Musculoskeletal Science and Practice最新文献

{"title":"Minimum clinically important difference of the original and short-form Örebro musculoskeletal pain questionnaire for low back pain","authors":"Catherine Hovens ,&nbsp;Jon Ford ,&nbsp;Andrew Hahne","doi":"10.1016/j.msksp.2025.103352","DOIUrl":"10.1016/j.msksp.2025.103352","url":null,"abstract":"<div><h3>Background</h3><div>The Örebro Musculoskeletal Pain Questionnaire (Örebro), although originally designed as a screening tool, has become more prevalently used as an outcome measure in the literature. To our knowledge, no study has investigated the Örebro's performance as an outcome measure. The minimum clinically important difference (MCID) is a fundamental psychometric property of outcome measures.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the performance of the Örebro (original and short-form versions) as an outcome measure, including establishing its MCID.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of a randomised controlled trial. The study sample consisted of 300 low back pain patients, receiving physiotherapy. Patients completed the Örebro at 5 timepoints. To establish the MCID, an anchor-based method using receiver operating characteristic (ROC) curve analysis was utilised as our primary analysis method, supplemented with a distribution-based method deriving the standard error of measurement. Subpopulation analyses were carried out based on allocated treatment group and Örebro baseline score.</div></div><div><h3>Results</h3><div>Both questionnaires were capable of detecting change over time as all area under the curves (AUCs) were &gt;0.7. The MCID was 20.3 for the Örebro and 9.0 for the SF-Örebro according to anchor-based methods. Using distribution-based methods, the MCID for the Örebro was 23.6 and 12.1 for the SF-Örebro. The MCID was larger for individuals with a higher baseline score but appeared independent of treatment group.</div></div><div><h3>Conclusions</h3><div>Both questionnaires were suitable for detecting change over time. To our knowledge, this is the first study to report a MCID estimation for either questionnaire.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103352"},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling health inequalities in UK Physiotherapy: Why cultural competence matters","authors":"Pauline May ,&nbsp;Louise Connell ,&nbsp;Nicola Middlebrook ,&nbsp;Gillian Yeowell","doi":"10.1016/j.msksp.2025.103343","DOIUrl":"10.1016/j.msksp.2025.103343","url":null,"abstract":"<div><div>Health inequalities, avoidable, unjust differences in health outcomes, are driven by intersecting social and economic factors, including ethnicity and disability. While the NHS promotes patient-centred care as a strategy to reduce these disparities , the distinct role of cultural competence is often under-explored. Cultural competence goes beyond tailoring care to individual preferences; it requires healthcare professionals to acknowledge systemic bias, reflect on their own cultural identity, and adapt practice in ways that address diversity and discrimination. This paper differentiates cultural competence from patient-centred care and argues that without explicit attention to culture, equity-oriented care risks falling short. It also highlights the lack of UK-based research in this area and calls for systematic investigation into how cultural competence is understood, practiced, and evaluated across UK physiotherapy settings.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103343"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal movement impairments in people with acute low back pain","authors":"Kayla O. Krueger ,&nbsp;Vanessa M. Lanier ,&nbsp;Ryan P. Duncan ,&nbsp;Linda R. van Dillen","doi":"10.1016/j.msksp.2025.103344","DOIUrl":"10.1016/j.msksp.2025.103344","url":null,"abstract":"<div><h3>Background</h3><div>Spinal movement impairments have been found to be important in people with chronic low back pain (LBP).</div></div><div><h3>Objectives</h3><div>Identify whether people with acute LBP display the impairments. Compare the prevalence of impairments in people with acute LBP to that of people with chronic LBP. Examine the effect on symptoms of systematically modifying the impairments.</div></div><div><h3>Design</h3><div>Secondary analysis</div></div><div><h3>Method</h3><div>183 people with LBP were examined by trained physical therapists using a standardized examination. Participants performed 9 primary tests using their preferred strategy. The clinician determined whether an impairment was present or absent. Participants reported the effect of the primary test on symptoms. If an impairment was present, it was modified to improve the impairment during a secondary test. Participants reported the effect of the secondary test on symptoms relative to symptoms with the primary test. Chi-square tests of independence were used to test for differences in the proportion of impairments between people with acute LBP and people with chronic LBP. A McNemar-Bowker test was used to test whether there was a change in symptoms from the primary test to the secondary test.