Journal of Manual & Manipulative Therapy最新文献

{"title":"Not \"that kind\" of doctor: an exploratory study on Doctor of Physical Therapy-patient introductions in the United States.","authors":"Justin Martino, James M Smoliga, Lance Mabry","doi":"10.1080/10669817.2024.2396706","DOIUrl":"10.1080/10669817.2024.2396706","url":null,"abstract":"<p><strong>Objective: </strong>This exploratory study examined the prevalence and determinants of the use of the title 'doctor' among the United States (U.S.) licensed Doctors of Physical Therapy (DPTs) during patient-provider introductions.</p><p><strong>Methods: </strong>A cross-sectional analysis of DPTs across eight states was conducted. Binary logistic regression analyzed demographic and experience-related factors influencing title use, including years of experience, board certification status, and clinical instructor (CI) experience. Stepwise logistic regression with forward selection identified significant predictors. Beliefs influencing title use were evaluated through descriptive statistics from multiple choice questions with an option for open-ended responses for additional opinions.</p><p><strong>Results: </strong>Of the 1,311 participants who met the inclusion criteria, 19.9% reported using 'doctor' during patient-provider introductions. The odds of using the title increased with age and was higher among males, with age controlled for. Completion of a residency program and not being a CI were also associated with greater odds of title use, with age and sex controlled for. Beliefs about demonstrating expertise, having earned the title, and advancing the profession were primary reasons for using the title, while concerns about patient confusion and therapeutic alliance were reasons for not using it. Both DPTs who did and did not report using the title 'doctor' commonly cited the impact on therapeutic alliance as justification.</p><p><strong>Conclusions: </strong>A minority of our sample of U.S. DPTs use the title 'doctor' during patient-provider introductions, with significant variation across age, gender, and professional experience. Deciding whether to use the title was primarily based on their perceived effects on patient beliefs.</p><p><strong>Discussion: </strong>This is the first study to formally investigate how DPTs refer to themselves during patient-provider introductions. Understanding title use in healthcare can inform best practices during patient interactions. This study provides a foundation for future research on the impact of DPTs mentioning their doctoral title on patient experiences and outcomes.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"630-639"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of low back pain-related attitudes and beliefs on the clinical decision making of physical therapists.","authors":"Adam Rufa, Gary Brooks, Kyle Adams, Michelle Dolphin","doi":"10.1080/10669817.2024.2346973","DOIUrl":"10.1080/10669817.2024.2346973","url":null,"abstract":"<p><strong>Background: </strong>The LBP-related attitudes and beliefs of clinicians may impact the experience of patients by influencing clinician decision-making and by shaping the attitudes, beliefs, and actions of patients. The purpose of this study was to identify the specific LBP-related attitudes and beliefs of US-based physical therapists and determine if those beliefs correlate with clinical decision-making.</p><p><strong>Methods: </strong>An electronic survey was sent to US-based physical therapists. Attitudes and beliefs were measured using the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and the Pain and Impairment Relationship Scale for Physiotherapists (PABS-PT). The survey also included 2 patient vignettes that collected information about clinical decision-making.</p><p><strong>Results: </strong>Complete survey responses were recorded from 420 physical therapists. Eleven of the 27 attitude and beliefs questions were answered in a more biomedically oriented way by at least 20% of respondents. Physical therapist low back pain-related attitudes and beliefs were associated with activity and management strategies for both vignettes in the expected direction. Higher scores on HC-PAIRS and PABS-BM were associated with more restrictive work and activity recommendations, lower-intensity exercise choices, biomechanical rationale for manual therapy and motor control exercises, pathoanatomical-focused education, and use of modalities.</p><p><strong>Conclusion: </strong>Some physical therapists hold biomedically oriented beliefs about the connection between pain and physical activity. Clinician beliefs were associated with activity and work recommendations, and treatment choices. Physical therapists with more biomedically oriented beliefs were more likely to limit physical activity and work, and less likely to incorporate psychologically informed interventions.