Nctid:
NCT06227637
Payload:
{"hasResults"=>false, "derivedSection"=>{"miscInfoModule"=>{"versionHolder"=>"2024-10-03"}, "conditionBrowseModule"=>{"meshes"=>[{"id"=>"D000007592", "term"=>"Joint Diseases"}], "ancestors"=>[{"id"=>"D000009140", "term"=>"Musculoskeletal Diseases"}], "browseLeaves"=>[{"id"=>"M10621", "name"=>"Joint Diseases", "asFound"=>"Joint Dysfunction", "relevance"=>"HIGH"}, {"id"=>"M12097", "name"=>"Musculoskeletal Diseases", "relevance"=>"LOW"}], "browseBranches"=>[{"name"=>"Musculoskeletal Diseases", "abbrev"=>"BC05"}, {"name"=>"All Conditions", "abbrev"=>"All"}]}}, "protocolSection"=>{"designModule"=>{"phases"=>["NA"], "studyType"=>"INTERVENTIONAL", "designInfo"=>{"allocation"=>"RANDOMIZED", "maskingInfo"=>{"masking"=>"DOUBLE", "whoMasked"=>["PARTICIPANT", "OUTCOMES_ASSESSOR"], "maskingDescription"=>"Participants will be blinded to the treatment they will receive, and the statistics doctor will be blinded."}, "primaryPurpose"=>"TREATMENT", "interventionModel"=>"PARALLEL", "interventionModelDescription"=>"The sample will be randomly subdivided into 2 Groups: Group (A)- Muscle Energy Techniques and Group (B)- Local Muscle Vibration."}, "enrollmentInfo"=>{"type"=>"ESTIMATED", "count"=>50}}, "statusModule"=>{"overallStatus"=>"RECRUITING", "startDateStruct"=>{"date"=>"2023-10-15", "type"=>"ACTUAL"}, "expandedAccessInfo"=>{"hasExpandedAccess"=>false}, "statusVerifiedDate"=>"2024-01", "completionDateStruct"=>{"date"=>"2024-06-15", "type"=>"ESTIMATED"}, "lastUpdateSubmitDate"=>"2024-01-25", "studyFirstSubmitDate"=>"2024-01-11", "studyFirstSubmitQcDate"=>"2024-01-25", "lastUpdatePostDateStruct"=>{"date"=>"2024-01-29", "type"=>"ACTUAL"}, "studyFirstPostDateStruct"=>{"date"=>"2024-01-29", "type"=>"ACTUAL"}, "primaryCompletionDateStruct"=>{"date"=>"2024-04-15", "type"=>"ESTIMATED"}}, "outcomesModule"=>{"primaryOutcomes"=>[{"measure"=>"Pain intensity", "timeFrame"=>"Assessment before treatment, then immediately after the intervention, then finally follow up after 2 weeks", "description"=>"VAS in the simple model, which will be used as a self-reported method of pain intensity measurement, the patient will be asked to put a mark point at the scale range (from 0 to 10 cm). This assessment procedure will be applied before and after treatment procedure."}, {"measure"=>"Pain pressure threshold", "timeFrame"=>"Assessment before treatment, then immediately after the intervention, then finally follow up after 2 weeks", "description"=>"PPT should be measured on both sides at the level of right and left posterior inferior iliac spines (PIIS). With the patient is a prone position, two algometer measurements will be taken before and after treatment at the level of (PIIS). All measurements will be recorded at intervals of 30 second. The patient will be instructed to report when the sensation beginning of pain."}, {"measure"=>"Back functional disability", "timeFrame"=>"Assessment before treatment, then immediately after the intervention, then finally follow up after 2 weeks", "description"=>"This questionnaire is Self-reported pain and disability method (Arabic model). The therapist will ask the patient ten questions covering pain severity, personal care, lifting, walking, sitting, standing, sleeping, social life, travelling, and changing degrees of pain. Each part has six statements, each with a score ranging from 0 (showing no disability) to 5 (representing maximum disability). The final score was calculated as a percentage out of 50, representing perceived disability at the time. The validated Arabic version of ODI will be used in this study."