British Journal of Sports Medicine最新文献

{"title":"#WhatWouldYouDo? A cross-sectional study of sports medicine physicians assessing their competency in managing harassment and abuse in sports.","authors":"Margo Mountjoy, Helena Verhelle, Jonathan T Finnoff, Andrew Murray, Amanda Paynter, Fabio Pigozzi, Camille Tooth, Evert Verhagen, Tine Vertommen","doi":"10.1136/bjsports-2024-108210","DOIUrl":"10.1136/bjsports-2024-108210","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the clinical competence of sports medicine physicians to recognise and report harassment and abuse in sports, and to identify barriers to reporting and the need for safeguarding education.</p><p><strong>Methods: </strong>We implemented a cross-sectional cohort study design recruiting through social media and international sports medicine networks in 2023. The survey captured participant perceptions related to the harmfulness of harassment and abuse. The survey incorporated the reasoned action approach as a theoretical framework to design survey questions to identify attitudes and self-efficacy to detect and report suspicions of harassment and abuse and to identify barriers to reporting.</p><p><strong>Results: </strong>Sports medicine physicians (n=406) from 115 countries completed the survey. The situations of harassment and abuse presented in the survey were described by sports medicine physicians as having occurred in the 12 months before participating in the survey. Despite recognising the situations as harmful, sports medicine physicians were somewhat uncomfortable being vigilant for the signs and symptoms and reporting suspicions and disclosures of harassment and abuse (M=2.13, SD=0.67). In addition, just over one-quarter (n<i>=</i>101, 26.9%) was unaware of where to report harassment and abuse, and over half did not know (n<i>=</i>114, 28.1%), or were uncertain (n<i>=</i>95, 23.4%) of who the safeguarding officer was in their sports organisation. Participants identified many barriers to reporting harassment and abuse, including concerns regarding confidentiality, misdiagnosis, fear of reprisals, time constraints and lack of knowledge. Over half felt insufficiently trained (n<i>=</i>223, 57.6%), and most respondents (n=324, 84.6%) desired more education in the field.</p><p><strong>Conclusions: </strong>Educational programmes to better recognise and report harassment and abuse in sports are needed for sports medicine trainees and practising clinicians. An international safeguarding code for sports medicine physicians should be developed.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406150","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":"Mouthguards for the prevention of orofacial trauma in sport: the Faculty of Sport and Exercise Medicine (UK) position statement.","authors":"Irfan Ahmed, Julie Gallagher, Ian Needleman, Rachel Bower, Paul Ashley, Asma Aloui, John Patrick Haughey, Gofrane Abdellaoui, Peter Fine","doi":"10.1136/bjsports-2024-108663","DOIUrl":"10.1136/bjsports-2024-108663","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388174","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":"Safeguarding policies and practices in International Federations: on the right track?","authors":"Tine Vertommen, Margo Mountjoy, Bram Constandt, Kirsty Burrows","doi":"10.1136/bjsports-2024-108861","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108861","url":null,"abstract":"Interpersonal violence in sport—whether physical, sexual, psychological or neglect—remains a pressing public health concern, casting a shadow over the well-being of athletes at all levels. The impact of interpersonal violence, often referred to as ‘harassment and abuse’ in sport policy documents, extends far beyond the individual, touching families, healthcare systems and society.1 In recent years, safeguarding strategies have emerged as a vital strategy to protect athletes in the Olympic Movement, with the International Olympic Committee (IOC) as a key actor. However, the landscape of safeguarding policies and practices within Summer and Winter Olympic International Federations (IFs) still reveals considerable variation, often lacking consistency and comprehensive implementation. Recognising these gaps, an internal quality control project driven by the IOC Safe Sport Unit set out to establish a framework for monitoring and evaluating the safeguarding efforts of IFs. By developing a set of indicators (see table 1), the project aimed to create a baseline framework for measuring safeguarding activities and to provide a tool for tracking changes over time. Through the application of this framework, it becomes possible to identify key challenges and areas in need of attention, resulting in the ability to support IFs in strengthening their safeguarding activities by pinpointing critical gaps. View this table: Table 1 Proposed set of safeguarding indicators for sport organisations All 39 Summer and Winter Olympic IFs participated, reflecting the importance placed on safeguarding by the sports community. As of 2022, 85% of these IFs reported having safeguarding policies, while only just over half had fully implemented them. Safeguarding officers, who are critical to the success of these policies, were predominantly women (54%), but a significant proportion (38%) did not officially hold the title of