Revista Panamericana De Salud Publica-pan American Journal of Public Health最新文献

{"title":"[Agreement on pandemics and access to vaccines for low- and middle-income countriesAcuerdo sobre el acceso a las vacunas durante las pandemias para los países de ingresos bajos y medianos].","authors":"Ariane de Jesus Lopes de Abreu, Deisy de Freitas Lima Ventura, Eliseu Alves Waldman","doi":"10.26633/RPSP.2025.42","DOIUrl":"https://doi.org/10.26633/RPSP.2025.42","url":null,"abstract":"<p><p>The COVID-19 pandemic exposed flaws in global public health emergency preparedness and response plans, highlighting the urgency of ensuring equitable access to health technologies and products, especially in low- and middle-income countries (LMICs). In this context, the World Health Organization is negotiating a Pandemic Accord to strengthen global governance, reduce disparities between high-income countries (HICs) and LMICs, and improve prevention and response to future pandemics.Articles 10 and 11 of the most recent version of the proposal (14 December 2024) address diversified and sustainable production of health products, as well as the transfer of technology and know-how, with a focus on LMICs. These provisions promote national capacity-building for the production of inputs, transparency in licensing agreements, and the use of TRIPS Agreement flexibilities on intellectual property. However, gaps remain, such as a lack of clear definitions for pandemics and health products, and an emphasis on voluntary measures.Brazil, a traditional vaccine producer, can potentially benefit from the new international context, strengthening its technological capacity and improving its health security ecosystem. Strategic measures include the adoption of sectoral and cross-sectoral policies, participation in technology and knowledge transfer initiatives, and investment in human resources training. These actions will contribute to equity in access to vaccines, especially for vulnerable populations, in line with the objectives of the Immunization Agenda 2030 and the lessons learned from the response to COVID-19.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e42"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ECoTES index of occupational safety and health (OSH) system performance: results of a pilot study in six Ibero-American countriesÍndice ECoTES de desempenho do sistema de segurança e saúde no trabalho: resultados de um estudo-piloto em seis países ibero-americanos].","authors":"Fernando G Benavides, Cecilia Cornelio, Lino Carmenate, Douglas Barraza, David Gimeno Ruiz de Porras, Alejandra Vives, Marianela Rojas, Luis Palomo, María López-Ruiz, Marcelo Amable, Pamela Merino-Salazar, Michael Silva-Peñaherrera","doi":"10.26633/RPSP.2025.37","DOIUrl":"10.26633/RPSP.2025.37","url":null,"abstract":"<p><strong>Objective: </strong>To describe and evaluate the methodology of the ECoTES index, after its implementation in a pilot study in six Ibero-American countries. The ECoTES index (Spanish acronym for surveys of working conditions, employment and health) is designed to measure the performance of national occupational safety and health (OSH) systems.</p><p><strong>Methods: </strong>The ECoTES index was calculated for each country based on two components: i) a 15-question survey answered by 47 experts from Argentina, Chile, Costa Rica, Spain, Honduras, and Peru; and ii) eight statistical indicators (total labor participation rate, female labor participation rate, rate of informal employment, percentage of gross domestic product allocated to social protection excluding health, percentage of the population covered by occupational risk insurance, percentage of the population covered by at least one social benefit, rate of fatalities due to occupational injuries, and rate of deaths attributable to occupational risks). Simulations were conducted with different weights given to each component, and the correlation between statistical indicators and the scores provided by experts was assessed.</p><p><strong>Results: </strong>The survey was answered without difficulty. In addition to enabling construction of the index, the responses also served to improve its wording. There was a significant correlation between the scores for the different components of the index (r = 0.66) and the country rankings in the different simulations (Spearman's rank correlation coefficient: between 0.95 and 1).</p><p><strong>Conclusions: </strong>The ECoTES index proved to be methodologically robust. It is the first indicator in the world to assess the performance of national OSH systems. Its periodic application will allow comparisons over time and between countries, and will help to foster improvements in national systems.