Journal of the International Association of Providers of AIDS Care最新文献

{"title":"Uncompromising Scientific Integrity.","authors":"José M Zuniga, Chris Duncombe","doi":"10.1177/23259582251333581","DOIUrl":"https://doi.org/10.1177/23259582251333581","url":null,"abstract":"","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251333581"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001439","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":"HIV Preexposure Prophylaxis Service Delivery Models for Emergency Departments: A Qualitative Study.","authors":"Ethan Cowan, Susie Hoffman, Laurie J Bauman, Yvette Calderon, Tatiana Gonzalez-Argoti, Christine T Rael, Jonathan Porter, Joanne E Mantell","doi":"10.1177/23259582251342842","DOIUrl":"10.1177/23259582251342842","url":null,"abstract":"<p><p>BackgroundOral preexposure prophylaxis (PrEP) effectively prevents HIV but is underutilized in the United States, particularly among populations with higher incidence of HIV. Emergency departments (EDs), which often care for medically underserved individuals, could play a key role in expanding PrEP access. However, integrating PrEP into ED workflows presents challenges.MethodsThis qualitative study involved interviews with 22 stakeholders from 15 EDs and 4 sexual health clinics across the United States. Participants included ED leaders, providers, and navigators. The data were analyzed using a PrEP care cascade model, focusing on provider buy-in, patient identification, education, PrEP initiation, and linkage to care.ResultsKey barriers included limited provider knowledge, ED priorities focused on acute care, and the reliance on grant funding without long-term plans for sustainability. Successful programs relied on ED champions to advocate for PrEP and improve staff engagement. Some EDs offered same-day PrEP prescriptions or starter packs, which improved uptake, but most relied on referrals and had low follow-up rates. Patient identification strategies, such as using navigators or risk scores, varied across sites. Education was often led by ancillary staff, as ED providers had limited time and training. Sustainability remained a major challenge, as most programs were dependent on short-term funding.ConclusionsTo expand PrEP access in EDs, it is essential to address systemic barriers, improve provider training and establish sustainable funding models. Streamlined workflows, dedicated staff, and targeted interventions can help EDs play a more active role in HIV prevention.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251342842"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150915","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":"A Longitudinal Investigation of Chemsex and Its Relationship with Depressive Symptoms Among Gay, Bisexual Men and Other Men Who Have Sex with Men in Taiwan.","authors":"Shih-Chun Hua, Stephane Wen-Wei Ku, PoYao Huang, Nai-Ying Ko, Chia-Wen Li, Adam Bourne, Carol Strong","doi":"10.1177/23259582251339906","DOIUrl":"10.1177/23259582251339906","url":null,"abstract":"<p><p>BackgroundThis study examines chemsex patterns among gay, bisexual, and other men who have sex with men (GBMSM) and their link to depression using a longitudinal approach. Recognizing and addressing chemsex is crucial for human immunodeficiency virus (HIV) care providers, as it supports harm reduction and effective HIV prevention and treatment for GBMSM.MethodsFrom 2017 to 2021, GBMSM at two sexual health clinics completed follow-up questionnaires. We identified chemsex trajectories using group-based modeling and assessed their association with depressive symptoms over two years using multivariable logistic models.ResultsAmong 256 GBMSM, three chemsex patterns were found: \"never or rarely engaged\" (87.4%), \"consistently engaged\" (8.8%), and \"high, decreasing and reinitiated\" (3.8%). There were no significant differences in depressive symptoms between the \"never or rarely engaged\" group and the other patterns.ConclusionsThe study reveals diverse chemsex behaviors but does not provide clear evidence linking these patterns to differences in depressive symptoms among GBMSM.