice. However, all marker sets systematically underestimated skeletal motions in knee flexion–extension compared to RSA measurements. Data from the transverse and frontal planes were too inconsistent and therefore not reliable for use.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112591"},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453753","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}
David T. Axford , Robert Potra , Richard Appleyard , Janos Tomka , Antonio Arenas-Miquelez , David Hollo , Sumit Raniga , Louis M. Ferreira
{"title":"A biomechanical investigation of the surface strains on the acromion and scapular spine during simulated ex-vivo arm motion","authors":"David T. Axford , Robert Potra , Richard Appleyard , Janos Tomka , Antonio Arenas-Miquelez , David Hollo , Sumit Raniga , Louis M. Ferreira","doi":"10.1016/j.jbiomech.2025.112588","DOIUrl":"10.1016/j.jbiomech.2025.112588","url":null,"abstract":"<div><div>While several biomechanical investigations have measured acromion and scapular spine strains for various pathological conditions to better understand the risk factors for fracture, no study has measured strains in the native shoulder. The objective of this study was to use an <em>ex-vivo</em> shoulder motion simulator to measure principal strain during continuous, unconstrained, muscle-driven motion of the native shoulder. Eight cadaveric specimens (57 ± 6 years) were used to simulate scapular plane abduction (27.5 to 80° of humerothoracic elevation), forward flexion (27.5 to 72.5° of humerothoracic elevation), external rotation (0 to 40° of external rotation), and circumduction (elliptical path) with glenohumeral rotation speeds of 10°/s. Principal strain was measured throughout motion in four clinically relevant regions of the scapular spine and acromion according to the Levy classification using tri-axial strain gauge rosettes. Increases in humeral elevation during scapular plane abduction and forward flexion were associated with increases in deltoid force and scapula strain. However, above approximately 60° of humerothoracic elevation, strains plateaued while deltoid forces continued to increase indicating that scapula strain patterns are influenced by deltoid force magnitude and direction. Scapula strain was higher during scapular plane abduction than forward flexion in all regions but was only significantly higher in Levy 3B (p = 0.038). The highest strains were observed in Levy regions 2 and 3A (p ≤ 0.01) which correspond to regions with the highest clinically observed fracture rates demonstrating that the shape of the acromion and scapular spine may influence strain distribution irrespective of the joint condition.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"183 ","pages":"Article 112588"},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487496","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":"Morphology and computational fluid dynamics support a novel classification of Spontaneous isolated superior mesenteric artery dissection","authors":"Haoyue Xu , Keli Yin , Chengxin Weng , Ding Yuan , Tinghui Zheng","doi":"10.1016/j.jbiomech.2025.112587","DOIUrl":"10.1016/j.jbiomech.2025.112587","url":null,"abstract":"<div><div>Flow patterns and classification within Spontaneous Isolated Superior Mesenteric Artery Dissection (SISMAD) are crucial for selecting subsequent treatment options. This study aims to propose a new classification of SISMAD and to propose two corresponding treatment plans based on this new classification. The 3D models of 70 patients with SISMAD were reconstructed and classified into Li types I-V based on morphology, followed by computational fluid dynamics analysis. The results show significant differences in blood flow patterns among patients with the same Li-type SISMAD, suggesting that the same treatment plan should not be applied universally. Based on the different blood flow conditions, a new classification of SISMAD is proposed (HX classification): Type I (dual-lumen flow type), subdivided into Ia and Ib; and Type II (single-lumen flow type). The simulation reveals that the rupture area of Type I SISMAD is related to the pressure difference between its true and false lumens, while the maximum-to-minimum diameter ratio of Type II SISMAD is associated with insufficient true lumen blood supply and lumen dilation. Furthermore, based on patient follow-up data and hemodynamic simulation results, corresponding treatment plans were proposed for the new classification: Type I was judged based on the ratio of rupture area to entrance area as a risk factor, and intervention treatment was recommended if the value was greater than 0.44; Type II can be judged as a risk factor based on the ratio of minimum diameter to maximum diameter, and if the value is less than 0.38, intervention treatment is recommended.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112587"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437480","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}
