Journal of Osteopathic Medicine最新文献

{"title":"A masquerading presentation of dermatofibrosarcoma protuberans.","authors":"Erin Berg, Nadia Khan, Robert Dazé","doi":"10.1515/jom-2023-0219","DOIUrl":"10.1515/jom-2023-0219","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"333-335"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The establishment of conscientious monopolies in rural communities.","authors":"Forrest Bohler, Allison Garden","doi":"10.1515/jom-2024-0012","DOIUrl":"10.1515/jom-2024-0012","url":null,"abstract":"<p><p>In the United States, healthcare providers have the federally protected right to conscientiously refuse to provide treatments or services that they feel violate their moral or religious values. This refusal of services is colloquially known as \"conscientious objection,\" which has become a polarizing topic in today's medical and ethical landscape. Typically, physicians exercising their right to conscientious objection do not represent a barrier in access to care for most patient populations. This dynamic shifts, however, in rural America, where there are relatively few providers. In this commentary, we discuss some of the unique ramifications that are likely to occur when rural providers invoke conscientious objection in their medical practice and how this can in turn establish conscientious monopolies for the members of their communities.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"377-378"},"PeriodicalIF":1.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The short- and long-term effect of osteopathic manipulative treatment on pain, and psychosocial factors in adults with chronic low back pain.","authors":"Clarence L Nicodemus, Jessica Epstein, Marianne Huebner, Barry DeCicco, Moaid Shaik","doi":"10.1515/jom-2023-0201","DOIUrl":"10.1515/jom-2023-0201","url":null,"abstract":"<p><strong>Context: </strong>Chronic low back pain (CLBP) has long plagued mankind, but little progress has been made in finding a rational and effective treatment, let alone a common cause. This study is an attempt to fill that void by measuring short- and long-term effects of osteopathic manipulative treatment (OMT), including psychosocial and pain reduction in CLBP patients.</p><p><strong>Objectives: </strong>The objectives of this study were to investigate the effectiveness of neuromusculoskeletal medicine/osteopathic manipulative medicine (OMM) in treating CLBP, with a focus on biopsychosocial (pain sensitivity questionnaire [PSQ]) and pain control in chronic conditions.</p><p><strong>Methods: </strong>The study involved a large, single cohort observational design of 101 patients. The inclusion criteria for selecting patients targeted those with \"nonspecific\" CLBP. The National Institutes of Health (NIH) Minimum Dataset for Chronic Low Back Pain (NMD) was the measurement tool and was administered at consent (baseline), 2, 4, and 8 weeks and at 6 and 12 months. Time trends were analyzed as overall mean. Pairwise differences were compared between time points. Mixed-effects models were utilized to test the association of time with pain and biopsychosocial scores.</p><p><strong>Results: </strong>Pain and PSQ scores decreased over the study timeline. The most significant change for both pain and biopsychosocial scores occurred at 6 months compared to baseline, with a further reduction at 12 months.</p><p><strong>Conclusions: </strong>OMT has been demonstrated to significantly reduce pain and psychosocial factors related to CLBP in both the short and long term.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"315-319"},"PeriodicalIF":1.1,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining differences in trends in the orthopedic surgery match for osteopathic and allopathic medical graduates after the transition to single accreditation.","authors":"Robert S Wood, Jacqueline Krumrey","doi":"10.1515/jom-2023-0240","DOIUrl":"10.1515/jom-2023-0240","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;The landscape of medical education in the United States has undergone significant changes, particularly with the rise of osteopathic medical students, constituting a substantial portion of medical school entrants. The merger of the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) in 2020 opened residency slots to allopathic graduates that were previously historically allocated to osteopathic (Doctor of Osteopathic Medicine [DO]) physicians. This has impacted various medical specialties, notably orthopedic surgery. Despite an increase in orthopedic surgery applicants, the match rates for DO candidates have faced challenges, raising concerns about the impact of this merger on the future of orthopedic training for DO students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This research aims to analyze the trends in orthopedic surgery match rates for DO vs MD applicants since the single accreditation merger, which began in 2015 with a 5-year transition period that was finalized by 2020. By examining factors such as application numbers, research output, standardized test scores, and program director preferences, the study seeks to identify disparities and challenges faced by DO applicants in securing orthopedic surgery residencies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study