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251339906"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027214","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":"Healthcare Providers' Perspective on HIV Testing and Hypothetical mHealth-connected Linkage to Care Among Men who have Sex with Men (MSM) in South Carolina.","authors":"Tony Brown, Prince Nii Ossah Addo, Monique J Brown, Xiaoming Li, Oluwafemi Adeagbo","doi":"10.1177/23259582251343669","DOIUrl":"10.1177/23259582251343669","url":null,"abstract":"<p><p>BackgroundHIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers' willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers' perceptions of HIV testing and treatment uptake among MSM, and providers' willingness to use mHealth technology to address barriers to HIV testing and treatment in SC.MethodsBetween August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on their experience (2-11 years of service) providing HIV-related services to MSM in peri-urban (<i>n</i> = 7) and rural (<i>n</i> = 3) SC. The interviews were audio recorded, lasted 40-70 min, and were transcribed verbatim. The interview transcripts were analyzed inductively.ResultsFive themes emerged from the analysis: (a) challenges to HIV testing services; (b) concerns about HIV knowledge and status in the MSM community; (c) mixed feelings about HIV self-testing; (d) providers' perception of HIV treatment uptake and retention; and (e) potential of mHealth technology for the delivery of HIV care. Overall, participants reported limited resources, homophobia, medical mistrust, distance, medical costs, and HIV-related stigma as major barriers to HIV testing and treatment uptake in their localities (especially in rural areas). Particularly, they reported that MSM experience significant stigma associated with their sexual orientation and HIV.ConclusionsGiven barriers to care such as stigma and lack of access to care still impede MSM from receiving appropriate HIV services, mHealth-connected approaches could potentially address the barriers to HIV testing and care among MSM and improve their health outcomes. This is key to ending the HIV epidemic in SC and the United States by 2030.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"24 ","pages":"23259582251343669"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150911","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":"Clinical Outcomes of a Nurse-Delivered, Technology-Enabled HIV Outpatient Model.","authors":"Sara Day, Rebecca Wilkins, Andrew Murungi, Christina Antoniadi, Yodit Fissahaye-Yimer, Samuel Ohene-Adomako, David Asboe, Caroline Rae","doi":"10.1177/23259582241274304","DOIUrl":"10.1177/23259582241274304","url":null,"abstract":"<p><p>We evaluated Klick, a nurse-led, digitally enabled model of HIV outpatient care, launched in 2020. Klick's smartphone app offers online booking, remote nurse-led consultations, and results. An audit of Klick nurse-led consultations was conducted against BHIVA monitoring guidelines, and nurses were interviewed about their experience. Of 40 Klick patients audited, 4 of 5 BHIVA standards were met: 100% had documented co-medications, smoking history, blood pressure, and viral load data, and 89% received a cardiovascular risk calculation (Targets 97%-90%-90%-90%-90%). Compared to national BHIVA audit findings, Klick performed better across 22 of 24 comparable measures. Nurses safely managed a cohort comprising some complexity (eg, co-morbidities, polypharmacy); no cases were escalated off the pathway, and all were virologically suppressed. Using a digitally supported model, nurses effectively provided safe care to HIV-positive patients with predominantly stable health, enabling consultants to focus on more complex caseloads. Care was comprehensive and person-centered and obtained better outcomes compared to previous national audits.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241274304"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289968","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":"Application of the UNAIDS Incidence Patterns Model to Determine the Distribution of New HIV Infection in Lagos State, Nigeria.","authors":"Toriola Femi-Adebayo, Monsurat Adeleke, Bisola Adebayo, Temitope Fadiya, Bukola Popoola, Opeyemi Ogundimu, Funmilade O Adepoju, Ayotomiwa Salawu, Oladipupo Fisher, Olusegun Ogboye, Leopold Zekeng","doi":"10.1177/23259582241238653","DOIUrl":"10.1177/23259582241238653","url":null,"abstract":"<p><strong>Background: </strong>Identifying patterns in the distribution of new HIV infections in the population is critical for HIV programmatic interventions. This study aimed to determine the distribution of New HIV infection by applying the incidence patterns mathematical model to data from Lagos state.</p><p><strong>Methods: </strong>The incidence patterns model (IPM) software is a mathematical model developed by UNAIDS to estimate the demographic and epidemic patterns of HIV infections. This model was adapted in Lagos state to predict the distribution of new HIV infections among specified risk groups in the next 12 months.