Medical problems of performing artists最新文献

{"title":"Prevalence and Treatment of Guitar-Related Medical Problems: A Systematic Review of Clinical Studies.","authors":"Tae-Hun Kim, Jung Won Kang, Hee Yeon Kim","doi":"10.21091/mppa.2026.01003","DOIUrl":"10.21091/mppa.2026.01003","url":null,"abstract":"<p><strong>Aims: </strong>As the number of professional and amateur guitarists continues to grow, there is a need to summarize the clinical evidence on the prevalence and treatment of this population. This systematic review aimed to provide an overview of the diseases and symptoms affecting guitarists and the available treatments.</p><p><strong>Methods: </strong>Published clinical studies, ranging from case reports to systematic reviews, addressing medical problems among guitarists were systematically searched in PubMed, EMBASE, and the Cochrane Library up to June 2025. A proportion meta-analysis was conducted to estimate the prevalence of these conditions, and the treatment evidence was summarized.</p><p><strong>Results: </strong>Among 1,001 publications identified from the literature search, a total of 42 clinical studies were included in this review, including case studies, observational studies, and randomized controlled trials. Guitarists were found to have a high prevalence of musculoskeletal pain (0.56, 95% confidence interval [0.26 to 0.84]) and psychological problems. Guitarists' musculoskeletal pain was potentially related to the long practice duration and inappropriate posture while playing. Various invasive and noninvasive treatment options are available for dystonia in guitarists, but clinical evidence of their effectiveness and safety has not yet been established. Moreover, there were some publications on rare conditions, which should be assessed from the perspective of therapeutic options and prevention in future research.</p><p><strong>Discussion: </strong>Guitarists are at notable risk of physical and psychological conditions. Therefore, preventative education and train¬ing are necessary. In addition, clinical evidence for treating these diseases remains inconclusive, and well-designed clinical studies for various interventions are necessary in the future. [Protocol: INPLASY202560088].</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"41 1","pages":"16-35"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317301","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":"Exploring Breathing During Ballet Performance: A Case Report.","authors":"Akito Miura, Natsuko Oshima, Mao Fujimuro, Azusa Yokoyama, Haruka Okuyama, Takahide Etani","doi":"10.21091/mppa.2026.01002","DOIUrl":"10.21091/mppa.2026.01002","url":null,"abstract":"<p><p>Literature on renowned classical ballet dancers and educators highlights the importance of breathing in dancing. The purpose of this case study was to explore the feasibility of investigating the underexplored relationship between breathing and dance movements. The participant, a 25-year-old female professional classical ballet dancer, performed ballet choreography requiring significant stamina and pointe technique. Her breathing sounds and video footage were recorded simultaneously using two smartphones. The timings of breathing and kinematic events were identified in the two segments. In both segments, the respiratory rate was approximately 60 breaths/minute, suggesting that breathing may be finely controlled in ballet. In the first segment, breathing occurred at a steady rhythm, and no clear coupling between breathing and movement phases was observed. In the second segment, the rhythms of turns and breathing appeared to be coupled, suggesting possible coordination between breathing and movement. These exploratory findings provide a basis for future research on breathing during ballet performance.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"41 1","pages":"10-15"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317322","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":"Translation and Initial Validation of the Simplified Chinese Version of the Performance-Related Pain in Musicians Questionnaire (PPAM-C) Among Music Students in Shandong, China.","authors":"Yu Fu, Fung Chiat Loo, Ana Zão","doi":"10.21091/mppa.2026.01001","DOIUrl":"10.21091/mppa.2026.01001","url":null,"abstract":"<p><p>The problem of occupational injuries and pain among musicians continues to receive wide attention. However, the limitations of survey tools have limited hindered the in-depth development of occupational health research on musicians across different regions to a certain extent. The aim of this study was to translate the Performance-Related Pain in Musicians Questionnaire (PPAM) into Simplified Chinese (PPAM-C) and to conduct the cultural adaptation and initial validation of the PPAM-C for music students. The reliability and validity of the questionnaire were tested with Chinese music students. A total of 610 valid questionnaires were collected (students' mean age 19.4 yrs, SD 1.146); females accounted for 69.7%. The respondents represented a variety of primary musical instrument types. Exploratory factor analysis (EFA) supported a three-factor structure consistent with the original version: pain intensity, pain interference in general activities, and pain interference in performance. The sample fit was good (KMO = 0.851; Bartlett's test of sphericity, p <0.001). The communalities and eigenvalues showed the robustness of the factor structure. The internal consistency (Cronbach's α = 0.786-0.937) of the subscales was good. The PPAM-C showed significant moderate to high correlations with the relevant domains of the Simplified Chinese versions of the Brief Pain Inventory (BPI), QuickDASH, and SF-36 scales, which confirmed its good convergent validity. The results of demographic analysis further showed that the questionnaire was applicable to music students of different ages, genders, and primary musical instruments. In conclusion, the PPAM-C exhibits excellent psychometric properties and is a reliable tool for assessing pain and its impact on music students' general and performance-related activities in the Chinese context.