{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:54:39Z","timestamp":1772258079105,"version":"3.50.1"},"reference-count":41,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:p>Major advances in our understanding of the mechanisms involved in chronic anal fissure have allowed the introduction of many new medical therapies for this condition. The literature about current treatment modalities licensed for anal fissure and those novel therapies still under evaluation has been reviewed. These new treatments are examined in the context of traditional surgical management of the disease and a future treatment algorithm suggested.<\/jats:p>","DOI":"10.1136\/jramc-148-03-02","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T23:44:55Z","timestamp":1363736695000},"page":"230-235","source":"Crossref","is-referenced-by-count":7,"title":["The Medical And Surgical Management Of Chronic Anal Fissure"],"prefix":"10.1136","volume":"148","author":[{"given":"JP","family":"Garner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"McFall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DP","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2002,9,1]]},"reference":[{"key":"ref_1","first-page":"428","article-title":"Fissure-in-ano","volume-title":"Surgery of the Anus Rectum and Colon","author":"Keighley, M.R.B.; Williams, N.S.","year":"1999","unstructured":"Keighley MRB, Williams NS. Fissure-in-ano. In: Keighley MRB, Williams NS, eds. Surgery of the Anus Rectum and Colon. London: WB Saunders 1999: 428-455."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1002\/bjs.1800640516","article-title":"Fissure-in-ano: the initial management and prognosis","volume":"64","author":"Lock, M.R.; Thompson, J.P.S.","year":"1977","unstructured":"Lock MR,Thompson JPS. Fissure-in-ano: the initial management and prognosis. Brit J Surg 1977; 64: 355-8.","journal-title":"Brit J Surg"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/BF00341218","article-title":"Conservative and surgical treatment in acute and chronic anal fissure: a study of 308 patients","volume":"7","author":"Frezza, E.E.; Sandie, F.; Leoni, G.; Biral, M.","year":"1992","unstructured":"Frezza EE, Sandie F, Leoni G, Biral M. Conservative and surgical treatment in acute and chronic anal fissure: a study of 308 patients. Int J Colorect Dis 1992; 7: 188-91.","journal-title":"Int J Colorect Dis"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1007\/BF02238017","article-title":"Alpha 1 adrenoreceptor blockade. Potential new treatment for anal fissures","volume":"43","author":"Pitt, J.; Craggs, M.M.; Henry, M.M.; Boulos, P.B.","year":"2000","unstructured":"Pitt J, Craggs MM, Henry MM, Boulos PB. Alpha 1 adrenoreceptor blockade. Potential new treatment for anal fissures. Dis Colon Rectum 2000; 43: 800-3.","journal-title":"Dis Colon Rectum"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1007\/BF02054409","article-title":"Relationship between pressure and anodermal bloodflow. The vascular pathogenesis of anal fissures","volume":"37","author":"Schouten, W.R.; Briel, J.W.; Auwerda, J.J.A.","year":"1994","unstructured":"Schouten WR, Briel JW, Auwerda JJA. Relationship between pressure and anodermal bloodflow. The vascular pathogenesis of anal fissures. Dis Colon Rectum 1994; 37: 664-9.","journal-title":"Dis Colon Rectum"},{"key":"ref_6","first-page":"6993","article-title":"Nerve mediated relaxation of the human internal anal sphincter: the role of nitric oxide","volume":"34","author":"O\u2019Kelly, V.; Brading, A.; Mortensen, N.","year":"1993","unstructured":"O\u2019Kelly V, Brading A, Mortensen N. Nerve mediated relaxation of the human internal anal sphincter: the role of nitric oxide. Gut 1993; 34: 6993.","journal-title":"Gut"},{"key":"ref_7","first-page":"30612","article-title":"Influence of autonomic nerves on internal anal sphincter in man","volume":"17","author":"Frekner, B.; Ihre, T.","year":"1976","unstructured":"Frekner B, Ihre T. Influence of autonomic nerves on internal anal sphincter in man. Gut 1976; 17: 