</p><p><strong>Results: </strong>The IPM predicted a total HIV incidence of 37 cases per 100 000 individuals (3979 new infections) will occur among the 15 to 49 subpopulations. The results also showed that sero-concordant HIV-negative couples with external partners (29%), female sex workers (26%), men-having-sex-with-men (18%), and previously married females (6%) accounted for the majority of the estimated new HIV infections. Overall, key populations constitute almost half (48%) of the estimated number of new HIV infections.</p><p><strong>Conclusion: </strong>The study helped to identify the population groups contributing significantly to new HIV infections. Therefore, priority interventions should be focused on these groups.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241238653"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175173","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":"Prevalence of Frailty Phenotypes in Older People Living with HIV: A Cross-Sectional Study from Brazil.","authors":"Susana Lilian Wiechmann, Alexandre Mestre Tejo, Manuel Victor Silva Inácio, Arthur Eumann Mesas, Marcos Aparecido Sarria Cabrera","doi":"10.1177/23259582241241169","DOIUrl":"10.1177/23259582241241169","url":null,"abstract":"<p><strong>Background: </strong>Frailty may affect people living with HIV (PLHIV) prematurely. Fried's frailty phenotype, composed of 5 criteria, is one of the most used instruments for its assessment. This study aimed to determine the prevalence of these criteria among PLHIV classified as prefrail and frail in Brazil.</p><p><strong>Methods: </strong>A cross-sectional study analyzed the prevalence of the Frailty Phenotype in Brazil with 670 individuals aged ≥ 50 years and undetectable viral load.</p><p><strong>Results: </strong>The prevalence of prefrail and frail individuals was 50.7% and 13.6%, respectively. A low level of physical activity was the most prevalent criterion (50.9%). Except for unintentional weight loss, all other criteria were more prevalent among individuals with lower education levels. All criteria were more prevalent among individuals of lower socioeconomic status than among those of moderate or high status (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>A low level of physical activity was the component that most contributed to PLHIV being considered prefrail or frail.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241241169"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11078087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876726","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":"Transfusion-Transmissible Infections Among Blood Donors in a Regional Hospital in Ghana: A 6-Year Trend Analysis (2017-2022).","authors":"Priscilla Yeboah Hadfield, Godwin Adjei Vechey, Emmanuel Bansah, Morkporkpor Nyahe, Nelisiwe Khuzwayo, Elvis Enowbeyang Tarkang","doi":"10.1177/23259582241274305","DOIUrl":"10.1177/23259582241274305","url":null,"abstract":"<p><strong>Background: </strong>This study determined the trends of transfusion-transmissible infections (TTIs) among blood donors in a regional hospital in Ghana from 2017 to 2022.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 6339 blood donor records. Data were analyzed using STATA version 17.0 at the 0.05 significance level.</p><p><strong>Results: </strong>The prevalence of TTIs was 31.4% in 2017, 13.8% in 2018, 20.4% in 2019, 9.5% in 2020, 9.6% in 2021, and 11.7% in 2022. There were significant associations between hepatitis C virus (HCV), Syphilis, and sex (OR = 2.06; 95% CI [1.29-3.30]; <i>P</i> = .003) and (OR = 2.28; 95% CI [1.48-3.54]; <i>P</i> < .001), respectively. Blood donors aged 20-29 were more likely to be infected with hepatitis B virus (OR = 1.96; 95% CI [1.28-2.99]; <i>P</i> = .002). Blood donors aged 40-49 had higher odds of infection with HCV (OR = 3.36; 95% CI [2.02-5.57]; <i>P</i> < .001) and Syphilis (OR = 3.79; 95% CI [2.45-5.87]; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>The study highlights the need to implement targeted prevention strategies for donors with a higher TTI prevalence.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241274305"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036174","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":"Service Interruption in HIV Care Amid COVID-19 Pandemic in Myanmar: Results From Analysis of Routine Program Data 2018-2022.","authors":"Myat Khaing, Sein Lwin, Naw Paw, Zun Htet, Lynn Htet, Hein Ko, May Thet","doi":"10.1177/23259582241299466","DOIUrl":"10.1177/23259582241299466","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;COVID-19 pandemic disrupted organized HIV screening efforts, HIV testing and management worldwide, and the impact of these disruptions from private HIV care clinics have not been examined in Myanmar. PSI/Myanmar had adapted through partner clinics, Sun Quality