International Journal of Osteopathic Medicine最新文献

{"title":"Immediate effects of osteopathic manipulative therapy on thoracoabdominal mobility, respiratory muscle strength and pulmonary function in healthy men: Preliminary crossover trial","authors":"Julio Zago ,&nbsp;Tatiana Rondinel ,&nbsp;Bruna Urueña ,&nbsp;Fellipe Amatuzzi ,&nbsp;Rogério Queiroz ,&nbsp;Leonardo Nascimento ,&nbsp;Gerson Cipriano ,&nbsp;Graziella F.B. Cipriano","doi":"10.1016/j.ijosm.2025.100803","DOIUrl":"10.1016/j.ijosm.2025.100803","url":null,"abstract":"<div><h3>Background</h3><div>Isolated high-velocity and low-amplitude techniques have been shown to be effective in improving joint mobility, supporting the gain of respiratory muscle strength and pulmonary function. However, it is not yet known if osteopathic manipulative therapy can improve these variables.</div></div><div><h3>Objectives</h3><div>Evaluate the feasibility of a clinical trial and the immediate effects of osteopathic manipulative therapy on thoracoabdominal mobility and its repercussions on respiratory muscle strength and pulmonary function.</div></div><div><h3>Design</h3><div>This is a preliminary crossover trial.</div></div><div><h3>Methods</h3><div>Twelve healthy men were allocated to the order of interventions into two groups: osteopathic manipulative therapy group and sham group. Osteopathic manipulative therapy was composed of high-velocity and low-amplitude techniques in cervicothoracic spine transition, thoracic and thoracolumbar spine transition, and myofascial release in cervical fascia and diaphragm. The sham group received simulated treatment. One session was performed at each group. The variables were evaluated pre and post interventions.</div></div><div><h3>Results</h3><div>There was a significant increase in thoracoabdominal mobility axillary of 7.73 [5.37; 10.08], xiphoid of 4.66 [3.24; 6.07] and abdominal of 4.42 [3.17; 5.68] centimeters in osteopathic manipulative therapy group when compared to sham. We observed an increase of 46.13 [28.06; 64.19] in maximum inspiratory pressure, 29.91 [17.78; 42.04] centimeters of water in maximum expiratory pressure, 0.41 [0.18; 0.65] in forced expiratory volume in the first second and 0.35 [0.05; 0.65] liters in forced vital capacity in the osteopathic manipulative therapy group when compared to the sham group.</div></div><div><h3>Conclusions</h3><div>Osteopathic manipulative therapy increased thoracoabdominal mobility, respiratory muscle strength and pulmonary function in healthy men.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"59 ","pages":"Article 100803"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760674","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":"Barriers and facilitators to the use of patient reported outcome measures by Australian osteopaths","authors":"Shamona Eaves ,&nbsp;George Kalatzis","doi":"10.1016/j.ijosm.2025.100806","DOIUrl":"10.1016/j.ijosm.2025.100806","url":null,"abstract":"<div><h3>Background</h3><div>Patient Reported Outcome Measures (PROMs) are increasingly being used to quantify and inform valued-based healthcare both globally and in Australia. However, use of these measures in specific allied health professions, notably osteopathy, is lacking.</div></div><div><h3>Objectives</h3><div>The current study aimed to determine potential barriers and facilitators to the use of PROMs in a cohort of Australian osteopaths.</div></div><div><h3>Methods</h3><div>Clinically active Australian osteopaths were recruited for the study. Information on potential barriers and facilitators was collected using focus groups (3 groups, n=12) and one-on-one interviews (n=8). Data was examined using thematic analysis which was completed using NVivo 14 for Microsoft Windows.</div></div><div><h3>Results</h3><div>20 Australian osteopaths participated in the study. Participants identified various factors that may impact or support the routine use of PROMs in osteopathic practice. Themes included environmental, organisational, and individual (clinician and patient) barriers. Time, administration burden, and clinician knowledge were identified as common barriers impeding PROM use, whereas facilitators included improved access to profession-relevant PROMs, access to training and information, and policy-based use.</div></div><div><h3>Conclusion</h3><div>PROMs provide an opportunity for osteopaths to embrace standardised routine measurement with the potential to support clinical decision-making, empower patients, and help build the professional standard of osteopathic care in Australia. Identifying factors that could hinder or improve routine PROM adoption by osteopaths remains paramount as this information may later be used to develop effective implementation strategies to improve the use of standardised outcome measures in practice.