30612.","journal-title":"Gut"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1002\/bjs.1800801041","article-title":"In vitro response of the human anal canal longitudinal muscle layer to cholinergic and adrenergic stimulation: evidence of sphincter specialization","volume":"80","author":"O\u2019Kelly, T.J.; Brading, A.; NJMcC, Mortensen","year":"1993","unstructured":"O\u2019Kelly TJ, Brading A, Mortensen NJMcC. In vitro response of the human anal canal longitudinal muscle layer to cholinergic and adrenergic stimulation: evidence of sphincter specialization. Brit J Surg 1993; 80: 1337-41.","journal-title":"Brit J Surg"},{"key":"ref_9","article-title":"Chemical sphincterotomy for anal fissure. Tripartite Meeting","author":"Kennedy, M.L.; Lubowski, D.Z.; King, D.W.","year":"1993","unstructured":"Kennedy ML, Lubowski DZ, King DW. Chemical sphincterotomy for anal fissure. Tripartite Meeting. Sydney, 1993."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1002\/bjs.1800830614","article-title":"Philips RK Topical glyceryl trinitrate in the treatment of chronic anal fissure","volume":"83","author":"Watson, S.J.; Kamm, M.A.; Nichols, R.J.","year":"1996","unstructured":"Watson SJ, Kamm MA, Nichols RJ, Philips RK Topical glyceryl trinitrate in the treatment of chronic anal fissure. Brit J Surg 1996; 83: 771-5.","journal-title":"Brit J Surg"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0140-6736(96)06090-4","article-title":"Randomised, prospective, double-blind placebo-controlled trial of glyceryl trinitrate ointment in the treatment of anal fissure","volume":"349","author":"Lund, J.N.; Scholfield, J.H.","year":"1997","unstructured":"Lund JN, Scholfield JH. Randomised, prospective, double-blind placebo-controlled trial of glyceryl trinitrate ointment in the treatment of anal fissure. Lancet 1997; 349: 11-4.","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1046\/j.1440-1622.2001.02182.x","article-title":"Effect of topical glyceryl trinitate on anodermal blood flow in patients with chronic anal fissures","volume":"71","author":"Kua, K.B.; Kocher, H.M.; Kelkar, A.; Patel, A.G.","year":"2001","unstructured":"Kua KB, Kocher HM, Kelkar A, Patel AG. Effect of topical glyceryl trinitate on anodermal blood flow in patients with chronic anal fissures. Aust N Zealand J Surg 2001; 71: 548-50.","journal-title":"Aust N Zealand J Surg"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1007\/BF02236691","article-title":"Glyceryl trinitrate ointment for the treatment of chronic anal fissure: results of a placebo controlled trial and long term follow-up","volume":"42","author":"Kennedy, M.L.; Sowter, S.; Nguyen, H.; Lubowski, D.Z.","year":"1999","unstructured":"Kennedy ML, Sowter S, Nguyen H, Lubowski DZ. Glyceryl trinitrate ointment for the treatment of chronic anal fissure: results of a placebo controlled trial and long term follow-up. Dis Colon Rectum 1999; 42: 1000-6.","journal-title":"Dis Colon Rectum"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/BF02236692","article-title":"Treatment of chronic anal fissure with topical glyceryl trinitrate","volume":"42","author":"Dorfman, G.; Levitt, M.; Platell, C.","year":"1999","unstructured":"Dorfman G, Levitt M, Platell C. Treatment of chronic anal fissure with topical glyceryl trinitrate. Dis Colon Rectum 1999; 42: 1007-10.","journal-title":"Dis Colon Rectum"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1007\/BF02236548","article-title":"Internal sphincterotomy is superior to topical nitroglycerin in the treatment of anal fissure: results of a randomized, controlled trial by the Canadian Colorectal Surgical Trials Group","volume":"43","author":"Richard, C.S.; Gregoire, R.; Plewes, E.A.","unstructured":"Richard CS, Gregoire R, Plewes EA et al. Internal sphincterotomy is superior to topical nitroglycerin in the treatment of anal fissure: results of a randomized, controlled trial by the Canadian Colorectal Surgical Trials Group. Dis Colon Rectum; 43: 1048-57.","journal-title":"Dis Colon Rectum"},{"key":"ref_16","first-page":"101","article-title":"Treatment of chronic anal fissure with