Physical Therapy最新文献

{"title":"The Longitudinal Course of Physical Activity Behavior Poststroke and Its Variation Across Subgroups: The Norwegian Cognitive Impairment After Stroke Study.","authors":"Geske Luzum, Heather Allore, Ling Han, Ingvild Saltvedt, Xiangchun Tan, Pernille Thingstad, Asta Håberg, Torunn Askim","doi":"10.1093/ptj/pzaf069","DOIUrl":"10.1093/ptj/pzaf069","url":null,"abstract":"<p><strong>Importance: </strong>Despite its importance as a modifiable target poststroke, the longitudinal course of physical activity (PA) is not fully understood.</p><p><strong>Objective: </strong>This study aimed to describe the course of poststroke PA behavior from 3 to 36 months and identify subgroups with different PA patterns using multi-trajectory modeling.</p><p><strong>Design: </strong>A prospective multicenter cohort study design was used.</p><p><strong>Setting: </strong>Follow-up at 3, 18, and 36 months poststroke was community-based.</p><p><strong>Participants: </strong>In total, 277 individuals (age = 70.1 [SD = 10.9]; 116 [41.9%] female) with primarily mild strokes were included. Participants provided at least 2 follow-up periods with accelerometer data each lasting at least 3 consecutive days.</p><p><strong>Main outcomes and measures: </strong>At each follow-up, daily estimates of upright time, time spent in light physical activity (LPA), time spent in moderate physical activity (MPA), step count, and the number of sit-to-stand transitions were measured.</p><p><strong>Results: </strong>Average daily upright time declined by -7.4 min (95% CI = -10.09 to 4.64), and average daily step count declined by -132 steps (95% CI = -176 to -88) each year. Four distinct groups of individuals with different characteristics were identified, following a similar developmental course across PA dimensions over time: one-fourth of the participants (25.6%) were characterized by stable low PA estimates and a tendency to decline over time. Two groups, making up 32.4% and 20.8% of the sample, were characterized by intermediate levels of LPA and MPA, with differing levels of sit-to-stand transitions; and 1 group (21.2% of participants) was characterized by stable high PA duration estimates over time.</p><p><strong>Conclusions: </strong>The overall course of PA poststroke was characterized by a modest decrease over 3 years. Differing PA trajectory groups characterized by different demographic and clinical features highlight the diverse needs for supporting people living with stroke in becoming more active.</p><p><strong>Relevance: </strong>Findings may help clinicians identify subgroups of people with stroke who need extended professional follow-up in long-term rehabilitation.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a Discrete Choice Experiment to Elicit Patient Preferences for Physical Therapist Services After Surgery for Breast Cancer.","authors":"Helen McTaggart-Cowan, Kendra Zadravec, Bolette S Rafn, Adam J N Raymakers, Dean A Regier, Kristin L Campbell","doi":"10.1093/ptj/pzaf077","DOIUrl":"10.1093/ptj/pzaf077","url":null,"abstract":"<p><strong>Importance: </strong>Patients often experience challenges accessing physical therapy for breast cancer-related impairments. Eliciting patient preferences for physical therapy can inform design of patient-centered, breast cancer-focused physical therapy programming.</p><p><strong>Objective: </strong>A discrete choice experiment (DCE) was used to elicit patient preferences for physical therapy after breast cancer surgery.</p><p><strong>Design: </strong>Sequential mixed methods identified 7 attributes of physical therapy: education timing; referral method; first appointment timing; physical therapist expertise level; treatment format; treatment frequency; and annual out-of-pocket cost. Respondents chose between 2 physical therapy programs and an opt-out option.</p><p><strong>Settings: </strong>The DCE was administered online.</p><p><strong>Participants: </strong>Participants were adults with breast cancer in Canada.</p><p><strong>Main outcomes and measures: </strong>Responses were analyzed using a mixed logit model. Willingness-to-pay estimates were calculated as the marginal rate of substitution between each attribute level with respect to cost.</p><p><strong>Results: </strong>The DCE was completed by 148 respondents (completion rate: 77.5%). Most were within 3 years post-diagnosis (54.1%), had completed post-secondary education (70.9%), and had annual family incomes over $40,000 (76.5%). Nearly half were referred to physical therapy (48.5%). Respondents preferred to be seen by a physical therapist with expertise in breast cancer (β = .368, SD = 0.091) and to receive more frequent appointments (β = -.011, SD = 0.025).</p><p><strong>Conclusion: </strong>The DCE was capable of eliciting patient preferences for physical therapy after breast cancer surgery. Respondents exhibited preferences for physical therapist expertise level and treatment frequency. Findings from this study will be the first step in informing development of accessible physical therapy programming that is responsive to the needs and preferences of patients with breast cancer.