{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T01:08:19Z","timestamp":1773364099438,"version":"3.50.1"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aging Clin Exp Res"],"published-print":{"date-parts":[[2020,6]]},"DOI":"10.1007\/s40520-019-01296-2","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T06:23:30Z","timestamp":1567232610000},"page":"1067-1076","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association between the trunk muscle function performance and the presence of vertebral fracture in older women with low bone mass"],"prefix":"10.1007","volume":"32","author":[{"given":"Luciana Mendes","family":"Cangussu-Oliveira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaqueline Mello","family":"Porto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato Campos","family":"Freire Junior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luana Let\u00edcia","family":"Capato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamilly Maciel","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Fernando Pereira da Silva","family":"Herrero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello Henrique","family":"Nogueira-Barbosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Jose Albuquerque","family":"de Paula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela Cristina Carvalho","family":"de Abreu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,8,30]]},"reference":[{"key":"1296_CR1","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1002\/9781118453926.ch37","volume-title":"Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism","author":"James F. Griffith","year":"2013","unstructured":"Griffith JF, Adams JE, Genant HK (2013) Diagnosis and classification of vertebral fracture. In: Rosen CJ (ed) Primer metabolic bone disease and disorders of mineral metabolism, 8th edn"},{"key":"1296_CR2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jocd.2015.08.004","volume":"19","author":"JT Schousboe","year":"2016","unstructured":"Schousboe JT (2016) Epidemiology of vertebral fractures. J Clin Densitom 19:8\u201322","journal-title":"J Clin Densitom"},{"key":"1296_CR3","doi-asserted-by":"publisher","first-page":"25S","DOI":"10.1097\/00007632-199712151-00005","volume":"22","author":"ER Myers","year":"1997","unstructured":"Myers ER, Wilson SE (1997) Biomechanics of osteoporosis and vertebral fracture. Spine 22:25S\u201331S","journal-title":"Spine"},{"key":"1296_CR4","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/1471-2318-13-71","volume":"13","author":"RM Daly","year":"2013","unstructured":"Daly RM, Rosengren BE, Alwis G et al (2013) Gender specific age-related changes in bone density, muscle strength and functional performance in the elderly: a-10\u00a0years prospective population-based study. BMC Geriat 13:71","journal-title":"BMC Geriat"},{"key":"1296_CR5","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s00198-013-2523-2","volume":"25","author":"LM Giangregorio","year":"2014","unstructured":"Giangregorio LM, Papaioannou A, Macintyre NJ et al (2014) Too fit to fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 25:821\u2013835","journal-title":"Osteoporos Int"},{"key":"1296_CR6","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1016\/j.pmrj.2012.10.008","volume":"4","author":"M Sinaki","year":"2012","unstructured":"Sinaki M (2012) Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention. PM&R 4:882\u2013888","journal-title":"PM&R"},{"key":"1296_CR7","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.pmr.2007.04.002","volume":"18","author":"M Sinaki","year":"2007","unstructured":"Sinaki M (2007) The role of physical activity in bone health: a new hypothesis to reduce risk of vertebral fracture. Phys Med Rehabil Clin N Am 18:593\u2013608","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"1296_CR8","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1016\/S8756-3282(02)00739-1","volume":"30","author":"M Sinaki","year":"2002","unstructured":"Sinaki M, Itoi E, Wahner HW et al (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10\u00a0years follow-up of postmenopausal women. Bone 30:836\u2013841","journal-title":"Bone"},{"key":"1296_CR9","volume-title":"Neuro-behavioral determinants of interlimb coordination: a multidisciplinary approach","author":"SP Swinnen","year":"2012","unstructured":"Swinnen SP, Duysens J (2012) Neuro-behavioral determinants of interlimb coordination: a multidisciplinary approach. Springer, Berlin"},{"key":"1296_CR10","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1016\/j.jelekin.2014.07.006","volume":"24","author":"G Guilhem","year":"2014","unstructured":"Guilhem G, Giroux C, Couturier A et al (2014) Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry. J Electromyogr Kinesiol 24:986\u2013993","journal-title":"J Electromyogr Kinesiol"},{"key":"1296_CR11","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jneumeth.2006.03.008","volume":"156","author":"M Mockova","year":"2006","unstructured":"Mockova M, Greenwood RJ, Day BL (2006) A method for quantifying directional strength and motor control of the trunk. J Neurosci Methods 156:211\u2013217","journal-title":"J Neurosci Methods"},{"key":"1296_CR12","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3233\/IES-150589","volume":"23","author":"JM Porto","year":"2015","unstructured":"Porto JM, Marques NR, Freire J\u00fanior RC et al (2015) The effect of foot support on trunk strength assessment using isokinetic dynamometry. Isok Exerc Sci 23:283\u2013289","journal-title":"Isok Exerc Sci"},{"key":"1296_CR13","doi-asserted-by":"publisher","first-page":"2781","DOI":"10.1007\/s00198-017-4151-8","volume":"28","author":"HP Hirschfeld","year":"2017","unstructured":"Hirschfeld HP, Kinsella R, Duque G (2017) Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int 28:2781\u20132790","journal-title":"Osteoporos Int"},{"key":"1296_CR14","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.rbo.2013.05.010","volume":"49","author":"RN Granito","year":"2014","unstructured":"Granito RN, Aveiro MC, Renn\u00f3 ACM et al (2014) Degree of thoracic kyphosis and peak torque of trunk flexors and extensors among healthy women. Rev Bras Ortop (Engl Ed) 49:286\u2013291","journal-title":"Rev Bras Ortop (Engl Ed)"},{"key":"1296_CR15","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1249\/mss.0b013e31814fb402","volume":"39","author":"P Aagaard","year":"2007","unstructured":"Aagaard P, Magnusson PS, Larsson B et al (2007) Mechanical muscle function, morphology, and fiber type in lifelong trained elderly. Med Sci Sports Exerc 39:1989\u20131996","journal-title":"Med Sci Sports Exerc"},{"key":"1296_CR16","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1249\/mss.0b013e31802d3ad3","volume":"39","author":"BL Tracy","year":"2007","unstructured":"Tracy BL, Dinenno DV, Jorgensen B et al (2007) Aging, visuomotor correction, and force fluctuations in large muscles. Med Sci Sport Exerc 39:469\u2013479","journal-title":"Med Sci Sport Exerc"},{"key":"1296_CR17","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s11914-016-0305-4","volume":"14","author":"H Mokhtarzadeh","year":"2016","unstructured":"Mokhtarzadeh H, Anderson DE (2016) The role of trunk musculature in osteoporotic vertebral fractures: implications for prediction, prevention, and management. Curr Osteoporos Rep Imaging 14:67\u201376","journal-title":"Curr Osteoporos Rep Imaging"},{"key":"1296_CR18","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.exger.2019.01.008","volume":"118","author":"S Balogun","year":"2019","unstructured":"Balogun S, Winzenberg T, Wills K et al (2019) Prospective associations of low muscle mass and strength with health-related quality of life over 10-year in community-dwelling older adults. Exp Gerontol 118:65\u201371","journal-title":"Exp Gerontol"},{"key":"1296_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1743-0003-12-3","volume":"12","author":"T Kienbacher","year":"2015","unstructured":"Kienbacher T, Paul B, Habenicht R et al (2015) Age and gender related neuromuscular changes in trunk flexion\u2013extension. J Neuroeng Rehab 12:1\u201310","journal-title":"J Neuroeng Rehab"},{"key":"1296_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/S0004-282X1994000100001","volume":"52","author":"PH Bertolucci","year":"1994","unstructured":"Bertolucci PH, Brucki SM, Campacci SR et al (1994) The mini-mental state examination in a general population: impact of educational status. Arq Neuropsiquiatr 52:1\u20137","journal-title":"Arq Neuropsiquiatr"},{"key":"1296_CR21","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1079\/PHN2005898","volume":"9","author":"M Hagstr\u00f6mer","year":"2006","unstructured":"Hagstr\u00f6mer M, Oja P, Sj\u00f6str\u00f6m M (2006) The international physical activity questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr 9:755\u2013762","journal-title":"Public Health Nutr"},{"key":"1296_CR22","doi-asserted-by":"publisher","first-page":"2486","DOI":"10.1001\/jama.285.19.2486","volume":"285","author":"Expert Panel on Detection E","year":"2001","unstructured":"Expert Panel on Detection E (2001) Treatment of high blood cholesterol in A. Executive summary of the third report of the national cholesterol education program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285:2486\u20132497","journal-title":"JAMA"},{"key":"1296_CR23","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1002\/jbmr.5650080915","volume":"8","author":"HK