Public Health in Practice最新文献

{"title":"Improving case-finding of long-term health problems in disadvantaged communities: A Policy-focused Evidence Brief.","authors":"Adnaan Ghanchi, Anita Patel, Helena Painter, Isla Kuhn, Anna Gkiouleka, Ian Holdroyd, Danielle Lamb, John Ford","doi":"10.1016/j.puhip.2026.100769","DOIUrl":"10.1016/j.puhip.2026.100769","url":null,"abstract":"<p><strong>Current challenges: </strong>Case finding, which actively identifies undiagnosed conditions, is key to tackling the growing chronic disease burden, especially in disadvantaged groups. Diseases like type 2 diabetes, cardiovascular disease, and chronic obstructive pulmonary disease already cause millions of preventable deaths, with numbers rising due to aging populations, urbanization, and widening inequalities. The poorest communities bear the heaviest load, with higher disease rates and lower diagnosis. Traditional healthcare models, which wait for patients to seek care, leave millions undiagnosed and untreated. Proactive case finding is a proven way to reduce disparities, improve outcomes, and ease the strain on healthcare systems.</p><p><strong>Key evidence to inform policy: </strong>This review identified two main approaches: targeted searches of primary care electronic health records (EHRs) to identify and engage high-risk individuals, and opportunistic screening in community, workplace, and emergency department settings. Systematic reviews and smaller observational studies, predominantly from high-income healthcare systems, support community-based health checks in trusted venues, workplace hypertension screening, and follow-up of elevated blood pressure readings in emergency departments, though evidence for these approaches is more limited. A stepped-wedge RCT found that targeted outreach nearly doubled diagnosis and treatment rates for cardiovascular risk factors compared with opportunistic case-finding (19.7% vs 10.8%). Meta-analyses of over 480,000 women found that self-sampling approximately doubled cervical screening uptake, with uptake increasing threefold when combined with community health worker support among under-screened ethnic minority and socioeconomically disadvantaged women. A cluster-randomised trial of over 74,000 participants showed that active case-finding using symptom questionnaires and handheld flowmeters identified four times more undiagnosed COPD than opportunistic screening, and was cost-effective at £16,596 per QALY gained.</p><p><strong>Further considerations and implications: </strong>This review identifies targeted case-finding in underserved communities as an evidence-based, high-impact strategy for early detection of chronic disease, provided it is integrated with sufficient downstream diagnostic and treatment capacity.</p>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100769"},"PeriodicalIF":2.2,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219953","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":"Rethinking child safety in community-based health programmes: A critical response to parents' perceptions of health coordinators.","authors":"Ulfah, Kadek Suhardita, Putu Ari Dharmayanti, I Wayan Widana, Rikas Saputra, Erfan Ramadhani, Sri Datuti, Arizona, Rizky Ananda Pohan, Laily Tiarani Soejanto, I Dewa Ayu Eka Purba Dharma Tari, Rr Dwi Umi Badriyah","doi":"10.1016/j.puhip.2026.100760","DOIUrl":"10.1016/j.puhip.2026.100760","url":null,"abstract":"","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100760"},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219950","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":"One size does not fit all: Understanding child safety through context, power, and co-creation.","authors":"Lisette Farias, Mai-Lis Hellenius, Gisela Nyberg, Susanne Andermo","doi":"10.1016/j.puhip.2026.100761","DOIUrl":"10.1016/j.puhip.2026.100761","url":null,"abstract":"","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"11 ","pages":"100761"},"PeriodicalIF":2.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220024","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":"Maternal health inequity in Somalia: A multivariate analysis of poverty and service utilization using nationwide cross-sectional survey data","authors":"Asma Mahamoud Abdillahi ,&nbsp;Omer Adam Farih ,&nbsp;Mustafe Abdillahi Ali ,&nbsp;Abdirizak Hassan Abokor ,&nbsp;Hodo Abdikarim ,&nbsp;Saeed Hassan Mohamed ,&nbsp;Awale Ali Omer ,&nbsp;Shabcan Mohamed Ali ,&nbsp;Abdisalam Hassan Muse","doi":"10.1016/j.puhip.2025.100647","DOIUrl":"10.1016/j.puhip.2025.100647","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal health is a fundamental human right, yet significant inequities persist in low-resource settings like Somalia. This study investigates the nexus between socioeconomic status and maternal healthcare utilization, specifically examining the determinants of antenatal care (ANC) visits and place of delivery, to inform strategies aimed at achieving health equity.</div></div><div><h3>Study design</h3><div>A quantitative, cross-sectional study.