</p><p><strong>Relevance: </strong>This work can inform design of accessible, patient-centered physical therapist services for patients with breast cancer. Receiving timely physical therapy can improve patients' physical function, quality of life, and ability to engage in life roles and activities.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174525","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":"The Heart of Movement: What's Love Got to Do With it?","authors":"Terrence M Nordstrom","doi":"10.1093/ptj/pzaf082","DOIUrl":"10.1093/ptj/pzaf082","url":null,"abstract":"<p><p>Terrence M. Nordstrom, PT, EdD, FAPTA, the 56th McMillan Lecturer, is emeritus professor in the Department of Physical Therapy at Samuel Merritt University in Oakland, California, where he has served as a faculty member, director of clinical education, department chair, assistant academic vice president, and vice president of enrollment and student services. During his 24 years of clinical and leadership experience, his research and writing focused on professional education, professional formation and ethics, and academic leadership development. He received his bachelor's degree from the University of California, Santa Cruz; his master's degree in physical therapy from Stanford University; and his doctor of education from the University of San Francisco. His American Physical Therapy Association (APTA) recognitions include being the first vice president and second president of the American Council of Academic Physical Therapy. He currently serves as the finance officer for the California Physical Therapy Association. He has served on many APTA committees and task forces including the Ethics and Judicial Committee. He was a mentor in the APTA Fellowship in Higher Education Leadership from 2017 to 2023 and has been a mentor in the Grant Writing and Mentorship in Education Research program since its inception in 2018. He is a Catherine Worthingham Fellow of APTA and senior fellow and retired scholar of the National Academy of Practice. He was the APTA Academy of Education Pauline Cerasoli Lecturer in 2019.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286113","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":"On \"Patient Experiences of a Group Intervention Integrating Vestibular Rehabilitation, Body Awareness, and Cognitive Behavioral Therapy for Long-Lasting Dizziness: A Focus Group Study.\" Magnussen LH, Wilhelmsen KT, Råheim M. Phys Ther. 2025:pzaf062. https://doi.org/10.1093/ptj/pzaf062.","authors":"Riza Amalia, Henny Indreswari, Ronal Surya Aditya, Harwanti Noviandari","doi":"10.1093/ptj/pzaf085","DOIUrl":"https://doi.org/10.1093/ptj/pzaf085","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507507","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":"Author Response to Amalia et al.","authors":"Liv Heide Magnussen, Kjersti Wilhelmsen, Målfrid Råheim","doi":"10.1093/ptj/pzaf087","DOIUrl":"https://doi.org/10.1093/ptj/pzaf087","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485546","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":"On \"Treatment Decision-Making for Anterior Cruciate Ligament Rupture from the Perspective of Physical Therapists in Australia: A Mixed Methods Study.\" Filbay SR, Rooney J, Hoffmann T, et al. Phys Ther. 2025;105(5):pzaf030. https://doi.org/10.1093/ptj/pzaf030.","authors":"Rikas Saputra, Yenni Lidyawati","doi":"10.1093/ptj/pzaf086","DOIUrl":"https://doi.org/10.1093/ptj/pzaf086","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485547","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 the Quality of Physical Therapy in Patients With Hip or Knee Osteoarthritis in Germany: A Cross-Sectional, Vignette-Based Study.","authors":"Franziska Weber, Corelien Kloek, Max Bonk, Christian Grüneberg, Cindy Veenhof","doi":"10.1093/ptj/pzaf083","DOIUrl":"https://doi.org/10.1093/ptj/pzaf083","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Conservative, non-pharmacological interventions are the recommended first-line treatment for hip and knee osteoarthritis (OA). Clinical practice guidelines (CPGs), such as those from the Osteoarthritis Research Society International (OARSI), guide evidence-based care by physical therapists. However, no studies in Germany have examined physical therapists' treatment choices across patient cases and compared them with the latest evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of this study was to investigate to what extent physical therapists meet the latest evidence when treating different type of people with hip or knee OA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design and setting: &lt;/strong&gt;A cross-sectional vignette-based online survey was conducted among physical therapists working in outpatient practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Eligible participants had adequate German language skills, internet access, and recent experience treating patients with hip or knee OA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measures: &lt;/strong&gt;The survey included 4 case vignettes of hip or knee OA, with and without comorbidities, and a list of treatment modalities from the