SSM - Health Systems最新文献

{"title":"Opportunities for authentic co-production in integrated care implementation","authors":"Marisa Sklar ,&nbsp;Anna Brubaker ,&nbsp;Lilliana Conradi ,&nbsp;Euan Sadler ,&nbsp;Nicole A. Stadnick","doi":"10.1016/j.ssmhs.2025.100074","DOIUrl":"10.1016/j.ssmhs.2025.100074","url":null,"abstract":"<div><div>This Short Communication proposes opportunities for authentic co-production in integrated care implementation. While there are targeted efforts to implement integrated care across healthcare systems, the extent to which these efforts have prioritized co-production is unknown. Opportunities for authentic integrated care implementation co-production are anchored to five core principles for implementation collaborations: 1) equity in relationship building, (2) reflexivity, (3) reciprocity and mutuality, (4) transformative and personalized, and (5) collaborative relationship structures or procedures.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contexts enabling effective codesign by people with lived experience of the mental healthcare system in the Canterbury and West Coast regions of New Zealand","authors":"Jillian Frater ,&nbsp;Denise Blake ,&nbsp;Annabel Ahuriri-Driscoll ,&nbsp;Martin Burke ,&nbsp;Finn Barclay ,&nbsp;Waiatamai Tamehana ,&nbsp;Annie Southern ,&nbsp;Karaitiana Tickell ,&nbsp;Kaaren Mathias","doi":"10.1016/j.ssmhs.2025.100073","DOIUrl":"10.1016/j.ssmhs.2025.100073","url":null,"abstract":"<div><div>The inclusion of people with lived experience of mental healthcare, their families and communities in the design, delivery and evaluation of mental and physical healthcare is necessary to improve healthcare in Aotearoa New Zealand. This study investigates the material, symbolic, relational, and wider social contexts that enable People with Lived Experience (PWLE) to participate in codesign of mental healthcare in the Canterbury and West Coast regions. We interviewed twenty-nine people working or engaged in organisations across the health system in both regions as part of this study and analysed the results using reflexive thematic analysis, using both Māori and non-Māori foci. We found the degree of participation by PWLE in the codesign of mental healthcare varied and codesign occurred to a greater extent in community organisations and in Māori organisations compared to other parts of the health system. Participants identified material, physical, symbolic and wider social factors that contributed to codesign and areas where improvements could be made. These factors related to remuneration of workers, the need to reduce stigma associated with PWLE, a need for the balance of power within the health system to change and increased inclusion of PWLE in the evaluation of services. These findings have implications across the health system in regard to the material, physical, symbolic and wider social contexts.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and newborn health prioritization in post-transition Somalia: Analysis of key stakeholder perspectives at the federal level","authors":"Mamothena Mothupi ,&nbsp;Maryan Abdulkadir Ahmed ,&nbsp;Asia Mohamed Mohamud ,&nbsp;Abdirisak Dalmar ,&nbsp;Mohamed A.O. Jimale ,&nbsp;Hawa Abdullahi ,&nbsp;Paul Spiegel ,&nbsp;Naoko Kozuki","doi":"10.1016/j.ssmhs.2025.100072","DOIUrl":"10.1016/j.ssmhs.2025.100072","url":null,"abstract":"<div><div>This case study explored the current drivers of Maternal and Newborn Health (MNH) prioritization in Somalia, a fragile country with very high maternal and neonatal mortality rates. To enhance MNH prioritization and improve outcomes, we need to understand macro contextual and health system factors that influence the level of attention and investment since 2012 with the establishment of the federal government of Somalia. This study consisted of a desk review and 20 semi-structured interviews with stakeholders in MNH policy and implementation, including government, donors, private sector, and non-governmental and multilateral organizations. The Health Policy Analysis triangle guided the analysis of findings, to capture policy content, context, actors, and processes. Our findings show a complex picture for MNH prioritization in Somalia. There is a level of priority for MNH through technical advancements driven by international partners, including development of policies, strategies, and guidelines. However, there is inadequate government ownership of the MNH agenda through poor domestic financial investment and capacity for governance (including partner coordination) in the health sector. The study found gaps in implementation of programs, and competing priorities due to insecurity and other health and social needs. Respondents highlighted a need to address fragmented accountability and oversight processes, and ensure meaningful inclusion of actors such as the private sector and the diaspora and women leaders.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to health services utilization among households with free community-based health insurance enrolment in Ethiopia: A qualitative study","authors":"Doris Osei Afriyie ,&nbsp;Kaku Attah Damoah ,&nbsp;Essa Chanie Mussa ,&nbsp;Frank Otchere ,&nbsp;Nyasha Tirivayi","doi":"10.1016/j.ssmhs.2025.100066","DOIUrl":"10.1016/j.ssmhs.2025.100066","url":null,"abstract":"<div><h3>Background</h3><div>To build an integrated social protection programme, Ethiopia introduced a pilot initiative that facilitated community-based health insurance (CBHI) premium exemptions for permanent direct support (PDS) beneficiaries. This study sought to explore the factors that influence access and utilization of health services among PDS beneficiaries following free CBHI enrolment.