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"59 ","pages":"Article 100806"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173567","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":"Comment on “Immediate effects of three different upper trapezius trigger point techniques on pain intensity and pressure threshold in students with cervical pain: a randomized clinical trial”","authors":"Pankaj Bansal,&nbsp;Prashant Ramdas Kokiwar,&nbsp;Janvi Patel,&nbsp;Archana Dhyani","doi":"10.1016/j.ijosm.2026.100809","DOIUrl":"10.1016/j.ijosm.2026.100809","url":null,"abstract":"","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"59 ","pages":"Article 100809"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173569","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":"Effects of the COVID-19 pandemic on the practice of osteopathic manipulative medicine: A survey study","authors":"Corey J. Luebbering ,&nbsp;Jane C. Johnson ,&nbsp;Sara AminiRad-Hall ,&nbsp;Gwyn Kelley-Franklin ,&nbsp;Brian F. Degenhardt","doi":"10.1016/j.ijosm.2025.100784","DOIUrl":"10.1016/j.ijosm.2025.100784","url":null,"abstract":"<div><h3>Background</h3><div>Because the practice of osteopathic manipulative medicine (OMM) put practitioners at risk of contracting COVID-19, they had to adjust treatment practices for active COVID-19 cases and local restrictions or regulations.</div></div><div><h3>Objective</h3><div>To assess practitioner environment when treating COVID-19 patients with OMM and the general impact of the pandemic on the practice of OMM.</div></div><div><h3>Methods</h3><div>In October 2020 and March 2022, we distributed surveys to DO-Touch.NET members. Both surveys included 11 questions about treating patients with active COVID-19 and practice changes caused by the pandemic. The second survey also included 4 questions about treating long COVID and 1 question about practice changes in the previous 6 months.</div></div><div><h3>Results</h3><div>Of 206 responses, 40 reported local restrictions or regulations prevented use of OMM for patients with active COVID-19, but 57 performed OMM on these patients, mostly through outpatient services. Main reasons for not treating COVID-19 patients were lack of opportunity, local protocol restrictions, and personal health concerns. Of 71 responses for the second survey, 48 treated patients with long COVID, primarily in the outpatient setting. The main reason for not treating these patients was lack of opportunity. The most frequently reported practice changes included adoption of universal COVID precautions and screening for COVID.</div></div><div><h3>Conclusion</h3><div>Study results suggested the COVID-19 pandemic had an immediate, worldwide impact on the practice of OMM by reducing available services to patients with active COVID-19. Although the effectiveness of OMM for treating COVID-19 or long COVID remains unknown, these results may be useful to prepare for future pandemics.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100784"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415785","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":"Trends in retention and attrition among osteopaths in Australia: Insights from the workforce retention and Attrition Project","authors":"Timothy Lathlean ,&nbsp;Paul Orrock ,&nbsp;Rebecca Malon ,&nbsp;Timothy McNamara ,&nbsp;Jade Tan ,&nbsp;Rechu Divakar ,&nbsp;Lee Barclay ,&nbsp;Cathy Woodward ,&nbsp;Eva Saar","doi":"10.1016/j.ijosm.2025.100793","DOIUrl":"10.1016/j.ijosm.2025.100793","url":null,"abstract":"<div><h3>Objective</h3><div>To identify factors associated with the retention and attrition of regulated osteopaths in Australia.</div></div><div><h3>Methods</h3><div>An online survey of osteopaths and a retrospective analysis of 10 years of Australian Health Practitioner Regulation Agency (Ahpra) osteopath registration data.</div></div><div><h3>Results</h3><div>Among surveyed osteopaths, 629 (79.2 %) intended to renew their registration, 85 (10.7 %) intended to leave, and 60 (7.6 %) were unsure. The most common reasons for staying registered included flexible work-life balance (73 %), enjoyment or fulfilling and meaningful work (69 %) and a sense of achievement (58 %). Main factors that would encourage osteopaths to stay were remuneration (60 %), opportunities for career progression (43.5 %) and a flexible work/life balance (28.2 %). Osteopaths with 5 or less years’ experience and those that on casual/temporary contracts were more likely to leave. Analysis of Ahpra registration data from 2014 to 2023, showed that the number of registered osteopaths per 100,000 population increased by 57.0 %, but the number of new osteopaths entering or returning to the profession for each one that leaves decreased by 39 %, indicating higher overall numbers but lower replacement rates.</div></div><div><h3>Conclusions</h3><div>While the overall number of osteopaths increased from 2014 to 2023, the replacement rate declined, highlighting concerns about potential workforce stability, particularly among osteopaths with 5 or less years’ experience as well as those in casual or temporary employment. Addressing intrinsic workplace factors such as remuneration, opportunities for career progression and a flexible work-life balance may help to encourage more osteopaths to stay in the profession.