topical gyceryl trinitrate: a double blind placebo controlled trial","volume":"20","author":"Chaudhuri, S.; Pal, A.K.; Acharya, A.","year":"2001","unstructured":"Chaudhuri S, Pal AK, Acharya A et al. Treatment of chronic anal fissure with topical gyceryl trinitrate: a double blind placebo controlled trial. Ind J Gastroenterol 2001; 20: 101-2.","journal-title":"Ind J Gastroenterol"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/BF02236977","article-title":"Glyceryl trinitate for chronic anal fissure \u2013 healing or headache? Results of a multi-centre, randomized, placebo-controlled, double-blind trial","volume":"43","author":"Altomare, D.F.; Rinaldi, M.; Milito, G.","year":"2000","unstructured":"Altomare DF, Rinaldi M, Milito G et al. Glyceryl trinitate for chronic anal fissure \u2013 healing or headache? Results of a multi-centre, randomized, placebo-controlled, double-blind trial. Dis Colon Rectum 2000; 43: 174-9.","journal-title":"Dis Colon Rectum"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1016\/S0022-3468(99)90318-4","article-title":"A prospective, randomized, double-blind, placebocontrolled trial of glyceryl trinitrate ointment in the treatment of children with anal fissure","volume":"34","author":"Tander, B.; Guven, A.; Demirbag, S.","year":"1999","unstructured":"Tander B, Guven A, Demirbag S et al. A prospective, randomized, double-blind, placebocontrolled trial of glyceryl trinitrate ointment in the treatment of children with anal fissure. J Paed Surg 1999; 34: 1810-2.","journal-title":"J Paed Surg"},{"key":"ref_19","first-page":"72730","article-title":"Randomised controlled trial shows that glyceryl trinitrate heals anal fissures, higher doses are not more effective and there is a high recurrence rate","volume":"44","author":"Carapeti, E.A.; Kamm, M.A.; McDonald, P.J.; Chadwick, S.J.; Melville, D.; Phillips, R.K.S.","year":"1999","unstructured":"Carapeti EA, Kamm MA, McDonald PJ, Chadwick SJ, Melville D, Phillips RKS. Randomised controlled trial shows that glyceryl trinitrate heals anal fissures, higher doses are not more effective and there is a high recurrence rate. Gut 1999; 44: 72730.","journal-title":"Gut"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1016\/S0140-6736(05)61453-5","article-title":"Follow-up of patients with chronic anal fissure treated with topical glyceryl trinitrate","volume":"352","author":"Lund, J.N.; Scholefield, J.H.","year":"1998","unstructured":"Lund JN, Scholefield JH. Follow-up of patients with chronic anal fissure treated with topical glyceryl trinitrate. Lancet 1998; 352: 1681.","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s003840000230","article-title":"A randomized trial of glyceryl trinitrate ointment and nitroglycerin patch in healing of anal fissures","volume":"15","author":"Zuberi, B.F.; Rajput, M.R.; Abro, H.; Shaikh, S.A.","year":"2000","unstructured":"Zuberi BF, Rajput MR, Abro H, Shaikh SA. A randomized trial of glyceryl trinitrate ointment and nitroglycerin patch in healing of anal fissures. Int J Colorectal Dis 2000; 15: 243-5.","journal-title":"Int J Colorectal Dis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"131820","DOI":"10.1007\/BF02050816","article-title":"Glyceryl trinitrate vs. sphincterotomy for treatment of chronic fissure-in-ano: a randomized controlled trial","volume":"40","author":"Oettle, G.J.","year":"1997","unstructured":"Oettle GJ. Glyceryl trinitrate vs. sphincterotomy for treatment of chronic fissure-in-ano: a randomized controlled trial. Dis Colon Rectum 1997; 40: 131820.","journal-title":"Dis Colon Rectum"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1136\/gut.45.5.719","article-title":"Topical diltiazem and bethanechol decrease anal sphincter pressure without side effects","volume":"45","author":"Carapeti, E.A.; Kamm, M.A.; Evans, B.K.; Phillips, R.K.","year":"1999","unstructured":"Carapeti EA, Kamm MA, Evans BK, Phillips RK. Topical diltiazem and bethanechol decrease anal sphincter pressure without side effects. Gut 1999; 45: 