</div></div><div><h3>Methods</h3><div>We conducted an exploratory qualitative inquiry using semi-structured interviews with 22 key informants and 22 PDS beneficiaries (focus group discussions and in-depth interviews) in two sub-cities of Addis Ababa where a pilot intervention was implemented. Thematic analysis was used to analyse the data.</div></div><div><h3>Results</h3><div>CBHI has facilitated timely access to healthcare services by reducing financial barriers for PDS beneficiaries. However, challenges related to the quality of health services, such as the shortages of commodities and attitudes of health professionals, have hindered optimal use. These challenges often lead to some beneficiaries returning to traditional sources or foregoing formal healthcare services altogether, as their cash transfers are insufficient for the ancilliary out-of-pocket health payments. Inadequate social support, lack of education about health services and insurance use are also key factors that have affected service uptake. A person-centred approach involving greater engagement with social workers could provide awareness and support for beneficiaries to maximize health services utilization.</div></div><div><h3>Conclusion</h3><div>After free enrolment in health insurance, it is crucial to address barriers to accessing healthcare services that are faced by vulnerable populations. There is a need for strengthening social services and primary health care systems and ensuring that health professionals are competent in caring for indigents.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"You are just like them: The paradoxical position of Nairobi's community health promoters, a photovoice study","authors":"Inviolata Njoroge ,&nbsp;Neele Wiltgen Georgi ,&nbsp;Linet Okoth ,&nbsp;Robinson Karuga ,&nbsp;Sally Theobald ,&nbsp;Laura Dean ,&nbsp;Lilian Otiso ,&nbsp;Rosie Steege","doi":"10.1016/j.ssmhs.2025.100068","DOIUrl":"10.1016/j.ssmhs.2025.100068","url":null,"abstract":"<div><div>Kenya's community health promoters (CHPs) are essential in expanding healthcare access for vulnerable and marginalised populations, particularly in informal settlements. Embedded within these communities, CHPs facilitate culturally sensitive care, improve service access, and contribute to the efficiency of the local health system. Despite global literature on community health workforces, the specific roles CHPs play in informal settlements remain neglected and underexplored. Understanding their realities is vital for creating supportive health policies that address urban transitions and enable CHPs to fulfil their roles.</div><div>This study uses photovoice with six CHPs in Nairobi's Viwandani settlement to document their experiences of marginalisation. Through co-analysis, we mapped the results using White's wellbeing dimensions, creating a framework for CHPs' lived realities in urban informality. Material challenges impacting CHP and community wellbeing include limited housing, water, sanitation, and employment. Social dimensions reveal complex dynamics between CHPs, community members, and government stakeholders, affecting CHPs' impact and community perceptions. Human dimensions reflect CHPs' aspirations, self-perception, and personal struggles, while subjective experiences intersect across all domains.</div><div>We highlight practically and theoretically that CHPs occupy a paradoxical role as healthcare providers within an environment and health system that fails to meet their needs and those of their communities. Our framework provides a unique contribution to knowledge that can support health systems decision-makers in thinking differently about the role of CHPs and the support needed for transforming urban health systems. CHPs' vulnerabilities should be recognised and addressed as they are crucial to creating a just and sustainable urban health system.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shattered assumptions: Unravelling of the social contract between the medical profession and society in India","authors":"Sayak Dutta ,&nbsp;Mayuri Samant ,&nbsp;Sanjana Santosh ,&nbsp;Michael Calnan ,&nbsp;Sumit Kane","doi":"10.1016/j.ssmhs.2025.100070","DOIUrl":"10.1016/j.ssmhs.2025.100070","url":null,"abstract":"<div><div>Incidents of violence against doctors are increasing across the world. Beyond concerns of physical security, this raises questions about the state of the social contract between medicine and society. We analyse the situation in India as a case using the ‘assumptive worlds’ framework to understand how doctors are coping with the situation and situating themselves within a rapidly changing health system and society. Interviews were conducted with forty-two purposively selected medical and non-medical (patients, journalists, lawyers, police) participants over eighteen months. We found that professional autonomy, respect for doctors, and trust in doctors and their altruism – key aspects of doctors’ assumptive worlds – are constantly challenged by assertive patients, an antagonistic society, and an apathetic administrative and regulatory system. The rise in violent attacks is creating a deep sense of being unfairly targeted and unjustly treated. To reconcile themselves with these developments, doctors in India are having to, often with anguish, reimagine their assumptive worlds and reshape their identities. Doctors are, however, unwittingly adopting a siege mentality. We conclude that the Indian medical profession’s response to these societal developments needs to instead be critical, and self-reflective, and that change must begin from within the medical profession.