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"41 1","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317336","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":"Alcohol and Drug Use in Musicians: A Systematic Review.","authors":"Xiao Zeng, Ringala Cainamisir, Hubertus Himmerich","doi":"10.21091/mppa.2026.01004","DOIUrl":"10.21091/mppa.2026.01004","url":null,"abstract":"<p><p>Musicians face unique psychological and professional challenges, which may increase their risk of substance abuse. Previous studies have reported that the prevalence of alcohol or drug use among musicians ranges from 13% to over 80%, depending on the substance, genre, and measurement tools. This systematic review includes studies on alcohol and drug use among musicians, summarizing their prevalence, associated factors, and the bidirectional impact on mental health. Following PRISMA guidelines, a total of 551 records were initially identified before screening and exclusion, and the review included 23 qualitative and quantitative studies published between 1959 and 2024, involving a total of 36,245 participants. The research results show that the incidence of substance abuse (especially alcohol and cannabis) among musicians is higher than that of the general population. Most studies concluded that this could be due to insufficient coping strategies, the unique challenges of their workplace, and the cultural norms of the music industry. Certain music genres and performance roles as well as economic instability also affect the substance abuse of musicians. Compared to previous studies, this review places more emphasis on the complex interaction between the psychological distress of musicians, their professional environment, and professional expectations. Future research should incorporate more longitudinal designs, include more multicultural backgrounds, and focus on the perspectives of musicians themselves. This review provides information for formulating mental health interventions and policies for the music profession.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"41 1","pages":"36-53"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317332","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":"Craniocervical Characteristics of Wind Musicians: An Observational Study in Spanish Conservatory Students.","authors":"Clara Rodríguez-Gude, Yaiza Taboada-Iglesias, Margarita Pino-Juste","doi":"10.21091/mppa.2025.04015","DOIUrl":"10.21091/mppa.2025.04015","url":null,"abstract":"<p><strong>Introduction: </strong>Playing wind instruments may promote neck, arm, or shoulder pain, as well as temporomandibular pain. The cervical and orofacial regions are associated, due to their proximity and the influence they both have on body posture. In wind musicians, the mouth is responsible for producing the sound. Any alteration in the characteristics of the orofacial system can affect the embouchure when playing a wind instrument.</p><p><strong>Aim: </strong>To observe demographic and physical characteristics in the cervicomandibular region in a sample of university wind students.</p><p><strong>Methods: </strong>An observational descriptive cross-sectional study was carried out with wind students in the two higher conservatories of the region of Galicia, Spain. We studied the posture of the head and neck, the range of cervical movement and mouth opening, the presence of trigger points in the upper trapezius and masseter, as well as their algometry and electromyographic value.</p><p><strong>Results: </strong>30 woodwind and 19 brass students were evaluated, 51% of whom were female. A tendency towards a forward position of the head and protraction of the shoulders was observed, maintaining horizontality in the frontal plane in both the head and shoulders. Cervical movements were diminished, while the mouth opening was greater than standard. In this sample, a relatively high prevalence of trigger points in the upper trapezius was observed, while the masseters showed greater sensitivity to pain and greater activation during trapezius contraction.</p><p><strong>Conclusions: </strong>Musicians in this study presented an anteriorized position of the head and shoulders in the sagittal plane, with a decrease in cervical range of motion particularly in the transverse plane.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"40 4","pages":"126-134"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564421","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":"Developing a Screening Tool for Psychological Stress in Musicians: The Lübeck Inventory on Musicians' Psychological Stress (LIMIT).","authors":"Christine Sickert, Stine Alpheis, Jonas Obleser, Daniel S Scholz","doi":"10.21091/mppa.2025.04013","DOIUrl":"10.21091/mppa.2025.04013","url":null,"abstract":"<p><strong>Objectives: </strong>Psychological stress concerns many musicians and poses a risk for their mental and physical health. However, there are thus far no instruments that measure psychological stress of musicians in particular. We aimed to fill this gap by developing a questionnaire designed specifically to detect components that increase psychological strain in musicians.