Lancet Regional Health-Americas最新文献

{"title":"Nationwide economic analysis of pulmonary tuberculosis in the Brazilian healthcare system over seven years (2015–2022): a population-based study","authors":"Beatriz Barreto-Duarte ,&nbsp;Klauss Villalva-Serra ,&nbsp;Vanessa M.S. Campos ,&nbsp;Marcelo Cordeiro-Santos ,&nbsp;Afrânio L. Kritski ,&nbsp;Mariana Araújo-Pereira ,&nbsp;Moreno M. Rodrigues ,&nbsp;Bruno B. Andrade","doi":"10.1016/j.lana.2024.100905","DOIUrl":"10.1016/j.lana.2024.100905","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a global challenge and disproportionately affecting vulnerable populations. This study analyses the economic burden of pulmonary TB in Brazil, focusing on direct healthcare costs. It also evaluates the cost-effectiveness of the Directly Observed Treatment (DOT) strategy and the economic effort required to achieve a 90% probability of cure.</div></div><div><h3>Methods</h3><div>A nationwide retrospective study utilized data from the Brazilian Information System for Notifiable Diseases (SINAN) between 2015 and 2022. The cost per pulmonary TB case was estimated, encompassing expenses related to healthcare professionals, medication, laboratory exams, and the duration of treatment reported in SINAN. The population was stratified based on the presence of social vulnerabilities or a history of previous anti-TB treatment. Number Needed to Treat (NNT) analyses assessed the effectiveness of DOT implementation. Additionally, the study calculated the cost needed to achieve a 90% probability of cure through binomial regression models.</div></div><div><h3>Findings</h3><div>The total direct cost for pulmonary TB in Brazil during the seven years exceeded $1.3 billion, with retreatment cases accounting for $23.5 million. The lowest NNT of DOT were homeless (3.0), people who use drugs (3.72), and retreatment (4.56) subpopulations. These groups also presented the highest cost to achieve a 90% probability of cure.</div></div><div><h3>Interpretation</h3><div>This study highlights the economic impact of pulmonary TB on the Brazilian healthcare system. It underscores the effectiveness of DOT across various patient groups, regardless of their vulnerabilities or previous anti-TB treatment history. NNT analyses highlighted retreatment, homeless, and people who use drugs subpopulations as the most effective for DOT implementation.</div></div><div><h3>Funding</h3><div><span>Intramural Research Program-Oswaldo Cruz Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100905"},"PeriodicalIF":7.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428561","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":"A self-help mobile messaging intervention to improve subthreshold depressive symptoms among older adults in a socioeconomically deprived region of Brazil (PRODIGITAL): a pragmatic, two-arm randomised controlled trial","authors":"Carina Akemi Nakamura ,&nbsp;Nadine Seward ,&nbsp;Tim J. Peters ,&nbsp;Thiago Vinicius Nadaleto Didone ,&nbsp;Felipe Azevedo Moretti ,&nbsp;Marcelo Oliveira da Costa ,&nbsp;Caio Hudson Queiroz de Souza ,&nbsp;Gabriel Macias de Oliveira ,&nbsp;Monica Souza dos Santos ,&nbsp;Luara Aragoni Pereira ,&nbsp;Mariana Mendes de Sá Martins ,&nbsp;Pepijn van de Ven ,&nbsp;William Hollingworth ,&nbsp;Ricardo Araya ,&nbsp;Marcia Scazufca","doi":"10.1016/j.lana.2024.100897","DOIUrl":"10.1016/j.lana.2024.100897","url":null,"abstract":"<div><h3>Background</h3><div>Subthreshold depression is a risk factor for major depression and is associated with increased morbidity and mortality, especially in older adults. There is emerging evidence that digital interventions, including self-help interventions, may reduce depressive symptoms. We aimed to evaluate the effectiveness of a mobile messaging intervention at reducing subthreshold depressive symptoms among older adults in Brazil.</div></div><div><h3>Methods</h3><div>PRODIGITAL was a single blind, two-arm, individually randomised controlled trial conducted in 46 primary care clinics in the city of Guarulhos, Brazil. Individuals aged 60+ years were contacted by phone following a randomly ordered list for a screening assessment. Those who presented with anhedonia and/or depressed mood (Patient Health Questionnaire (PHQ)-2≥1), and who subsequently scored between 5 and 9 on the PHQ-9 were invited to participate. The intervention arm received the ‘Viva Vida’ digital self-help intervention consisting of automated multi-media messages sent via WhatsApp. Forty-eight audio and visual messages based on psychoeducation and behavioural activation were automatically delivered over six weeks. The control arm received a single message containing information about depression. The primary outcome was the difference in mean PHQ-9 scores between treatment arms at the three-month follow-up. All primary analyses were performed according to allocated arm with imputed data. The trial is registered with ReBEC, RBR-6c7ghfd.