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Zhou XC, Huang YB, Liu Z, Wu HJ, Huang HZ, Tian Y, Hong SW, Hu HJ, Lv LJ, Lv ZZ. Bibliometric Analysis of Functional Magnetic Resonance Imaging Studies on Manual Therapy Analgesia from 2002-2022. J Pain Res 2023; 16:2115-2129. [PMID: 37361428 PMCID: PMC10289250 DOI: 10.2147/jpr.s412658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Background Research on the brain mechanisms underlying manual therapy (MT)-induced analgesia has been conducted worldwide. However, no bibliometric analysis has been performed on functional magnetic resonance imaging (fMRI) studies of MT analgesia. To provide a theoretical foundation for the practical application of MT analgesia, this study examined the current incarnation, hotspots, and frontiers of fMRI-based MT analgesia research over the previous 20 years. Methods All publications were obtained from the Science Citation Index-Expanded (SCI-E) of Web of Science Core Collection (WOSCC). We used CiteSpace 6.1.R3 to analyze publications, authors, cited authors, countries, institutions, cited journals, references, and keywords. We also evaluated keyword co-occurrences and timelines, and citation bursts. The search was conducted from 2002-2022 and was completed within one day on October 7, 2022. Results In total, 261 articles were retrieved. The total number of annual publications showed a fluctuating but overall increasing trend. Author B. Humphreys had the highest number of publications (eight articles) and J. E. Bialosky had the highest centrality (0.45). The United States of America (USA) was the country with the most publications (84 articles), accounting for 32.18% of all publications. Output institutions were mainly the University of Zurich, University of Switzerland, and the National University of Health Sciences of the USA. The Spine (118) and the Journal of Manipulative and Physiological Therapeutics (80) were most frequently cited. The four hot topics in fMRI studies on MT analgesia were "low back pain", "magnetic resonance imaging", "spinal manipulation", and "manual therapy." The frontier topics were "clinical impacts of pain disorders" and "cutting-edge technical capabilities offered by magnetic resonance imaging". Conclusion fMRI studies of MT analgesia have potential applications. fMRI studies of MT analgesia have linked several brain areas, with the default mode network (DMN) garnering the most attention. Future research should include international collaboration and RCTs on this topic.
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Affiliation(s)
- Xing-Chen Zhou
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yu-Bo Huang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhen Liu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hong-Jiao Wu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hua-Zhi Huang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yu Tian
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Shuang-Wei Hong
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hui-Jie Hu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Li-Jiang Lv
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhi-Zhen Lv
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
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Khil EK, Choi I, Lee SA, Seo W, Choi JA. Novel MRI signs of ruptured disc in the cervical spine with intraoperative comparisons. Eur Radiol 2023; 33:1475-85. [PMID: 36066732 DOI: 10.1007/s00330-022-09124-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/04/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of two novel MRI signs for extruded disc (ED) and uncontained ED (ruptured disc, RD) in the cervical spine using intraoperative findings as reference. METHODS This retrospective study included patients who underwent cervical spine MRI and surgery for disc pathology with intraoperative confirmation of RD from September 1, 2016, to January 31, 2021. Two radiologists determined whether the disc was extruded or ruptured with and without the aid of two novel MRI signs suggesting RD (sign 1: blurred margin of the disc; sign 2: mushroom-shaped disc). The diagnostic performance was analyzed using surgical findings as reference. Intra- and interobserver agreements were measured for each MRI sign. RESULTS A total of 91 patients totaling 131 discs were enrolled (mean age: 56.02 ± 12.93; range: 26-88; 62 men and 29 women), of whom 62 were surgically confirmed with RD. When the diagnosis was based exclusively on existing ED definitions, ED was diagnosed with 62.9-79.0% sensitivity and 80.2% accuracy, whereas RD was diagnosed with 35.5-45.2% sensitivity and 67.9-71.0% accuracy. However, when the two novel MRI signs were used as an aid in the diagnosis, ED was diagnosed with 95.2-96.8% sensitivity and 84.0-88.5% accuracy, while RD was diagnosed with 95.2-96.8% sensitivity and 84.0-89.3% accuracy. Intra- and interobserver agreement was substantial (k = 00.77-0.86, 0.69-0.79, respectively, p < 0.001). CONCLUSIONS The detection of two novel MRI signs on preoperative MRI can lead to a more accurate RD diagnosis. KEY POINTS • The diagnostic sensitivity of MRI for cervical ruptured disc is very low (about 35-45 %) using the standardized definition of lumbar disc nomenclature. • Two novel MRI signs can lead to a more accurate diagnosis of the surgically confirmed ruptured disc in the cervical spine. • These two novel MRI signs showed substantial intra-and interobserver reliabilities.