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking adolescent and youth health - Insights from adolescent youth-friendly services in Migori County, Kenya: A cross-sectional mixed-methods study","authors":"Lillian Njoki Nyaga ,&nbsp;Eunice Muthoni Mwangi","doi":"10.1016/j.ssmhs.2025.100067","DOIUrl":"10.1016/j.ssmhs.2025.100067","url":null,"abstract":"<div><h3>Background</h3><div>The provision of adolescent and youth-friendly services (AYFS) can be facilitated by various strategies, including capacity building of health care providers (HCPs), coordination of AYFS, community engagement, and networking of AYFS stakeholders. Adolescents and youth face various health challenges including but not limited to adolescent pregnancies, HIV infections, sexual and gender based violence, strategies that would help curb these challenges is paramount. Although various studies have evaluated AYFS utilization and integration in Kenya, scant data exist on strategies facilitating or hindering the provision of the AYFS in accordance with the Kenya 2016 AYFS guidelines. The aim of this study was to document the implementation of AYFS strategies and how they affect the provision of AYFS in Migori County, Kenya.</div></div><div><h3>Methods</h3><div>This cross-sectional study targeted 159 public health facilities and 455 HCPs in Migori County. The study utilized Taro Yamane’s formula to determine a sample size of 114 health facilities with a target population of 455HCPs, from which a sample of 213 HCPs was drawn. The data were collected from the 210 providers using a structured questionnaire, whereas the qualitative data were collected from three health facility-in-charges using a key informant interview guide. Statistical significance was set at p &lt; 0.05 for quantitative data.</div></div><div><h3>Results</h3><div>Bivariate analysis reported positive and significant associations between capacity building, coordination of actors and activities, stakeholder networking, and community engagement and the provision of the AYFS, with p = 0.001, r = .548; p = 0.001, r = .482; p = 0.001, r = .390; and p = 0.001, r = .460, respectively. There was a 10.092-fold ( CI 4.007–25.417) increase in the odds of providing AYFS among workers who were trained on the AYFS compared with those who were not trained; a 2.987-fold (CI 1.124–7.937) increase in the odds of providing an AYFS when the coordination of AYFS actors and activities was performed compared with that where coordination was not performed; and a 4.979-fold ( CI 1.844–13.441) increase in the odds of providing AYFS when there was community involvement compared with that where there was no community involvement. The networking of stakeholders (<em>p = 0.135) was</em> not found to be significant in the provision of the AYFS.</div></div><div><h3>Conclusion</h3><div>Policy interventions should prioritize healthcare worker training initiatives, foster effective coordination mechanisms, and promote community involvement. These strategies demonstrate substantial increases in AYFS provision, emphasizing the need for sustained investment and commitment. Prioritizing these factors can catalyze transformative policy actions toward youth-centric healthcare services.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using fuzzy set qualitative comparative analysis to identify conditions for good performance in the decentralized health system of Tanzania","authors":"M. Baroudi ,&nbsp;S. Maluka ,&nbsp;P. Kamuzora ,&nbsp;M. San Sebastián ,&nbsp;A.N. Kapologwe ,&nbsp;A.K. Hurtig","doi":"10.1016/j.ssmhs.2025.100065","DOIUrl":"10.1016/j.ssmhs.2025.100065","url":null,"abstract":"<div><h3>Background</h3><div>Decentralization has been a prominent strategy to enhance health systems’ efficiency, service quality, autonomy and accountability in low- and middle-income countries (LMICs) like Tanzania since the 1990s. Previous studies have mainly focused on assessing how much power for decision-making on different health system functional areas is granted to local-level authorities from the central government and the interconnections between decision space, organizational capacity, and accountability mechanisms. Empirical evidence on its impact on performance remains limited. This study investigates conditions for good performance in a decentralised health system of Tanzania.</div></div><div><h3>Methods</h3><div>We used fuzzy set qualitative comparative analysis to analyse the necessary and sufficient conditions for good health system performance. Eighteen purposively districts were chosen to capture variations in performance and geography in a multiple case study approach.