British Journal of Sports Medicine最新文献

{"title":"Elevating the games: the future of the Olympics and Paralympics at higher altitudes","authors":"Olivier Girard","doi":"10.1136/bjsports-2024-108107","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108107","url":null,"abstract":"Climate change and global warming may prompt the relocation of future Summer and Winter Olympic/Paralympic Games to higher elevations, driven by the pursuit of sustainability and emerging health concerns for athletes.1 This shift could be motivated by the quest for safer environmental conditions, aiming to reduce thermal stress in Summer Olympics/Paralympics or ensure adequate snow conditions in Winter Games. While the Summer Olympic and Paralympic Games have traditionally been held during the hot summer season in the northern hemisphere, relocating the competition to a different time of year could lead to safer environmental conditions, even at sea level. Organising the 2022 FIFA World Cup in winter in Qatar, instead of during the hottest months, serves as a notable example. However, rescheduling the Summer Games may lead to scheduling conflicts with other major sporting events, reducing global participation and viewership, while also disrupting athletes’ training cycles and potentially impacting their performance. With the exception of Mexico City in 1968, situated at an altitude of 2300 metres above sea level, no other Summer Olympic/Paralympic Games have been held at altitudes exceeding 530 metres (Munich in 1972).2 A thorough investigation is needed to understand the impact of moderate terrestrial altitude on various sports and the required athletic preparations for optimal performance at higher elevations. Essentially, the argument centres on altitude providing a cooler and more moderate climate, addressing challenges posed by extreme heat in …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"170 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining the recipe or spoiling the broth? Reframing perceptions of programme adaptation in sports injury prevention","authors":"James O'Brien, Torstein Dalen-Lorentsen, Joar Harøy","doi":"10.1136/bjsports-2024-108270","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108270","url":null,"abstract":"Multiple injury prevention exercise programmes have demonstrated efficacy under randomised controlled conditions.1 However, successfully implementing these programmes under real-world conditions poses a significant challenge. It is well documented that football teams modify programmes to better fit their specific context, drawing not only on evidence from randomised controlled trials (RCTs) but also their past experiences, guidelines and individual player screening data.2 Furthermore, evaluation of injury prevention programmes under real-world conditions demonstrates that increased programme adaptability, variation and individualisation can facilitate implementation efforts.2 Modifying efficacious programmes can potentially enhance context-specificity but may also jeopardise fidelity. Replicating the exact protocol from an RCT increases the chances of achieving the desired injury reduction, but failing to consider the intricacies of the specific implementation context and modify the intervention accordingly increases the risk of poor adherence. Balancing these dual aspirations of fidelity and context-specific modifications has been coined the adaptation-fidelity dilemma.3 To evaluate implementation outcomes, sports injury prevention researchers have embraced the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework.4–6 While this has heightened awareness of different implementation factors and common pitfalls, most analyses only consider teams’ use of interventions in their original (RCT) form. But programme modifications are common2 7 and failing to assess and analyse them will paint an incomplete picture of real-world adherence. Taking the example of the Copenhagen Adduction Exercise (CAE), under RCT conditions, the programme reduced the risk of groin problems …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of cardiorespiratory fitness with dementia risk across different levels of genetic predisposition: a large community-based longitudinal study","authors":"Shuqi Wang, Liyao Xu, Wenzhe Yang, Jiao Wang, Abigail Dove, Xiuying Qi, Weili Xu","doi":"10.1136/bjsports-2023-108048","DOIUrl":"https://doi.org/10.1136/bjsports-2023-108048","url":null,"abstract":"Objective We aimed to investigate the association of cardiorespiratory fitness (CRF) with cognitive function and dementia risk, taking genetic predisposition for dementia into account. Methods Within the UK Biobank, 61 214 dementia-free participants aged 39–70 years were followed for up to 12 years. CRF score was estimated using a 6 min submaximal exercise test on a stationary bike and divided into tertiles (ie, low, moderate, and high; standardised by age and sex). Global cognitive function was evaluated at baseline. Dementia was identified based on medical history and medical records. Genetic predisposition for dementia was estimated using the polygenic risk