utilized publicly available data from the National Residency Match Program (NRMP) 2018, 2020, and 2022 reports. Data encompassed applicant characteristics, including standardized test scores, research experiences, and match outcomes. The study also incorporated insights from NRMP program director surveys, focusing on interview and ranking practices. The analysis involved comparisons of application numbers, match rates, research productivity, and test scores between DO and MD applicants. Statistical analysis was employed to identify any statistically significant differences among the examined variables for the 3 years included in the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The research revealed a consistent increase in orthopedic surgery applicants from both DO and MD backgrounds. However, MD applicants consistently had higher match rates compared to their DO counterparts, with the gap narrowing over the years. Notably, disparities persisted in research output, with MD applicants demonstrating a significant advantage in publications and presentations. Standardized test scores, although slightly higher for MD applicants, did not significantly impact the differences in match rates. MD applicants had statistically significantly higher numbers of applicants (&lt;i&gt;P&lt;/i&gt; = .0010), number of publications (&lt;i&gt;P&lt;/i&gt; = .0091), and number of research experiences (&lt;i&gt;P&lt;/i&gt; = .0216) over the years examined. However, there was no statistically significant difference in the scores on Step 1 (&lt;i&gt;P&lt;/i&gt; = .5038) or Step 2 (&lt;i&gt;P&lt;/i&gt; = .4714) between MD and DO candidates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite progress in th","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"291-297"},"PeriodicalIF":1.1,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A validity study of COMLEX-USA Level 3 with the new test design.","authors":"Xia Mao, John R Boulet, Jeanne M Sandella, Michael F Oliverio, Larissa Smith","doi":"10.1515/jom-2023-0011","DOIUrl":"10.1515/jom-2023-0011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;The National Board of Osteopathic Medical Examiners (NBOME) administers the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA), a three-level examination designed for licensure for the practice of osteopathic medicine. The examination design for COMLEX-USA Level 3 (L3) was changed in September 2018 to a two-day computer-based examination with two components: a multiple-choice question (MCQ) component with single best answer and a clinical decision-making (CDM) case component with extended multiple-choice (EMC) and short answer (SA) questions. Continued validation of the L3 examination, especially with the new design, is essential for the appropriate interpretation and use of the test scores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The purpose of this study is to gather evidence to support the validity of the L3 examination scores under the new design utilizing sources of evidence based on Kane's validity framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Kane's validity framework contains four components of evidence to support the validity argument: Scoring, Generalization, Extrapolation, and Implication/Decision. In this study, we gathered data from various sources and conducted analyses to provide evidence that the L3 examination is validly measuring what it is supposed to measure. These include reviewing content coverage of the L3 examination, documenting scoring and reporting processes, estimating the reliability and decision accuracy/consistency of the scores, quantifying associations between the scores from the MCQ and CDM components and between scores from different competency domains of the L3 examination, exploring the relationships between L3 scores and scores from a performance-based assessment that measures related constructs, performing subgroup comparisons, and describing and justifying the criterion-referenced standard setting process. The analysis data contains first-attempt test scores for 8,366 candidates who took the L3 examination between September 2018 and December 2019. The performance-based assessment utilized as a criterion measure in this study is COMLEX-USA Level 2 Performance Evaluation (L2-PE).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All assessment forms were built through the automated test assembly (ATA) procedure to maximize parallelism in terms of content coverage and statistical properties across the forms. Scoring and reporting follows industry-standard quality-control procedures. The inter-rater reliability of SA rating, decision accuracy, and decision consistency for pass/fail classifications are all very high. There is a statistically significant positive association between the MCQ and the CDM components of the L3 examination. The patterns of associations, both within the L3 subscores and with L2-PE domain scores, fit with what is being measured. The subgroup comparisons by gender, race, and first language showed expected small differences in mean scores between ","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"257-265"},"PeriodicalIF":1.