Physical Therapy最新文献

{"title":"Effects of Educational Interventions Designed to Develop Physical Therapist Learners' Clinical Reasoning: A Systematic Review.","authors":"Wing Fu, Tobi F Baldwin, Jacklyn H Brechter, Mark R Erickson, Kara Kobal, Vicki LaFay, Teresa M Miller, Jaclyn Morales","doi":"10.1093/ptj/pzae182","DOIUrl":"10.1093/ptj/pzae182","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this systematic review was to investigate the effects of educational interventions designed to develop physical therapist learners' clinical reasoning (CR) across the full continuum of professional development.</p><p><strong>Data sources: </strong>A systematic search was conducted of 6 databases, the entire Journal of Physical Therapy Education collection, and the reference lists of included articles through March 2022.</p><p><strong>Study selection: </strong>English-language primary relevant research studies of all research designs were included while grey literature was excluded.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently extracted data from and determined risk of bias of each of the 40 included studies. Disagreements were resolved by consensus or use of a third reviewer. A narrative synthesis summarized and explained the quantitative data. Meta-analysis was not possible due to data heterogeneity. Qualitative data were synthesized using thematic analysis.</p><p><strong>Main outcome(s) and measure(s): </strong>Main outcomes were effects of the educational interventions per the Kirkpatrick model.</p><p><strong>Results: </strong>Forty articles met the inclusion criteria. Twenty-two of the 33 studies with quantitative data involving student or practicing physical therapists reported statistically significant positive outcomes. Three major themes emerged from thematic analysis of 23 studies: perceived educational gain, valued elements of educational interventions, and identified challenges to learning.</p><p><strong>Conclusions and relevance: </strong>Educational interventions that appeared to have a positive impact on learning outcomes were identified. However, the available research lacks rigor for the authors to develop evidence-based guidelines to support the development of CR in physical therapist learners. Given the importance of CR, high quality studies are warranted. This comprehensive systematic review appeared to be the first one in the profession to have investigated the effects of educational interventions designed to develop learners' CR across the entire professional development. Educators and researchers may benefit from the findings to develop educational interventions and future studies.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882521","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 Movement System and Diagnosis: Are We There Yet?","authors":"Philip McClure","doi":"10.1093/ptj/pzaf011","DOIUrl":"10.1093/ptj/pzaf011","url":null,"abstract":"<p><p>In the 29th Maley lecture, Phil McClure PT, PhD, FAPTA, shares a Perspective regarding the movement system and diagnosis. Despite declarations from the House of Delegates >10 years ago, the concept of a movement system has not been widely embraced in either education or practice. In this perspective, he offers critical analysis and 3 proposals that could potentially make the concept of a movement system more relevant and meaningful. The first is to operationally define the movement system, arguing that the current definition is too vague and not operational, and therefore not meaningful. The second is to intentionally separate the movement system from any specific diagnostic classification scheme which would allow the focus to remain on movement and movement analysis. He argues that diagnostic classification schemes require a biopsychosocial framework and that movement, while important, cannot be the only consideration. The third proposal is that diagnostic schemes must be developed by clinical scientists through appropriate research guided by sound theory, not by administrative or political process. He further argues that a greater focus on determining which patients are likely to be helped by physical therapists is necessary and offered the example of developing \"appropriateness criteria\" as a tool toward promoting value-based care. Achieving broad consensus around these proposals could unify our professional focus and assist toward the vision of optimizing movement to enhance the human experience.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399617","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":"Measurement Properties of the BESTest Scale in People With Neurological Conditions: A Systematic Review With Meta-Analysis.","authors":"Ilaria Arcolin, Marica Giardini, Federica Tagliabue, Valeria Belluscio, Fay Horak, Marco Godi","doi":"10.1093/ptj/pzae178","DOIUrl":"10.1093/ptj/pzae178","url":null,"abstract":"<p><strong>Objective: </strong>People with neurological conditions (PwNC) frequently fall, mainly due to balance impairments. Among the scales assessing balance, the Balance Evaluation System Test (BESTest) is one of the most comprehensive in evaluating all components of postural control. This study aimed to systematically review and summarize the measurement properties of the BESTest in PwNC.</p><p><strong>Methods: </strong>Embase, MEDLINE, ScienceDirect, Scopus, and PEDro were searched up to December 2023. Studies assessing at least 1 BESTest measurement property in PwNC were included. Methodological quality of studies was assessed with the COSMIN Risk of Bias checklist. Overall rating and level of evidence for each property were given according to COSMIN criteria. Where possible, meta-analysis was performed.