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e37"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Inclusive digital transformation: the scenario of digital service usage by women in BrazilTransformación digital inclusiva: panorama del uso de los servicios digitales por parte de las mujeres en Brasil].","authors":"Luciana Portilho, Javiera F Medina Macaya, Manuella Maia Ribeiro, Camila Lima","doi":"10.26633/RPSP.2025.21","DOIUrl":"https://doi.org/10.26633/RPSP.2025.21","url":null,"abstract":"<p><p>The present study used data from the 2023 ICT Households Survey conducted by the Regional Center for Studies on the Development of the Information Society (Cetic.br|NIC.br) to analyze internet access among women in Brazil, as well as their engagement in online health-related activities (searching for health information, accessing government digital services, and using public health services). These indicators were compared based on education level, age, area of residence (urban or rural), and social class. The data revealed higher internet usage rates among young women (95% for ages 10-15 and 96% for ages 16-24), those in social class A, the highest social class bracket (98%), urban residents (86%), and women with higher education (97%). In turn, lower usage rates were observed among older women (56% for ages 60 or older), those in social class DE (73%), rural residents (80%), and women with no formal education or only preschool education (32%). This was observed across all variables investigated, except for the use of public online services, which was low across all categories. The results highlight that women facing greater social and economic vulnerability (low income, rural residence, or low educational attainment) face significant barriers to accessing digital health services. It is recommended that public policies on inclusion and digital governance address these disparities by promoting greater access to the internet and other technologies for women, which could enhance their access to healthcare services.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e21"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Razones para Vivir\": Hybrid implementation study in Colombia for health governance and improving suicidal behavior.","authors":"Felipe Agudelo-Hernández, Luz María Salazar-Vieira, Laura Inés Plata-Casas","doi":"10.26633/RPSP.2025.46","DOIUrl":"https://doi.org/10.26633/RPSP.2025.46","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the implementation of a strategy to promote reasons for living and to assess its impact on acute mental health symptoms, psychosocial disability, and perceptions of health services.</p><p><strong>Methods: </strong>A quasi-experimental methodology that incorporates methods from a Type I hybrid implementation study. The Caldas Scale, Self-Reporting Questionnaire (SRQ-20), and the Zarit Caregiver Burden Scale were applied to people with a history of mental disorder and suicidal ideation, before and after the implementation of the \"Razones para Vivir\" strategy, to determine psychosocial disability associated with mental disorders and caregiver burden.</p><p><strong>Results: </strong>The Razones para Vivir strategy has modified the relationship between the quality and perception of health services and psychosocial disability associated with mental disorders. Large effect sizes were found for the variables of occupational disability (r = 0.68), social disability (r = 0.55), therapeutic adherence (r = 0.71), and perception of services (r = 0.51), with a moderate effect size for acute mental health symptoms (r = 0.41).</p><p><strong>Conclusions: </strong>The implementation of the strategy contributed to institutional involvement in promoting mental health, in addition to the improvement of acute mental health symptoms and some psychosocial disability variables. Mental health promotion strategies can be integrated with implementation frameworks to facilitate their development in specific sociopolitical contexts.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e46"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Contemporary challenges for digital health: literacy, media education, and prevention of disinformationDesafíos actuales para la salud digital: alfabetización, educación mediática y prevención de la desinformación].","authors":"Ana Valéria Machado Mendonça, Maria Fátima de Sousa","doi":"10.26633/RPSP.2025.14","DOIUrl":"https://doi.org/10.26633/RPSP.2025.14","url":null,"abstract":"<p><p>The objective of this article is to analyze the contemporary challenges facing digital health, focusing on literacy, media education, and the prevention of disinformation. The study shows that strengthening digital literacy is crucial to empowering health professionals and citizens, enabling them to critically navigate the digital environment and identify reliable information. The results indicate the need for multisectoral collaboration and public policies that prioritize digital inclusion and media education, promoting a safe information environment. It is recommended to implement comprehensive training policies, use advanced technologies to monitor disinformation, and implement specific strategies to reduce inequalities in access to digital technologies. The conclusion is that overcoming these challenges will require continuous efforts between governments, health professionals, educators, and civil society to strengthen public trust and achieve digital resilience.