</div></div><div><h3>Methods</h3><div>We used data from the 2020 Somalia Health and Demographic Survey (SHDS), a nationwide survey. The final analytical sample included 8248 women with a recent birth. We analyzed two dependent variables: number of ANC visits and place of delivery (home vs. health facility). Independent variables included wealth index, maternal education, residence, region, and other social determinants. Zero-inflated Negative Binomial (ZINB) regression was used for ANC visits, and binary logistic regression was used for place of delivery, with all analyses adjusted for the complex survey design.</div></div><div><h3>Results</h3><div>Marked disparities were found based on wealth. A significantly larger proportion of poorer women delivered at home (87.6 %) compared to richer women (55 %). Richer women had higher rates of ANC visits (Adjusted Incidence Rate Ratio [aIRR] = 1.41, p &lt; 0.001) and were more likely to have facility-based deliveries (Adjusted Odds Ratio [AOR] = 1.57, p &lt; 0.001). Higher maternal education, mobile phone ownership, and not wanting to go alone to a facility were also associated with better utilization. Significant regional disparities were observed.</div></div><div><h3>Conclusions</h3><div>Socioeconomic status is a primary driver of maternal healthcare utilization in Somalia, leading to substantial health inequities. Addressing these disparities requires multisectoral, targeted interventions that tackle poverty, enhance education, improve access to technology, and address cultural barriers to care.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100647"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893561","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":"Human rabies exposure and associated risk factors in North-West Ethiopia","authors":"Workneh Wondimagegn Azalu ,&nbsp;Sefinew Alemu Mekonnen ,&nbsp;Ambaye Kenubih ,&nbsp;Araya Mengistu Kassa ,&nbsp;Wassie Abebe Molla ,&nbsp;Wudu Temesgen Jemberu","doi":"10.1016/j.puhip.2025.100651","DOIUrl":"10.1016/j.puhip.2025.100651","url":null,"abstract":"<div><h3>Objectives</h3><div>The study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and its associated risk factors.</div></div><div><h3>Study design</h3><div>A retrospective cohort study was conducted to assess community awareness of rabies, and incidence of human rabies exposure and associated risk factors.</div></div><div><h3>Method</h3><div>A total of 642 study participants were selected using multistage cluster sampling from seven districts in Gondar zones in northwest Ethiopia. Data was collected using a questionnaire by face-to-face interviews. Logistic regression analysis was used to identify associations between rabies exposure and potential risk factors.</div></div><div><h3>Results</h3><div>The incidence of rabies exposure in the current study was estimated to be 20.95 % per year. Almost all (99.68 %) of respondents were aware of the existence of rabies, and 98.44 % of them know that rabies is a zoonotic disease. Residents of Genda Wuha (OR = 7.68) and Metema districts (OR = 7.12) had a greater risk of rabies exposure compared to those living in Debre Tabor district. Dog ownership (OR = 1.61) was greater risk for rabies exposure than non-dog ownership, larger family size (≥7 members) (OR = 2.23) had greater risk for rabies exposure.</div></div><div><h3>Conclusion</h3><div>The study outlined that although awareness of existence of rabies and its zoonotic risk was high, taking post-exposure prophylaxis was low. Therefore, use post exposure rabies vaccine of should be promoted.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100651"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095294","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":"Strategic implementation of HPV vaccination to eliminate cervical cancer in Georgia","authors":"Irakli Khuntsaria ,&nbsp;Konstantine Gachechiladze ,&nbsp;Elene Liparta ,&nbsp;Tamar Kobulashvili ,&nbsp;Mariam Jorbenadze ,&nbsp;Tamaz Revazishvili ,&nbsp;Ana Mamiseishvili ,&nbsp;Elene Kekelia ,&nbsp;Marina Topuridze ,&nbsp;Lela Sturua ,&nbsp;Thomas Schrader ,&nbsp;Ekaterina Kldiashvili","doi":"10.1016/j.puhip.2025.100679","DOIUrl":"10.1016/j.puhip.2025.100679","url":null,"abstract":"<div><h3>Objectives</h3><div>Human Papillomavirus (HPV) is a prevalent sexually transmitted infection and a leading cause of cervical cancer. In Georgia, cervical cancer ranks as the fifth most common cancer among women, with approximately 330 new cases and 200 deaths reported annually. Despite the availability of effective HPV vaccines, national vaccination coverage remains low. This study aimed to evaluate HPV vaccination coverage, analyze cervical cancer incidence trends, and model the potential impact of increased vaccination uptake on cancer prevention outcomes in Georgia.</div></div><div><h3>Study design</h3><div>A retrospective observational study was conducted using national health registry data and modeling projections to assess the burden of cervical cancer and estimate the effect of scaled vaccination coverage.