OARSI guideline. Correct selections matched high-evidence recommendations. Descriptive statistics analyzed demographics and treatment choices; linear regression assessed the influence of professional degree and work experience on meeting the latest evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 612 eligible therapists, 335 (54.7%) completed the survey (mean age 35.9 +/- 11.9 years; 60% female). Only 22% selected all recommended modalities across vignettes. Structured exercise (96%) and arthritis education (95%) were the most frequently chosen. However, many therapists also selected interventions with limited or conflicting evidence, such as massage and taping. Both professional degree and work experience significantly influenced the extent to which the latest evidence was met. Additionally, 49% were aware of at least 1 OA guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;While many physical therapists aligned with evidence-based practices, inappropriate modality selection remained common. De-implementation is needed where evidence suggests a lack of benefit or potential safety concerns. Translating and implementing the OARSI guideline into various languages, specifically for physical therapists, is recommended to close knowledge gaps.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact statement: &lt;/strong&gt;The study's findings underscore the importance of understanding the treatment modalities used by physical therapists in managing hip or knee OA worldwide. This insight is crucial for addressing the evidence-to-practice gap and ensuring the effective implementation of high-quality physical therapy, a need that is equally relevant in other countries. Additionally, this knowledge is vital for developing targeted strategies, such as the creation and integration of (de-)implementation protocols into the education and o","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507506","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":"First-Contact Physical Therapy Compared to Usual Primary Care for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Bremen Abuhl, Dallas Ehrmantraut, Mitchell Wolden","doi":"10.1093/ptj/pzaf080","DOIUrl":"https://doi.org/10.1093/ptj/pzaf080","url":null,"abstract":"<p><strong>Importance: </strong>This study aims to enhance the care provided for patients with musculoskeletal disorders (MSKDs).</p><p><strong>Objective: </strong>The objective of this study is to compare first-contact physical therapy (FCPT) and usual primary care (UPC) for societal and clinical outcomes of patients with MSKDs.</p><p><strong>Design: </strong>The design was a systematic review and meta-analysis of randomized controlled trials.</p><p><strong>Setting: </strong>The study took a global perspective on FCPT compared to UPC for societal and clinical outcomes of patients with MSKDs.</p><p><strong>Participants: </strong>The study included patients presenting with MSKDs.</p><p><strong>Intervention(s) or exposure(s): </strong>FCPT was compared to UPC for patients with MSKDs.</p><p><strong>Main outcomes and measures: </strong>Societal outcomes including clinical imaging rates, prescription medication rates, cost, and clinical outcomes including pain, disability, and health-related quality of life (HRQoL) were assessed.</p><p><strong>Results: </strong>Ten randomized controlled trials were included with a sample size of 2081 patients. Very low to moderate quality of evidence showed patients achieved similar to superior societal and clinical outcomes with FCPT compared to UPC. Lower clinical imaging rates (RR = 0.55; 95% CI = 0.45 to 0.68) and prescription medication rates (RR = 0.29; 95% CI = 0.16 to 0.53) were associated with FCPT. All effects favored FCPT, including a small effect for cost (MD = -309.79; 95% CI = -678.69 to 59.12), a medium effect for pain (SMD = -0.75; 95% CI = -1.57 to 0.06), and negligible effects for disability (SMD = -0.15; 95% CI = -0.32 to 0.03) and HRQoL (SMD = -0.03; 95% CI = -0.17 to 0.11).</p><p><strong>Conclusions: </strong>When compared to UPC, FCPT is likely to reduce clinical imaging rates, and may result in a reduction of prescription medication rates. FCPT may result in little to no difference in disability and HRQoL. Evidence is very uncertain about the effect of FCPT on pain and cost. All conclusions can be interpreted for the medium term.</p><p><strong>Relevance: </strong>Health care organizations treating patients with MSKDs should consider integrating FCPTs to support primary care.