Claire B. Crossley , Matthew T.O. Worsey , Laura E. Diamond , David J. Saxby , Thomas Wackwitz , Matthew N. Bourne , David G. Lloyd , Claudio Pizzolato
{"title":"A calibrated EMG-informed neuromusculoskeletal model can estimate hip and knee joint contact forces in cycling better than static optimisation","authors":"Claire B. Crossley , Matthew T.O. Worsey , Laura E. Diamond , David J. Saxby , Thomas Wackwitz , Matthew N. Bourne , David G. Lloyd , Claudio Pizzolato","doi":"10.1016/j.jbiomech.2025.112586","DOIUrl":"10.1016/j.jbiomech.2025.112586","url":null,"abstract":"<div><div>Cycling is a popular competitive and recreational exercise and is recommended as safe to perform following hip or knee surgery. During cycling, joint contact forces (JCF) have been recorded <em>in-vivo</em> and estimated <em>via</em> neuromusculoskeletal models, but model estimates are yet to be validated. In this study, motion data, crank force, and electromyograms for a range of cadences (40 and 60 revolutions per minute (rpm)) and power outputs (25, 35, 50, 60, 79, 75, 85, 95, 120 W) were collected from 7 healthy people cycling on a powered stationary ergometer. A (1) calibrated electromyogram-informed neuromusculoskeletal model and an (2) uncalibrated model that utilised static optimisation were used to estimate hip and knee JCF. Hip and knee JCF estimates were compared against <em>in-vivo</em> measurements of hip and knee JCF from literature. Peak hip and knee JCF were overestimated by both electromyogram-informed and static optimisation solutions, however, the magnitude and gradients of JCF as a function of cadence and power estimated by the electromyogram-informed solution more closely matched <em>in-vivo</em> measurement than those computed by static optimisation. Similarly, the profile of knee JCF as a function of crank angle estimated by the electromyogram-informed solution more closely matched <em>in-vivo</em> knee JCF than the static optimisation solution. Results indicate electromyogram-informed modelling is a valid computational approach to estimate knee and hip biomechanics during standard seated ergometer cycling.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112586"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437484","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}
Hanna Piotrzkowska-Wróblewska , Jacek M. Bajkowski , Bartłomiej Dyniewicz , Czesław I. Bajer
{"title":"Identification of a spatially distributed diffusion model for simulation of temporal cellular growth","authors":"Hanna Piotrzkowska-Wróblewska , Jacek M. Bajkowski , Bartłomiej Dyniewicz , Czesław I. Bajer","doi":"10.1016/j.jbiomech.2025.112581","DOIUrl":"10.1016/j.jbiomech.2025.112581","url":null,"abstract":"<div><div>This study introduces a spatially distributed diffusion model based on a Navier–Stokes formulation with a pseudo-velocity field, providing a framework for modelling cellular growth dynamics within diseased tissues. Five coupled partial differential equations describe diseased cell development within a two-dimensional spatial domain over time. A pseudo-velocity field mimics biomarker concentration increasing over time and space, influencing tumour growth dynamics. An <span><math><mi>S</mi></math></span>-shape coupling functions for individual equations were assumed to establish the mathematical relationship between parameters and variables. The parameters were identified in a minimisation procedure to validate the model’s efficacy based on limited clinical data. While the model draws inspiration from applications in oncology and could potentially be adopted for treatment planning and evaluation, it can also be helpful in applications from developmental biology to tissue engineering in clinical and experimental settings.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112581"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422218","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}
Bahar Rastgar , Amir Massoud Arab , Khosro Khademi-Kalantari , Zahra Amini-Farsani , Yaghoub Shavehei
