Global Epidemiology最新文献

{"title":"Machine learning-based identification of determinants of pulse pressure in pregnant women","authors":"Merga Abdissa Aga","doi":"10.1016/j.gloepi.2026.100245","DOIUrl":"10.1016/j.gloepi.2026.100245","url":null,"abstract":"<div><h3>Background</h3><div>Pulse pressure (PP) is an important marker of arterial stiffness and cardiovascular risk during pregnancy, yet its longitudinal determinants remain insufficiently characterized, particularly in low-resource settings.</div></div><div><h3>Objective</h3><div>To identify determinants of longitudinal pulse pressure among pregnant women using machine learning approaches and to compare their predictive performance with a conventional mixed-effects modeling framework.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 549 pregnant women attending public antenatal care services at Bishoftu General Hospital, Oromia region, Ethiopia, comprising 2760 repeated pulse pressure measurements. Pulse pressure was modeled as a continuous longitudinal outcome. Predictors included maternal sociodemographic characteristics, clinical measurements, obstetric history, and gestational age at each visit. A generalized linear mixed model, random forest regression, and XGBoost regression were applied. Participant-level data partitioning was used for model training and evaluation, and predictive performance was assessed using root mean squared error (RMSE) and mean absolute error (MAE).</div></div><div><h3>Results</h3><div>Tree-based machine learning models showed improved predictive performance compared with the mixed-effects model, indicating the presence of nonlinear and time-dependent relationships between predictors and pulse pressure trajectories. Maternal age, body weight, gestational age, and pulse pressure values from previous visits consistently contributed to pulse pressure prediction.</div></div><div><h3>Conclusion</h3><div>Machine learning methods applied to longitudinal antenatal data provide a flexible and effective framework for modeling pulse pressure dynamics during pregnancy. This approach enhances understanding of key clinical and temporal determinants and may support improved cardiovascular risk assessment in maternal health care settings.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926429","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":"Spatial disparities and associated factors of composite index of anthropometric failure for under-five children across three African countries","authors":"Nigussie Adam Birhan ,&nbsp;Abebew Aklog Asmare ,&nbsp;Kefale Tilahun Getahun ,&nbsp;Zelalem Meraf wolde ,&nbsp;Denekew Bitew Belay ,&nbsp;Ding-Geng Chen","doi":"10.1016/j.gloepi.2026.100268","DOIUrl":"10.1016/j.gloepi.2026.100268","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition is associated with both undernutrition and over nutrition. Child undernutrition remains the greatest public health problem in developing countries. This study assessed factors associated with the Composite Index of Anthropometric Failure (CIAF) and explored spatial patterns across the provinces of three African countries.</div></div><div><h3>Methods</h3><div>A nationally representative secondary record from the recent Demographic and Health Survey was used. Spatial Autocorrelation was used to identify particular provinces clustering with high and low CIAF values. A Bayesian generalized geo-additive mixed modelling approach was applied using Integrated Nested Laplace Approximation with a binomial family and logit link function.</div></div><div><h3>Results</h3><div>The overall prevalence of CIAF among the three African countries was 41.2%, with a difference between countries ranging from Zambia (34.9%) to Democratic Republic of Congo (46.0%). Both Moran's I and Geary's C tests evidenced the existence of spatial autocorrelation of CIAF among children in the three African countries. Bayesian generalized geo-additive model with Besag-York-Mollie mixed effect was found to be the best model to assess the spatial dependencies and the non-linear effects of factors on CIAF. This study showed the existence of spatial disparities in the CIAF. Place of residence, mother's education level, child sex, wealth index, marital status, access to health facilities, child birth size, type of birth, diarrhea, vitamin A supplementation, place of birth, child anemia status, iron supplementation, and country were associated with CIAF.</div></div><div><h3>Conclusion</h3><div>This study revealed a high burden of CIAF across the three African countries, with marked spatial disparities and clustering of CIAF in children. The Bayesian geo-additive model identified multiple socioeconomic, demographic, geographical, and health-related factors associated with the CIAF. These findings highlight the need for geographically targeted, multifaceted interventions to address the underlying factors associated with malnutrition and reduce regional inequalities.