Journal of the American Podiatric Medical Association最新文献

{"title":"The Effect of Foot Anthropometric Measurements on Pain and Functional Disability of Pregnant and Non-Pregnant Women.","authors":"Rabia Koca, Müşerref Ebru Şen, Mehmet Yılmazer","doi":"10.7547/22-202","DOIUrl":"https://doi.org/10.7547/22-202","url":null,"abstract":"<p><strong>Background: </strong>Weight gain during pregnancy, loosening of the foot ligaments with the release of relaxin hormone, anthropometric and biomechanical changes can be seen in the foot with the growing fetus. It was aimed to determine whether these changes that occur during pregnancy cause painful musculoskeletal problems by altering the proximal structures of the lower extremities and the structure of the spine.</p><p><strong>Methods: </strong>Within the scope of this study, 210 women, half of whom are 3rd trimester of pregnancy (in the 28-40 weeks), aged between 18 and 40, with similar demographic characteristics are evaluated through measuring their navicular drops, hallux valgus angles, foot widths, foot lengths and tibial-calcaneal angles of both feet. Foot Function Index for foot-ankle, Kujala Patellofemoral Score for knee, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) for hip, Oswestry Disability Index for waist and Modified Neck Disability Index for neck were used to determine pain and functional limitation.</p><p><strong>Results: </strong>In this study, pain and functional disability in the waist, hip, knee, foot-ankle joints, navicular drops, hallux valgus angles and tibial-calcaneal angles were found to be significantly higher in pregnant women compared to the control group (P=0.00). It was observed that pain and dysfunction in all joints increased as navicular drop increased in both pregnant and nonpregnant women. In addition, it was determined that the increase in other anthropometric measurements in both groups caused pain and functional disability in most of the women, especially in the foot and ankle joints. However, the cause of joint pain and functional deficiencies was not related to pregnancy.</p><p><strong>Conclusions: </strong>It was observed that foot deformities and proximal region complaints were significantly higher in pregnant women, and foot deformities caused more foot-ankle pain and disability in both the study and control groups. No difference was observed in pregnant women with the control group.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-26"},"PeriodicalIF":0.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073648","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":"Feasibility for Utilization of Assessment for Lack of Protective Sensation as Part of a Foot Screening for Persons with Intellectual Disabilities.","authors":"Montana Von Musser, Hannah McCulley, David Jenkins","doi":"10.7547/24-112","DOIUrl":"https://doi.org/10.7547/24-112","url":null,"abstract":"<p><strong>Background: </strong>Persons with intellectual disability have a significantly higher prevalence of diabetes than the general population. Special Olympics Fit Feet, a major screening process for evaluating foot health in persons with intellectual disability, has not included an assessment for the risk of diabetic foot ulcers thus far. A probable reason for this may be that clinicians in the past have felt that persons with intellectual disability were not capable of understanding how to complete the Semmes-Weinstein test for lack of protective sensation. A study was designed to assess whether the Special Olympics athletes could complete the Semmes-Weinstein test for lack of protective sensation.</p><p><strong>Methods: </strong>31 Special Olympics athletes with intellectual disability participating in a Fit Feet foot screening underwent a Semmes-Weinstein test for lack of protective sensation (LOPS). An assessment was completed using predetermined criteria to establish whether the subject understood what was required and could satisfactorily complete the test. Likewise, it was also determined if the Special Olympics athletes believed they understood the test.</p><p><strong>Results: </strong>Study findings determined that approximately 67% of the athletes in the study were able to successfully complete the test and 90% of the Special Olympics athletes reported they completely understood the test. These results do not apply to the intellectual disability population at large.</p><p><strong>Conclusion: </strong>A significant percentage of the test population appeared able to successfully undergo the Semmes-Weinstein test for lack of protective sensation (LOPS). Therefore, it is recommended that any foot screening process for Special Olympics athletes should include an assessment for loss of protective sensation including use of monofilament testing.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-23"},"PeriodicalIF":0.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075022","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":"Intra-Foot Coordination and Its Variability During Walking in Males With and Without Chronic Ankle Instability.","authors":"Takahiro Watanabe, Tomoya Takabayashi, Takanori Kikumoto, Yudai Kikuchi, Masayoshi Kubo","doi":"10.7547/23-203","DOIUrl":"https://doi.org/10.7547/23-203","url":null,"abstract":"<p><strong>Background: </strong>Investigating the kinematics of copers, who are individuals with no recurrent ankle sprains, is necessary to prevent the development of chronic ankle instability (CAI). Since the \"giving way\" of the ankle joint (episodes of excessive inversion of the rearfoot, which do not result in an acute lateral ankle sprain) usually occurs during walking, investigating the intra-foot coordination during walking is necessary. This study aims to identify intra-foot coordination and its variability in copers while walking.