</div></div><div><h3>Methods</h3><div>National health databases were used to analyze HPV vaccination rates and cervical cancer incidence. Descriptive statistics, chi-square tests, and linear regression were applied to identify trends and disparities. Additionally, a dynamic transmission model was developed to simulate the 10-year impact of increasing HPV vaccination coverage on cervical cancer incidence.</div></div><div><h3>Results</h3><div>The crude cervical cancer incidence rate was 15.7 per 100,000 women, with an age-standardized rate of 10.6 per 100,000. In 2022, only 38 % of eligible girls aged 13–18 received the first HPV vaccine dose, and 26 % completed the second dose. Regional disparities in vaccination and screening were noted, and overall screening coverage declined to 13,890 women screened in 2022. Modeling showed that increasing vaccine coverage to 60 % could reduce cervical cancer incidence by 50 % (preventing ∼163 cases); coverage of 80 % and 90 % could reduce incidence by 70 % and 85 %, preventing 228 and 276 cases, respectively.</div></div><div><h3>Conclusion</h3><div>Low HPV vaccination uptake in Georgia (38 % first dose and 26 % dull coverage) and declining screening limit cervical cancer prevention. Modeling shows that increasing vaccination coverage to 60–90 % could prevent 163–276 cases over the next decade. Strengthening vaccination and screening strategies is essential to move forward elimination.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100679"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416103","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":"Power of public health advice: Effectiveness and spillover effects of federal vaccine recommendations","authors":"Junying Zhao ,&nbsp;Ahmed El Fatmaoui ,&nbsp;Mahla Shourian ,&nbsp;Bethanie Lor ,&nbsp;Pallab K. Ghosh","doi":"10.1016/j.puhip.2025.100667","DOIUrl":"10.1016/j.puhip.2025.100667","url":null,"abstract":"<div><h3>Objectives</h3><div>This paper focuses on the national-level, inexpensive, demand-side vaccine policy—federal recommendations. It evaluates the effectiveness of 2008 and 2010 influenza vaccine recommendations, the spillover effect of the 2009 H1N1 vaccine recommendation on influenza vaccination, and heterogeneous policy effects across individual characteristics.</div></div><div><h3>Study design</h3><div>Observational study with before-after comparison assessing changes in vaccination following policy implementation.</div></div><div><h3>Methods</h3><div>We used nationally representative 2004–2015 NHIS data on 77,361, 23,653, and 238,866 individuals in age groups targeted by the 2008, 2009, and 2010 policies, respectively. Using the Linear Probability Model with fixed effects, we estimated policy effectiveness, spillover effects, and heterogeneous effects across individual characteristics.</div></div><div><h3>Results</h3><div>Both 2008 and 2010 influenza vaccine recommendations boosted influenza vaccination likelihood by 20.9–26.5 % among children and 5.2–6.6 % among older adults. The 2009 H1N1 vaccine recommendation had a positive spillover effect, with a 5.7–9.8 % increase in influenza vaccination likelihood among younger adults. Low influenza vaccination likelihoods exist across demographic and socioeconomic characteristics: Children uninsured or privately insured, White, and low-income; Adults uninsured or publicly insured, White, African and Hispanic American, male, childless, self-reported poor or excellent health, low-educated, and low-income.</div></div><div><h3>Conclusions</h3><div>Future policies may address the cost barriers faced by the uninsured, and multi-level non-cost barriers experienced by privately insured children and publicly insured adults. Future policies may consider extending beyond the federal recommendation, such as implementing simultaneous anti-poverty policies, to achieve minimum coverage and utilize the spillover effects of one vaccine policy to maximize coverage of other vaccines. Future research may investigate potential policy spillover effects among influenza, COVID-19, RSV, and new vaccines.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100667"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416102","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":"Analyzing health inequality among adolescents in Chile: Physical activity, socioeconomics, and play environments across genders","authors":"Josivaldo de Souza-Lima ,&nbsp;Maribel Parra-Saldías ,&nbsp;Sandra Mahecha Matsudo ,&nbsp;Gerson Ferrari ,&nbsp;Andrés Godoy-Cumillaf ,&nbsp;Claudio Farias-Valenzuela ,&nbsp;Pedro Valdivia-Moral","doi":"10.1016/j.puhip.2025.100666","DOIUrl":"10.1016/j.puhip.2025.100666","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the association between socioeconomic factors, gender, physical activity, and health satisfaction among Chilean adolescents. It aims to identify key disparities and their implications for public health policies.</div></div><div><h3>Study design</h3><div>Cross-sectional study based on the third wave (2016–2019) of the international Children's Worlds survey.</div></div><div><h3>Methods</h3><div>A total of 911 adolescents aged 12–13 years from Santiago, Chile, participated. Physical activity levels, socioeconomic indicators, and health satisfaction were assessed. Statistical analyses included t-tests, chi-square tests, ANOVA, and multiple linear regression models stratified by gender.