</div></div><div><h3>Findings</h3><div>Participants were recruited between 8 September 2021 and 19 August 2022. Of the 454 participants enrolled, 223 were randomised to the intervention arm, 231 to the control arm. Participants’ mean age was 65.3 years (SD 5.0) and 64.0% (n = 292) were female. A total of 385 (84.8%) completed the three-month follow-up assessment; no difference in mean PHQ-9 scores between the treatment arms was observed (adjusted difference: −0.61; 95% CI: −1.75, 0.53; <em>p</em> = 0.29).</div></div><div><h3>Interpretation</h3><div>These results demonstrate that the Viva Vida digital self-help intervention did not help to improve subthreshold depressive symptoms amongst older adults. Further research is needed to understand why this self-help intervention was not effective in this population, and to explore how it might be adapted to achieve this goal.</div></div><div><h3>Funding</h3><div><span>São Paulo Research Foundation</span> and <span>UK Joint Global Health Trials</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100897"},"PeriodicalIF":7.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428560","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":"Spatiotemporal patterns and surveillance artifacts in maternal mortality in the United States: a population-based study","authors":"K.S. Joseph ,&nbsp;Sarka Lisonkova ,&nbsp;Amélie Boutin ,&nbsp;Giulia M. Muraca ,&nbsp;Neda Razaz ,&nbsp;Sid John ,&nbsp;Yasser Sabr ,&nbsp;Sophie Simon ,&nbsp;Johanna Kögl ,&nbsp;Elizabeth A. Suarez ,&nbsp;Wee-Shian Chan ,&nbsp;Azar Mehrabadi ,&nbsp;Justin S. Brandt ,&nbsp;Enrique F. Schisterman ,&nbsp;Cande V. Ananth","doi":"10.1016/j.lana.2024.100902","DOIUrl":"10.1016/j.lana.2024.100902","url":null,"abstract":"<div><h3>Background</h3><div>Reports of high and rising maternal mortality ratios (MMR) in the United States have caused serious concern. We examined spatiotemporal patterns in cause-specific MMRs, in order to obtain insights into the cause for the increase.</div></div><div><h3>Methods</h3><div>The study included all maternal deaths recorded by the Centers for Disease Control and Prevention from 1999 to 2021. Changes in overall and cause-specific MMRs were quantified nationally; in low-vs high-MMR states (i.e., MMRs &lt;20 vs ≥26 per 100,000 live births in 2018–2021); and in California vs Texas (populous states with low vs high MMRs). Cause-specific MMRs included those due to unambiguous causes (e.g., selected obstetric causes such as pre-eclampsia/eclampsia) and less-specific/potentially incidental causes (e.g., “other specified pregnancy-related conditions”, chronic hypertension, and malignant neoplasms).</div></div><div><h3>Findings</h3><div>MMRs increased from 9.60 (n = 1543) in 1999–2002 to 23.5 (n = 3478) per 100,000 live births in 2018–2021. The temporal increase in MMRs was smaller in low-MMR states (from 7.82 to 14.1 per 100,000 live births) compared with high-MMR states (from 11.1 to 31.4 per 100,000 live births). MMRs due to selected obstetric causes decreased to a similar extent in low-vs high-MMR states, whereas the increase in MMRs from less-specific/potentially incidental causes was smaller in low- vs high-MMR states (MMR ratio (RR) 5.57, 95% CI 4.28, 7.25 vs 7.07, 95% CI 5.91, 8.46), and in California vs Texas (RR 1.67, 95% CI 1.03, 2.69 vs 10.8, 95% CI 6.55, 17.7). The change in malignant neoplasm-associated MMRs was smaller in California vs Texas (RR 1.21, 95% CI 0.08, 19.3 vs 91.2, 95% CI 89.2, 94.8). MMRs from less-specific/potentially incidental causes increased in all race/ethnicity groups.</div></div><div><h3>Interpretation</h3><div>Spatiotemporal patterns of cause-specific MMRs, including similar reductions in unambiguous obstetric causes of death and variable increases in less-specific/potentially incidental causes, suggest misclassified maternal deaths and overestimated maternal mortality in some US states.</div></div><div><h3>Funding</h3><div>This work received no funding.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100902"},"PeriodicalIF":7.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428558","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":"Transition towards cancer mortality predominance over cardiovascular disease mortality in Brazil, 2000–2019: a population-based study","authors":"Beatriz Rache ,&nbsp;Rudi Rocha ,&nbsp;Luciana Alves de Medeiros ,&nbsp;Letícia Martins Okada ,&nbsp;Gerson Ferrari ,&nbsp;Hongmei Zeng ,&nbsp;Alessandro Bigoni ,&nbsp;Maria Paula Curado ,&nbsp;Catarina M. Azeredo ,&nbsp;Leandro F.M. Rezende","doi":"10.1016/j.lana.2024.100904","DOIUrl":"10.1016/j.lana.2024.100904","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) and cancer are the first and second leading causes of death in Brazil and worldwide. However, an ongoing epidemiological transition in which cancer surpasses CVD has been observed in many high and middle-income countries. In this study, we provided a nationwide analysis of the transition towards cancer mortality predominance over CVD mortality in Brazil.