</p><p><strong>Methods: </strong>The Lübecker Inventar für psychischen Stress bei Musizierenden (Lübeck Inventory on Musicians' Psychological Stress, LIMIT) was developed through consultation with experts from the field. Subsequently, the factorial structure was examined on a sample of N = 602 musicians. Multiple factor extraction methods were compared using model fit criteria to determine an adequate/representative number of factors and items. Reliability and validity of the questionnaire were tested.</p><p><strong>Results: </strong>The Kaiser-Meyer-Olkin criterion revealed an excellent sampling adequacy (0.945). Excluding non-fitting items, the final LIMIT is composed of 34 items loading on four factors: \"self-efficacy,\" \"depression,\" \"time-management,\" and \"pressure.\" The scale reached an excellent reliability (Cronbach's a = 0.938) and fulfilled validation criteria.</p><p><strong>Conclusions: </strong>The LIMIT can be a useful screening tool for assessing musician-specific psychological strain, enabling musicians and practitioners to identify stress at an early stage and to seek out support in good time. An English validation is in progress.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"40 4","pages":"97-113"},"PeriodicalIF":0.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563500","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":"College Marching Band Artists' Access to and Satisfaction with Healthcare Providers.","authors":"Andria L Merrill, Zachary K Winkelmann, Nancy A Uriegas, Lindsey E Eberman","doi":"10.21091/mppa.2025.03009","DOIUrl":"https://doi.org/10.21091/mppa.2025.03009","url":null,"abstract":"<p><strong>Objective: </strong>Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered care (PCC). The purpose of this study was to explore healthcare providers (HCPs) who MB artists have access to and the artists' perceptions of PCC.</p><p><strong>Methods: </strong>We used a cross-sectional, web-based survey to explore which providers MB artists had access to. In total, 751 MB artists (age 20±8 yrs) completed the survey. Respondents who reported no access or were unsure were prompted to complete an open-ended response describing what they would do if an injury or illness occurred. Participants who had access to an athletic trainer (AT) completed the Global Perceptions of Athletic Trainer Patient-Centered Care Tool (GPATPCC; a=0.90; 15 items [1 reverse-scored]; 4-point Likert scale [1=strongly disagree, 4=strongly agree, 0=unsure]; score=average). Participants with access to other HCPs completed the Consultation and Relational Empathy tool (CARE; a=0.97; 10 items; 5-point Likert scale [1=poor, 5=excellent]; score=sum). Scores for the tools were standardized (z-score), and a Mann-Whitney U test determined PCC differences between those with access to ATs and those with access to other HCPs.</p><p><strong>Results: </strong>Overall, 42.5% of MB artists had access to a HCP. The MB artists with access to ATs expressed satisfaction (mean 3.05±0.67) on the GPATPCC tool. Participants who completed the CARE tool expressed they were satisfied (mean 39.59±8.78). However, 57.5% of MB artists reported having no access or being unsure, who commonly relied upon communicated with MB leadership (33.8%) when injured. No significant differences were identified between ATs and other HCP ratings of PCC (U=4615, z=-0.36 p=0.719).</p><p><strong>Conclusion: </strong>Over half of MB artists reported a lack of access or a lack of familiarity with what HCPs are available. Those with access to HCPs were satisfied with the care they received. Continued efforts should be focused on improving MB artists' access to HCPs.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"40 3","pages":"69-76"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959820","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":"Death Drop and Not Drop Dead: A Preliminary Examination of Drag Queen Health.","authors":"Kathleen L Davenport, Jennifer Mj Yang, Winlove Mojica, Esteban Padilla, John N Viana","doi":"10.21091/mppa.2025.03011","DOIUrl":"https://doi.org/10.21091/mppa.2025.03011","url":null,"abstract":"<p><strong>Purpose: </strong>The health concerns of drag queens remain understudied. This paper examines the physical health and healthcare access of drag queens and reflects on ways to holistically promote their well-being.</p><p><strong>Methods: </strong>Professional drag queens in the United States underwent the Dance/USA Task Force on Dancer Health Annual Post-Hire Health Screen, which assesses medical history, musculoskeletal metrics, and cardiovascular fitness. To discuss healthcare needs, this paper draws from the authors' expertise in physiatry, dermatology, gender studies, mental health, and medical anthropology.</p><p><strong>Results: </strong>Seven performers chose to participate in the study, with 6 participants participating in both the history and physical examination portions. While 3 (50%) had excellent cardiovascular fitness, 2 had below aver¬age or very poor results. None of the performers met the Beighton criteria for hypermobility. Bilateral hip flexion tightness was seen in 5 (83%) of performers, while 100% had tightness in bilateral hip internal rotation. The weakest muscle groups included lower abdominals and hip extensors bilaterally, left weaker than right. Four out of 7 reported a current or prior musculoskeletal injury. Three of 7 have health insurance, 4 felt they would benefit from psychology counseling, and 4 reported binge drinking at least three times in the past year. Four out of 7 were overdue (>24 months) for visiting their primary care physician.