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb spasticity and telemedicine consultation for reconstructive surgery: patient perspectives of surgical assessment.","authors":"Abigail Bardwell, Christopher S Crowe, Peter C Rhee","doi":"10.1515/jom-2023-0235","DOIUrl":"10.1515/jom-2023-0235","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Spasticity is characterized by increased muscle tone and stretch reflexes, often caused by an upper motor neuron (UMN) syndrome. Many patients live with their dysfunction of their upper or lower limbs for many years and are managed by a multidisciplinary team including physical medicine and rehabilitation specialists, neurologists, and/or physical therapists in an attempt to decrease their spasticity and enhance their quality of life. Reconstructive surgery is a treatment option for many patients living with spasticity. The goal of surgery is to permanently decrease their spastic tone and improve their quality of life. Spastic hemiplegia or hemiparesis is an area of orthopedic surgery that is uniquely suited to telemedicine evaluation. Telemedicine visits can lower the threshold for patients to obtain consultation, receive second opinions, and determine whether traveling for an in-person assessment might be worthwhile, particular to larger medical centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of our study was to characterize patient perceptions of telemedicine consultation for spasticity surgery and to determine its effectiveness for indicating reconstructive procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An electronic survey consisting of 16 questions was distributed to all patients after the virtual consultation from April 2020 to September 2022 as part of a neuro-orthopedic evaluation. Domains of inquiry included patient demographic and diagnosis information, satisfaction with provider assessment, ease of use, appointment preference, and whether surgery was eventually performed. Identifying information was voluntarily provided by patients and allowed for survey data to be linked to the medical record. Patients were included in the study if they were diagnosed with upper and/or lower extremity spasticity, were evaluated by telemedicine visit, and were over the age of 18. They were excluded from the study if they were evaluated for any condition aside from spasticity or returned an incomplete survey. Patients who completed the survey were prospectively followed through December 2022 to determine whether a subsequent in-person visit was pursued and/or reconstructive surgery was performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 19 of 36 patients completed surveys, for a response rate of 52.7 %. Nearly all (94.7 %, n=18) patients felt that the provider expressed maximal concern for patient questions/worries, included them in decisions regarding care, and appropriately discussed treatment strategies. Similarly, the majority (89.5 %, n=17) were maximally satisfied with explanations about their condition and would recommend the care provider to others. Most patients (84.2 %, n=16) also felt that the ease of communication via the virtual platform was very good. All patients were eventually indicated for and subsequently underwent reconstructive surgery for spasticity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Spastic","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"393-397"},"PeriodicalIF":1.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association and disparities of food insecurity and exposure to violence: analysis of the National Survey of Children's Health.","authors":"Molly Bloom, Cassie McCoy, Amy D Hendrix-Dicken, Covenant Elenwo, Michael A Baxter, Sara Coffey, Micah Hartwell","doi":"10.1515/jom-2023-0263","DOIUrl":"10.1515/jom-2023-0263","url":null,"abstract":"<p><strong>Context: </strong>Lack of access to food is a significant concern for child well-being, and it creates many health disparities and adverse social outcomes. Food insecurity and its many associated risk factors increase parental stress, which are strongly correlated with an increased risk of child abuse and maltreatment. Research now identifies being witness to domestic abuse as a form of child maltreatment, and exposure to violence in the community has been shown to result in similar long-term impacts.</p><p><strong>Objectives: </strong>Given the potential for lifelong adverse effects from experiencing adverse childhood events involving violence and food insecurity, our primary objective was to assess the relationship between the two and disparities among demographic factors.</p><p><strong>Methods: </strong>We conducted an observational study utilizing data from the National Survey of Children's Health (NSCH) 2016-2021. The NSCH is a United States nationally representative survey completed by primary caregivers of one child per home aged 0-17 years. We determined population estimates (n=216,799; n=83,424,126) and rates of children experiencing food insecurity and parent-reported exposure to violence. We then constructed logistic regression models to assess associations, through odds ratios (ORs), between food security and exposure to violence including demographic factors.