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Kruse RA, White BA, Gudavalli S. Management of Lumbar Radiculopathy Associated With an Extruded L4-L5 Spondylolytic Spondylolisthesis Using Flexion-Distraction Manipulation: A Case Study. J Chiropr Med 2019; 18:311-316. [DOI: 10.1016/j.jcm.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/22/2019] [Accepted: 02/05/2019] [Indexed: 10/23/2022] Open
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Onodera K, Berry DB, Shahidi B, Kelly KR, Ward SR. Intervertebral disc kinematics in active duty Marines with and without lumbar spine pathology. JOR Spine 2019; 2:e1057. [PMID: 31463467 PMCID: PMC6686816 DOI: 10.1002/jsp2.1057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 04/01/2019] [Accepted: 05/16/2019] [Indexed: 11/06/2022] Open
Abstract
Military members are required to carry heavy loads frequently during training and active duty combat. We investigated if operationally relevant axial loads affect lumbar disc kinematics in forty-one male active duty Marines with no previous clinically diagnosed pathology. Marines were imaged standing upright with and without load. From T2-weighted magnetic resonance images, intervertebral disc (IVD) health and kinematic changes between loading conditions and across lumbar levels were evaluated using two-way repeated measures analysis of variance tests. IVD kinematics with loading were compared between individuals with and without signs of degeneration on imaging. Linear regression analyses were performed to determine associations between IVD position and kinematic changes with loading. Fifty-eight percent (118/205) of IVDs showed evidence of degeneration and 3% (7/205) demonstrated a disc bulge. IVD degeneration was not related to posterior annular position (P > .205). Changes in sagittal intervertebral angle were not associated with changes in posterior annular position between baseline and loaded conditions at any lumbar level (r < 0.267; P = .091-.746). Intervertebral angles were significantly larger in the lower regions of the spine (P < .001), indicating increased local lordosis when moving in the caudal direction Disc height at the L5/S1 level was significantly smaller (6.3 mm, mean difference = 1.20) than all other levels (P < .001) and baseline posterior disc heights tended to be larger at baseline (7.43 mm ± 1.46) than after loading (7.18 ± 1.57, P = .071). Individuals with a larger baseline posterior annular position demonstrated greater reduction with load at all levels (P < .002), with the largest reductions at L5/S1 level. Overall, while this population demonstrated some signs of disc degeneration, operationally relevant loading did not significantly affect disc kinematics.
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Affiliation(s)
- Keenan Onodera
- Department of Orthopaedic SurgeryUniversity of California San DiegoLa JollaCalifornia
| | - David B. Berry
- Department of BioengineeringUniversity of California San DiegoLa JollaCalifornia
| | - Bahar Shahidi
- Department of Orthopaedic SurgeryUniversity of California San DiegoLa JollaCalifornia
- Department of RadiologyUniversity of California San DiegoLa JollaCalifornia
| | - Karen R. Kelly
- Warfighter Performance DepartmentNaval Health Research CenterSan DiegoCalifornia
| | - Samuel R. Ward
- Department of Orthopaedic SurgeryUniversity of California San DiegoLa JollaCalifornia
- Department of BioengineeringUniversity of California San DiegoLa JollaCalifornia
- Department of RadiologyUniversity of California San DiegoLa JollaCalifornia
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Argent V, Fraser A, Alves L, Freeman P. Spontaneous regression of a cervical intervertebral disc extrusion in French bulldogs documented on MRI after medical management. Vet rec case rep 2019. [DOI: 10.1136/vetreccr-2019-000817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Victoria Argent
- Department of Neurology and NeurosurgeryQueen's Veterinary School HospitalCambridgeUK
| | - Anne Fraser
- Department of Neurology and NeurosurgeryAnderson MooresWinchesterUK
| | - Lisa Alves
- Department of Neurology and NeurosurgeryQueen's Veterinary School HospitalCambridgeUK
| | - Paul Freeman
- Department of Neurology and NeurosurgeryQueen's Veterinary School HospitalCambridgeUK
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Annen M, Peterson C, Humphreys BK. Comparison of Treatment Outcomes in Nonspecific Low-Back Pain Patients With and Without Modic Changes Who Receive Chiropractic Treatment. J Manipulative Physiol Ther 2018; 41:561-570. [PMID: 30442355 DOI: 10.1016/j.jmpt.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine if there was a difference in outcomes in patients with nonspecific low back pain, both with and without Modic changes (MCs), who received chiropractic care. METHODS This prospective outcomes study included 112 patients with low back pain without disc herniation on magnetic resonance imaging. All patients were treated with spinal manipulative therapy. At baseline, the numerical rating scale (NRS) and Bournemouth Questionnaire (BQ) for disability were collected. The NRS, BQ, and Patient's Global Impression of Change (primary outcome) were collected at the follow-up time points of 1 week, 1 month, and 3 months to assess overall improvement. Magnetic resonance imaging scans were analyzed for the presence of MCs and, if present, classified as Modic I or II. The χ2 test was used to compare the proportion of patients reporting clinically relevant "improvement" between patients with and without MCs and between Modic I and Modic II patients. The unpaired Student t test was used to compare NRS and BQ at baseline and change scores at all follow-up time points. RESULTS For the primary outcome measure, the proportion of patients reporting relevant "improvement" (Patient's Global Impression of Change), and for the secondary outcome measures (NRS and BQ change scores), there were no significant differences between Modic positive and Modic negative patients or between Modic I and Modic II patients. CONCLUSION Neither the presence nor absence of MCs nor the Modic change category were related to treatment outcomes for patients with low back pain without disc herniation who received chiropractic care.