</div></div><div><h3>Results</h3><div>Boys reported higher levels of electronic gaming (64.6 % vs. 35.4 %, p &lt; 0.001), while girls engaged more in outdoor play at lower frequencies (52.8 % vs. 47.2 %, p = 0.045). Perceived safety was a stronger predictor of health satisfaction for girls (β = 0.252, p &lt; 0.001) than for boys (β = 0.251, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Socioeconomic and environmental factors significantly influence adolescent health satisfaction, with gender-specific differences. Policies should focus on improving access to recreational spaces and addressing economic barriers, particularly for girls.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100666"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265480","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":"Black US women share their experiences with follow-up after abnormal cervical cancer screening","authors":"Ariel Washington ,&nbsp;Kassidy F. Houck ,&nbsp;Bridget W. Nelson ,&nbsp;Diane M. Harper","doi":"10.1016/j.puhip.2025.100658","DOIUrl":"10.1016/j.puhip.2025.100658","url":null,"abstract":"<div><h3>Objectives</h3><div>Black women have both high screening and high cancer rates, indicating a lack of appropriate follow-up after an abnormal screening. Our mixed methods study explores the experiences of Black women who had abnormal cervical cancer screening results in Michigan.</div></div><div><h3>Study design</h3><div>Sequential mixed-method study design.</div></div><div><h3>Methods</h3><div>We identified a random group of 72 Black women with recent abnormal screening results requiring colposcopy follow-up from the aggregated local healthcare systems and invited them to participate. We designed a quantitative survey based on validated national health survey modules and a qualitative interview structured on the Theoretical Domains Framework (TDF), which was analyzed using Applied Thematic Analysis (ATA). We calculated each person's social deprivation index (SDI) based on quantitative results.</div></div><div><h3>Results</h3><div>Fourteen women completed the survey and interview. Five, seven, and two women chose no colposcopy, appropriate colposcopy, and missed colposcopy, but returned for close interval surveillance, respectively. The qualitative themes provided a potent emerging theme: the eternal cycle of human papillomavirus (HPV) uncertainty, which provided context for the other identified themes centered around lack of knowledge leading to emotional burdens, which intersected with being seen as a Black woman. We found similar barriers that have been noted for screening, such as relationships, positive and negative, having some influence on follow-up behavior.</div></div><div><h3>Conclusions</h3><div>With the shift to primary HPV screening, new educational platforms must be created and tailored to explain the HPV cycle for each racial/ethnic community.</div></div><div><h3>Precis</h3><div>The lack of knowledge about the eternal cycle of HPV uncertainty leads to Black women's lack of colposcopy follow-up.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100658"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265479","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":"Factors associated with quality of life and the use of public healthcare and social services in older adults experiencing loneliness","authors":"Ma Elena Martínez-Ochoa ,&nbsp;Pablo Moya-Martínez ,&nbsp;Elisa Amo-Saus ,&nbsp;María Ángeles Tortosa-Chuliá","doi":"10.1016/j.puhip.2025.100673","DOIUrl":"10.1016/j.puhip.2025.100673","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study is to understand how different measures of loneliness affect the quality-of-life of older adults and their use of social and healthcare services.</div></div><div><h3>Study design</h3><div>An observational, cross-sectional study was conducted, administering a survey to 1003 non-institutionalized individuals aged 65 years or over in Spain.</div></div><div><h3>Methods</h3><div>Data on sociodemographic variables, quality-of-life, and the use of social and healthcare services were collected. The prevalence of loneliness was analyzed using various measures, while its relationship with quality-of-life and the use of social and healthcare services was assessed through linear and logistic regression models, adjusting for other factors.</div></div><div><h3>Results</h3><div>Loneliness reduced quality-of-life by between 11.1 % and 20.7 %. Of the social and health services analyzed, we found that loneliness increased the likelihood of using home help services by a factor of 1.75–2.36 and increased the number of visits to primary care/nursing services by a factor of 1.51–1.70.</div></div><div><h3>Conclusions</h3><div>Loneliness has detrimental effects on quality-of-life. Moreover, it may negatively impact health status, leading to increased use of social and healthcare services.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"10 ","pages":"Article 100673"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319580","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}