</div></div><div><h3>Results</h3><div>Functional Health Facility Governing Committees (HFGCs) emerged as a necessary condition for good performance. To achieve good performance, however, there is a need for functional decision space among managers or high accountability among managers or high capacity of staff/ okay level of staffing.</div></div><div><h3>Conclusion</h3><div>The study underscores the importance of the interplay between decision space, organizational capacity, and accountability in improving health system performance. While decentralization aims to provide greater autonomy, effective implementation depends on the development of local capacities and oversight through accountability. Decentralization alone is not sufficient to enhance healthcare delivery; HFGCs and their local context that promote (social) accountability are essential. Further research is warranted to identify interventions supporting HFGCs in fulfilling their mandates and enhancing health service delivery.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of environmental health services on patient well-being and quality of care: A qualitative study in Malawi’s public healthcare facilities","authors":"Tara Fitzpatrick ,&nbsp;Lucy K. Tantum ,&nbsp;Jennifer Mmodzi Tseka ,&nbsp;Innocent Mofolo ,&nbsp;Holystone Kafanikhale ,&nbsp;Irving Hoffman ,&nbsp;Ryan Cronk ,&nbsp;Darcy M. Anderson","doi":"10.1016/j.ssmhs.2025.100064","DOIUrl":"10.1016/j.ssmhs.2025.100064","url":null,"abstract":"<div><div>Healthcare facility environmental conditions – including water, sanitation, hygiene, waste management, cleaning, energy, and building design – contribute to safe and quality care delivery. However, how environmental conditions shape patient experiences have not been systematically assessed. We conducted a case study to examine the impacts of environmental conditions on patient well-being and quality of care through interviews with 56 patients and caregivers from all service delivery levels and geographic areas in public healthcare facilities in Malawi. We analyzed interview data to identify impacts of environmental conditions on multiple dimensions of well-being (physical, mental, social, and economic well-being) and quality of care (patient-centeredness, equity, safety, efficiency, and timeliness). Many participants reported poor environmental conditions and extensive impacts on well-being. Patients felt stress, fear of infection, and dissatisfaction with inadequate water, sanitation, and hygiene services. To cope with poor conditions, patients and family caregivers cleaned areas, fetched water, or spent money on supplies, leading to economic impacts. Facility conditions influenced perceptions of dignified and respectful care. Inadequate or overcrowded conditions led to negative encounters with other patients and healthcare workers. Patients felt more satisfied and respected when they observed healthcare workers performing hand hygiene or maintaining the facility. Findings demonstrate that environmental conditions influence numerous aspects of patient experience and well-being. The development of quantitative measures for well-being and quality of care would allow programs to routinely monitor these impacts and detect changes over time. Patient perspectives and priorities should be considered in future efforts to evaluate and improve environmental conditions in healthcare facilities.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a common understanding of gender-responsive monitoring and evaluation for health programs and interventions: Evidence from a scoping review","authors":"Anna Kalbarczyk ,&nbsp;Daniel Krugman ,&nbsp;Shatha Elnakib ,&nbsp;Elizabeth Hazel ,&nbsp;Amy Luo ,&nbsp;Anju Malhotra ,&nbsp;Rosemary Morgan","doi":"10.1016/j.ssmhs.2025.100059","DOIUrl":"10.1016/j.ssmhs.2025.100059","url":null,"abstract":"<div><div>Given the many approaches to and definitions of gender responsive monitoring and evaluation (M&amp;E) for health programs and interventions there is a lack of clarity on how to operationalize it including what to measure and how to measure it. We conducted a scoping review to understand what makes M&amp;E gender responsive. We included 31 studies and conducted two rounds of extraction to delineate ways in which gender was integrated into M&amp;E. Twelve articles described the use of theory to guide M&amp;E though most were not related to gender. Twelve articles employed a gender score in data collection, most of which measured Likert scale responses related to gender equity. Even though most studies did not use a specific gender framework, most incorporated gender domains in their analysis. Seven studies used participatory methods in the design and implementation of M&amp;E. Most studies conducted M&amp;E on programs or interventions that were designed to be gender intentional and related to gender issues. Gender responsive M&amp;E intentionally integrates gender into the M&amp;E process, regardless of how gender-intentional the program or intervention is. Gender dimensions can be identified through gender theories, models, scores, and frameworks to inform tool development, data collection, analysis, and stakeholder engagement processes.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100059"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}