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100793"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415786","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 outcome of a short course of osteopathy for older adults with chronic musculoskeletal (MSK) pain. A single-arm, prospective feasibility study","authors":"Daniel Orchard ,&nbsp;Dominic Bolt ,&nbsp;Thomas Pinna ,&nbsp;Gabriel Antoni-Pineda","doi":"10.1016/j.ijosm.2025.100795","DOIUrl":"10.1016/j.ijosm.2025.100795","url":null,"abstract":"<div><h3>Introduction</h3><div>With an ageing population and limited efficacy of analgesics, alternative strategies for managing chronic musculoskeletal (MSK) pain in older adults are required. Osteopathy is frequently used by people aged 65 and over and may offer a viable non-pharmacological approach.</div></div><div><h3>Objective</h3><div>To evaluate the feasibility and acceptability of a 12-week course of osteopathy in older adults with chronic MSK pain.</div></div><div><h3>Methods</h3><div>A single-arm, prospective, pre–post feasibility study was conducted with twenty participants aged 65+. Feasibility was examined across treatment delivery, study procedures, and methodological processes. Acceptability was assessed using patient-reported experience measures of care quality, treatment satisfaction, and likelihood of recommendation. Secondary outcomes explored potential effects on pain, physical function, quality of life, mental wellbeing, and loneliness, using the Symptom Severity Scale, PSFS, MSK-HQ, SWEMWBS, and UCLA Loneliness Scale, respectively. Data were also used to inform sample size calculations for a definitive future trial.</div></div><div><h3>Results</h3><div>The intervention demonstrated adequate feasibility and acceptability, with high satisfaction ratings and attrition within acceptable thresholds. Improvements were observed in physical function and quality of life. Sample size calculations indicated that 46 participants would be required in the intervention arm to detect a clinically meaningful MSK-HQ difference in subsequent studies.</div></div><div><h3>Conclusion</h3><div>A short course of osteopathy for older adults with chronic MSK pain appears feasible and acceptable, with early evidence suggesting benefits in function and quality of life. A larger trial is warranted to confirm these findings and assess clinical effectiveness.</div></div><div><h3>Implications for practice</h3><div><ul><li><span>•</span><span><div>A short course of osteopathy showed good feasibility and acceptability for older adults with chronic musculoskeletal pain.</div></span></li><li><span>•</span><span><div>Six sessions of osteopathy may improve quality of life and function at 3-months when assessed using the MSK-HQ and PSFS.</div></span></li><li><span>•</span><span><div>Osteopathy, alongside pain education, exercise and self-care, may improve quality of life in older adults with chronic pain.</div></span></li></ul></div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100795"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465541","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":"Effect of osteopathic manipulative treatment on primary pelvic pain - A systematic review with meta-analysis","authors":"Júlia G. Parada ,&nbsp;Elirez B. da Silva ,&nbsp;Ana Paula Fernandes ,&nbsp;Guilhermo B. Portugal","doi":"10.1016/j.ijosm.2025.100786","DOIUrl":"10.1016/j.ijosm.2025.100786","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the effectiveness of osteopathic manipulative treatment on primary pelvic pain.</div></div><div><h3>Methods</h3><div>In May 2024, a systematic review was carried out in the MEDLINE, BVS, SciELO, PEDro, SCOPUS, Web of Science, Science Direct, CINAHL, Cochrane and Osteopathic Research databases. The inclusion criteria followed the PICOS strategy, including patients with cyclical or chronic primary pelvic pain, who underwent pragmatic OMT in comparison to another type of therapeutic resource and/or placebo, with pain measured as an outcome. For this review, only randomized controlled clinical trials evaluating the effect of osteopathic manipulative treatment on primary pelvic pain were selected.</div></div><div><h3>Results</h3><div>1157 studies were found; 5 studies were selected for this systematic review. Among them, 2 were women with primary dysmenorrhea, 2 with people with irritable bowel syndrome and 1 with men with chronic prostatitis. We analyzed the methodological quality and the risk of bias through the Jadad Scale and the Revised Cochrane risk-of-bias tool for randomized trials - RoB 2 respectively. We used the Grading of Recommendations Assessment, Development and Evaluation Approach - GRADE tool to assess the level of evidence. The meta-analysis of five studies, with six comparisons, showed that of the 204 participants, 109 who received OMT significantly decreased primary pelvic pain by -1.09 [95%CI = -1.79 to - 0.39] (p =0021).</div></div><div><h3>Conclusion</h3><div>Considering the results found in this meta-analysis, it is possible to conclude that osteopathic manipulative treatment can be effective in reducing cyclical or chronic primary pelvic pain and may be a new conservative treatment option. However, further studies are needed to improve the level of evidence.