</p><p><strong>Results: </strong>Among the sample, 5.42 % of children experienced low food security and 7.4 % were exposed to violence. The odds of exposure to violence are 5.19 times greater for children with low food security compared to food-secure children (95 % confidence interval [CI]: 4.48-6.02). Indigenous and Black children were 7.8 and 6.81 times more likely to experience or witness violence when food insecure compared to food secure White children, respectively (95 % CI: 3.18-19.13, 5.24-8.86 respectively).</p><p><strong>Conclusions: </strong>Food insecurity was associated with increased odds of children experiencing and/or witnessing violence compared to those who were food secure. The interaction between exposure to violence and food insecurity also disproportionately impacts children with specific demographic factors, notably race/ethnicity including multiracial, Indigenous, and Black children. By developing and adapting strategies to improve food security, it is possible to indirectly reduce the rates of childhood exposure to violence and the long-term impacts that result.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"369-376"},"PeriodicalIF":1.1,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superficial fascia displacement in cervical flexion: differentiating myofascial pain syndrome, a cross-sectional study.","authors":"Valentin C Dones, Mark Angel B Serra, Lyle Patrick D Tangcuangco, Vergel B Orpilla","doi":"10.1515/jom-2023-0222","DOIUrl":"10.1515/jom-2023-0222","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Myofascial pain syndrome (MPS) is primarily characterized by myofascial trigger points related to fascial adhesions. MPS hinders fascial flexibility and mobility, leading to myofascial limitations, dysfunctional movement, and limitation of motion (LOM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study determined the association of age, sex, type of work, symptom chronicity, symptom laterality, cervical LOM, altered direction of fascial displacement, and magnitude of superficial fascial displacement during active cervical flexion with the clinical diagnosis of MPS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study selectively included MPS and non-MPS participants from different workplaces from January to October 2019. The MPS group exhibited clinical symptoms like tender spots, recognized pain patterns, and local twitch response upon palpation, often accompanied by cervical LOM. The non-MPS group lacked these symptoms, and those with certain pre-existing conditions or recent physiotherapy were not part of the study. Participants performed cervical active range of motion (AROM) while a sonographer recorded superficial fascial displacement utilizing ultrasound, which was later analyzed by three physiotherapists with the Tracker. Aiming for a multiple regression R-squared of 0.2, the target was 384 participants to account for a 20 % dropout, resulting in 307 participants after attrition. To explore the relationships between MPS and various factors, logistic regression models, rigorously tested for reliability and validity, were utilized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the study, there were 192 participants with MPS and 137 without MPS. The median ages were 33 years for the non-MPS group and 38 years for the MPS group. The adjusted model found significant links for sex (odds ratio [OR]=2.63, p&lt;0.01), symptom chronicity (OR=8.28, p&lt;0.01), and cervical LOM (OR=3.77, p=0.01). However, age and the presence of nodules/taut bands were not statistically significant (p&gt;0.05). Also, the type of work, the direction of fascial displacement, and the difference in superficial fascial displacement during cervical flexion did not show a significant association with the clinical diagnosis of MPS (p&gt;0.05). The adjusted model had a sensitivity of 73.80 % and a specificity of 81.34 %, correctly identifying 84.66 % of positive cases and 68.99 % of negative ones, resulting in an overall accuracy of 76.95 % in predicting MPS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We provided an in-depth examination of MPS, identifying sex, duration of symptoms, and cervical LOM as significant predictive factors in its diagnosis. The study emphasizes the critical role of these variables in the accurate diagnosis of MPS, while delineating the comparatively minimal diagnostic value of other factors such as age, type of occupation, presence of nodules or taut bands, and variations in fascial displacement. This study underscores the imperative for further schol","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"353-363"},"PeriodicalIF":1.1,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering a research culture in osteopathic medical education.","authors":"Samuel Kadavakollu, Thu Dang, Sherese Richards","doi":"10.1515/jom-2023-0072","DOIUrl":"10.1515/jom-2023-0072","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"465-467"},"PeriodicalIF":1.1,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumid lupus masquerading as rosacea.","authors":"Austin B Ambur, Mahroo Khalid, Aaron B Ambur, Kiana Kaya, Rajiv Nathoo","doi":"10.1515/jom-2023-0269","DOIUrl":"10.1515/jom-2023-0269","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"285-286"},"PeriodicalIF":1.1,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}