}, {"measure"=>"The innominate angle tilt", "timeFrame"=>"Assessment before treatment, then immediately after the intervention, then finally follow up after 2 weeks", "description"=>"The patient will be instructed to march 10 steps in place before standing in a fully erect posture without bending ankles, knees, or hips, feet in front 30.5 cm apart, and arms across the chest. The therapist will stand beside the patient and mark the anterior and posterior superior iliac spines (ASIS and PSIS)."}]}, "oversightModule"=>{"isFdaRegulatedDrug"=>false, "isFdaRegulatedDevice"=>false}, "conditionsModule"=>{"conditions"=>["Sacroiliac Joint Dysfunction"]}, "referencesModule"=>{"references"=>[{"pmid"=>"30662072", "type"=>"BACKGROUND", "citation"=>"Germann D, El Bouse A, Shnier J, Abdelkader N, Kazemi M. Effects of local vibration therapy on various performance parameters: a narrative literature review. J Can Chiropr Assoc. 2018 Dec;62(3):170-181."}, {"pmid"=>"33239942", "type"=>"BACKGROUND", "citation"=>"Konrad A, Glashuttner C, Reiner MM, Bernsteiner D, Tilp M. The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles' Range of Motion and Performance. J Sports Sci Med. 2020 Nov 19;19(4):690-694. eCollection 2020 Dec."}], "seeAlsoLinks"=>[{"url"=>"https://doi.org/10.21608/svupts.2019.230984", "label"=>"Alkady, S. M. E., Kamel, R. M., AbuTaleb, E., Lasheen, Y., \\& Alshaarawy, F. A. (2019). Effect of Muscle Energy Technique in Chronic Sacroiliac Joint Dysfunction. South Valley University International Journal of Physical Therapy and Sciences, 1(1), 8-19."}, {"url"=>"https://doi.org/10.1016/j.clinbiomech.2019.02.009", "label"=>"Salvador Coloma, P., \\& Sánchez-Zuriaga, D. (2019). Effects of myofascial release in erector spinae myoelectric activity and lumbar spine kinematics in non-specific chronic low back pain: Randomized controlled trial. Clinical Biomechanics, 63(1), 27-33."}, {"url"=>"https://doi.org/10.1016/j.jbmt.2013.05.017", "label"=>"Azevedo, D. C., Santos, H., Carneiro, R. L., \\& Andrade, G. T. (2014). Reliability of sagittal pelvic position assessments in standing, sitting and during hip flexion using palpation meter. Journal of Bodywork and Movement Therapies, 18(2), 210-214."}, {"url"=>"https://doi.org/10.3233/BMR-2012-0347", "label"=>"Barbosa, A. C., Martins, F. L. M., Barbosa, M. C. S. A., \\& Dos Santos, R. T. (2013). Manipulation and selective exercises decrease pelvic anteversion and low-back pain: A pilot study. Journal of Back and Musculoskeletal Rehabilitation, 26(1), 33-36."}, {"url"=>"https://doi.org/10.1016/j.jcm.2016.08.004", "label"=>"Posterior , Lateral , and Anterior Hip Pain Due to Musculoskeletal Origin : A Narrative Literature Review of History , Physical Examination , and Diagnostic Imaging. Journal of Chiropractic Medicine, 15(4), 281-293."}, {"url"=>"https://doi.org/10.3390/medicina57070691", "label"=>"Guidolin, D., \\& Stecco, C. (2021). Pilot study of sacroiliac joint dysfunction treated with a single session of fascial manipulation method: Clinical implications for effective pain reduction. Medicina (Lithuania), 57(7), 1-11."}, {"url"=>"https://doi.org/10.2519/jospt.2007.2429", "label"=>"Changes in Pain and Disability Secondary to Shoe Lift Intervention in Subjects With Limb Length Inequality and Chronic Low Back Pain: A Preliminary Report. Journal of Orthopaedic and Sports Physical Therapy, 37(7), 380-388"}, {"url"=>"https://doi.org/10.1007/s11914-012-0132-1", "label"=>"Chan, M. E., Uzer, G., \\& Rubin, C. T. (2013). The potential benefits and inherent risks of vibration as a non-drug therapy for the prevention and treatment of osteoporosis. Current Osteoporosis Reports, 11(1), 36-44."