</p><p><strong>Methods: </strong>The study included 12 copers, 13 CAIs, and 10 controls. The participants were required to walk on a treadmill at a fixed speed of 1.3 m/s. Using the modified vector coding technique, the coupling angle between the intra-foot joints, representing inter-joint coordination, was calculated and categorized into four coordination patterns. The coupling angle standard deviation represented the coordination variability during the stance phase.</p><p><strong>Results: </strong>The coordination between the rearfoot and midfoot in the frontal plane showed a significantly lower proportion of anti-phase with proximal dominance in the coper group than in the CAI and control groups during mid-stance (p < .05). Regarding coordination between the midfoot and forefoot in the sagittal plane, the coper group also showed a significantly lower proportion of in-phase coordination with distal dominancy than the CAI group during mid-stance (p < .05). For coordination between the midfoot and forefoot in the frontal plane, the coper group also showed a significantly lower proportion of anti-phase with distal dominance than the CAI group during the late stance (p < .05).The coordination variability between the sagittal midfoot and forefoot in the coper group was significantly lower than that in the CAI group and similar to that in the control group during mid-stance (p < .050).</p><p><strong>Conclusions: </strong>These differences may explain why copers do not experience ankle sprain recurrence.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-31"},"PeriodicalIF":0.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074950","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":"Comparing Self-Perceived Awareness to Actual Awareness of the Podiatric Profession Among High School and College Students.","authors":"Ashlee Starr, Tiffany Duong, David W Jenkins, Charlotte Bolch, Jeffrey L Jensen","doi":"10.7547/23-172","DOIUrl":"https://doi.org/10.7547/23-172","url":null,"abstract":"<p><strong>Background: </strong>Over the past few years there has been a decrease in the number of applicants applying to podiatric medical school. It has been suggested that this may be due to unfamiliarity with the profession of podiatric medicine. The goal of this study is to shed light on the misconceptions and lack of awareness of podiatric medicine so that the profession can better bridge the gap in knowledge with a resultant strategy to better increase recruiting efforts. It is hypothesized that high school and college students will overestimate their awareness of podiatry and that a significant percentage of students will have a low actual awareness of the profession. It is presumed that this shortfall will be greater in high school students.</p><p><strong>Methods: </strong>An eight question self-completion survey was created using RedCap that analyzed self-perceived and actual awareness of the podiatric profession. 318 students, 171 high school and 147 college, attending school within the state of Arizona completed the survey to test their actual and perceived knowledge of podiatry.</p><p><strong>Results: </strong>A total of 294 survey responses met the inclusion criteria and were used in the final evaluation of data. 57.1% of high school students and 47.9% of college students described their knowledge of podiatry as \"poor\". Each of the five true/false questions were answered incorrectly over 50% of the time. Overall, there was a statistically significant association between student's perceived knowledge of podiatry (good and higher, fair or poor) compared to their actual knowledge of podiatry.</p><p><strong>Conclusion: </strong>Evidence supports that many high school and undergraduate students are unaware of the podiatric profession. Furthermore, there are many misconceptions that are believed about the profession that could be causing a decline in applicants over the last few years.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-20"},"PeriodicalIF":0.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023944","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":"Results of Bioabsorbable Screws for the Fixation of Chevron Osteotomy in the Treatment of Hallux Valgus Deformities.","authors":"Hanyang Zhang, Zhaoyan Li, Zhuan Zhong, Bingzhe Huang, Zhende Jiang, Fei Chang","doi":"10.7547/24-043","DOIUrl":"https://doi.org/10.7547/24-043","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the safety and reliability of using bioabsorbable screws for the fixation of chevron osteotomy in the treatment of hallux valgus (HV) deformity.</p><p><strong>Methods: </strong>Clinical cases of chevron osteotomy in the treatment of HV deformities in our hospital between December 2018 and August 2022 were retrospectively summarised to compare preoperative imaging indices with those at the final follow-up session, including the hallux valgus angle (HVA), intermetatarsal angle (IMA) and tibial sesamoid position (TSP). The American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale, short-form health survey questionnaire (SF-36) and European Foot and Ankle Society (EFAS) scale were used to assess therapeutic efficacy. The visual analogue scale (VAS) was used to assess pain relief. Moreover, complications were recorded.