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e14"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Use of screens by female adolescents in Brazil: practice and perceptionsUso de pantallas por parte de las adolescentes en Brasil: prácticas y percepciones].","authors":"Webert Alex Dos Santos Benetti, Tcharles da Silva Gomes, Beatriz Elizabeth Bagatin Veleda Bermudez","doi":"10.26633/RPSP.2025.17","DOIUrl":"https://doi.org/10.26633/RPSP.2025.17","url":null,"abstract":"<p><strong>Objective: </strong>To describe the screen usage profile among female adolescents in Brazil and analyze the practices and perceptions related to the use of these technologies.</p><p><strong>Methods: </strong>A cross-sectional, observational study was conducted with volunteer female adolescents who completed anonymous questionnaires administered in a public school in 2024 as part of community outreach activities. The questionnaire addressed the adolescents' screen usage and their perception of screen usage by their guardians. The data were categorized for descriptive statistical analysis.</p><p><strong>Results: </strong>A total of 214 valid questionnaires were collected. The participants' average age was 14.9 years. Of the participants, 45.3% were in elementary school, 50.1% in high school, and 62.7% reported starting screen use before the age of 10. Regarding privacy, 46.4% had private social media profiles, while 39.7% had public profiles. Lack of supervision in internet use was reported by 81.5%. In terms of screen time, 76.4% used screens for more than 4 hours per day; on non-school days, this proportion reached 80.5%. Mobile phone use in the classroom was reported by 90.6%, while 79.5% indicated they would use screens less if they had more leisure options or greater parental attention.</p><p><strong>Conclusion: </strong>Inadequate screen use was observed among female adolescents. The lack of parental supervision facilitates exposure to digital dangers, particularly due to the absence of leisure activities or greater parental involvement.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e17"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort.","authors":"Nicole Reis, Omar Sued, Tarsila Vieceli, Diego R Falci, Larissa R Silva, Pedro M Fonseca, Renata B A Soares, Cassia S M Godoy, Marineide G Melo, Nayla A Hatem, Ana C G Castelo, Freddy Perez, Alessandro C Pasqualotto","doi":"10.26633/RPSP.2025.36","DOIUrl":"https://doi.org/10.26633/RPSP.2025.36","url":null,"abstract":"<p><strong>Objective: </strong>To identify clinical characteristics and risk factors associated with mortality, with a focus on opportunistic infections (OIs), in patients with advanced HIV in Brazil.</p><p><strong>Methods: </strong>A prospective cohort study was conducted in five Brazilian tertiary hospitals, including 419 adults with advanced HIV. Baseline demographic and clinical data were collected during hospital admission, and participants were screened for tuberculosis, cryptococcosis, and histoplasmosis using rapid diagnostic tests. Participants were followed for 90 days to assess mortality, with causes of death classified using the Coding of Death in HIV (CoDe) protocol. Statistical analysis identified the variables associated with mortality.</p><p><strong>Results: </strong>The median CD4 count was 66 cells/mm³, and the median HIV viral load was 104 887 copies/mL. After 90 days, 18.1% of participants had died. ART-naive status, mental confusion, anemia, and elevated creatinine levels were strongly associated with mortality. OIs were diagnosed in 45.6% of participants, with severe histoplasmosis and cryptococcal meningitis significantly increasing the risk of mortality. Social determinants, such as sex, race, gender, and education level, did not have a significant impact on mortality, but socio-economic factors influenced health care access.</p><p><strong>Conclusion: </strong>Early HIV diagnosis and continuous ART are essential to reduce mortality. Public health strategies should prioritize improving HIV testing, treatment adherence, and addressing social disparities to mitigate health care inequalities.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e36"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HEARTS Pharmacy: A framework for integrating pharmacists in hypertension and cardiovascular disease risk management in primary care.","authors":"Emily Ridley, Donald J DiPette, Stephanie Gysel, Andres Rosende, Norm R C Campbell, Carolina Neira Ojeda, Ricardo Pesenti, Irma Consuelo Sanchez, Vilma Irazola, Ricardo Humberto Ruano Arevalo, María Paz López Olivares, Daniela Cortés Vidal, Mailin Beltran Delgado, Jessenia Zurita, Pedro Ordunez","doi":"10.26633/RPSP.2025.35","DOIUrl":"https://doi.org/10.26633/RPSP.2025.35","url":null,"abstract":"<p><p>HEARTS Pharmacy, a project within the HEARTS in the Americas Initiative, provides a framework to integrate pharmacists into primary health care. Pharmacists are highly respected in health care but face challenges, such as