}, {"url"=>"https://doi.org/10.1111/j.1526-4637.2004.04009.x", "label"=>"Chou, L. H., Slipman, C. W., Bhagia, S. M., Tsaur, L., Bhat, A. L., Isaac, Z., Gilchrist, R., El Abd, O. H., \\& Lenrow, D. A. (2004). Inciting events initiating injection-proven sacroiliac joint syndrome. Pain Medicine, 5(1), 26-32."}, {"url"=>"https://doi.org/10.1213/01.ANE.0000180831.60169.EA", "label"=>"Cohen, S. P. (2005). Sacroiliac Joint Pain : A Comprehensive Review of Anatomy , Diagnosis , and Treatment. Anesthesia \\& Analgesia, 101(5), 1440-1453."}, {"url"=>"https://doi.org/10.1136/jnnp.29.1.1", "label"=>"De Gail, P., Lance, J. W., \\& Neilson, P. D. (1966). Differential effects on tonic and phasic reflex mechanisms produced by vibration of muscles in man. Journal of Neurology, Neurosurgery, and Psychiatry, 29(1), 1-11."}, {"url"=>"https://doi.org/10.1016/j.clinbiomech.2020.105071", "label"=>"Dueñas, L., Zamora, T., Lluch, E., Artacho-Ramírez, M. A., Mayoral, O., Balasch, S., \\& Balasch-Bernat, M. (2020). The effect of vibration therapy on neck myofascial trigger points: A randomized controlled pilot study. Clinical Biomechanics, 78(May 2019),"}, {"url"=>"https://doi.org/10.1016/j.spinee.2013.10.009", "label"=>"Increase in paravertebral muscle activity in lumbar kyphosis patients by surface electromyography compared with lumbar spinal canal stenosis patients and healthy volunteers. The Spine Journal, 13(11), 1711."}, {"url"=>"https://doi.org/10.1016/j.jelekin.2018.09.009", "label"=>"Feeney, D. F., Capobianco, R. A., Montgomery, J. R., Morreale, J., Grabowski, A. M., \\& Enoka, R. M. (2018). Individuals with sacroiliac joint dysfunction display asymmetrical gait and a depressed synergy between muscles providing sacroiliac joint force"}, {"url"=>"https://doi.org/10.1177/1941738110366000", "label"=>"Frank, R. M., Slabaugh, M. A., Grumet, R. C., Virkus, W. W., Bush-joseph, C. A., \\& Nho, S. J. (2010). Posterior Hip Pain in an Athletic Population : Differential Diagnosis and Treatment Options. Sports Health, 2(3), 237-246."}, {"url"=>"https://doi.org/10.1016/S0021-9290(99)00210-9", "label"=>"Fritton, S. P., J. McLeod, K., \\& Rubin, C. T. (2000). Quantifying the strain history of bone: Spatial uniformity and self-similarity of low-magnitude strains. Journal of Biomechanics, 33(3), 317-325."}, {"url"=>"https://doi.org/10.1016/j.jbmt.2013.05.006", "label"=>"Fryer, G., \\& Pearce, A. J. (2013). The effect of muscle energy technique on corticospinal and spinal reflex excitability in asymptomatic participants. Journal of Bodywork and Movement Therapies, 17(4), 440-447."}, {"url"=>"https://doi.org/10.1007/s00586-021-06927-9", "label"=>"Gartenberg, A., Nessim, A., \\& Cho, W. (2021). Sacroiliac joint dysfunction : pathophysiology , diagnosis , and treatment. European Spine Journal, 30(10), 2936-2943."}, {"url"=>"https://doi.org/10.1186/s40798-015-0022-z", "label"=>"Goebel, R. T., Kleinöder, H., Yue, Z., Gosh, R., \\& Mester, J. (2015). Effect of Segment-Body Vibration on Strength Parameters. Sports medicine - open, 1(1), 14."}, {"url"=>"https://doi.org/10.1016/0304-3959(94)90097-3", "label"=>"Harkins\\&, I, D. D. P., Bush, F. M., Long, S., S. W. (1993). A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain, 56(2), 21-226."}, {"url"=>"https://doi.org/10.2519/jospt.1983.5.2.74", "label"=>"Henricson, A., Larsson, A., Olsson, E., \\& Westlin, N. (1983). The effect of stretching on the range of motion of the ankle joint in badminton players. Journal of Orthopaedic and Sports Physical Therapy, 5(2), 74-77."}, {"url"=>"https://doi.org/10.1016/s0031-9406(05)66417-6", "label"=>"Holey, L. (1996). Muscle Energy Techniques. Physiotherapy, 82(8), 493."