</div></div><div><h3>Results</h3><div>People with acute LBP displayed the spinal movement impairments and the prevalence was similar to that of people with chronic LBP for 7 of the 9 primary tests. Most participants with symptomatic impairments reported their symptoms improved when the impairment was modified.</div></div><div><h3>Conclusions</h3><div>Spinal movement impairments are prevalent in people with acute LBP and may be modified during clinical tests to improve LBP symptoms.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103344"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and content validity of the musculoskeletal self-management questionnaire (MSK-SMQ)","authors":"Nathan Hutting ,&nbsp;Joletta Belton ,&nbsp;J.P. Caneiro ,&nbsp;Vinicius Cunha Oliveira ,&nbsp;Hemakumar Devan ,&nbsp;Venerina Johnston ,&nbsp;Pete Moore ,&nbsp;Julie Richardson ,&nbsp;J. Bart Staal ,&nbsp;Nicola Walsh","doi":"10.1016/j.msksp.2025.103342","DOIUrl":"10.1016/j.msksp.2025.103342","url":null,"abstract":"<div><h3>Background</h3><div>Self-management is recommended for managing persistent musculoskeletal conditions. In self-management, standardized and validated measurements (e.g., questionnaires) should be used. However, there is no general questionnaire to evaluate the level of self-management in people with persistent musculoskeletal conditions.</div></div><div><h3>Objectives</h3><div>To develop a generic questionnaire to evaluate the level of self-management and self-management skills in people with persistent musculoskeletal conditions.</div></div><div><h3>Design</h3><div>Measurement properties study focused on the development and content validity of the Musculoskeletal Self-Management Questionnaire (MSK-SMQ).</div></div><div><h3>Methods</h3><div>The MSK-SMQ was developed, consisting of 24 questions. To assess the content validity of the MSK-SMQ, three panels (patients, professionals, researchers/academics) were used. The relevance, clarity and essentiality of each question was evaluated. Moreover, specific feedback could be provided. The Content Validity Index (CVI) was used to test content validity (Item-CV [I-CVI]) and the Scale-level-CVI [S-CVI]). The CVI was calculated for both relevance and clarity. The essentiality of each item was measured with the content validity ratio (CVR).</div></div><div><h3>Results/findings</h3><div>91 people participated in this study. The overall content validity (relevance) was excellent, with an S-CVI of 0.96. Overall clarity was also excellent, with a score of 0.97. The range of the I-CVI for relevance was 0.91–1.00 and the range for clarity was 0.93–1.00. The mean CVR value was 0.51 and ranged from 0.14 to 0.87.</div></div><div><h3>Conclusions</h3><div>The content validity of the questionnaire was found to be excellent. The study resulted in a revised version of the MSK-SMQ, which can be used in future research to determine further psychometric properties.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103342"},"PeriodicalIF":2.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Beyond single sessions: Reflections on pain education and EIH heterogeneity in knee osteoarthritis”","authors":"Adrian Ram ,&nbsp;Jeanette M. Thom ,&nbsp;Mitchell T. Gibbs ,&nbsp;John Booth ,&nbsp;Matthew D. Jones","doi":"10.1016/j.msksp.2025.103340","DOIUrl":"10.1016/j.msksp.2025.103340","url":null,"abstract":"","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103340"},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical range of motion in individuals with and without chronic subacromial pain syndrome: a cross-sectional study","authors":"Jaqueline Martins,&nbsp;Amanda Rodrigues,&nbsp;Jackeline Suzan Gentil Garcia dos Anjos,&nbsp;Thiele de Cássia Libardoni,&nbsp;Débora Bevilaqua-Grossi,&nbsp;Anamaria Siriani de Oliveira","doi":"10.1016/j.msksp.2025.103341","DOIUrl":"10.1016/j.msksp.2025.103341","url":null,"abstract":"<div><h3>Objective</h3><div>To compare cervical range of motion (ROM) between asymptomatic individuals and those with subacromial pain syndrome (SAPS), and to investigate its relationship with shoulder pain, disability, and other clinical factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 50 individuals with SAPS and 50 asymptomatic controls (both sexes, aged 32–66). The Shoulder Pain and Disability Index (SPADI) assessed shoulder disability, and cervical ROM was measured using a <strong>cervical range of motion (</strong>CROM) device.</div></div><div><h3>Results</h3><div>Individuals with SAPS had significantly reduced cervical ROM compared to controls, confirmed by Student's t-test or Mann-Whitney test. Large effect sizes were observed (Cohen's d = 1.08 and 1.65 for right bending and extension; Mann-Whitney effect size = −0.44 to −0.56 for other movements). Pearson correlations revealed a significant inverse relationship between cervical ROM and SPADI scores (r = −0.42 to −0.61). Chi-square analysis indicated that shoulder pain was associated with cervical ROM deficits (Χ² = 6.83 to 27.75), with prevalence ratios ranging from 1.5 (flexion) to 4.25 (left rotation) higher in individuals with SAPS. These deficits were also associated with longer duration of shoulder pain, higher neck pain intensity, and older age.