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167564","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":"Sleep quality and psychological distress among Bangladeshi medical students: Prevalence, predictors, and sex-institutional differences","authors":"Abdul Muyeed ,&nbsp;Ratul Rahman ,&nbsp;Sumaiya Islam Suchi ,&nbsp;Kawsar Ahmed ,&nbsp;Tahmina Akter Tithi","doi":"10.1016/j.gloepi.2026.100243","DOIUrl":"10.1016/j.gloepi.2026.100243","url":null,"abstract":"<div><h3>Background</h3><div>Poor <strong>s</strong>leep quality and psychological distress are common in medical students worldwide. Understanding the relationship between sleep quality and psychological distress is crucial for enhancing student well-being and academic achievement. This study aimed to assess the prevalence and influencing factors of poor sleep quality and psychological distress among Bangladeshi medical students, and to explore sex and institutional differences.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 378 medical students using a structured questionnaire. Data were collected using the Depression, Anxiety, and Stress Scale (DASS-21) and the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses including confirmatory factor analysis (CFA), independent samples <em>t</em>-tests, and a bivariate test of association were conducted.</div></div><div><h3>Results</h3><div>The prevalence rates of poor sleep quality (67.2 %), depression (55.8 %), anxiety (58.7 %), and stress (38.6 %) were significantly high among medical students in Bangladesh. The CFA test recommended a three-factor model for DASS-21 and a two-factor model for PSQI. A moderately positive association was found between sleep quality and depression, anxiety, and stress. Independent samples <em>t</em>-tests showed that male students reported lower PSQI and DASS-21 scores. Additionally, depression (AOR = 2.61, 95 % CI: 1.37–4.99) and stress (AOR = 2.77, 95 % CI: 1.25–6.14) were found as the most significant predictors of sleep quality.</div></div><div><h3>Conclusions</h3><div>Psychological distress, excessive time spent on social media, and online games negatively influence sleep quality, while being a male, smoking, and having career-building opportunities positively influence sleep quality. Interventions aimed at reducing stress and promoting healthy sleep practices are urgently needed within medical institutions.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100243"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926532","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":"Complexity does not create precision; the case of counting the number of vapers","authors":"Carl V. Phillips","doi":"10.1016/j.gloepi.2026.100265","DOIUrl":"10.1016/j.gloepi.2026.100265","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100265"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230803","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":"Erratum regarding Missing disclaimer statement from Editor [in Chief] on the decision process in previously published articles","authors":"","doi":"10.1016/j.gloepi.2026.100252","DOIUrl":"10.1016/j.gloepi.2026.100252","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100252"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230804","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":"Unveiling hidden heterogeneity and inequalities in the continuum of care for reproductive, maternal, and child health services in sub-Saharan Africa: A multilevel latent class analysis approach","authors":"Abebew Aklog Asmare ,&nbsp;Awoke Seyoum Tegegne ,&nbsp;Denekew Bitew Belay","doi":"10.1016/j.gloepi.2025.100237","DOIUrl":"10.1016/j.gloepi.2025.100237","url":null,"abstract":"<div><div>Improving reproductive, maternal, newborn, and child health (RMNCH) services is vital for achieving the Sustainable Development Goals (SDGs) for maternal and child survival. This study utilized multilevel latent class analysis (MLCA) on Demographic and Health Surveys (DHS) data from 29 sub-Saharan African (sSA) countries to identify RMNCH service utilization patterns, examine covariate effects, and assess coverage inequalities. Secondary data from the most recent DHS conducted in 29 sSA countries from 2015 to 2024 were used. MLCA was performed on 12 RMNCH service indicators to account for the hierarchical structure of the data. Summary inequality indicators were used to assess differences in posterior class membership for lower-level classes across wealth quintiles, maternal education, maternal occupation, and place of residence. Women's RMNCH service utilization was divided into two categories: optimal and suboptimal users, and two higher-level categories: high and low coverage. Higher maternal education, household wealth, media access, and early antenatal care were related to a higher likelihood of being in the optimal utilizer class. In contrast, rural location and a longer distance to health services were associated with a lower likelihood. Inequality indices revealed significant differences among optimal utilizers, particularly in terms of mother education and household wealth. Targeted interventions are urgently required to promote RMNCH service utilization in sSA by addressing persistent socioeconomic disparities, particularly among women with no education, lower incomes, and low access to health care.