}, {"url"=>"https://doi.org/10.53730/ijhs.v6ns4.10935", "label"=>"Hussein, Y. I., Hassan, K. A., \\& EL-Nahass, B. G. E. (2022). Strain-counterstrain versus muscle energy technique in sacroiliac joint dysfunction. International Journal of Health Sciences, 6(July), 8738-8754."}, {"url"=>"https://doi.org/10.1007/s00421-010-1677-2", "label"=>"Iodice, P., Bellomo, R. G., Gialluca, G., Fanò, G., \\& Saggini, R. (2011). Acute and cumulative effects of focused high-frequency vibrations on the endocrine system and muscle strength. European Journal of Applied Physiology, 111(6), 897-904."}, {"url"=>"https://doi.org/10.1097/BRS.0b013e3181978ea3", "label"=>"Ivanov, A. A., Kiapour, A., Ebraheim, N. A., \\& Goel, V. (2009). Lumbar Fusion Leads to Increases in Angular Motion and Stress Across Sacroiliac Joint A Finite Element Study. Spine, 34(5), 162-169."}, {"url"=>"https://doi.org/10.2147/JPR.S327351", "label"=>"Kiapour, A. L. I., Joukar, A., Elgafy, H., \\& Erbulut, D. U. (2020). Biomechanics of the Sacroiliac Joint : Anatomy , Function , Biomechanics , Sexual Dimorphism , and Causes of Pain. Journal of Pain Research, 14(1), 3135-3143."}, {"url"=>"https://doi.org/10.1016/S0004-9514(14)60125-2", "label"=>"Diagnosing painful sacroiliac joints : A validity study of a McKenzie evaluation and sacroiliac provocation tests. Australian Journal of Physiotherapy, 49(2), 89-97."}, {"url"=>"https://doi.org/10.1093/jscr/rjw102", "label"=>"Delayed iliacus compartment syndrome following femoral artery puncture: case report and literature review. Journal of Surgical Case Reports, 16(6), 102."}, {"url"=>"https://doi.org/10.1016/j.jelekin.2014.07.014", "label"=>"The acute effects of local muscle vibration frequency on peak torque, rate of torque development, and EMG activity. Official Journal of the International Society of Electrophysiological Kinesiology. 24(6), 888-894."}, {"url"=>"https://doi.org/10.1093/ptj/59.8.988", "label"=>"Paris, S. V. (1979). Mobilization of the spine. Physical Therapy, 59(8), 988-995."}, {"url"=>"https://doi.org/10.3892/ijmm_00000259", "label"=>"Effects of local vibrations on skeletal muscle trophism in elderly people: mechanical, cellular, and molecular events. International journal of molecular medicine, 24(4), 503-512."}, {"url"=>"https://doi.org/10.1016/j.math.2011.09.002", "label"=>"Deformation of the innominate bone and mobility of the pubic symphysis during asymmetric moment application to the pelvis. Manual Therapy, 17(1), 66-70."}, {"url"=>"https://doi.org/10.14444/6082", "label"=>"Prather, H., Bonnette, M., \\& Hunt, D. (2020). Nonoperative Treatment Options for Patients With Sacroiliac Joint Pain. International Journal of Spine Surgery, 14, 35-40."}, {"url"=>"https://doi.org/10.1016/j.disamonth.2004.12.004", "label"=>"Prather, H., \\& Hunt, D. (2004). Sacroiliac Joint Pain. Disease-a-Month, 50(12), 670-683."}, {"url"=>"https://core.ac.uk/download/pdf/37321542.pdf", "label"=>"Ramzy, R. (2008). Validation of the Arabic Version of the Oswestry Disability Index Developed in Tunisia for low back pain patients in the UAE."}, {"url"=>"https://doi.org/10.5958/2394-2800.2018.00003.2", "label"=>"Effects of Muscle Energy Technique versus Mobilization on Pain and Disability in Post-Partum Females with Sacroiliac Joint Dysfunction. In Indian Journal of Health Sciences and Care, 5(1), 11."}, {"url"=>"https://doi.org/10.1016/j.jmpt.2005.07.006", "label"=>"A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome. Journal of Manipulative and Physiological Therapeutics, 28(7), 493-501."}, {"url"=>"https://doi.org/10.1016/j.jmpt.2017.09.004", "label"=>"Effect of Sacroiliac Joint Mobilization on the Level of Soft Tissue Pain Threshold in Asymptomatic Women. Journal of Manipulative and Physiological Therapeutics, 41(3), 258-264."