719-22.","journal-title":"Gut"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1007\/BF02236630","article-title":"Topical diltiazem and bethanechol decrease anal sphincter pressure and heal anal fissures without side effects","volume":"43","author":"Carapeti, E.A.; Kamm, M.A.; Phillips, R.K.S.","year":"2000","unstructured":"Carapeti EA, Kamm MA, Phillips RKS. Topical diltiazem and bethanechol decrease anal sphincter pressure and heal anal fissures without side effects. Dis Colon Rectum 2000; 43: 1359-62.","journal-title":"Dis Colon Rectum"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1046\/j.1365-2168.2001.01736.x","article-title":"Topical diltiazem ointment in the treatment of chronic anal fissure","volume":"88","author":"Knight, J.S.; Birks, M.; Farouk, R.","year":"2001","unstructured":"Knight JS, Birks M, Farouk R. Topical diltiazem ointment in the treatment of chronic anal fissure. Brit J Surg 2001; 88: 553-6.","journal-title":"Brit J Surg"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1007\/BF02234624","article-title":"A randomized trial of oral vs topical diltiazem for chronic anal fissure","volume":"44","author":"Jonas, M.; Neal, K.R.; Abercrombie, J.F.; Scolefield, J.H.","year":"2001","unstructured":"Jonas M, Neal KR, Abercrombie JF, Scolefield JH. A randomized trial of oral vs topical diltiazem for chronic anal fissure. Dis Colon Rectum 2001; 44: 1074-8.","journal-title":"Dis Colon Rectum"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1046\/j.1365-2168.1999.01292.x","article-title":"Oral nifedipine reduces resting anal pressure and heals chronic anal fissure","volume":"86","author":"Cook, T.A.; Smilgin Humphreys, M.M.; NJMcC, Mortensen","year":"1999","unstructured":"Cook TA, Smilgin Humphreys MM, Mortensen NJMcC. Oral nifedipine reduces resting anal pressure and heals chronic anal fissure. Brit J Surg 1999; 86: 1269-73.","journal-title":"Brit J Surg"},{"key":"ref_28","first-page":"714","article-title":"Treatment of anismus in intractable constipation with Botulinum A toxin","volume":"2","author":"Hallan, R.I.; Williams, N.S.; Melling, J.; Waldron, D.J.; Womack, N.R.; Morrison, J.F.","year":"1988","unstructured":"Hallan RI, Williams NS, Melling J, Waldron DJ, Womack NR, Morrison JF.Treatment of anismus in intractable constipation with Botulinum A toxin. Lancet 1988; 2: 714-6.","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1007\/BF02050639","article-title":"Use of botulinum toxin in anal fissure","volume":"36","author":"Jost, W.H.; Schrimrigk, K.","year":"1993","unstructured":"Jost WH, Schrimrigk K. Use of botulinum toxin in anal fissure. Dis Colon Rectum 1993; 36: 974.","journal-title":"Dis Colon Rectum"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1007\/BF02050924","article-title":"One hundred cases of anal fissure treated with botulinum toxin. Early and long-term results","volume":"40","author":"Jost, W.H.","year":"1997","unstructured":"Jost WH. One hundred cases of anal fissure treated with botulinum toxin. Early and long-term results. Dis Colon Rectum 1997; 40: 1029-32.","journal-title":"Dis Colon Rectum"},{"key":"ref_31","first-page":"163","article-title":"Therapeutic use of botulinum toxin in anal fissure","volume":"12","author":"Espi, A.; Melo, F.; Minguez, M.","year":"1997","unstructured":"Espi A, Melo F, Minguez M et al. Therapeutic use of botulinum toxin in anal fissure. Int J Colorect Dis 1997; 12: 163.","journal-title":"Int J Colorect Dis"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1056\/NEJM199801223380402","article-title":"A comparison of botulinum toxin and saline for the treatment of chronic anal fissure","volume":"338","author":"Maria, G.; Cassetta, E.; Gui, D.; Brisinda, G.; Bentivoglio, A.R.; Albanese, A.","year":"1998","unstructured":"Maria G, Cassetta E, Gui D, Brisinda G, Bentivoglio AR, Albanese A. A comparison of botulinum toxin and saline for the treatment of chronic anal fissure. N Eng J Med 1998; 338: 217-20.","journal-title":"N Eng J