{"title":"Functional data analysis of the full-body kinematics during a step-up task in subjects with and without low back pain: A cross-sectional study","authors":"Bahar Rastgar , Amir Massoud Arab , Khosro Khademi-Kalantari , Zahra Amini-Farsani , Yaghoub Shavehei","doi":"10.1016/j.jbiomech.2025.112585","DOIUrl":"10.1016/j.jbiomech.2025.112585","url":null,"abstract":"<div><div>This study aims to explore comprehensive kinematic patterns of all body joints utilizing a nonlinear functional data analysis (FDA) approach during a step-up task in patients with nonspecific chronic low back pain (NSCLBP). The kinematics of the trunk, pelvis, and upper- and lower-extremities during step-up exercises were assessed in NSCLBP (N = 23) and control (N = 22) groups using a Motion Analysis System. FDA was employed to compare movement-patterns of 15 segments between two groups. In the NSCLBP group, there was a significant decrease in flexion in specific spine regions (upper-thoracic and upper-lumbar segments) and increased flexion in the lower-thoracic-segment and most lower limb joints (except the dominant-knee) during the first phase (swing phase of leading-leg). Throughout the movement-cycle, in frontal-plane, increased adduction and inversion, along with decreased abduction and eversion were found in most lower limb joints (except the non-dominant hip and knee). Furthermore, during the movement-cycle, in transverse-plane, were observed, increased internal-rotation and decreased external-rotation in both hips and dominant knee, increased contralateral-rotation and decreased ipsilateral-rotation (relative to leading-limb) in all spine-segments, and increased forward-rotation in the pelvis. Notably, the upper-limbs showed decreased dominant-shoulder flexion, increased abduction of both shoulders, and increased upward-rotation of the non-dominant scapula throughout the movement-cycle in LBP group. This study revealed compensatory-mechanisms in NSCLBP-patients to counterbalance reduced sagittal-plane movement in specific spine regions, leading to increased motion across various joints in all three-planes, particularly frontal- and transverse-planes. Overall, FDA showed a prevalent pattern of flexion, adduction, and internal-rotation in most segments during step-up task in NSCLBP-patients.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"183 ","pages":"Article 112585"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601235","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}
Bart Bolsterlee , Rob Lloyd , Lynne E. Bilston , Robert D Herbert
{"title":"A mechanically consistent muscle model shows that the maximum force-generating capacity of muscles is influenced by optimal fascicle length and muscle shape","authors":"Bart Bolsterlee , Rob Lloyd , Lynne E. Bilston , Robert D Herbert","doi":"10.1016/j.jbiomech.2025.112584","DOIUrl":"10.1016/j.jbiomech.2025.112584","url":null,"abstract":"<div><div>Muscle forces are difficult to measure in vivo, so the force-generating capacity of muscles is commonly inferred from muscle architecture. It is often assumed, implicitly or explicity, that a muscle’s maximum force-generating capacity is proportional to physiological cross-sectional area (PCSA), and that a muscle’s operating range is proportional to mean optimal fascicle length. Here, we examined the effect of muscle architecture (PCSA and fascicle length) on muscle function (maximal isometric force and operating range) using a three-dimensional finite element model which accounts in a mechanically consistent way for muscle deformation and other complexities of muscle contraction. By varying architectural properties independently, it was shown that muscle force-generating capacity does not scale by the same factor as PCSA, and that operating range does not scale by the same factor as optimal fascicle length. For instance, 3-fold independent variation of mean optimal fascicle length caused the maximum isometric force-generating capacity of the muscle to vary from 83% to 105% of the force predicted by PCSA alone. Non-uniformities in fascicle length that develop as the muscle deforms during contraction reduce muscle force and operating range. Thus, a three-dimensional finite element model that satisfies fundamental physical constraints predicts that the maximum force-generating capacity of skeletal muscle depends on factors other than PCSA, and that operating range depends on factors other than optimal fascicle length. These findings have implications for how the force-generating properties of animal muscles are scaled to human muscles, and for how the functional capacity of muscles is predicted from muscle architecture.</div></div>","PeriodicalId":15168,"journal":{"name":"Journal of biomechanics","volume":"182 ","pages":"Article 112584"},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427895","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}