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"515-523"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical reasoning skills of German and Dutch manual therapists: a cross-sectional study.","authors":"Myrthe Veenstra, Riccarda Klemm, Tibor M Szikszay, Kerstin Luedtke, Andres Jung","doi":"10.1080/10669817.2024.2330775","DOIUrl":"10.1080/10669817.2024.2330775","url":null,"abstract":"<p><strong>Introduction: </strong>Reflective clinical reasoning (CR) is believed to play a crucial role in achieving an efficient therapy process, supported by evidence-based approaches that improve patient outcomes. The aim of this study was to evaluate the CR process of German manual therapists (MTs) using the CR skills of Dutch MTs as a reference.</p><p><strong>Methods: </strong>This cross-sectional study evaluated the CR process and diagnostic ability of German MTs. Dutch MTs served as the reference standard due to their experience with direct access. The CR skills were assessed using the Diagnostic Thinking Inventory (DTI), a questionnaire measuring diagnostic competence. Descriptive and inferential statistics were conducted to compare the groups. Subgroup analyses were performed to analyze the influence of work experience (in years) and the level of education on CR.</p><p><strong>Results: </strong>396 manual therapists (229 German and 167 Dutch) completed the DTI. Dutch MTs revealed higher DTI sum-scores compared to German MTs (<i>p</i> < .001; Cohen´s d = .41). Subgroup analyses regarding professional education revealed no significant differences in DTI sum-scores within German MTs and between both groups. In the subgroup analyses regarding professional experience, differences of moderate effect size were reached between German and Dutch novice MTs (in favor of Dutch novice MTs; <i>p</i> = .001; Cohen´s d = .62), and between German novice MTs and experienced German MTs (in favor of experienced German MTs; <i>p</i> < .001; Cohen´s d = .6).</p><p><strong>Conclusion: </strong>The results suggest that academically educated German and Dutch MTs as well as experienced German and Dutch MTs are similar in terms of their hypothetical-deductive CR skills. In turn, German novice MTs seem to use hypothetical-deductive processing to a lesser extent compared to Dutch novice MTs and experienced German MTs, which in turn may support the hypothesis that the level of professional experience and education has a significant impact on the development of hypothetical-deductive CR skills.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"531-539"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrater reliability of the modified prone instability test for lumbar segmental instability in individuals with mechanical low back pain.","authors":"Ellen R Larkin, Darren Q Calley, John H Hollman","doi":"10.1080/10669817.2024.2352934","DOIUrl":"10.1080/10669817.2024.2352934","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to establish the interrater reliability of measures obtained with a novel Modified Prone Instability Test (mPIT), which, like the original Prone Instability Test (PIT), is proposed to identify lumbar segmental instability. The mPIT has clinical feasibility advantages to the PIT, but its psychometric properties are yet to be determined.</p><p><strong>Design: </strong>Repeated measures (test-retest) design, methods study.</p><p><strong>Methods: </strong>The mPIT was administered by two blinded testers, an orthopedic physical therapy resident with < 1 year experience and board-certified orthopedic specialist physical therapist with >25 years' experience. Procedures were administered at an outpatient physical therapy clinic of a tertiary Medical Center. Participants included 50 adults (≥18 years old) with mechanical low back pain and no radicular (below the knee) symptoms (mean age 50.7 years, 66% female, 76% reported previous episodes of low back pain). Interrater reliability was measured via Fleiss' kappa coefficient.</p><p><strong>Results: </strong>Assessments of the mPIT had moderate interrater agreement (κ = .579 [95% CI = .302 to .856], <i>p</i> < .001.).</p><p><strong>Conclusion: </strong>Measures obtained using the mPIT demonstrated moderate interrater reliability between a new graduate and an experienced clinician, which aligns with several studies examining interrater reliability of the original PIT. Further study examining comparative validation of the mPIT with other lumbar instability measures is warranted.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"540-547"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the layers of concern for safe dry needling of the rectus abdominis: a cadaveric study.","authors":"Ryan C McConnell, Christi L Williams, Christian R Falyar","doi":"10.1080/10669817.2024.2355007","DOIUrl":"10.1080/10669817.2024.2355007","url":null,"abstract":"<p><strong>Objectives: </strong>To assess needle placement accuracy in the rectus abdominis (RA) muscle during dry needling (DN) without entering the peritoneum.</p><p><strong>Methods: </strong>Two physical therapists performed DN on a cadaver, making 10 attempts each to needle the RA without entering the peritoneum. Techniques followed two common DN approaches. Ultrasound verified needle depth and safety.