</p><p><strong>Results: </strong>Twenty-six patients (39 feet) were included, and the mean follow-up period was 24.0 months. No infection, delayed healing or non-healing was recorded. The osteotomy ends healed well without non-union or delayed union. Four cases of recurrence (HVA ≥20°), two of numbness in the distal toe, one of necrosis of the first metatarsal head and one of osteoarthritis of the first metatarsophalangeal joint occurred. No patients underwent secondary surgery. The HVA, IMA and TSP significantly reduced at the final follow-up session compared with their preoperative values, and significant improvement was seen in clinical scores.</p><p><strong>Conclusion: </strong>The use of bioabsorbable screws for the fixation of chevron osteotomy is safe and effective in the treatment of HV deformities.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-24"},"PeriodicalIF":0.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023946","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":"Correlation Between Plantar Fascia Thickness and Other Variables in Women Diagnosed with Plantar Fasciopathy.","authors":"Ruben Montes-Salas, Ramon Mahillo-Durán, Alvaro Gomez-Carrion, Estela Gomez-Aguilar, Gabriel Camunas-Nieves, Jose Manuel Castillo-Lopez","doi":"10.7547/24-099","DOIUrl":"https://doi.org/10.7547/24-099","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to explore the relationship between plantar fascia (PF) thickness and various factors including pain, function, anthropometric parameters, and other variables in women diagnosed with plantar fasciopathy.</p><p><strong>Methods: </strong>A total of 37 feet from female patients were randomly selected for this investigation. Utilizing ultrasound, the thickness of the PF was meticulously measured. Subsequently, the correlation between PF thickness and several factors such as pain intensity, functional impairment, height, age, weight, biconvexity of the plantar fascia, duration of the disease, recurrence of plantar fasciopathy, and daily activity levels were analyzed.</p><p><strong>Results: </strong>The findings of this study unveiled a significant positive correlation between PF thickness and several parameters. Specifically, there was a notable correlation with pain intensity, where increased thickness corresponded to heightened pain levels. Additionally, PF thickness exhibited positive associations with height, age, and weight, indicating that these anthropometric factors may influence PF thickness. Moreover, the biconvexity of the plantar fascia, disease duration, and recurrence of plantar fasciopathy showed correlations with PF thickness, suggesting potential implications for disease progression and management. Furthermore, the study identified a relationship between PF thickness and daily activity levels, underscoring the impact of physical exertion on PF health. Notably, the presence of hyperemia in the plantar fascia, as determined by power Doppler ultrasound, also showed a correlation with PF thickness, highlighting potential vascular implications in plantar fasciopathy.</p><p><strong>Conclusion: </strong>In conclusion, this study provides valuable insights into the multifaceted relationship between PF thickness and various clinical parameters in women with plantar fasciopathy. Understanding these correlations may aid in the development of more targeted and effective management strategies for this debilitating condition.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-17"},"PeriodicalIF":0.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023945","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":"Large Osteolipoma of the Posterior Ankle: A Rare Tumor in an Unusual Location.","authors":"Forrest Rackard, Xuefei Huang, Debajyoti Saha, Ali Akalin, George Watts, Mathew Most","doi":"10.7547/23-182","DOIUrl":"https://doi.org/10.7547/23-182","url":null,"abstract":"<p><p>Osteolipoma is a rare lipoma variant characterized by mature osseus metaplasia within mature adipose tissue, most commonly found in the head and neck, and seldom reported in the extremities. We present a case of a large osteolipoma of the posterior ankle associated with antecedent trauma. These tumors are typically slow growing and can be associated with pain and stiffness, depending on tumor size and location. Treatment is surgical excision, and recurrence is not reported. Interdisciplinary care involving radiology, pathology, and the surgical service is necessary for proper diagnosis and treatment of this rare benign neoplasm.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700830","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":"Effects of Home-Based Telerehabilitation on Foot Intrinsic Muscle Activity and Thickness in Individuals With Flat Feet: A Preliminary Study.","authors":"Dong-Chul Moon, Jun-Seok Kim","doi":"10.7547/22-178","DOIUrl":"https://doi.org/10.7547/22-178","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the effects of movement control exercise (MCE) and abductor hallucis (AbH) muscle contraction, performed via home-based telerehabilitation, on foot intrinsic and extrinsic muscle activity, AbH muscle thickness, and balance in individuals with flat feet.</p><p><strong>Methods: </strong>In total, 30 individuals with flat feet were enrolled in the study. Participants were randomly assigned to home-based telerehabilitation focusing on MCE only or MCE emphasizing short foot motion (SFMCE) for the lower extremities. Exercises were performed over 4 weeks. Data for foot intrinsic and extrinsic muscle activity, AbH muscle thickness, and the Y-balance test were collected before and after the 4-week intervention.