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791465","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":"Magnitude and correlates of overweight or obesity among adults with diabetes mellitus duration of five or more years in rural Uganda: A cross-sectional study","authors":"Boniface Amanee Elias Lumori ,&nbsp;Lodiong Jackson Dumo Lodiong ,&nbsp;Ucama Ufoymungu Patrick ,&nbsp;Jonathan Izudi","doi":"10.1016/j.gloepi.2026.100254","DOIUrl":"10.1016/j.gloepi.2026.100254","url":null,"abstract":"<div><h3>Background</h3><div>Overweight and obesity are major risk factors for micro and macrovascular diseases, with diabetes mellitus exacerbating these burdens. We determined the prevalence of overweight or obesity and its associated factors among adults with diabetes mellitus with a duration of ≥5 years at Mbarara Regional Referral Hospital in Southwestern Uganda.</div></div><div><h3>Methods</h3><div>This analytic cross-sectional study was conducted over 5 months, from November 2017 to March 2018. We collected demographic and clinical data and measured body mass index (BMI). The outcome was overweight or obesity, measured as the proportion of individuals with a BMI of 25 kg/m² or more. We used binary logistic regression to estimate associations of a priori selected variables with the outcome.</div></div><div><h3>Results</h3><div>Of 189 participants, 138 (73%) were female, the mean age was 61.5 ± 11.1 years, and the median duration of diabetes mellitus since diagnosis was 10 years (interquartile range, 7–15). Overall, 122 (64.5%) participants were overweight or obese. In the multivariable logistic regression analysis, former cigarette smoking (adjusted odds ratio (AOR) 0.2, 95% confidence interval (CI) 0.1–0.6), every 1-year increase in the duration of diabetes mellitus (AOR 1.1, 95% CI 1.0–1.1), and hypertension (AOR 2.8, 95% CI 1.2–6.5) were independently associated with overweight or obesity.</div></div><div><h3>Conclusion</h3><div>Overweight/obesity is prevalent among adults with diabetes mellitus duration of 5 years and over, in a rural Ugandan population. Former cigarette smokers have a decreased likelihood of being overweight or obese, while hypertension and every 1-year increase in the duration of diabetes mellitus are associated with a higher likelihood of being overweight or obese.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378863","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 comparative analysis of social support, risk behaviors, and HIV health service use among adolescent and young males and females in Lusaka, Zambia","authors":"Sanjana Batabyal ,&nbsp;Ronald Mungoni ,&nbsp;Drosin Mulenga ,&nbsp;Nachela Chelwa ,&nbsp;Michael Mbizvo ,&nbsp;Laura Nyblade ,&nbsp;Yevgeniya Kaganova ,&nbsp;Sonja Hoover ,&nbsp;Sujha Subramanian","doi":"10.1016/j.gloepi.2025.100240","DOIUrl":"10.1016/j.gloepi.2025.100240","url":null,"abstract":"<div><h3>Background</h3><div>Human immunodeficiency virus (HIV) remains the leading cause of death in Zambia. While females are disproportionately affected by HIV, males – especially young males – are vulnerable to the disease due to a variety of risk factors. This study aimed to understand what, if any, sex-related differences exist between young females and males on social support, risk behavior, and HIV healthcare utilization issues.</div></div><div><h3>Methods</h3><div>Baseline survey responses from an implementation trial (<span><span>NCT03995953</span><svg><path></path></svg></span>) were examined for 863 females and 302 males affected by HIV between ages 15 and 26. We created summary statistics related to peer and familial support, risk factors (i.e., physical safety, economic security, mental health, substance abuse, and sexual behavior), and HIV healthcare utilization. Summary statistics were evaluated for statistical significance through Pearson Chi-Square testing.</div></div><div><h3>Findings</h3><div>Females and males, regardless of HIV status, have higher average confidence in familial support (67 %) than peer support (40 %). Across HIV status, females and males had similar rates of physical safety risk. Regardless of HIV status, about half the participants reported worrying about running out of food. Substance abuse risk is higher among males; 15 % of males at risk of HIV and 7 % of males living with HIV report drug usage other than alcohol or marijuana compared to just 1 % of all females. Among individuals at risk of HIV, there are differences in rates of HIV testing by sex: 27.7 % among males vs. 6.7 % among females.</div></div><div><h3>Interpretations</h3><div>While there are some differences, the many similarities between young females and males suggest that joint interventions which incorporate familial support could be beneficial to address shared risk factors. These joint interventions can be supplemented with sex-specific interventions related to substance abuse for males and HIV testing for females.</div></div><div><h3>Funding</h3><div>Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute Of Child Health &amp; Human Development of the National Institutes of Health under Award Number UH3HD096908. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926531","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":"Exploring the proper use of p-values and confidence intervals in leading epidemiology journals","authors":"Montana Kekaimalu Hunter ,&nbsp;Anthony James Russell ,&nbsp;George Maldonado ,&nbsp;Igor Burstyn","doi":"10.1016/j.gloepi.2026.100247","DOIUrl":"10.1016/j.gloepi.2026.100247","url":null,"abstract":"<div><div>Misinterpretation of null-hypothesis tests (<em>p</em>-values) and confidence intervals has been a longstanding issue in epidemiology. Despite efforts by leading journals to discourage or ban such practices, the extent of misinterpretations in modern epidemiologic literature remains unclear. We examined papers published in 2022 in three leading epidemiology journals (International Journal of Epidemiology, Epidemiology, and American Journal of Epidemiology) to assess the frequency and types of misinterpretations of <em>p</em>-values and confidence intervals. We randomly sampled 64 papers that assessed exposure-outcome relationships. Two authors independently reviewed the selected papers, cataloging misinterpretations according to guidelines published in 2016. While concerns about <em>p</em>-value misuse persist in scientific literature, our review of recent epidemiological studies reveals encouraging progress: outright statistical misinterpretations were not observed in the leading journals. We identified subtle opportunities to enhance reporting, including reducing reliance on binary “significant” vs. “non-significant” language, more consistently pairing <em>p</em>-values with effect sizes, and fuller interpretations of confidence intervals. In a sense, our concerns relate to the suitability of null hypothesis testing framework in epidemiology, rather than its correct application. Notably, we highlight examples of commendable practices where studies successfully integrated statistical results with clinical and public health context. Modern epidemiological research shows improved statistical reporting, while some concerns persist. Importantly, the findings of this review apply only to the primary results as reported in published manuscripts and do not extend to the broader analytic process that generates those results. Such assumptions are not secondary to hypothesis testing; rather, they contribute as much to the resulting <em>p</em>-value as the target hypothesis itself and overlooking them can lead to overly optimistic interpretations. Recognizing this distinction is essential for contextualizing our conclusions and for situating <em>p</em>-values and confidence intervals within the broader inferential framework. We recommend targeted refinements: avoiding binary language, mandating effect size reporting, and developing methods to interpret confidence intervals beyond null-hypothesis testing. These steps will align the field with evolving standards while preserving the utility of <em>p</em>-values where appropriate.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977193","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":"Modelling seizure-related predictors of epilepsy diagnostic gap in two urban informal settlements of Nairobi using machine learning","authors":"Daniel Mwanga ,&nbsp;Frederick Murunga Wekesah ,&nbsp;Frank Ouma ,&nbsp;Symon M. Kariuki ,&nbsp;Joan Kinuthia ,&nbsp;Peter Otieno ,&nbsp;Thomas Kwasa ,&nbsp;Quincy Mongare ,&nbsp;Abigael Machuka ,&nbsp;Steve Cygu ,&nbsp;Samuel Iddi ,&nbsp;Gabriel Davis Jones ,&nbsp;Arjune Sen ,&nbsp;Charles R. Newton ,&nbsp;Gershim Asiki ,&nbsp;Damazo T. Kadengye ,&nbsp;for the EPInA Study Group","doi":"10.1016/j.gloepi.2025.100241","DOIUrl":"10.1016/j.gloepi.2025.100241","url":null,"abstract":"<div><h3>Background</h3><div>There is a wide gap in epilepsy diagnosis, particularly in low- and middle-income countries. We used machine learning models to identify seizure-related factors associated with the epilepsy diagnostic gap within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), Kenya, to inform effective community-level interventions.</div></div><div><h3>Methods</h3><div>Data were drawn from a two-stage, population-based census. In Stage-I, 56,425 residents of NUHDSS were screened for possible convulsive and non-convulsive epilepsy using a standardized questionnaire. In Stage-II, individuals who screened positive were invited for clinical assessment and diagnostic confirmation by neurologists. We used latent class analysis to classify symptom patterns. Seven machine learning models were trained, with extreme gradient boost and random forest models achieving the highest area under the receiver operating characteristic curve (98 %).</div></div><div><h3>Results</h3><div>A total of 528 individuals were diagnosed with epilepsy, among whom 80 % (<em>n</em> = 420) had not been previously diagnosed. The epilepsy diagnostic gap was 100 % (<em>n</em> = 160/160) in persons with non-convulsive epilepsy, meaning that none of them had been diagnosed before the survey. Among those with convulsive epilepsy, the diagnostic gap was 71 % (<em>n</em> = 260/368). Experiencing fewer types of seizure symptoms, non-convulsive seizures, or seizures with subtle features, such as those involving only one body part and those whose first experience of a seizure was recent, were associated with a wider epilepsy diagnostic gap.</div></div><div><h3>Conclusion</h3><div>There is critically huge diagnostic gap for epilepsy in Nairobi's informal settlements. People with subtle, fewer or less obvious seizure types are more likely to be undiagnosed. These findings highlight the importance of seizure symptom characteristics in understanding patterns of underdiagnosis. Thus, approaches to reducing the diagnostic gap should take into consideration subtle and non-convulsive seizure presentations, such as training on symptom recognition and timely care-seeking.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977194","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}