</p><p><strong>Conclusions: </strong>Drag queens may be at risk for musculoskeletal injuries and strength asymmetries, dermatologic issues, and psychosocial harms. An urgent need exists for a comprehensive understanding of drag queen health to promote the well-being of understudied LGBTQIA+ populations.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"40 3","pages":"88-93"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959788","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":"Biomechanical Validation of a Dance-specific Heel Raise to Jump Progression.","authors":"Catherine Haber, Andrea Schärli","doi":"10.21091/mppa.2025.03010","DOIUrl":"https://doi.org/10.21091/mppa.2025.03010","url":null,"abstract":"<p><strong>Background: </strong>In ballet, a single movement can be developed into multiple variations by changing factors such as direction or magnitude. Similarly, the Dance-Specific Graded Rehabilitation Program (DSGRP) is built on the progression of three factors: (1) movement (relevés, heel raises; explosive relevés [EXrelevé], heel raises with the intention to jump but not actually jumping; and sautés, small jumps), (2) leg support (double-leg and single-leg), and (3) barre support (two hands, one hand, and no hands). However, these factors are yet to be fully analyzed biomechanically.</p><p><strong>Objective: </strong>This study aimed to investigate the influence of movement, leg support, and barre support on mechanical load and impact characteristics of a dance-specific heel raise to jump progression.</p><p><strong>Methods: </strong>Eighteen healthy dancers performed the stages of the progression in a semi-randomized order. Mechanical load was quantified by peak vertical ground reaction force (vGRF) and illustrated by weight-bearing profiles. Impact characteristics relating to force-time dynamics were quantified by the rate of force attenuation (RFA) during takeoff and the rate of force development (RFD) during landing. Linear mixed models assessed the significance and incremental contributions of each factor for peak vGRF, RFA, and RFD, while weight-bearing profiles were analyzed descriptively.</p><p><strong>Results: </strong>Results revealed increasing load and impact characteristics with movement type and leg support, though negligible influence of barre support. Incre¬mental increases were quantified for the first time in a dance-specific context.</p><p><strong>Conclusion: </strong>Findings support the inclusion of EXrelevés as an intermediary movement between relevés and sautés. Barre support did not influence vertical kinetics, suggesting the need to explore its potential role in transverse plane stabilization. The reported increments suggest the following progression for optimal loading: double-leg relevés, double-leg EXrelevé, single-leg relevé, single-leg EXrelevé, double-leg sauté, and single-leg sauté. Incremental effects of observed factors inform optimal sequencing for training and rehabilitation progressions in dance.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"40 3","pages":"77-87"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959717","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- and Inter-Rater Reliability of Pointe-Readiness Tests.","authors":"Annette Karim, Christopher Patterson, Michael Wong","doi":"10.21091/mppa.2025.03008","DOIUrl":"https://doi.org/10.21091/mppa.2025.03008","url":null,"abstract":"<p><strong>Objective: </strong>To investigate via video review the intra-rater and inter-rater reliability of three pointe-readiness tests: the topple test, airplane test, and sauté test.</p><p><strong>Methods: </strong>Ten ballet-trained pre-professional and professional dancers were videotaped performing the topple test, airplane test, and sauté test from the front and side views. The videos, written instructions, and rater score sheets were provided to the raters via individually linked electronic access over four sessions, with a washout period of 2 weeks between sessions. The videos were reviewed at slow speed and at real-time speed, with two sessions at each speed, assigned in random order. Raters received a training session prior to the start of their first session. Intraclass correlation coefficients were calculated for intra-rater and inter-rater reliability for all raters for each test and for the total score of the three tests.</p><p><strong>Results: </strong>Twenty-two raters assessed the 10 dancers. Intra-rater reliability was good between session 1 and session 2 for the real-time speed (ICC range = 0.83-0.88), good for the slow speed (ICC = 0.83-0.85), good to excellent for the average of real-time vs slow speed (ICC = 0.88-0.94), and excellent for session 1 vs session 2 (ICC = 0.93-0.96). Inter-rater reliability was good to excellent for the first real-time speed (ICC = 0.88-0.94), for the first slow speed (ICC = 0.85-0.96), and for the first session regardless of speed (ICC = 0.88-0.96).</p><p><strong>Conclusion: </strong>The criteria for the pointe-readiness tests are acceptable. Raters with and without a dance background were able to conduct the movement assessments with good to excellent intra-rater and inter-rater reliability in real-time review.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":18336,"journal":{"name":"Medical problems of performing artists","volume":"40 3","pages":"61-68"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959793","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}