Genant","year":"1993","unstructured":"Genant HK, Wu CY, vanKuijk C et al (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137\u20131148","journal-title":"J Bone Miner Res"},{"key":"1296_CR24","doi-asserted-by":"publisher","first-page":"330","DOI":"10.7326\/0003-4819-147-5-200709040-00008","volume":"147","author":"DM Kado","year":"2007","unstructured":"Kado DM, Prenovost K, Crandall C (2007) Narrative review: hyperkyphosis in older persons. Ann Intern Med 147:330\u2013338","journal-title":"Ann Intern Med"},{"key":"1296_CR25","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1093\/gerona\/glu010","volume":"69","author":"SA Studenski","year":"2014","unstructured":"Studenski SA, Peters KW, Alley DE et al (2014) The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol Ser A Biomed Sci Med Sci 69:547\u2013558","journal-title":"J Gerontol Ser A Biomed Sci Med Sci"},{"key":"1296_CR26","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1007\/s001980070029","volume":"11","author":"KM Shipp","year":"2000","unstructured":"Shipp KM, Purse JL, Gold DT et al (2000) Timed loaded standing: a measure of combined trunk and arm endurance suitable for people with vertebral osteoporosis. Osteoporos Int 11:914\u2013922","journal-title":"Osteoporos Int"},{"key":"1296_CR27","first-page":"1","volume":"31","author":"JM Porto","year":"2018","unstructured":"Porto JM, J\u00fanior RCF, Bocarde L et al (2018) Contribution of hip abductor\u2013adductor muscles on static and dynamic balance of community-dwelling older adults. Aging Clin Exp Res 31:1\u20137","journal-title":"Aging Clin Exp Res"},{"key":"1296_CR28","doi-asserted-by":"publisher","first-page":"2480","DOI":"10.1097\/00007632-199312000-00018","volume":"18","author":"JC Tan","year":"1993","unstructured":"Tan JC, Parnianpour M, Nordin M et al (1993) Isometric maximal and submaximal trunk extension at different flexed positions in standing: triaxial torque output and EMG. Spine 18:2480\u20132490","journal-title":"Spine"},{"key":"1296_CR29","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s00198-007-0510-1","volume":"19","author":"SS Freitas","year":"2008","unstructured":"Freitas SS, Barrett-Connor E, Ensrud KE, Osteoporotic Fractures in Men (MrOS) Research Group et al (2008) Rate and circumstances of clinical vertebral fractures in older men. Osteoporos Int 19:615\u2013623","journal-title":"Osteoporos Int"},{"key":"1296_CR30","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1097\/00002060-199609000-00013","volume":"75","author":"M Sinaki","year":"1996","unstructured":"Sinaki M, Itoi E, Rogers JW et al (1996) Correlation of back extensor strength with thoracic kyphosis and lumbar lordosis in estrogen-deficient women1. Am J Phys Med Rehabil 75:370\u2013374","journal-title":"Am J Phys Med Rehabil"},{"key":"1296_CR31","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1159\/000311935","volume":"56","author":"I Grunte","year":"2010","unstructured":"Grunte I, Hunter GR, McCurry BD et al (2010) Age and gender differences in hip extension and flexion torque steadiness. Gerontology 56:533\u2013541","journal-title":"Gerontology"},{"key":"1296_CR32","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s13293-017-0133-y","volume":"8","author":"RE Deering","year":"2017","unstructured":"Deering RE, Senefeld JW, Pashibin T et al (2017) Muscle function and fatigability of trunk flexors in males and females. Biol Sex Differ 8:12","journal-title":"Biol Sex Differ"},{"key":"1296_CR33","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1080\/00222891003612789","volume":"42","author":"R Mehta","year":"2010","unstructured":"Mehta R, Cannella M, Smith SS et al (2010) Altered trunk motor planning in patients with nonspecific low back pain. J Mot Behav 42:135\u2013144","journal-title":"J Mot Behav"},{"key":"1296_CR34","doi-asserted-by":"publisher","first-page":"170","DOI":"10.7150\/ijms.1.170","volume":"1","author":"AM Briggs","year":"2004","unstructured":"Briggs AM, Greig AM, Wark JD et al (2004) A review of anatomical and mechanical factors affecting vertebral body integrity. Int J Med Sci 1:170\u2013180","journal-title":"Int J Med Sci"},{"key":"1296_CR35","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1007\/s00586-006-0276-8","volume":"16","author":"AM Briggs","year":"2007","unstructured":"Briggs AM, Greig AM, Bennell KL et al (2007) Paraspinal muscle control in people with osteoporotic vertebral fracture. Eur Spine J 16:1137\u20131144","journal-title":"Eur Spine J"},{"key":"1296_CR36","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/S1013-7025(08)70002-2","volume":"25","author":"BO