safeguarding officer or did not receive specialised training (49%), suggesting that many are working without the full recognition, support or training their role requires. …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"29 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440199","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":"Prescribing strength training for stroke recovery: a systematic review and meta-analysis of randomised controlled trials","authors":"Kenneth S Noguchi, Kevin Moncion, Elise Wiley, Ashley Morgan, Eric Huynh, Guilherme Moraes Balbim, Brad Elliott, Carlene Harris-Blake, Brent Krysa, Barb Koetsier, Karolyn Pinili, Marla K Beauchamp, Stuart M Phillips, Lehana Thabane, Ada Tang","doi":"10.1136/bjsports-2024-108476","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108476","url":null,"abstract":"Objective To examine the effects of strength training on patient-important outcomes of stroke recovery and to quantify the influence of the exercise prescription on treatment effects. Design Systematic review and meta-analysis. Data sources Eight electronic databases (MEDLINE, EMBASE, EMCARE, AMED, PsycINFO, CINAHL, SPORTDiscus, and Web of Science) and two clinical trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) were searched from inception to 19 June 2024. Eligibility criteria Randomised controlled trials were eligible if they examined the effects of strength training compared with no exercise or usual care and reported at least one exercise prescription parameter. An advisory group of community members with lived experience of stroke helped inform outcomes most relevant to stroke recovery. Results Forty-two randomised trials (N=2204) were included. Overall risk of bias was high across most outcomes. Strength training improved outcomes rated as ‘critical for decision-making’ by the advisory group, including walking capacity (standardised mean difference (SMD)=0.95 (95% CI 0.34–1.56)), balance (SMD=1.13 (0.51–1.75)), functional ability and mobility (SMD=0.61 (0.09–1.14)), and habitual (mean difference (MD)=0.05 m/s (0.02–0.09)) and fast-paced walking speed (MD=0.09 m/s (0.01–0.17)), with very low to moderate certainty of evidence, mainly due to risk of bias and inconsistency. More frequent strength training, traditional strength training programmes and power-focused intensities (ie, emphasis on movement velocity) were positively associated with walking capacity, health-related quality of life and fast-paced walking speed. Conclusion Strength training alone or combined with usual care improves stroke recovery outcomes that are important for decision-making. More frequent strength training, power-focused intensities and traditional programme designs may best support stroke recovery. PROSPERO registration number CRD42023414077. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All individual study data included in this review are available directly from the original manuscripts. Any other data used for this review are available on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"44 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440211","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":"Refugee Olympic Team: a team like no other.","authors":"Carlo Bagutti","doi":"10.1136/bjsports-2024-109192","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109192","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"57 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439248","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":"Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning.","authors":"Bradley Stephen Neal,Simon David Lack,Clare Bartholomew,Dylan Morrissey","doi":"10.1136/bjsports-2024-108110","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108110","url":null,"abstract":"OBJECTIVEDefine a best practice guide for managing people with patellofemoral pain (PFP).METHODSA mixed-methods convergent segregated synthesis of meta-analysed data with a thematic analysis of semistructured interviews and focus groups. Agreement between subproject results informed the strength of clinical recommendation for interventions eligible for best practice recommendation.DATA SOURCESMedline, Web of Science, Scopus, reference lists and citation tracking; semistructured interviews of people with PFP; and semistructured interviews and focus groups with clinical experts.ELIGIBILITY CRITERIAHigh-quality (PEDro scale >7) randomised controlled trials (RCTs) were retained for efficacy estimation using meta-analysis. People with PFP were required to have experienced an episode of care in the past 6 months and clinical experts were required to have>5 years of clinical experience alongside direct involvement in research.RESULTSData from 65 high-quality RCTs involving 3796 participants informed 11 meta-analyses of interventions. Interviews with 12 people with PFP led to 3 themes and interviews with 19 clinical experts led to 4 themes. These were further explored in three clinical expert focus groups. Best practice for PFP should first involve understanding a patient's background risk factors, their reasons for seeking care, greatest symptoms, and physical impairments, to inform treatment selection. Synthesis led to six distinct interventions being recommended. Knee-targeted±hip-targeted exercise therapy underpinned by education should be delivered, with additional supporting interventions such as prefabricated foot orthoses, manual therapy, movement/running retraining, or taping decided on and tailored to a patient's needs and preferences.CONCLUSIONA best practice guide based on a synthesis of three data streams recommends that exercise therapy and education be delivered as the primary intervention for people with PFP. Prescription of other supporting interventions should be aligned with the individual patient's particular presentation following a thorough assessment.