limited scope of practice, regulatory barriers, and insufficient recognition, compounded by social norms that hinder their full potential. This paper presents compelling evidence that pharmacist-led interventions improve blood pressure control, lower cardiovascular risk, and reduce health care costs. It underscores the role of national pharmacy systems in ensuring access to high-quality medications. HEARTS Pharmacy emphasizes the role pharmacists play in team-based care, highlighting their expertise in medication management, patient education, and adherence. This paper advocates policy changes that empower pharmacists with greater responsibility, enabling them to play an active role in patient care. It also recommends actions to fully integrate pharmacists into care teams, positioning them as key players in hypertension control and cardio-vascular disease risk management within primary health care.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e35"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systematic review of teen pregnancy prevention programs using websites and chatbotsProgramas de prevenção de gravidez na adolescência com base em sites e chatbots: revisão sistemática].","authors":"Natanael Librado González, Dora Julia Onofre Rodríguez, Romeo Sánchez Nigenda, Juliana Cristina Dos Santos Monteiro, Raquel Alicia Benavides Torres, María Aracely Márquez Vega","doi":"10.26633/RPSP.2025.22","DOIUrl":"https://doi.org/10.26633/RPSP.2025.22","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of artificial intelligence (AI)-based chatbots in preventing teenage pregnancy compared with traditional methods of sex education or no intervention.</p><p><strong>Materials and methods: </strong>A systematic review of original studies published between January 2010 and December 2024 was conducted based on the PRISMA guidelines and the population, intervention, comparator, outcome, time, and data (PICOT-D) question formulation strategy. Databases such as PubMed, the Cochrane Library, Embase, and Scopus were searched; DeCS and MeSH descriptors were used. Data were managed in Rayyan^® and in an Excel^® spreadsheet. The protocol was registered in PROSPERO (CRD42024580136).</p><p><strong>Results: </strong>We analyzed 14 studies involving 10,018 participants (71.1% were women). Chatbots demonstrated high usability (SUS score of 77.7, 82nd percentile). Of the total users, 83% interacted with the chatbot, 46% initiated hormonal contraceptives, and 56.8% rated the chatbot as easy to understand. A significant increase was seen in the use of contraceptives (adjusted odds ratio [aOR] = 1.60); <i>p</i> = 0.02) and condoms (aOR = 1.48; <i>p</i> <0.001). There were also improvements in knowledge of emergency contraception (57.3% vs. 47.5%; <i>p</i> <0.01) and access to contraceptive services (95.6% versus 91.8%; <i>p</i> = 0.01).</p><p><strong>Conclusion: </strong>AI-based chatbots are effective in preventing teenage pregnancy and can be a key complement to traditional sex education methods.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e22"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI's ongoing impact: Implications of AI's effects on health equity for women's healthcare providers.","authors":"Suman Vadlamani, Elizabeth Wachira","doi":"10.26633/RPSP.2025.19","DOIUrl":"https://doi.org/10.26633/RPSP.2025.19","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effects of the current use of artificial intelligence (AI) in women's health on health equity, specifically in primary and secondary prevention efforts among women.</p><p><strong>Methods: </strong>Two databases, Scopus and PubMed, were used to conduct this narrative review. The keywords included \"artificial intelligence,\" \"machine learning,\" \"women's health,\" \"screen,\" \"risk factor,\" and \"prevent,\" and papers were filtered only to include those about AI models that general practitioners may use.</p><p><strong>Results: </strong>Of the 18 articles reviewed, 8 articles focused on risk factor modeling under primary prevention, and 10 articles focused on screening tools under secondary prevention. Gaps were found in the ability of AI models to train using large, diverse datasets that were reflective of the population it is intended for. Lack of these datasets was frequently identified as a limitation in the papers reviewed (<i>n</i> = 7).</p><p><strong>Conclusions: </strong>Minority, low-income women have poor access to health care and are, therefore, not well represented in the datasets AI uses to train, which risks introducing bias in its output. To mitigate this, more datasets should be developed to validate AI models, and AI in women's health should expand to include conditions that affect men and women to provide a gendered lens on these conditions. Public health, medical, and technology entities need to collaborate to regulate the development and use of AI in health care at a standard that reduces bias.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e19"},"PeriodicalIF":2.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}