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286059","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":"Are There Speed Limits in Doctor of Physical Therapy Education? Future Research Directions.","authors":"Duane Scott Davis","doi":"10.1093/ptj/pzaf079","DOIUrl":"https://doi.org/10.1093/ptj/pzaf079","url":null,"abstract":"<p><p>The increasing prevalence of accelerated Doctor of Physical Therapy (DPT) programs, which condense the conventional 3-year curriculum into a 2-year format, has emerged with limited national discussion, and debate, and without substantive educational research support. This novel approach challenges the traditional 3-year DPT educational framework. This perspective draws historical parallels between the challenges and unintended consequences that arose from the acceleration of Anterior Cruciate Ligament reconstruction rehabilitation protocols with early return-to-play and the current shift toward accelerated DPT education. While advocates argue that accelerated programs offer advantages over traditional 3-year DPT curricula, there is insufficient evidence to support these claims or to determine whether these benefits outweigh potential drawbacks. Using Rogers' Diffusion of Innovation framework, this perspective explores key questions and potential concerns regarding accelerated DPT programs. This perspective critically examines the potential impact of reducing the duration of DPT education on program and graduate outcomes, including National Physical Therapy Exam pass rates, clinical readiness, and broader educational experiences. It also raises questions about the potential effects on student well-being and mental health. The perspective emphasizes the need for rigorous, data-driven educational inquiry and recommends comprehensive data collection to evaluate the effects of accelerated DPT programs on a wide range of important variables. This perspective emphasizes the importance of prioritizing student learning and development by exploring potential unforeseen risks associated with accelerated DPT curricula. It advocates for a student-centered approach to educational research, ensuring that any changes to program length support both the depth and quality of learning. Through systematic investigation, the profession can determine whether safeguards are necessary to maintain the integrity of DPT education, ensuring that students receive the comprehensive training they need without compromising educational excellence in the pursuit of speed.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258616","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":"Pneumothorax After Dry Needling of Intrascapular Muscles Using a Rib Bracketing Technique: Insights from the Clinician, Patient, and Clinical Expert.","authors":"Paul E Mintken, Blair Denman, Jan Dommerholt","doi":"10.1093/ptj/pzaf078","DOIUrl":"https://doi.org/10.1093/ptj/pzaf078","url":null,"abstract":"<p><strong>Importance: </strong>This case report emphasizes the importance of recognizing and preventing adverse events, specifically pneumothorax related to dry needling (DN), particularly when using rib bracketing techniques in the intrascapular region. It highlights the need for greater clinician awareness to enhance patient safety and minimize the risk of complications during DN interventions.</p><p><strong>Objective: </strong>The objective of this case report was to describe the clinical presentation, progression, and outcome of a patient who developed a pneumothorax following DN, and to propose alternative methods for safer needling in the intrascapular musculature.</p><p><strong>Design: </strong>This case report presents a detailed account of a single patient's clinical experience-including the adverse event, its management, and outcome-supplemented by expert commentary from a clinician specializing in dry needling.</p><p><strong>Setting: </strong>The setting of this case report was an outpatient physical therapy clinic.</p><p><strong>Participants: </strong>A 24-year-old woman undergoing physical therapy for chronic neck and shoulder pain.</p><p><strong>Intervention(s) or exposure(s): </strong>The physical therapist administered DN to the left intrascapular muscles using a rib bracketing technique to treat trigger points.</p><p><strong>Main outcome(s) and measure(s): </strong>The primary outcome was the development of a pneumothorax, identified through clinical symptoms and confirmed by radiographic imaging. Outcomes included hospitalization, symptom resolution, and return to physical activity.</p><p><strong>Results: </strong>The patient experienced an unusually sharp pain during needle insertion. Over the following 2 days, she developed dyspnea, thoracic pain, dry cough, and chest discomfort. A radiograph confirmed a moderate left-sided pneumothorax, which was treated with chest tube reinflation and 1 night of hospitalization. Post-discharge, the patient had residual symptoms for 2 weeks but achieved complete recovery by 1 month, returning to activities like hiking and skiing.</p><p><strong>Conclusions: </strong>DN can result in serious complications such as pneumothorax. Early recognition and immediate treatment can lead to full recovery. This case raises concerns about the safety of the rib bracketing technique for DN in the thoracic intrascapular region.</p><p><strong>Relevance: </strong>Physical therapists should exercise caution when performing DN, especially in high-risk anatomical areas. Safer techniques should be considered, and vigilance is crucial to detect and manage adverse events promptly. Enhancing practitioner awareness can significantly improve patient outcomes and safety during rehabilitation interventions.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226289","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}