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Affiliation(s)
- Michèle Annen
- Chiropractic Medicine Department, Faculty of Medicine, University of Zurich, Orthopaedic University Hospital Balgrist, Zürich, Switzerland.
| | - Cynthia Peterson
- Chiropractic Medicine Department, Faculty of Medicine, University of Zurich, Orthopaedic University Hospital Balgrist, Zürich, Switzerland
| | - B Kim Humphreys
- Chiropractic Medicine Department, Faculty of Medicine, University of Zurich, Orthopaedic University Hospital Balgrist, Zürich, Switzerland
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Shokri E, Kamali F, Sinaei E, Ghafarinejad F. Spinal manipulation in the treatment of patients with MRI-confirmed lumbar disc herniation and sacroiliac joint hypomobility: a quasi-experimental study. Chiropr Man Therap 2018; 26:16. [PMID: 29796250 PMCID: PMC5956754 DOI: 10.1186/s12998-018-0185-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 04/04/2018] [Indexed: 02/08/2023] Open
Abstract
Background To investigate the effect of lumbar and sacroiliac joint (SIJ) manipulation on pain and functional disability in patients with lumbar disc herniation (LDH) concomitant with SIJ hypomobility. Methods Twenty patients aged between 20 and 50 years with MRI-confirmed LDH who also had SIJ hypomobility participated in the trial in 2010. Patients who had sequestrated disc herniation were excluded. All patients received five sessions of spinal manipulative therapy (SMT) for the SIJ and lumbar spine during a 2-week period. Back and leg pain intensity and functional disability level were measured with a numerical rating scale (NRS) and the Oswestry Disability Index (ODI) at baseline, immediately after the 5th session, and 1 month after baseline. Results A significantly greater mean improvement in back and leg pain was observed in the 5th sessions and 1 month after SMT. Mean changes in ODI in the 5th session and 1 month after treatment also showed significant improvement. The MCIC for NRS and ODI scores in the present study were considered 20 and 6 points, respectively. Therefore, the mentioned improvements were not clinically significant in the 5th session or at 1-month follow-up. Conclusion Five sessions of lumbar and SIJ manipulation can potentially improve pain and functional disability in patients with MRI-confirmed LDH and concomitant SIJ hypomobility. Trial registration Irct.ir (Identifier: IRCT2017011924149N33), registered 19 February 2017 (retrospectively registered).
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Affiliation(s)
- Esmaeil Shokri
- 1Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh Kamali
- 1Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,2Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,3School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Abiverdi 1 St,Chamran Blvd., P.O. Box 71345-1733, Shiraz, Iran
| | - Ehsan Sinaei
- 2Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farahnaz Ghafarinejad
- 1Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,2Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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DiGiorgi D, Cerf JL, Bowerman DS. Outcomes indicators and a risk classification system for spinal manipulation under anesthesia: a narrative review and proposal. Chiropr Man Therap 2018. [PMID: 29541445 PMCID: PMC5842582 DOI: 10.1186/s12998-018-0177-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice. With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications. Also absent from current relevant literature is acknowledgement or guidance on the preliminary evidence that may predict poor clinical outcomes with SMUA. This review considers risk and unfavorable outcomes indicators in therapeutic decision making for spinal manipulation under anesthesia. A new risk classification system is proposed that identifies patient safety and quality of care interests for a procedure that remains without higher-level research evidence. A scale which categorizes risk and outcome potential for SMUA is offered for the chiropractic clinician, which aims to elevate the standard of care and improve patient selection through the incorporation of specific indices from existing medical literature.