</p><p><strong>Results: </strong>Thirty-six studies (1749 PwNC) were included. The BESTest demonstrated a high quality of evidence supporting good reliability (intraclass correlation coefficients = 0.96-0.98 for total score, and 0.70-0.98 for subsections), internal consistency, and measurement error. High quality levels of responsiveness, and content and construct validity were also found. However, evidence for structural validity was insufficient to be sure the BESTest actually tests several, or 1, balance constructs. Criterion validity cannot be evaluated. While translated into different languages, cross-cultural validity has never been assessed in PwNC. Evidence to support use of the BESTest for specific neurological conditions is limited to Parkinson disease and stroke, due to the small sample sizes and number of studies in other populations.</p><p><strong>Conclusion: </strong>This systematic review provided high quality evidence supporting the reliability, content and construct validity, and responsiveness of the BESTest to intervention, being able to detect balance changes and to differentiate heterogeneous PwNC based on fall history, falling risk, and physical performance. However, low-quality evidence was found when considering each neurological condition alone. To comprehensively understand the BESTest measurement properties, future studies are needed with larger samples for each neurological condition, especially assessing cross-cultural and structural validity.</p><p><strong>Impact: </strong>Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.</p><p><strong>Lay summary: </strong>Assessing balance is crucial for fall risk prevention. The BESTest has been demonstrated to be a reliable, responsive, and valid scale usable in clinical setting for assessing balance in PwNC.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814109","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":"Influence of Race and Ethnicity on Application to Doctor of Physical Therapy Programs.","authors":"Nicole Tombers, Rachel Pfeifer, Kaitlyn Froemke","doi":"10.1093/ptj/pzae184","DOIUrl":"10.1093/ptj/pzae184","url":null,"abstract":"<p><strong>Objective: </strong>This study uses data from the Physical Therapist Centralized Application Service (PTCAS) to compare influences on application to Doctor of Physical Therapy (DPT) programs between White applicants and people of color (POC)-applicants who identified as Black, American Indian, Asian, Hispanic, or Pacific Islander.</p><p><strong>Methods: </strong>This is a retrospective study using holistic narrative analysis. PTCAS data for the 2020 to 2021 application cycle were obtained, including essays and demographic data. Random samples were drawn such that 736 total applicants to PTCAS were included: 372 White applicants and 364 POC applicants. Using categories previously described in the literature, 3 reviewers coded application essays into as many influence categories as applied. Interrater reliability was evaluated on a sample of 12 essays, using Cohen kappa between reviewer pairs and a total arithmetic mean. Chi-square was used to test for difference between groups, based on Bonferroni correction.</p><p><strong>Results: </strong>Personal experience with physical therapy (53.8% for White applicants, 54.9% for POC applicants), observation of the field (68.5% for White applicants, 71.2% for POC applicants), and alignment with values and interests (62.9% for White applicants, 67.3% for POC applicants) were the most common influences. Applicants of color were more likely to indicate a desire to bring services back to their community of origin, formative experience in health care based on race, and paid work experience in the field. Interrater reliability was excellent (.869).</p><p><strong>Conclusions: </strong>Applicants in the POC group were primarily influenced toward pursuing DPT education by personal interaction with physical therapy and alignment of the field with their values. They were more likely than their White peers to have racially based health care experiences, paid work in the physical therapy field, and a desire to provide services to their community.</p><p><strong>Impact: </strong>Providing opportunities for people from racial and ethnic minority groups to experience physical therapy through equitable access to physical therapist care, observation hours, internships, or paid work experience may improve enrollment of more diverse cohorts.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882623","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":"News From the Foundation for Physical Therapy Research, March 2025.","authors":"","doi":"10.1093/ptj/pzaf013","DOIUrl":"https://doi.org/10.1093/ptj/pzaf013","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":"105 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677069","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":"Experiences of People With Persistent Nonspecific Neck Pain Who Used Immersive Virtual Reality Serious Games in the Home Setting: A Qualitative Study.","authors":"Alexandre Luc, Nicolas Lambricht, Isabelle Aujoulat, Christine Detrembleur, Laurent Pitance","doi":"10.1093/ptj/pzae149","DOIUrl":"10.1093/ptj/pzae149","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to explore the experiences of individuals with persistent nonspecific neck pain who used immersive virtual reality (VR) serious games at home for 2 weeks.