</div></div><div><h3>Conclusion</h3><div>Individuals with SAPS have reduced cervical mobility compared to asymptomatic individuals, especially for cervical rotation. Cervical ROM deficits were more prevalent in individuals with SAPS and correlated with greater shoulder disability. Clinical factors such as duration of shoulder pain, neck pain intensity, and age contribute to these deficits. These findings highlight the need to assess cervical mobility in patients with SAPS.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103341"},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle strength is a key predictor of physical function in advanced knee osteoarthritis","authors":"Mani Izadi ,&nbsp;Tiril Tøien ,&nbsp;Frank-David Øhrn ,&nbsp;Otto Schnell Husby ,&nbsp;Vigdis Kvitland Schnell Husby ,&nbsp;Siri Bjørgen Winther ,&nbsp;Ronan Sherman ,&nbsp;Mathias Forsberg Brobakken ,&nbsp;Eivind Wang ,&nbsp;Ole Kristian Berg","doi":"10.1016/j.msksp.2025.103339","DOIUrl":"10.1016/j.msksp.2025.103339","url":null,"abstract":"<div><div>Skeletal muscle strength of the lower limbs is negatively impacted in advanced knee osteoarthritis. However, its role in predicting physical function of these patients remains unclear. Therefore, we aimed to evaluate hierarchical linear regression associations between lower limbs' maximal muscle strength, rate of force development and physical function in 50 patients (age: 65 ± 8 years; 22 males and 28 females; and BMI: 31 ± 5 kg/m²) with advanced knee osteoarthritis. Results revealed that leg press maximal strength and leg extension maximum voluntary contraction were associated with sit-to-stand and stair climbing performance (all p &lt; 0.001) and accounted for variances of 29 % and 38 % in 30-s sit-to-stand and 37 % and 24 % in stair climbing performance, respectively. Leg press maximal strength and leg extension maximum voluntary contraction were also associated with Knee Injury and Osteoarthritis Outcome Score - Physical Function Short Form (KOOS-PS) (both <em>p</em> = 0.041), each accounting for 7 % of the variance. Similarly, rate of force development was associated with 30-s sit-to-stand (<em>p</em> &lt; 0.001) and stair climbing performance (<em>p</em> = 0.05), explaining 22 % and 6 % of additional variances, respectively. No association was observed between measures of muscle strength and 40 m fast-paced walking. The present study highlights maximal muscle strength, and in part rate of force development, as powerful predictors of physical function in patients with advanced knee osteoarthritis and may be used as simple, valuable measures when evaluating patients’ physical function.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103339"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing safety in conservative physical management of the cervical spine: A modified Delphi study","authors":"Bryden Leung,&nbsp;Julia Treleaven,&nbsp;Lucy Thomas","doi":"10.1016/j.msksp.2025.103335","DOIUrl":"10.1016/j.msksp.2025.103335","url":null,"abstract":"<div><h3>Background</h3><div>Conservative cervical spine treatment is generally safe, but serious adverse events (SAEs) still occur despite various available clinical guidelines. There have been several challenges in understanding the specific circumstances of these events to direct prevention such as inconsistent reporting, misuse of professional titles, and incomplete data. There are also differences in opinions between professions. It is now important to understand expert views and consensus across professions regarding prevention strategies and minimum requirements for reporting standards for future SAEs.</div></div><div><h3>Methods</h3><div>A modified Delphi method was used, involving 28 international experts from various allied health professions, including chiropractic, physiotherapy, osteopathy, and medicolegal fields. The experts took part in three rounds of online surveys to reach a consensus on reporting, characteristics, risk factors, and prevention of SAEs associated with neck treatments. An agreement of &gt;74 % was required before consensus was reached.</div></div><div><h3>Results</h3><div>Consensus was reached for more standardised reporting of SAEs across different types of treatments and professions. Addressing underlying health conditions and improving the recognition of potential risks, precautions, and contraindications during treatment were highlighted. Recommendations for strategies to improve safety, including early identification of risk factors and careful application of techniques, especially in vulnerable populations were also provided.</div></div><div><h3>Conclusion</h3><div>Experts called for the development of universally accepted clinician friendly clinical guidelines that focus on improving SAE reporting, early identification of SAEs, and safer technique application, particularly in special populations. Implementing these recommendations will help reduce the occurrence of SAEs and improve the safety of conservative cervical spine management across professions.