</p><p><strong>Results: </strong>Seventy percent of attempts were recorded as safe needle placement, while 30% were unsafe. Accurate RA needle placement without peritoneal entry occurred in 55% of attempts.</p><p><strong>Discussion/conclusion: </strong>Inadvertent peritoneal needle placement during RA DN poses risks regardless of experience. Ultrasound guidance may enhance safety and precision in clinical practice.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"524-530"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering tomorrow's healers: a perspective on integrating person-centered care into physical therapist education.","authors":"Amy W McDevitt, Jamie McMullen, Mark Shepherd","doi":"10.1080/10669817.2024.2402100","DOIUrl":"10.1080/10669817.2024.2402100","url":null,"abstract":"","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":"32 5","pages":"457-463"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate effects of myofascial release to the pectoral fascia on posture, range of motion, and muscle excitation: a crossover randomized clinical trial.","authors":"Sarah Bohunicky, Lindsey Rutherford, Kara-Lyn Harrison, Quinn Malone, Cheryl M Glazebrook, Trisha D Scribbans","doi":"10.1080/10669817.2024.2316414","DOIUrl":"10.1080/10669817.2024.2316414","url":null,"abstract":"<p><strong>Context: </strong>Forward shoulder posture (FSP) is a risk factor for shoulder pathology. Manual therapists often use myofascial release (MFR) to elongate restricted pectoral fascia to reduce FSP and improve shoulder function; however, the effects of this treatment approach remain anecdotal.</p><p><strong>Objective: </strong>Determine the acute effects of 4-min of MFR, compared to a soft-touch control (CON), to the pectoral fascia on: 1) FSP, 2) shoulder horizontal abduction ROM (HA-ROM), and 3) muscle excitation of the trapezius (upper, middle, lower [UT, MT, LT]) and pectoralis major (PEC).</p><p><strong>Methods: </strong>Fifty-nine right-handed participants (27 ± 9 years, 30 female) with FSP, but otherwise asymptomatic shoulders participated in a randomized crossover clinical trial by attending two experimental sessions: one MFR and one CON treatment, each administered by a Registered Massage Therapist. FSP, HA-ROM, and muscle excitation during a reaching task, were measured before and after each treatment.</p><p><strong>Results: </strong>There was a significant interaction between treatment and time for FSP (<i>p</i> = .018, η_p = .093) with FSP decreasing from PRE MFR (128 ± 19 mm) to POST MFR (123 ± 19 mm; <i>p</i> < .001, η_p = .420) and PRE CON (126 ± 19 mm) to POST CON (124 ± 18 mm; <i>p</i> < .001, η_p = .191) interventions. There were no significant differences in HA-ROM or muscle excitation.</p><p><strong>Conclusion: </strong>Four minutes of MFR or CON to the pectoral fascia acutely reduces FSP.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"495-505"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying physical therapists' attitudes, beliefs, and barriers toward diagnostic imaging referral: a mixed-methods study.","authors":"Matthew R Schumacher, Kendra A Karl, Mattias A Stich, Christopher R Dean, Sara R Lawson, Jason L Hogan","doi":"10.1080/10669817.2024.2346957","DOIUrl":"10.1080/10669817.2024.2346957","url":null,"abstract":"<p><strong>Objective: </strong>Ten states, including the District of Columbia, have laws that currently permit physical therapists (PTs) to directly order diagnostic imaging (DI) in the United States. Military and civilian PTs order DI judiciously and appropriately demonstrating optimal patient outcomes and satisfaction when compared to other medical professionals. However, no studies have explored perceived attitudes, beliefs, and barriers to PT DI referral specific to North Dakota (ND). Therefore, the purpose of this mixed-methods study was to identify ND PTs' attitudes, beliefs, and barriers toward DI referral.</p><p><strong>Methods: </strong>A total of 147 participants completed an online survey with a subset of 17 participants agreeing to an interview. Frequency counts of demographic data and perceived barriers were completed. A binary logistic regression was run on demographic data. One-on-one interviews were conducted with a thematic coding process completed within a qualitative analysis.</p><p><strong>Results: </strong>Seventy-four percent of PTs reported not currently referring for DI, although 71% felt that it would improve their patient outcomes. PTs with post-professional training (OR = 4.59), a doctorate degree (OR = 3.84), practicing in an orthopaedic or sports setting (OR = 3.55), and practicing within an urban setting of ND (OR = 3.01) were more likely to refer for DI. The main barriers identified in the survey included: (1) the logistics of performing a DI referral, (2) DI referrals only privileged to other medical providers, (3) provider/work relationship dynamics, (4) the cost of continuing education (CE), (5) and the inability to identify CE. One-on-one interviews further identified five main themes related to DI referral.