score for Alzheimer’s disease (PRSAD), tertiled as low, moderate, or high. Data were analysed using linear regression, Poisson regression, and Laplace regression. Results Compared with low CRF, high CRF was related to better global cognitive function (β=0.05, 95% CI 0.04 to 0.07). Over the follow-up period, 553 individuals developed dementia. Compared with low CRF, the incidence rate ratio (IRR) of all dementia was 0.60 (95% CI 0.48 to 0.76) for high CRF, and the onset of all dementia was delayed by 1.48 (95% CI 0.58 to 2.39) years among people with high versus low CRF. Among people with a moderate/high polygenic risk score, high CRF attenuated all dementia risk by 35% (IRR 0.65, 95% CI 0.52 to 0.83). Conclusion High CRF is associated with better cognitive performance at baseline, and lower dementia risk long-term. High CRF could mitigate the impact of genetic predisposition on the development of dementia by 35%. Data may be obtained from a third party and are not publicly available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"178 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and life expectancy: a life-table analysis.","authors":"Lennert Veerman, Jakob Tarp, Ruth Wijaya, Mary Njeri Wanjau, Holger Möller, Fiona Haigh, Peta Lucas, Andrew Milat","doi":"10.1136/bjsports-2024-108125","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108125","url":null,"abstract":"<p><strong>Objective: </strong>Low physical activity (PA) levels are associated with increased mortality. Improved measurement has resulted in stronger proven associations between PA and mortality, but this has not yet translated to improved estimates of the disease burden attributable to low PA. This study estimated how much low PA reduces life expectancy, and how much life expectancy could be improved by increasing PA levels for both populations and individuals.</p><p><strong>Methods: </strong>We applied a predictive model based on device-measured PA risk estimates and a life-table model analysis, using a life-table of the 2019 US population based on 2017 mortality data from the National Centre for Health Statistics. The participants included were 40+ years with PA levels based on data from the 2003-2006 National Health and Nutritional Examination Survey. The main outcome was life expectancy based on PA levels.</p><p><strong>Results: </strong>If all individuals were as active as the top 25% of the population, Americans over the age of 40 could live an extra 5.3 years (95% uncertainty interval 3.7 to 6.8 years) on average. The greatest gain in lifetime per hour of walking was seen for individuals in the lowest activity quartile where an additional hour's walk could add 376.3 min (~6.3 hours) of life expectancy (95% uncertainty interval 321.5 to 428.5 min).</p><p><strong>Conclusion: </strong>Higher PA levels provide a substantial increase in population life expectancy. Increased investment in PA promotion and creating PA promoting living environments can promote healthy longevity.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory fitness, body mass index and mortality: a systematic review and meta-analysis","authors":"Nathan R Weeldreyer, Jeison C De Guzman, Craig Paterson, Jason D Allen, Glenn A Gaesser, Siddhartha S Angadi","doi":"10.1136/bjsports-2024-108748","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108748","url":null,"abstract":"Objective The purpose of this review was to assess the joint relationship of cardiorespiratory fitness (CRF) and Body Mass Index (BMI) on both cardiovascular disease (CVD) and all-cause mortality risk. Design A systematic review and meta-analysis was conducted. Pooled HR and 95% CI were calculated using a three-level restricted maximum likelihood estimation random-effects model with robust variance estimation. The reference group was normal weight-fit and was compared with normal weight-unfit, overweight-unfit and fit, and obese-unfit and fit. Data sources Electronic databases (PubMed/MEDLINE, Web of Science and SportDiscus) were searched following registration on PROSPERO. Eligibility criteria Articles meeting the following criteria were included: (1) published between January 1980 and February 2023, (2) prospective cohort study, (3) CRF assessed using a maximal or VO2peak exercise test, (4) BMI reported and directly measured, (5) joint impact of CRF and BMI on all-cause mortality or CVD mortality were analysed, and (6) the reference group was normal weight, fit individuals. Results 20 articles were included in the analysis resulting in a total of 398 716 observations. Compared with the reference group, overweight-fit (CVD HR (95% CI): 1.50 (0.82–2.76), all-cause HR: 0.96 (0.61–1.50)) and obese-fit (CVD: 1.62 (0.87–3.01), all-cause: 1.11 (0.88–1.40)) did not have a statistically different risk of mortality. Normal weight-unfit (CVD: 2.04 (1.32–3.14), all-cause: 1.92 (1.43–2.57)), overweight-unfit (CVD: 2.58 (1.48–4.52), all-cause: 1.82 (1.47–2.24)) and obese-unfit (CVD: 3.35 (1.17–9.61), all-cause: 2.04 (1.54–2.71)) demonstrated 2–3-fold greater mortality risks. Conclusions CRF is a strong predictor of CVD and all-cause mortality and attenuates risks associated with overweight and obesity. These data have implications for public health and risk mitigation strategies. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"69 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142600975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing an exercise intervention to minimise hip bone mineral density loss following traumatic lower limb amputation: a Delphi study.","authors":"Fearghal P Behan, Anthony M J Bull, Belinda R Beck, Katherine Brooke-Wavell, Ralph Müller, Laurence Vico, Hanna Isaksson, Nicholas C Harvey, Arjan Buis, Kate Sherman, Gemma Jefferson, Daniel J Cleather, Alison McGregor, Alexander N Bennett","doi":"10.1136/bjsports-2024-108721","DOIUrl":"10.1136/bjsports-2024-108721","url":null,"abstract":"<p><strong>Objective: </strong>To elicit expert opinion and gain consensus on specific exercise intervention parameters to minimise hip bone mineral density (BMD) loss following traumatic lower limb amputation.</p><p><strong>Methods: </strong>In three Delphi rounds, statements were presented to a panel of 13 experts from six countries. Experts were identified through publications or clinical expertise. Round 1 involved participants rating their agreement with 22 exercise prescription statements regarding BMD loss post amputation using a 5-point Likert scale. Agreement was deemed as 3-4 on the scale (agree/strongly agree). Statements of <50% agreement were excluded. Round 2 repeated remaining statements alongside round 1 feedback. Round 3 allowed reflection on round 2 responses considering group findings and the chance to change or maintain the resp onse. Round 3 statements reaching ≥70% agreement were defined as consensus.</p><p><strong>Results: </strong>All 13 experts completed rounds 1, 2 and 3 (100% completion). Round 1 excluded 12 statements and added 1 statement (11 statements for rounds 2-3). Round 3 reached consensus on nine statements to guide future exercise interventions. Experts agreed that exercise interventions should be performed at least 2 days per week for a minimum of 6 months, including at least three different resistance exercises at an intensity of 8-12 repetitions. Interventions should include weight-bearing and multiplanar exercises, involve high-impact activities and be supervised initially.</p><p><strong>Conclusion: </strong>This expert Delphi process achieved consensus on nine items related to exercise prescription to minimise hip BMD loss following traumatic lower limb amputation. These recommendations should be tested in future interventional trials.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1251-1257"},"PeriodicalIF":11.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fitness-related physical activity intensity explains most of the association between accelerometer data and cardiometabolic health in persons 50-64 years old.","authors":"Jonatan Fridolfsson, Elin Ekblom-Bak, Örjan Ekblom, Göran Bergström, Daniel Arvidsson, Mats Börjesson","doi":"10.1136/bjsports-2023-107451","DOIUrl":"10.1136/bjsports-2023-107451","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the physical activity (PA) intensity associated with cardiometabolic health when considering the mediating role of cardiorespiratory fitness (CRF).</p><p><strong>Methods: </strong>A subsample of males and females aged 50-64 years from the cross-sectional Swedish CArdioPulmonary bioImage Study was investigated. PA was measured by accelerometry and CRF by a submaximal cycle test. Cardiometabolic risk factors, including waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides and glycated haemoglobin, were combined to a composite score. A mediation model by partial least squares structural equation modelling was used to analyse the role of CRF in the association between PA and the composite score.</p><p><strong>Results: </strong>The cohort included 4185 persons (51.9% female) with a mean age of 57.2 years. CRF mediated 82% of the association between PA and the composite score. The analysis of PA patterns revealed that moderate intensity PA explained most of the variation in the composite score, while vigorous intensity PA explained most of the variation in CRF. When including both PA and CRF as predictors of the composite score, the importance of vigorous intensity increased.</p><p><strong>Conclusion: </strong>The highly interconnected role of CRF in the association between PA and cardiometabolic health suggests limited direct effects of PA on cardiometabolic health beyond its impact on CRF. The findings highlight the importance of sufficient PA intensity for the association with CRF, which in turn is linked to better cardiometabolic health.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1244-1250"},"PeriodicalIF":11.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update to terminology describing abnormal uterine bleeding in female athletes: facilitating cross-disciplinary health care.","authors":"Chimsom T Oleka, Travis Anderson, Kathryn E Ackerman, Kirsty J Elliott-Sale, Emily Kraus, Ellen Casey, Trent Stellingwerff, Amber T Donaldson, Jonathan T Finnoff, Eric G Post, William M Adams","doi":"10.1136/bjsports-2024-108261","DOIUrl":"10.1136/bjsports-2024-108261","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1237-1239"},"PeriodicalIF":11.