</div></div><div><h3>Methods</h3><div>We leveraged data from 5570 municipalities using the Mortality Information System and classified the causes of death using ICD-10 codes. Age-standardized CVD and cancer mortality rates were calculated annually between 2000 and 2019. Mortality rate ratios (MRRs = CVD rates divided by cancer rates) described the predominance of cancer or CVD mortality across municipalities and states. Choropleth maps displayed state-specific MRRs and the transition in the predominant cause of death over time.</div></div><div><h3>Findings</h3><div>From 2000 to 2019, CVD mortality rates declined in 25 out of 27 states, whereas cancer mortality increased in 15 states, indicating a shift towards cancer predominance. While in 2000 cancer mortality was lower than CVD in all states and only exceeded the latter in 7% of the municipalities, by 2019 the gap narrowed considerably, with 13% of municipalities displaying higher cancer mortality rates vs CVD mortality rates. Additionally, higher household income correlated with higher mortality from cancer vs CVD.</div></div><div><h3>Interpretation</h3><div>An ongoing epidemiological transition in which cancer mortality surpasses CVD mortality is occurring in Brazil, particularly in municipalities with higher household incomes. Our findings may provide important information for policymakers and public health practitioners in Brazil.</div></div><div><h3>Funding</h3><div><span>National Council for Scientific and Technological Development</span> (CNPq).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100904"},"PeriodicalIF":7.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428559","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":"Brazil has a problem: therapeutic itinerary, research and data about eating disorders","authors":"Jônatas de Oliveira ,&nbsp;Thais di Stasi Marques dos Santos ,&nbsp;João Luiz Coelho Ferro ,&nbsp;Ms Isis de Carvalho Stelmo","doi":"10.1016/j.lana.2024.100903","DOIUrl":"10.1016/j.lana.2024.100903","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100903"},"PeriodicalIF":7.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428557","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":"Pamela Serón: bridging evidence-based rehabilitation and community-driven research","authors":"Taissa Vila","doi":"10.1016/j.lana.2024.100907","DOIUrl":"10.1016/j.lana.2024.100907","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100907"},"PeriodicalIF":7.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420620","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":"Identifying when racial and ethnic disparities arise along the continuum of transplant care: a national registry study","authors":"Maya N. Clark-Cutaia ,&nbsp;Gayathri Menon ,&nbsp;Yiting Li ,&nbsp;Garyn T. Metoyer ,&nbsp;Mary Grace Bowring ,&nbsp;Byoungjun Kim ,&nbsp;Babak J. Orandi ,&nbsp;Stephen P. Wall ,&nbsp;Melissa D. Hladek ,&nbsp;Tanjala S. Purnell ,&nbsp;Dorry L. Segev ,&nbsp;Mara A. McAdams-DeMarco","doi":"10.1016/j.lana.2024.100895","DOIUrl":"10.1016/j.lana.2024.100895","url":null,"abstract":"<div><h3>Background</h3><div>Fewer minoritized patients with end-stage kidney disease (ESKD) receive kidney transplantation (KT); efforts to mitigate disparities have thus far failed. Pinpointing the specific stage(s) within the transplant care continuum (being informed of KT options, joining the waiting list, to receiving KT) where disparities emerge among each minoritized population is pivotal for achieving equity. We therefore quantified racial and ethnic disparities across the KT care continuum.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study (2015–2020), with follow-up through 12/10/2021. Patients with incident dialysis were identified using the US national registry data. The exposure was race and ethnicity (Asian, Black, Hispanic, and White). We used adjusted modified Poisson regression to quantify the adjusted prevalence ratio (aPR) of being informed of KT, and cause-specific hazards models to calculate adjusted hazard ratios (aHR) of listing, and transplantation after listing.