}, {"url"=>"https://doi.org/10.1016/0268-0033(93)90002-Y", "label"=>"New concepts and hypotheses Transfer of lumbosacral load to iliac bones and legs Part 1 : Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clinical Biomechanics, 8(6), 285-294."}, {"url"=>"https://doi.org/10.1016/j.jpain.2008.09.014", "label"=>"Szadek, K. M., Wurff, P. Van Der, Tulder, M. W. Van, Zuurmond, W. W., \\& Perez, R. S. G. M. (2009). Diagnostic Validity of Criteria for Sacroiliac Joint Pain : The Journal of Pain, 10(4), 354-368."}, {"url"=>"https://doi.org/10.1589/jpts.28.2688", "label"=>"Effect of the single-leg, lateral oblique, decline squat exercise on sacroiliac joint pain with knee pain. Journal of Physical Therapy Science, 28(9), 2688-2689."}, {"url"=>"https://doi.org/10.55522/jmpas.V11I3.1364", "label"=>"Zunzunwala, S., Phansopkar, P., \\& Lakhwani, M. (2022). Effect of theragun on calf muscle tightness in asymptomatic individuals. Journal of Medical Pharmaceutical and Allied Sciences, 11(3), 4863-4866."}]}, "descriptionModule"=>{"briefSummary"=>"The purpose of this study is to compare the effect of Local Muscle Vibration versus Muscle energy technique on pain intensity, pain pressure threshold, functional disability, and innominate angle tilt in SIJD.\n\nThis study will try to answer the following question:\n\nWhat is the effect of Local Muscle Vibration compared to Muscle energy technique on pain intensity, pain pressure threshold, functional disability, and innominate angle tilt in SIJD?", "detailedDescription"=>"Clinicians will attempt to identify the primary factors that contribute to the development of low back pain. These factors are related to specific areas of malfunction that may irritate the tissues and create pain, or cause pain through hypersensitivity of nociceptive pathways in the CNS. Joint dysfunction is one risk factor, which is defined as \"loss of joint play movement that cannot be produced by voluntary muscles\". Pain in the joint can result from joint dysfunction, in addition to joint dysfunction, muscle dysfunction is evaluated. History, inspection, palpation, and flexibility tests can all be used to determine this.\n\nMuscle energy technique is based on the concepts of Autogenic Inhibition and Reciprocal Inhibition, to lengthen a shortened muscle, mobilize a stiff joint, strengthen a weak muscle, and reduce localized edema and passive congestion. Several studies approved that (MET) affects positively on SIJD cases.\n\nLocal Muscle Vibration is used to pain relief, stimulate edema absorption, improve blood flow, alleviate wound healing, and for its anti-inflammatory and ant-adhesion effects. In addition, pain relief effect have also been widely demonstrated. Vibration comprised of low-magnitude high-intensity stimuli which represents a suitable technique to securely transmit appropriate mechanical signals to patients who are unable to exercise to increase musculoskeletal strength. According to a narrative literature review contain about 35 study descuss effects of local vibration therapy on various performance parameters, LMV have apositive effect on muscle activation, strengh, power and joint range of motion.\n\nAccording to Iodice et al (2011), local administration of high-frequency VT resulted in significant increase in muscle function after several weeks however, some hormonal alterations and moderate performance gains were observed after a single session. This study will try to investigate the effect of Local Muscle Vibration versus Muscle energy technique, which is more effective in reducing low back pain and disability in cases of SIJD. Up to the authors knowledge no previous study discussed the difference between (LMV) and (MET) on SIJD."