Health Clinics (SQH) and Lan Pya Kyel clinics (LPK), with measures like online booking, staff scheduling and awareness campaigns. The purpose of this paper was to describe whether HIV-related services changed before, during, and after the COVID-19 pandemic in Myanmar. This study aimed to identify factors influencing ART retention and VL testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;Data from 43 healthcare facilities across 8 regions (2018-2022) was analyzed for HIV indicators, including HIV tests, positive cases, ART retention, viral load (VL) testing, and suppression rates in two channels during different phases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the COVID-19 pandemic, both Channel 1 (SQH) and Channel 2 (LPK) showed fluctuations in HIV testing and new positive cases. Channel 1 had 28.2% decrease in testing (37 735 fewer tests) while Channel 2 had 8.1% increase (81 596 tests). However, testing numbers continued to decline. ART retention declined over 12 months compared to 6 months for both channels. Channel 1 had a slight drop in 6-month retention during the crisis (89.3-88.1%) but an increase in 12-month retention after. Channel 2 maintained high 6-month retention rates (&gt;90%) but varied in 12-month rates (from 80.1% to 92.9%). Unsuccessful outcomes were more common at 12 months in both channels (4.7-21.8% in Channel 1; 7.1-19.9% in Channel 2). VL testing at 12 months significantly decreased during the crisis, notably in Channel 2 (81.9-1.3%). However, high rates of VL suppression (&gt;91%) were consistently seen in those tested in both channels before, during, and after COVID-19. Univariable and multivariable cox proportional hazards models were used to identify factors influencing ART retention. Univariable and multivariable logistic regression analyses were done for VL testing. Factors such as residence location, the period of COVID-19, use of second-line ART, and patient demographics (such as age and key population type) influenced both. Specifically, individuals seeking care from Mandalay [aHR = 1.37, &lt;i&gt;P&lt;/i&gt; value &lt; 0.01], and enrolled for ART during or after COVID-19 [aHR = 3.31, &lt;i&gt;P&lt;/i&gt; value &lt; 0.01], were more likely to be retained at 12 months. VL testing was positively associated with having no TB [aOR = 1.35, &lt;i&gt;P&lt;/i&gt; value &lt; 0.01], being MSM [aOR = 1.69, &lt;i&gt;P&lt;/i&gt; value &lt; 0.01], PWIDs [aOR = 2.51, &lt;i&gt;P&lt;/i&gt; value &lt; 0.01], and seeking care at Channel 2[aOR = 1.76, &lt;i&gt;P&lt;/i&gt; value &lt; 0.01].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study highlighted interruption in ART retention and VL testing because of the COVID-19 pandemic, emphasizing the need to maintain essential HIV services and address gaps based on patient demographics, clinic type, ART enrol","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241299466"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794938","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":"Clinical Implications of HIV Treatment and Prevention for Polygamous Families in Kenya and Uganda: \"My Co-Wife Is the One Who Used to Encourage Me\".","authors":"Jason Johnson-Peretz, Anjeline Onyango, Sarah A Gutin, Laura Balzer, Cecilia Akatukwasa, Lawrence Owino, Titus M O Arunga, Fred Atwine, Maya Petersen, Moses Kamya, James Ayieko, Ted Ruel, Diane Havlir, Carol S Camlin","doi":"10.1177/23259582241255171","DOIUrl":"10.1177/23259582241255171","url":null,"abstract":"<p><p>Polygamy is the practice of marriage to multiple partners. Approximately 6-11% of households in Uganda and 4-11% of households in Kenya are polygamous. The complex families produced by polygamous marriage customs give rise to additional considerations for healthcare providers and public health messaging around HIV care. Using 27 in-depth, semi-structured qualitative interviews with participants in two studies in rural Kenya and Uganda, we analysed challenges and opportunities that polygamous families presented in the diagnosis, treatment and prevention of HIV, and provider roles in improving HIV outcomes in these families. Overall, prevention methods seemed more justifiable to families where co-wives live far apart than when all members live in the same household. In treatment, diagnosis of one member did not always lead to disclosure to other members, creating an adverse home environment; but sometimes diagnosis of one wife led not only to diagnosis of the other, but also to greater household support.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":"23 ","pages":"23259582241255171"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945415","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}