</div></div><div><h3>Findings</h3><div>Among 637,951 adults initiating dialysis, the mean age (SD) was 63.8 (14.6), 41.8% were female, 5.4% were Asian, 26.3% were Black, 16.6% were Hispanic, and 51.7% were White (median follow-up in years [IQR]:1.92 [0.97–3.39]). Black and Hispanic patients were modestly more likely to be informed of KT (Black: aPR = 1.02, 95% confidence interval [CI]:1.01–1.02; Hispanic: aPR = 1.03, 95% CI: 1.02–1.03) relative to White patients. Asian patients were more likely to be listed (aHR = 1.18, 95% CI: 1.15–1.21) but less likely to receive KT (aHR = 0.56, 95% CI: 0.54–0.58). Both Black and Hispanic patients were less likely to be listed (Black: aHR = 0.87, 95% CI: 0.85–0.88; Hispanic: aHR = 0.85, 95% CI: 0.85–0.88) and receive KT (Black: aHR = 0.61, 95% CI: 0.60–0.63; Hispanic: aHR = 0.64, 95% CI: 0.63–0.66).</div></div><div><h3>Interpretation</h3><div>Improved characterization of the barriers in KT access specific to each racial and ethnic group, and the interventions to address these distinct challenges throughout the KT care continuum are needed; our findings identify specific stages most in need of mitigation.</div></div><div><h3>Funding</h3><div><span>National Institutes of Health</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100895"},"PeriodicalIF":7.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420542","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":"Facilitators of and barriers to buprenorphine initiation in the emergency department: a scoping review","authors":"Nikki Bozinoff ,&nbsp;Erin Grennell ,&nbsp;Charlene Soobiah ,&nbsp;Zahraa Farhan ,&nbsp;Terri Rodak ,&nbsp;Christine Bucago ,&nbsp;Katie Kingston ,&nbsp;Michelle Klaiman ,&nbsp;Brittany Poynter ,&nbsp;Dominick Shelton ,&nbsp;Elizabeth Schoenfeld ,&nbsp;Csilla Kalocsai","doi":"10.1016/j.lana.2024.100899","DOIUrl":"10.1016/j.lana.2024.100899","url":null,"abstract":"<div><div>Buprenorphine initiation in the Emergency Department (ED) has been hailed as an evidence-based strategy to mitigate the opioid overdose crisis, but its implementation has been limited. This scoping review synthesizes barriers and facilitators to buprenorphine initiation in the ED, and uses the Consolidated Framework for Implementation Research and a critical lens to analyze the literature. Results demonstrate an immense effort across the U.S. and Canada to implement ED-initiated buprenorphine. Facilitators include multidisciplinary addiction teams and co-located, low-barrier, harm reduction-informed services to support transitions. Barriers include a failure to address structural stigma, client complexity, and an increasingly toxic drug supply. The literature also misses the opportunity to include the perspectives of service users, health administrators, and learners. Increased coordination of implementation efforts, and a shift to equitable and inclusive opioid agonist therapy initiation pathways are needed across the U.S. and Canada.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100899"},"PeriodicalIF":7.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357074","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":"Ending violence against Indigenous peoples in Canada: a healthcare responsibility","authors":"Jessica Kolopenuk","doi":"10.1016/j.lana.2024.100893","DOIUrl":"10.1016/j.lana.2024.100893","url":null,"abstract":"<div><div>By foregrounding the embodiment of colonial dispossession–how the body feels colonialism–this article theorises violence against Indigenous peoples in Canada, positioning it firmly within the purview of healthcare. The article critically questions the discourse of reconciliation currently shaping Indigenisation policies and Indigenous health research in the country’s public institutions. It contends that a narrow application of “closing the Indigenous health gap,” described more robustly by the Truth and Reconciliation Commission of Canada, falls short of addressing the root problem: “ending colonial violence.” Aligning with critical Indigenous studies scholarship, I redirect representations of Indigenous health away from the presumption of deficit. I argue that health care in Canada is responsible for recognising and confronting colonial violence as a matter of public health. As a starting point, this responsibility involves implementing the relevant Calls for Justice outlined in Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100893"},"PeriodicalIF":7.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420543","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":"Burning amazon: the dire consequences of climate inaction","authors":"The Lancet Regional Health – Americas","doi":"10.1016/j.lana.2024.100918","DOIUrl":"10.1016/j.lana.2024.100918","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100918"},"PeriodicalIF":7.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420619","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}