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103335"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating physiotherapists, occupational therapists, and psychologists in the management of chronic and complex musculoskeletal pain in the municipality – a workshop study","authors":"Nielsen RB ,&nbsp;Johansen SK ,&nbsp;Andreasen J ,&nbsp;Palsson TS ,&nbsp;Carlsen A ,&nbsp;Rathleff MS","doi":"10.1016/j.msksp.2025.103336","DOIUrl":"10.1016/j.msksp.2025.103336","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal (MSK) pain is a major societal burden, costing up to 2 % of the EU's gross national product. Complex cases often involve comorbidities, increasing treatment challenges. Integrating physiotherapy, occupational therapy, and psychological support in primary care may improve patient outcomes. Aalborg Municipality, Denmark, is exploring interdisciplinary care models to enhance treatment for chronic MSK pain.</div></div><div><h3>Aim</h3><div>This study investigates physiotherapists', occupational therapists', and psychologists' perspectives on i) current management of chronic and complex MSK pain, ii) elements of ideal care, and iii) strategies for implementation.</div></div><div><h3>Method</h3><div>Using an action research approach, we conducted two workshops with 30 healthcare professionals. WS1 employed a future workshop design to explore solutions, while WS2 used an adapted affinity diagram to define patient characteristics. Data were analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Three main themes emerged: 1) Navigating a State of Limbo: Challenges Faced by Patients with Chronic MSK Pain, including difficulties in navigating treatment, emotional distress, and social relationships; 2) Navigating Healthcare: Receiving and Providing in a Frustrating System, highlighting systemic frustrations and limitations in care coordination; and 3) Optimizing Patient Care Pathways: Strategies for Enhanced Engagement, Integration and Collaboration, emphasizing improved collaboration, patient engagement, and support for transitions in care.</div></div><div><h3>Conclusion</h3><div>Findings highlight the importance of a person-centered, interdisciplinary approach to managing chronic MSK pain. Key strategies include early interventions, patient empowerment, and enhanced communication among professionals. Implementing a biopsychosocial model within healthcare systems is essential for improving patient outcomes and addressing complex needs.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103336"},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural brain alterations and clinical associations in individuals with chronic nonspecific neck pain","authors":"Rungtawan Chaikla ,&nbsp;Munlika Sremakaew ,&nbsp;Suwit Saekho ,&nbsp;Sureeporn Uthaikhup","doi":"10.1016/j.msksp.2025.103337","DOIUrl":"10.1016/j.msksp.2025.103337","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pain is associated with changes in brain structures. However, the specific morphological changes in chronic nonspecific neck pain (CNSNP) are still unclear.</div></div><div><h3>Objectives</h3><div>To investigate altered brain morphology in patients with CNSNP and its relationships with clinical characteristics of neck pain.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>Thirty CNSNP and 30 controls underwent T1-weighted structural MRI to assess whole-brain vertex-wise cortical thickness and gray matter volume. Between-group differences were determined using cluster-wise correction for multiple comparisons and analyses of global structure and pain-related regions of interest (ROIs). Pain outcomes were neck pain duration, intensity, disability and pressure pain thresholds (PPTs) over the cervical spine.</div></div><div><h3>Results</h3><div>Overall, the cluster-wise analysis revealed increased cortical thickness and decreased gray matter volume in several brain regions such as the precuneus, supramarginal gyrus and parietal cortex in the neck pain group (CWP&lt;0.05). The global analysis showed that the neck pain group had increased total thickness and decreased total volume (p &lt; 0.05). The ROI analysis showed that the neck pain group exhibited increased thickness in the primary somatosensory cortex (S1), anterior cingulate cortex (ACC) and precuneus and decreased volume in the prefrontal cortex (PFC), S1, ACC and insula compared to controls (adjusted p-values&lt;0.05). Reduced insula volume correlated with greater neck disability (r = −0.53, adjusted p-value&lt;0.01). Increased PPTs correlated with greater S1 and precuneus thickness (r = 0.46−0.48, adjusted p-values&lt;0.05) and S1 volume (r = 0.53−0.58, adjusted p-values&lt;0.05).</div></div><div><h3>Conclusion</h3><div>Patients with CNSNP exhibited increased cortical thickness and decreased gray matter volume in brain regions involved in pain processing and emotional and cognitive responses.</div></div>","PeriodicalId":56036,"journal":{"name":"Musculoskeletal Science and Practice","volume":"78 ","pages":"Article 103337"},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}