</p><p><strong>Methods: </strong>In this descriptive qualitative study, semi-structured one-on-one interviews were conducted at the participant's home after the 2-week period. Interviews were analyzed using qualitative content analysis. Sample size was determined using the information power concept (where \"information power\" refers to the amount of relevant information the sample provides for addressing the research question).</p><p><strong>Results: </strong>Eleven adults with continuous or recurrent nonspecific neck pain participated in the study. Three main categories were identified. The first revolves around the home environment, revealing that participants had mixed perceptions about being at home, yet held a positive perspective on the utilization of immersive VR in that setting. The second pertains to immersive VR as a novel technology, indicating its overall comfort, user-friendliness, and varying degrees of immersion and presence experienced by the participants. The third focuses on exercising in immersive VR, drawing comparisons with conventional exercises, exploring the facilitators and barriers to usage, and addressing various aspects of integrating this technology into rehabilitation.</p><p><strong>Conclusion: </strong>Immersive VR was deemed comfortable for almost all participants and easy to use. Participants found exercising in immersive VR motivating and enjoyable, compared to conventional exercises. The home environment proved suitable for using immersive VR, though challenges included autonomy and reduced human contact. Participants highlighted facilitators and barriers in using immersive VR serious games, as well as immersive VR's rehabilitation potential. They also underscored the crucial role of physical therapists for guidance, remote supervision, and personalized treatment.</p><p><strong>Impact: </strong>These findings could help clinicians to better understand the experiences of individuals with persistent nonspecific neck pain when using immersive VR, as well as its use at home. This understanding can improve patient care and optimize the effectiveness of immersive VR as a treatment method.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472420","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":"Fostering Adherence to Evidence-Based Care in the Management of Musculoskeletal Shoulder Pain: A Mixed-Methods Study.","authors":"Christina Maxwell, Jon Salsberg, Katie Robinson, François Desmeules, Véronique Lowry, Christie Tetreault, Karen McCreesh","doi":"10.1093/ptj/pzae176","DOIUrl":"10.1093/ptj/pzae176","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective was to identify the priorities of individuals with musculoskeletal shoulder pain and their health care providers (HCPs) that are perceived to foster multistakeholder adherence to evidence-based recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study used a mixed-methods design, informed by concept mapping. Patients with shoulder pain (ie, ≥6 weeks) and HCPs involved in their care (recruited via social media, email, etc) were invited to complete an initial survey to identify perceived priorities to foster adherence to evidence-based recommendations. Preliminary data sorting resulted in a final priority list, with a subset (n = 20) of respondents rating their importance using a Likert scale. A public and patient involvement (PPI) panel (N = 8) assisted in this rating phase, further sorting of priorities based on thematic similarities (ie, into categories and then domains), analysis, interpretation, and developing a concept map illustrating relationships between them.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One hundred and fifty-four participants (HCPs = 133; patients = 21) responded to the initial survey, generating 77 priorities, grouped into 13 categories, and then into 3 domains: (1) Education, (2) Patient-centered care, and (3) Health care communication. Patients prioritized categories relating to the provision of a specific diagnosis, the establishment of a strong therapeutic relationship, and the need for education on progress and recovery timelines, as well as treatment options. HCPs prioritized these same educational categories, also prioritizing the need for tailoring exercise therapy and providing a unified message on best management. PPI panelists identified education on treatment options coupled with a strong therapeutic alliance and a unified message on best management to be of pivotal importance in fostering adherence. Panelists also stressed that future knowledge translation resources must provide tailored education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;HCPs and patients agree on the need to prioritize education related to progress and recovery timelines as well as treatment options, with a strong therapeutic alliance and a unified message on best management also considered of pivotal importance for adherence to evidence-based recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;To the knowledge of the authors, this is the first study, including a broad range of stakeholder groups spanning across 11 different countries, to explore the priorities that stakeholders perceived to support stricter adherence to evidence-based recommendations for musculoskeletal shoulder pain, with the relationship between these priorities visually illustrated using a concept map. Patients and HCPs were united in their prioritization of education relating to expected progress and recovery timelines, as well as