Med"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1056\/NEJM199907083410201","article-title":"A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure","volume":"341","author":"Brisinda, G.; Maria, G.; Bentivoglio, A.R.; Cassetta, E.; Gui, D.; Albanese, A.","year":"1999","unstructured":"Brisinda G, Maria G, Bentivoglio AR, Cassetta E, Gui D, Albanese A. A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure. N Eng J Med 1999; 341: 65-9.","journal-title":"N Eng J Med"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1136\/bmj.2.5405.342","article-title":"Stretching of anal sphincters in treatment of fissure-in -ano","volume":"2","author":"JMcK, Watts; RC, Bennett; JC, Goligher","year":"1964","unstructured":"Watts JMcK, Bennett RC, Goligher JC. Stretching of anal sphincters in treatment of fissure-in -ano. BMJ 1964; 2: 342-3.","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/BF02238595","article-title":"Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano: an endosonographic study","volume":"36","author":"Neilsen, M.B.; Rasmussen, O.O.; Pederson, J.F.; Christiansen, J.","year":"1993","unstructured":"Neilsen MB, Rasmussen OO, Pederson JF, Christiansen J. Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano: an endosonographic study. Dis Colon Rectum 1993; 36: 677-80.","journal-title":"Dis Colon Rectum"},{"key":"ref_36","first-page":"486","article-title":"The surgical correction of chronic internal anal (sphincteric) contracture","volume":"25","author":"Eisenhammer, S.","year":"1951","unstructured":"Eisenhammer S. The surgical correction of chronic internal anal (sphincteric) contracture. S Afr Med J 1951; 25: 486-9.","journal-title":"S Afr Med J"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/BF00341296","article-title":"Anal fissure: correlation between symptoms and manometry before and after surgery","volume":"7","author":"Melange, M.; Colin, J.F.; Wymersch, T.V.; Vanheurverzwyn, R.","year":"1992","unstructured":"Melange M, Colin JF, Wymersch TV, Vanheurverzwyn R. Anal fissure: correlation between symptoms and manometry before and after surgery. Int J Colorec Dis 1992; 7: 108-11.","journal-title":"Int J Colorec Dis"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/BF02553897","article-title":"Keyhole deformity: fact or fiction","volume":"8","author":"Mazier, W.P.","year":"1985","unstructured":"Mazier WP. Keyhole deformity: fact or fiction. Dis Colon Rectum 1985; 8: 8-11.","journal-title":"Dis Colon Rectum"},{"key":"ref_39","first-page":"37882","article-title":"Anal fissure. 20-year experience","volume":"38","author":"Oh, C.; Divino, C.M.; Steinhagen, R.M.","year":"1995","unstructured":"Oh C, Divino CM, Steinhagen RM. Anal fissure. 20-year experience. Dis Colon Rectum 1995; 38: 37882.","journal-title":"Dis Colon Rectum"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1007\/BF02054061","article-title":"Madoff RD. Open vs closed sphincterotomy for chronic anal fissure: long term results","volume":"39","author":"Garcia-Aguilar, J.; Belmonte, C.; Wong, W.D.; Lowry, A.C.","year":"1996","unstructured":"Garcia-Aguilar J, Belmonte C, Wong WD, Lowry AC, Madoff RD. Open vs closed sphincterotomy for chronic anal fissure: long term results. Dis Colon Rectum 1996; 39: 440-3.","journal-title":"Dis Colon Rectum"},{"key":"ref_41","first-page":"6971","article-title":"Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure","volume":"38","author":"Leong, A.F.P.K.; Seow-Choen, F.","year":"1995","unstructured":"Leong AFPK, Seow-Choen F. Lateral sphincterotomy compared with anal advancement flap for chronic anal fissure. Dis Colon Rectum 1995; 38: 6971.","journal-title":"Dis Colon Rectum"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-148-03-02","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T04:48:20Z","timestamp":1716180500000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-148-03-02"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,9]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2002,9,1]]},"published-print":{"date-parts":[[2002,9]]}},"alternative-id":["10.1136\/jramc-148-03-02"],"URL":"https:\/\/doi.org\/10.1136\/jramc-148-03-02","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,9]]}}}