</p><p><strong>Discussion/conclusion: </strong>Several barriers identified resulted in 74.1% of PTs not directly referring for DI, although certain characteristics (post-professional training, doctorate degree, orthopaedic/sports setting, practicing in an urban area in ND) were more likely to refer for DI. This study may help improve future adoption and implementation of DI referral in current and future states.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"506-514"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical review of the role of manual therapy in the treatment of individuals with low back pain.","authors":"Jean-Pascal Grenier, Maria Rothmund","doi":"10.1080/10669817.2024.2316393","DOIUrl":"10.1080/10669817.2024.2316393","url":null,"abstract":"<p><p>The number of low back pain (LBP) cases is projected to increase to more than 800 million by 2050. To address the substantial burden of disease associated with this rise in prevalence, effective treatments are needed. While clinical practice guidelines (CPG) consistently recommend non-pharmacological therapies as first-line treatments, recommendations regarding manual therapy (MT) in treating low back pain vary. The goal of this narrative review was to critically summarize the available evidence for MT behind these recommendations, to scrutinize its mechanisms of action, and propose some actionable steps for clinicians on how this knowledge can be integrated into a person-centered approach. Despite disparate recommendations from CPG, MT is as effective as other available treatments and may be offered to patients with LBP, especially as part of a treatment package with exercise and education. Most of the effects of MT are not specific to the technique. MT and other interventions share several mechanisms of action that mediate treatment success. These mechanisms can encompass patients' expectations, prior experiences, beliefs and convictions, epistemic trust, and nonspecific contextual effects. Although MT is safer than opioids for patients with LBP, this alone is insufficient. Our goal is to encourage clinicians to shift away from outdated and refuted ideas in MT and embrace a person-centered approach rooted in a comprehensive biopsychosocial framework while incorporating patients' beliefs, addressing illness behaviors, and seeking to understand each patient's journey.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"464-477"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The majority of clinical trials assessing mobilization and manipulation for neck pain lack a pragmatic approach: a systematic review of 174 trials.","authors":"Kyle A Cottone, Matthew R Schumacher, Jodi L Young, Daniel I Rhon","doi":"10.1080/10669817.2024.2327127","DOIUrl":"10.1080/10669817.2024.2327127","url":null,"abstract":"<p><strong>Background: </strong>Disorders of the cervical spine are some of the costliest musculoskeletal conditions to manage globally. Joint mobilization and manipulation have been shown to be an effective treatment for neck pain. However, the generalizability and clinical translation depends on the nature of the trial designs that inform its use. The extent to which randomized control trials (RCTs) assessing manual therapy treatments for cervical spine disorders fall on the efficacy (explanatory) -effectiveness (pragmatic) spectrum often informs how the findings are translated into clinical practice.</p><p><strong>Objective: </strong>The aim of this systematic review was to determine where RCTs of manual therapy for neck disorders fall on the efficacy-effectiveness spectrum.</p><p><strong>Methods: </strong>A search of three electronic databases including PubMed, CINAHL, and CENTRAL were completed for trials published from inception to May 2023. RCTs in which joint mobilization or manipulation were used to treat cervical spine disorders were assessed on the effectiveness-efficacy spectrum using the Rating of Included Trials on the Efficacy-Effectiveness Spectrum (RITES) tool and risk of bias using the Revised Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>A total of 174 trials met eligibility. RITES domain two trial setting (71.3% vs 16.1%), domain three flexibility of intervention(s) (62.1% vs 23%), and domain four clinical relevance of experimental and comparison intervention(s) (51.7% vs 29.3%) all favored efficacy over effectiveness. Domain one participant characteristic(s) had a slightly greater emphasis on effectiveness compared to efficacy (36.8% vs 44.8%). Most studies (96%) had at least some risk of bias.</p><p><strong>Conclusion: </strong>Over half of the RCTs assessing the treatment effect of joint mobilization and manipulation for neck pain favor efficacy (explanatory) over effectiveness (pragmatic) designs. Future RCTs on this topic should consider a greater emphasis on pragmatic trial design components in order to better reflect real-world translation to clinical practice.</p>","PeriodicalId":47319,"journal":{"name":"Journal of Manual & Manipulative Therapy","volume":" ","pages":"478-494"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}