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100786"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465545","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 effect of exercise on fatigue in rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials","authors":"Xianjun Jiang ,&nbsp;Liuqian Yu ,&nbsp;Yanfang Yan ,&nbsp;Shuning Zhou ,&nbsp;Qi Zheng","doi":"10.1016/j.ijosm.2025.100794","DOIUrl":"10.1016/j.ijosm.2025.100794","url":null,"abstract":"<div><h3>Objectives</h3><div>This meta-analysis aimed to evaluate the effectiveness of exercise in reducing fatigue, pain, and improving functional status in patients with rheumatoid arthritis (RA).</div></div><div><h3>Methods</h3><div>Two independent reviewers conducted an extensive literature search in PubMed, Embase, the Cochrane Library, and Web of Science databases up to August 5, 2024. The review included randomized controlled trials (RCTs) comparing exercise interventions with non-exercise controls in RA patients.</div></div><div><h3>Results</h3><div>Nine RCTs involving 631 RA patients (358 in the exercise group, 273 in the control group) were included. Exercise significantly reduced fatigue (SMD = −0.71, P = 0.02) and pain (SMD = −0.24, P = 0.008). However, the improvement in functional status (MD = −0.23, P = 0.09) did not reach statistical significance. High heterogeneity was observed for fatigue (I² = 90 %) and functional status (I² = 57 %), likely due to variations in study design and sample size.</div></div><div><h3>Conclusions</h3><div>Exercise significantly reduces fatigue and pain in RA patients, reinforcing its role in comprehensive disease management. Further research is needed to establish optimal exercise protocols and compare them with other therapeutic options to refine RA management strategies.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100794"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415780","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":"Comparing the effects of home exercise programmes and supervised exercise therapy on functional disability in adults with chronic non-specific low back pain. A Systematic Review of Randomised Controlled Trials","authors":"André Ingebrigtsen ,&nbsp;Robert Froud ,&nbsp;Jo Andreas Gundersen","doi":"10.1016/j.ijosm.2025.100778","DOIUrl":"10.1016/j.ijosm.2025.100778","url":null,"abstract":"<div><h3>Background:</h3><div>Low back pain is the highest contributor to years lived with disability. Many patients experience symptoms lasting over 12 weeks, often without a specific pathology. It remains unclear whether one type of exercise is superior for treating chronic non-specific low back pain (CNSLBP), and few trials have explored whether the exercise setting influences outcomes.</div></div><div><h3>Objective:</h3><div>To compare the effects of home exercise programmes (HEP) and supervised exercise therapy (SE) on functional disability in adults with CNSLBP.</div></div><div><h3>Method:</h3><div>MEDLINE, Embase and PEDro were searched for randomised controlled trials (RCTs) evaluating adults (18–65 years) with CNSLBP lasting more than 12 weeks. Trials had to compare SE and HEP effects on functional disability. Databases were searched from inception to January 17^th, 2023. Quality was assessed with Cochrane Risk of Bias 2.0 tool (RoB2). A narrative synthesis was conducted.</div></div><div><h3>Results:</h3><div>Database search resulted in 2310 hits. 119 were screened in full text, and seven RCTs were included in this review. Most trials were of low quality, scoring either “high risk” or “some concerns” on RoB2. SE was more effective than HEP in four trials, with Cohen’s d effect sizes ranging from near-medium to very large (<span><math><mrow><mi>d</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>43</mn></mrow></math></span> to 1.12) and statistical significance varying from non-significant (i.e. <span><math><mo>&gt;</mo></math></span> 0.05) to strong (i.e. <span><math><mo>&lt;</mo></math></span> 0.01).</div></div><div><h3>Conclusions:</h3><div>There is some evidence that supervised exercise may be more effective than home exercise for improving functional disability in adults with CNSLBP. However, the quality of the trials was low. Higher quality trials are needed to establish definitive conclusions.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100778"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019455","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":"Response to letter to the Editor “Repositioning menstrual pain management: Multidisciplinary collaboration and cultural sensitivity as key priorities” about the article “Conesa-Albaladejo, M., Espí-López, G. V., Martínez-Graullera, E., & Arnal-Gómez, A. (2025). Potential effects of combining osteopathic manual therapy and menstrual awareness on pain and associated symptoms in women with primary dysmenorrhea: A randomized clinical trial. International Journal of Osteopathic Medicine, 56, 100761”","authors":"Gemma Victoria Espí-López","doi":"10.1016/j.ijosm.2025.100775","DOIUrl":"10.1016/j.ijosm.2025.100775","url":null,"abstract":"","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100775"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907310","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}