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"66 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439247","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":"Quantitative analysis of effectiveness and associated factors of exercise on symptoms in osteoarthritis: a pharmacodynamic model-based meta-analysis.","authors":"Shun Han, Ting Li, Ying Cao, Zewei Li, Yiying Mai, Tianxiang Fan, Muhui Zeng, Xin Wen, Weiyu Han, Lijun Lin, Lixin Zhu, Siu Ngor Fu, Kim L Bennell, David J Hunter, Changhai Ding, Lujin Li, Zhaohua Zhu","doi":"10.1136/bjsports-2023-107625","DOIUrl":"https://doi.org/10.1136/bjsports-2023-107625","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the time point and magnitude of peak effectiveness of exercise and the effects of various exercise modalities for osteoarthritis (OA) symptoms and to identify factors that significantly affect the effectiveness of exercise.</p><p><strong>Design: </strong>Pharmacodynamic model-based meta-analysis (MBMA).</p><p><strong>Data sources: </strong>Embase, PubMed, Cochrane Library, Web of Science and Scopus were searched for randomised controlled trials (RCTs) examining the effect of exercise for OA from inception to 20 November 2023.</p><p><strong>Eligibility criteria: </strong>RCTs of exercise interventions in patients with knee, hip or hand OA, using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscales or Visual Analogue Scale (VAS) pain scores as outcome measures, were included. The minimum clinically important difference (MCID) for WOMAC total, pain, stiffness, function and VAS pain was 9.0, 1.6, 0.8, 5.4 and 0.9, respectively.</p><p><strong>Results: </strong>A total of 186 studies comprising 12 735 participants with symptomatic or radiographic knee, hip or hand OA were included. The effectiveness of exercise treatments peaked at 1.6-7.2 weeks after initiation of exercise interventions. Exercise was more effective than the control, but the differences in the effects of exercise compared with control on all outcomes were only marginally different with the MCID (7.5, 1.7, 1.0, 5.4 and 1.2 units for WOMAC total, pain, stiffness, function and VAS pain, respectively). During a 12-month treatment period, local exercise (strengthening muscles and improving mobilisations of certain joints) had the best effectiveness (WOMAC pain decreasing by 42.5% at 12 weeks compared with baseline), followed by whole-body plus local exercise. Adding local water-based exercise (eg, muscle strengthening in warm water) to muscle strengthening exercise and flexibility training resulted in 7.9, 0.5, 0.7 and 8.2 greater improvements in the WOMAC total score, pain, stiffness and function, respectively. The MBMA models revealed that treatment responses were better in participants with more severe baseline symptom scores for all scales, younger participants for the WOMAC total and pain scales, and participants with obesity for the WOMAC function. Subgroup analyses revealed participants with certain characteristics, such as female sex, younger age, knee OA or more severe baseline symptoms on the WOMAC pain scale, benefited more from exercise treatment.</p><p><strong>Conclusion: </strong>Exercise reaches peak effectiveness within 8 weeks and local exercise has the best effectiveness, especially if local water-based exercise is involved. Patients of female sex, younger age, obesity, knee OA or more severe baseline symptoms appear to benefit more from exercise treatment than their counterparts.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406151","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":"Tale of quadriceps and hamstring muscle strength after ACL reconstruction: a systematic review with longitudinal and multivariate meta-analysis.","authors":"Michael Girdwood, Adam G Culvenor, Ebonie K Rio, Brooke E Patterson, Melissa Haberfield, Jamon Couch, Benjamin Mentiplay, Michael Hedger, Kay M Crossley","doi":"10.1136/bjsports-2023-107977","DOIUrl":"https://doi.org/10.1136/bjsports-2023-107977","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate how knee extensor and flexor strength change over time after anterior cruciate ligament reconstruction (ACLR).</p><p><strong>Design: </strong>Systematic review with longitudinal meta-analysis.</p><p><strong>Data sources: </strong>Medline, Embase, CINAHL, Scopus, Cochrane CENTRAL and SPORTDiscus to 28 February 2023.</p><p><strong>Eligibility criteria: </strong>Studies of primary ACLR (n≥50), with mean participant age 18-40 years, reporting a quantitative measure of knee extensor or flexor strength were eligible. Muscle strength had to be reported for the ACL limb and compared with: (1) the contralateral limb (within-person); and/or (2) an uninjured control limb (between-person).