treatment options and supporting evidence. Stakeholders also identified the need for greater emphasis to be placed o","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838565","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":"Federal Funding of Rehabilitation Research: Delayed and Disrupted.","authors":"Steven Z George, Alan M Jette","doi":"10.1093/ptj/pzaf025","DOIUrl":"10.1093/ptj/pzaf025","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557400","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":"Taking the Next Step in Neurologic Rehabilitation: Contributions of Intensity and Variability of Stepping Tasks During Locomotor Training.","authors":"T George Hornby, Jennifer Moore, Carey L Holleran, Christopher E Henderson","doi":"10.1093/ptj/pzaf005","DOIUrl":"10.1093/ptj/pzaf005","url":null,"abstract":"<p><p>Research over the past 20 years indicates the amount of task-specific walking practice provided to individuals with stroke, brain injury, or incomplete spinal cord injury can strongly influence walking recovery. However, more recent data suggest that attention toward 2 other training parameters, including the intensity and variability of walking practice, may maximize walking recovery and facilitate gains in non-walking outcomes. The combination of these training parameters represents a stark contrast from traditional strategies, and confusion regarding the potential benefits and perceived risks may limit their implementation in clinical practice. The purpose of this perspective is to delineate the evidence regarding the contributions of intensity and variability of locomotor training to improve mobility outcomes in individuals with acute-onset brain and spinal cord injury. The rationale and evidence supporting the utility of these training parameters in controlled laboratory settings is first described by integrating concepts in the field of neuroscience, motor learning, biomechanics, and exercise physiology into a rehabilitation intervention. Subsequently, the evidence supporting the efficacy of this paradigm is addressed, including discussions of some of the misconceptions regarding perceived negative consequences of these strategies in an effort to mitigate common clinical concerns. Finally, the utility of these strategies implemented during inpatient rehabilitation is delineated to facilitate a more comprehensive understanding of the feasibility and potential benefits early following neurologic injury. A greater understanding of how and why to integrate higher intensity, variable stepping practice will support therapists to take the next step to maximize mobility in the patients they serve.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009947","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":"Motor Impairment and Disuse Are Independent Predictors of Vascular Outcomes Poststroke.","authors":"Tiev Miller, Huixi Ouyang, Charlotte S L Tsang, Martín Calderón-Juárez, Michael T C Ying, Marco Y C Pang","doi":"10.1093/ptj/pzaf002","DOIUrl":"10.1093/ptj/pzaf002","url":null,"abstract":"<p><strong>Importance: </strong>Cardiorespiratory fitness is reduced after stroke due to inactivity which may cause structural and functional changes to blood vessels in the extremities. Identifying clinical factors contributing to vascular function may be important for tailoring rehabilitation programs that reduce secondary disease risk and adverse events.</p><p><strong>Objective: </strong>The study objective was to compare measures of arterial and intramuscular blood flow between the paretic and nonparetic upper limbs of individuals with stroke and healthy comparators. Associations between these parameters and stroke-related impairment were also examined.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Setting: </strong>The setting was a university laboratory.</p><p><strong>Participants: </strong>Participants were individuals with stroke (n = 64; mean age = 60.8 [SD = 7.7] years) and matched controls (n = 64; mean age = 59.4 [SD = 7.8] years).</p><p><strong>Main outcomes/measures: </strong>Brachial artery blood flow volume (Vflow) and arterial diameter (AD) were measured using Doppler ultrasound. Intramuscular blood perfusion of the biceps brachii was estimated using the vascularity index (VI). Motor recovery and perceived use of paretic upper limbs were assessed with the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), respectively.</p><p><strong>Results: </strong>Side × group interactions were observed for AD (F = 22.6) and VI (F = 4.00). Post hoc analyses showed lower AD and VI for paretic sides (stroke group), greater Vflow for dominant sides (comparators), and greater percent side-to-side differences (%SSDs) in AD and VI for the stroke group than for comparators. %SSDs in Vflow, AD, and VI demonstrated weak correlations with impairment (MAL, FMA; ρ = 0.253 to 0.347). MAL was an independent predictor of %SSD in Vflow (β = -0.286), and FMA was an independent predictor of %SSDs in AD (β = -0.307) and VI (β = 0.371).</p><p><strong>Conclusions/relevance: </strong>Relative to the nonparetic and bilateral limbs of comparators, arterial size and intramuscular blood flow in the paretic upper limbs of individuals with stroke were significantly reduced. Motor impairment and disuse emerged as independent predictors of all vascular outcomes and may be potential intervention targets for reducing cardiovascular disease risk after stroke.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468757","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}