Adegoke","year":"2007","unstructured":"Adegoke BO, Babatunde FO (2007) Effect of an exercise protocol on the endurance of trunk extensor muscles\u2014a randomized control trial. Hong Kong Physiother J 25:2\u20139","journal-title":"Hong Kong Physiother J"},{"key":"1296_CR37","doi-asserted-by":"publisher","first-page":"165","DOI":"10.2519\/jospt.1980.1.3.165","volume":"1","author":"GL Smidt","year":"1980","unstructured":"Smidt GL, Amundsen LR, Dostal WF (1980) Muscle strength at the trunk. J Orthop Sports Phys Ther 1:165\u2013170","journal-title":"J Orthop Sports Phys Ther"},{"key":"1296_CR38","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1682\/JRRD.2014.03.0086","volume":"52","author":"JB Eyskens","year":"2015","unstructured":"Eyskens JB, Nijs J, D\u2019Ao\u00fbt K et al (2015) Timed loaded standing in female chronic fatigue syndrome compared with other populations. J Rehabil Res Dev 52:21\u201329","journal-title":"J Rehabil Res Dev"},{"key":"1296_CR39","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1007\/s00198-017-4358-8","volume":"29","author":"M Newman","year":"2018","unstructured":"Newman M, Newman R, Hughes T et al (2018) Is the timed loaded standing test a valid measure of back muscle endurance in people with vertebral osteoporosis? Osteoporos Int 29:893\u2013905","journal-title":"Osteoporos Int"},{"key":"1296_CR40","doi-asserted-by":"publisher","first-page":"2831","DOI":"10.1007\/s00198-017-4109-x","volume":"28","author":"WB Katzman","year":"2017","unstructured":"Katzman WB, Vittinghoff E, Lin F et al (2017) Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial. Osteoporos Int 28:2831\u20132841","journal-title":"Osteoporos Int"},{"key":"1296_CR41","unstructured":"Ziebart C (2016) The association between fractures, posture and physical performance measures in women over the age of 6.5. Master\u2019s thesis, University of Waterloo"},{"key":"1296_CR42","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1007\/s00774-013-0443-z","volume":"31","author":"N Miyakoshi","year":"2013","unstructured":"Miyakoshi N, Hongo M, Mizutani Y et al (2013) Prevalence of sarcopenia in Japanese women with osteopenia and osteoporosis. J Bone Min Metab 31:556\u2013561","journal-title":"J Bone Min Metab"},{"key":"1296_CR43","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s00198-005-1900-x","volume":"17","author":"MC Walsh","year":"2006","unstructured":"Walsh MC, Hunter GR, Livingstone MB (2006) Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density. Osteoporos Int 17:61\u201367","journal-title":"Osteoporos Int"},{"key":"1296_CR44","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.bone.2015.02.010","volume":"80","author":"M Brotto","year":"2015","unstructured":"Brotto M, Bonewald L (2015) Bone and muscle: interactions beyond mechanical. Bone 80:109\u2013114","journal-title":"Bone"},{"key":"1296_CR45","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.archger.2019.03.005","volume":"82","author":"JM Porto","year":"2019","unstructured":"Porto JM, Nakaishi APM, Cangussu-Oliveira LM et al (2019) Relationship between grip strength and global muscle strength in community-dwelling older people. Arch Gerontol Geriatr 82:273\u2013278","journal-title":"Arch Gerontol Geriatr"}],"container-title":["Aging Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-019-01296-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s40520-019-01296-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-019-01296-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T23:20:56Z","timestamp":1598656856000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s40520-019-01296-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,30]]},"references-count":45,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["1296"],"URL":"https:\/\/doi.org\/10.1007\/s40520-019-01296-2","relation":{},"ISSN":["1720-8319"],"issn-type":[{"value":"1720-8319","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,30]]},"assertion":[{"value":"17 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 August 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"On behalf of all authors, the corresponding author states that there is no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"The study was approved by the Ethics Committee for Research Involving Human Beings of the Clinics Hospital of the Ribeirao Preto Medical School, University of Sao Paulo, Brazil, Under No. 72799917.7.0000.5440.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of human and animal rights"}},{"value":"All participants signed an informed consent form approved by the local ethics committee.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}