</p><p><strong>Results: </strong>We included 232 studies of 34 220 participants. Knee extensor and flexor strength showed sharp initial improvement postoperatively before tailing off at approximately 12-18 months post surgery with minimal change thereafter. Knee extensor strength was reduced by more than 10% compared with the contralateral limb and approximately 20% compared with uninjured controls at 1 year for slow concentric, fast concentric and isometric contractions. Knee flexor strength showed smaller deficits but was still 5%-7% lower than the contralateral limb at 1 year for slow concentric, fast concentric and isometric contractions. Between-person comparisons showed larger deficits than within-person comparisons.</p><p><strong>Conclusion: </strong>Knee extensor muscle strength is meaningfully reduced (>10%) at 1 year, with limited improvement after this time up to and beyond 5 years post surgery. Many people likely experience persistent and potentially long-term strength deficits after ACLR. Comparison within person (to the contralateral limb) likely underestimates strength deficits in contrast to uninjured controls.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399467","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":"Infographic. Medical management of harassment and abuse in sports. #WhatWouldYouDo?","authors":"Margo Mountjoy, Helena Verhelle, Jonathan T Finnoff, Andrew Murray, Amanda Paynter, Fabio Pigozzi, Camille Tooth, Evert Verhagen, Tine Vertommen","doi":"10.1136/bjsports-2024-108876","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108876","url":null,"abstract":"There are four types of harassment and abuse: psychological, physical, sexual and neglect. Harassment and abuse can affect athletes of all ages and in all sports, with varying prevalence depending on the type, location, sport, age and cultural setting. #WhatWouldYouDo?1 is the first study to assess sports medicine physicians’: 1. Perceptions of harm in presented scenarios of harassment and abuse. 2. Witnessing of presented behaviours of harassment and abuse in the past 12 months. 3. Beliefs, attitudes and confidence in recognising and reporting suspicions and allegations of harassment and abuse, as well as their knowledge of reporting mechanisms and barriers to reporting. 4. Level of training and desire for more education in safeguarding. We implemented a cross-sectional cohort study design recruiting through social media and international sports medicine networks. The survey …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"53 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385572","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":"Running is acceptable and efficacious in adults with non-specific chronic low back pain: the ASTEROID randomised controlled trial","authors":"Christopher Neason, Claire L Samanna, Scott D Tagliaferri, Daniel L Belavý, Steve J Bowe, Matthew J Clarkson, Emma A Craige, Romina Gollan, Luana C Main, Clint T Miller, Ulrike H Mitchell, Niamh L Mundell, David Scott, Jamie L Tait, Grace E Vincent, Patrick J Owen","doi":"10.1136/bjsports-2024-108245","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108245","url":null,"abstract":"Objectives Running is one of the most accessible forms of exercise, yet its suitability for adults with chronic low back pain (LBP) is unknown. This study assessed the efficacy and acceptability of running in adults with chronic LBP. Methods This two-arm parallel (1:1) individually randomised controlled trial allocated 40 participants (mean (SD) age: 33 (6) years, female: 50%) with non-specific chronic LBP to a 12-week intervention or waitlist control. The intervention was a progressive run–walk interval programme comprising three 30-min sessions per week that were digitally delivered and remotely supported by an exercise physiologist. Efficacy outcomes were self-reported pain intensity (100-point visual analogue scale) and disability (Oswestry Disability Index). Acceptability outcomes were attrition, adherence and adverse events. Results At 12-week follow-up, the intervention improved average pain intensity (mean net difference (95% CI): −15.30 (–25.33, –5.27) points, p=0.003), current pain intensity (−19.35 (–32.01, –6.69) points, p=0.003) and disability (−5.20 (–10.12, –0.24) points, P=0.038), compared with control. There was no attrition, and mean (SD) training adherence was 70% (20%; ie, 2.1 of 3 sessions per week). Nine non-serious adverse events deemed likely study-related were reported (lower limb injury/pain: n=7, syncope associated with an underlying condition: n=1, LBP: n=1). Conclusions A run–walk programme was considered an acceptable intervention by the participants to improve the pain intensity and disability in individuals aged 18–45 years with non-specific chronic LBP when compared with the control. An individualised and conservative run–walk programme should be considered a suitable form of physical activity for adults with chronic LBP. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12622001276741. Registered on 29 September 2022. Data are available upon reasonable request. The datasets used and analysed during the current study are available from the corresponding author on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"79 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384148","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}