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Affiliation(s)
| | - John L Cerf
- Clinical and Consultant Practice- Jersey City, NJ, USA
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Farshad M, Sutter R, Hoch A. Severity of foraminal lumbar stenosis and the relation to clinical symptoms and response to periradicular infiltration-introduction of the "melting sign". Spine J 2018; 18:294-299. [PMID: 28739476 DOI: 10.1016/j.spinee.2017.07.176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/25/2017] [Accepted: 07/17/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT Nerve root compression causing symptomatic radiculopathy can occur within the intervertebral foramen. Sagittal magnetic resonance imaging (MRI) sequences are reliable in detection of nerve root contact to intraforaminal disc material, but a clinically relevant classification of degree of contact is lacking. PURPOSE This study aimed to investigate a potential relation of amount of contact between intraforaminal disc material and nerve root to clinical findings and response after periradicular corticosteroid infiltration. STUDY DESIGN A post hoc analysis of a prospective cohort was carried out. PATIENT SAMPLE Patients who underwent computed tomography (CT)-guided periradicular corticosteroid infiltration (L1-L5) at our institution (January 2014 to May 2016) were included. OUTCOME MEASURES The medical records and radiographic imaging were reviewed. METHODS T2-weighted MRI of the lumbar spine of patients with single-level symptomatic radiculopathy with (responders, n=28) or without (non-responders, n=14) pain relief after periradicular infiltration with corticosteroids were measured and compared by two independent readers to determine the amount of intraforaminal nerve root contact with the intervertebral disc ("melting" of the T2-hypointense signal). Pain relief was defined with a pain level decrease of >50% on a visual analogue scale and lack of pain relief with a pain level decrease of <25%, respectively. The amount of T2-hypointensity melting of disc and nerve root was categorized to 0%, 1%-25%, and over 25%. RESULTS Reader one identified 0% T2-melting in none of the responders, 1%-25% melting in 13 patients (46.4%), 26%-50% in 15 of the 28 patients (53.6%) with pain relief after periradicular corticosteroid infiltration (responders), with a mean amount of T2-melting of 5.9±2.1 mm, whereas the non-responder group had 0% T2-melting in 2 patients (14.3%), 1%-25% T2-melting in 11 patients (78.6%), and 26%-50% in 1 patient (7.1%), with a mean amount of T2-melting of 2.6±1.9 mm (p<.05). Reader two identified 0% T2-melting in none, 1%-25% T2-melting in 15 (53.6%) patients, and 26%-50% in 13 of the 28 responders (46.4%), with mean amount of 6.3±1.9 mm. In the non-responder group 0% T2-melting was seen in 3 patients (21.4%), 1%-25% T2-melting in 10 patients (71.4%), and 26%-50% in 1 patient (7.1%), with a mean amount of T2-melting of 2.7±1.9 mm (p<.05). None of the MRI showed T2-melting in over 50% of the circumference of the intraforaminal nerve root. A T2-melting of >25% had a high specificity of 93% but a sensitivity of 50%, thus a positive likelihood ratio of 7.5, to identify those with a pain relief of more than 50% after infiltration. CONCLUSION The amount of T2-melting of disc material and nerve root on sagittal MRI (>25%) predicts the amount of pain relief by periradicular infiltration in patients with intraforaminal nerve root irritation.
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Affiliation(s)
- Mazda Farshad
- Division of Spine Surgery and Radiology, Balgrist University Hospital, University of Zürich, Forchstrasse 340, 8008 Zürich, Switzerland.
| | - Reto Sutter
- Division of Spine Surgery and Radiology, Balgrist University Hospital, University of Zürich, Forchstrasse 340, 8008 Zürich, Switzerland
| | - Armando Hoch
- Division of Spine Surgery and Radiology, Balgrist University Hospital, University of Zürich, Forchstrasse 340, 8008 Zürich, Switzerland
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Kressig M, Peterson CK, McChurch K, Schmid C, Leemann S, Anklin B, Humphreys BK. Relationship of Modic Changes, Disk Herniation Morphology, and Axial Location to Outcomes in Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation: A Prospective Study. J Manipulative Physiol Ther 2016; 39:565-575. [DOI: 10.1016/j.jmpt.2016.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
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