</p><p><strong>Results: </strong>Abductor hallucis muscle activity in the SFMCE group was significantly higher after exercise compared with before, and there was also a significant difference between the groups. Furthermore, AbH muscle thickness was significantly greater in the SFMCE group compared with the MCE-only group. The Y-balance test performance improved significantly in the posterolateral direction in the SFMCE group.</p><p><strong>Conclusions: </strong>Home-based telerehabilitation focused on SFMCE can be used to improve foot intrinsic muscle activity, AbH muscle thickness, and functional balance in individuals with flat feet.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700820","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":"Patient Knowledge and Habits as Predictors of Foot Complications in Diabetes: A Cross-Sectional Study.","authors":"Khalid M Edrees, Alanood I Alqahtani, Mansoor Radwi","doi":"10.7547/23-069","DOIUrl":"https://doi.org/10.7547/23-069","url":null,"abstract":"<p><strong>Background: </strong>This cross-sectional study aimed to identify patients' awareness of predictors of diabetic foot complications (DFCs) based on 1) knowledge of hemoglobin A1c (HbA1c), 2) performance of fasting blood glucose (FBG) at home, and 3) type of footwear used and relationship with DFCs.</p><p><strong>Methods: </strong>A total of 4,652 diabetic patients were seen between 2006 and 2021 at Dr. Khalid Edrees Specialized Medical Center. A questionnaire was completed by trained nurses at the patients' initial visit, collecting patients' knowledge of the HbA1c test, monitoring of FBG at home, and type of footwear used at the time of the visit. History of foot ulcers, current foot ulceration (CU), and history of lower limb amputation (LLA) were obtained.</p><p><strong>Results: </strong>The majority of our cohort were male (60%), and the mean age was 60 years (SD, 17.5 years). Ninety-six percent had type 2 diabetes, and 39% were diagnosed with diabetes for at least 11 years. More than half did not know what HbA1c was, 32% were not doing home FBG, and 62% were using inappropriate footwear. Fifty-two percent had a CU, 35% had a history of foot ulcers, and 13% had an LLA. We found a significant association between CU and knowledge of HbA1c and type of footwear (P < .001). Similarly, LLA was significantly associated with all of the aforementioned variables (P < .001). A history of foot ulcers was significantly associated with knowledge of HbA1c and type of footwear (P = .001) but not with home FBG.</p><p><strong>Conclusions: </strong>A high proportion of patients in our cohort had never heard of HbA1c and were using traditional footwear. This highlights the importance of patient education regarding the basics of diabetes and the use of appropriate footwear in preventing DFCs.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700518","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":"Use of Antibiotic Spacer with Syndesmotic \"Fin\" for Treatment of Septic Ankle Joint: Two-Stage Approach or Definitive Management?","authors":"Samantha L Williams, Elizabeth Connolly, John Levin","doi":"10.7547/22-120","DOIUrl":"https://doi.org/10.7547/22-120","url":null,"abstract":"<p><p>Septic ankle joint following orthopedic surgery is a rare but limb-threatening complication that requires emergent multi-modal management. Traditionally, spacers serve as stage one of a two-stage approach involving deep infections seeding to a joint. However, a paucity of literature exists regarding the outcomes and longevity of antibiotic spacers in patients who are poor candidates for a subsequent reoperation. We present a case of an 89-year-old female who sustained an open pilon fracture treated with external fixation, and a subsequent open reduction internal fixation following a fall from a height. The patient developed surgical site dehiscence that progressed to a septic ankle joint, confirmed via single-photon emission computed tomography and a three-phase bone scanning. The patient underwent a debridement with operative wash-out and fashioning of a methylmethacrylate antibiotic spacer containing 1 g of vancomycin and 1.2 g of tobramycin. This was positioned in the ankle joint with an adapted \"fin\" extending anteriorly and proximally in the tibiofibular syndesmosis, to provide stability to the spacer, and potentially increase its longevity interpositionally. With aggressive local wound care and an oral antibiotic course, the patient proceeded to complete reepithelialization of the sinus tract 6 weeks postoperatively. Serial imaging and computed tomographic scan confirmed a well-seated spacer, without evidence of migration or extrusion, 14 months after surgery. Outcome data regarding cement ankle arthroplasties are extremely limited. Retrospective case series have quantified average retention anywhere from 6 to 62 months with varying techniques. However, in the setting of multiple comorbidities, or other factors making a patient a poor candidate for reoperation, an antibiotic spacer may serve as a definitive treatment for such an infection with satisfactory outcomes. We believe the presented method, with use of a proximal fin articulating in the tibiofibular syndesmosis, not only improves implant retention, but also, maintains a functional, plantigrade ankle joint.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700666","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}