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of self-reported health problems and interpersonal violence in sport: a cross-sectional study in world-level performing athletes.","authors":"Margo Mountjoy, Karolien Adriaens, Astrid Junge, Helena Verhelle, Felien Laureys, Sandi Kirby, Lenka Dienstbach-Wech, Jeremy Foster, Tine Vertommen","doi":"10.1136/bjsports-2024-109022","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109022","url":null,"abstract":"<p><strong>Objectives: </strong>A paucity of studies assesses the intersection of physical health (injury and illness), mental health and experiences of interpersonal violence (IV, also known as harassment and abuse) in sport. The objectives of this study were to examine the (a) frequency of self-reported physical and mental health problems of elite athletes in the 12 months prior to the survey, (b) differences in physical and mental health between male and female athletes and (c) relationship of athlete health with experiences of IV.</p><p><strong>Methods: </strong>Elite adult athletes from four sports were approached at eight international events to answer an online questionnaire on their physical and mental health, as well as experiences of IV in sport within the past 12 months.</p><p><strong>Results: </strong>A total of 562 athletes completed the questionnaire. Overall, 75% reported at least one physical symptom, most commonly headache and fatigue (n=188; 33.5% each), followed by musculoskeletal symptoms (n=169; 29.4%). 65.1% reported at least one mental health symptom, mostly of anxiety or depression. More female than male athletes reported physical (F:81.9%; M:68.3%; p<0.001) and mental (F:71.9%; M:58.4%; p<0.001) health problems, while addiction problems were more frequent in male athletes (F:1.8%; M:6.4%; p=0.006. 53.0% of the female and 42.3% of the male participants reported having experienced at least one form of IV. Linear regression analysis demonstrated that all forms of IV, except physical IV (all p's<0.001), were associated with an increasing number of physical and mental health symptoms. In addition, the analysis showed that female athletes had a higher increase in symptoms in response to IV than male athletes.</p><p><strong>Conclusions: </strong>This study demonstrates the relationship of elite athlete physical and mental health with IV. Injury and illness prevention programmes in international sport should include strategies to reduce IV.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of postpartum physical activity on maternal depression and anxiety: a systematic review and meta-analysis.","authors":"Andy Deprato, Stephanie-May Ruchat, Muhammad Usman Ali, Chenxi Cai, Milena Forte, Madelaine Gierc, Sarah Meyer, Talia Noel Sjwed, Safi Shirazi, Brittany A Matenchuk, Paris A T Jones, Allison Sivak, Margie H Davenport","doi":"10.1136/bjsports-2024-108478","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108478","url":null,"abstract":"<p><strong>Objective: </strong>To examine the influence of postpartum exercise on maternal depression and anxiety.</p><p><strong>Design: </strong>Systematic review with random effects meta-analysis and meta-regression.</p><p><strong>Data sources: </strong>Online databases up to 12 January 2024, reference lists, recommended studies and hand searches.</p><p><strong>Eligibility criteria: </strong>Randomised controlled trials (RCTs) and non-randomised interventions of any publication date or language were included if they contained information on the Population (postpartum people), Intervention (subjective or objective measures of frequency, intensity, duration, volume, type, or mode of delivery of exercise), Comparator (no exercise or different exercise measures), and Outcome (postpartum depression, anxiety prevalence, and/or symptom severity).</p><p><strong>Results: </strong>A total of 35 studies (n=4072) were included. Moderate certainty evidence from RCTs showed that exercise-only interventions reduced the severity of postpartum depressive symptoms (19 RCTs, n=1778, SMD: -0.52, 95% CI -0.80 to -0.24, I²=86%, moderate effect size) and anxiety symptoms (2 RCTs, n=513, SMD: -0.25, 95% CI -0.43 to -0.08, I²=0%, small effect size), and the odds of postpartum depression by 45% (4 RCTs, n=303 OR 0.55, 95% CI 0.32 to 0.95, I²=0%) compared with no exercise. No included studies assessed the impact of postpartum exercise on the odds of postpartum anxiety. To achieve at least a moderate reduction in the severity of postpartum depressive symptoms, postpartum individuals needed to accumulate at least 350 MET-min/week of exercise (eg, 80 min of moderate intensity exercise such as brisk walking, water aerobics, stationary cycling or resistance training).</p><p><strong>Conclusions: </strong>Postpartum exercise reduced the severity of depressive and anxiety symptoms and the odds of postpartum depression.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}