}, "eligibilityModule"=>{"sex"=>"ALL", "stdAges"=>["ADULT"], "maximumAge"=>"40 years", "minimumAge"=>"20 years", "healthyVolunteers"=>false, "eligibilityCriteria"=>"Inclusion Criteria:\n\nboth male and female participants with ages between 20-40.\n\n* Pain intensity is greater than 3 over the scale of VAS.\n* Pain around SIJ (around PSIS and sacral sulcus).\n* Participants with at least three positives out of six provocation and motion palpation tests that have been validated (distraction, compression, Gaenslen, posterior friction test, sacral thrust, and FABER tests).\n\nExclusion Criteria:\n\n* Neurological impairments in the leg\n* Sacroiliitis\n* Spondylolisthesis\n* pre-diagnosed central or peripheral nervous system disease\n* The current pregnancy\n* rheumatoid arthritis\n* Major surgery of lower limbs and spine"}, "identificationModule"=>{"nctId"=>"NCT06227637", "acronym"=>"SIJD", "briefTitle"=>"Local Muscle Vibration Versus Muscle Energy Technique In Sacroiliac Joint Dysfunction", "organization"=>{"class"=>"OTHER", "fullName"=>"Cairo University"}, "officialTitle"=>"Local Muscle Vibration Versus Muscle Energy Technique In Sacroiliac Joint Dysfunction", "orgStudyIdInfo"=>{"id"=>"local vibration vs MET in SIJD"}}, "armsInterventionsModule"=>{"armGroups"=>[{"type"=>"ACTIVE_COMPARATOR", "label"=>"Group (A) (Muscle Energy Techniques )", "description"=>"Muscle Energy Techniques", "interventionNames"=>["Other: Local Muscle Vibration compared to Muscle energy technique in SIJD"]}, {"type"=>"ACTIVE_COMPARATOR", "label"=>"Group( B) (Local Muscle Vibration)", "description"=>"Local Muscle Vibration", "interventionNames"=>["Other: Local Muscle Vibration compared to Muscle energy technique in SIJD"]}], "interventions"=>[{"name"=>"Local Muscle Vibration compared to Muscle energy technique in SIJD", "type"=>"OTHER", "description"=>"Apply Local Muscle Vibration compared to Muscle energy technique on patients with sacroiliac joint dysfunction and note the effect on pain intensity, pain pressure threshold, functional disability, and innominate angle tilt in SIJD.", "armGroupLabels"=>["Group (A) (Muscle Energy Techniques )", "Group( B) (Local Muscle Vibration)"]}]}, "contactsLocationsModule"=>{"locations"=>[{"city"=>"Cairo", "status"=>"RECRUITING", "country"=>"Egypt", "contacts"=>[{"name"=>"asmaa a ali radwan, Bachelors", "role"=>"CONTACT", "email"=>"asmaa.aboalmakarem2022@gmail.com", "phone"=>"01020779243"}, {"name"=>"ahmed o abdelnaeem, Doctorate", "role"=>"CONTACT", "email"=>"ahmed.omar@pt.cu.edu.eg", "phone"=>"011407436820"}], "facility"=>"The faculty of physical therapy, Cairo university, and Gezira Youth Center", "geoPoint"=>{"lat"=>30.06263, "lon"=>31.24967}}], "centralContacts"=>[{"name"=>"Asmaa A ali radwan, Bachelors", "role"=>"CONTACT", "email"=>"asmaa.aboalmakarem2022@gmail.com", "phone"=>"01020779243"}, {"name"=>"Ahmed O Abdelnaeem, Doctorate", "role"=>"CONTACT", "email"=>"ahmed.omar@pt.cu.edu.eg", "phone"=>"01140736820"}], "overallOfficials"=>[{"name"=>"Mona M ibrahim, Doctorate", "role"=>"STUDY_CHAIR", "affiliation"=>"Cairo University"}, {"name"=>"Enas F youssef, Doctorate", "role"=>"STUDY_CHAIR", "affiliation"=>"Cairo University"}]}, "ipdSharingStatementModule"=>{"ipdSharing"=>"NO"}, "sponsorCollaboratorsModule"=>{"leadSponsor"=>{"name"=>"Cairo University", "class"=>"OTHER"}, "responsibleParty"=>{"type"=>"PRINCIPAL_INVESTIGATOR", "investigatorTitle"=>"Principal investigator", "investigatorFullName"=>"Asmaa Abou Almakarem Ali Radwan", "investigatorAffiliation"=>"Cairo University"}}}}
