Clinical Epidemiology and Global Health最新文献

{"title":"Determinants of delays in the tuberculosis care pathway and adverse treatment outcomes in Chennai, South India: A retrospective cohort study","authors":"Yuvaraj Krishnamoorthy ,&nbsp;C. Selvaraja ,&nbsp;Dhanajayan Govindan","doi":"10.1016/j.cegh.2025.102123","DOIUrl":"10.1016/j.cegh.2025.102123","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains significant public health issue in India, particularly in high-burden areas. Understanding factors associated with adverse treatment outcomes and delays in TB care pathway is crucial for improving TB control efforts. Hence, this study aimed to identify the determinants of delay in TB care pathway and adverse treatment outcomes in Chennai, South India.</div></div><div><h3>Methods</h3><div>We conducted retrospective cohort study among 497 newly diagnosed, drug-sensitive TB patients at ESIC Medical College &amp; PGIMSR, Chennai, from April 2020 to April 2022. Data were collected from the National TB Elimination Programme portal and supplemented via phone interviews. Patients were assessed for sociodemographic, behavioral, and clinical characteristics, and delays in TB care cascade. Logistic regression models identified predictors of patient delay, total delay, non-adherence, and adverse treatment outcomes and interpreted as adjusted odds ratio (AOR).</div></div><div><h3>Results</h3><div>The study found median patient delay of 18 days and total delay of 28 days in TB care pathway. Females and patients without fever at baseline had significantly longer delays. Extrapulmonary TB was associated with longer total delay. Non-adherence to medication was prevalent (26.6 %) and was the strongest predictor of adverse treatment outcomes (AOR:39.18, 95 %CI: 21.56–71.20, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our study found significant delays in care-seeking, especially among females and individuals without fever at baseline. Non-adherence to treatment was prevalent and associated with adverse treatment outcomes. Implementation of community-based adherence support programs that include regular patient follow-ups and counseling sessions will address barriers to treatment adherence, especially tailored for women and individuals with extrapulmonary TB.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102123"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614346","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":"One health perspective on Rabies: Incidence and risk factors in humans and livestock in Northwest Ethiopia","authors":"Workneh Wondimagegn Azalu ,&nbsp;Sefinew Alemu Mekonnen ,&nbsp;Wudu Temesgen Jemberu","doi":"10.1016/j.cegh.2025.102119","DOIUrl":"10.1016/j.cegh.2025.102119","url":null,"abstract":"<div><h3>Background</h3><div>Rabies is a widespread disease affecting all warm-blooded animals. In developing countries, most human mortalities originate from rabid dogs. Every year, rabies is responsible for an estimated 60,000 human deaths worldwide, with 15 million people receiving rabies post-exposure prophylaxis (PEP), 4 million disability-adjusted life years, and 9 billion US$ dollars in economic losses. Incidence and associated risk factors of rabies in humans and livestock were conducted in North-West Ethiopia with the aim of quantifying the incidence and associated risk factors of rabies.</div></div><div><h3>Methods</h3><div>The prospective follow-up of rabid victims was recorded in seven districts of North-West Ethiopia for 18 consecutive months. Information from victims or bit animal owners was collected, entered into Excel, and analyzed using Stata 17.</div></div><div><h3>Results</h3><div>A total of 393 rabid suspected cases were recorded during the follow-up period, of which 293 were bites by potentially rabid animals and 100 were probable rabid cases. Males to female ratio of human victims was (59.46 % vs. 40.54 %, respectively). Dog owned were more infected (62 %) than non-dog owned. Dogs were the major animals (&gt;96 %) for exposure. The 5–14 years age group had the highest number of bites in human cases. The legs/feet (53.5 %) were the most affected body part. The mortality rate of humans was 2.09 per 100,000 people per year during the current outbreak.</div></div><div><h3>Conclusion</h3><div>People living in rural residences, males, and having dogs in the house were the main risk factors for exposure to rabies. Hence, rabies continues to pose a threat to humans and animals.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102119"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604144","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":"Evaluation of the performance of epidemic-prone disease management systems in Guinea","authors":"Dimaï Ouo Kpamy ,&nbsp;Alexandre Delamou ,&nbsp;Fodé Amara Traore ,&nbsp;Seydou Doumbia ,&nbsp;John Winch Peter ,&nbsp;Abdoulaye Toure ,&nbsp;Alioun Camara ,&nbsp;Sidikiba Sidibe ,&nbsp;Sory Conde ,&nbsp;Fatoumata Cherif ,&nbsp;Fatoumata Keita ,&nbsp;Moumié Barry","doi":"10.1016/j.cegh.2025.102120","DOIUrl":"10.1016/j.cegh.2025.102120","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the performance of response systems for epidemic-prone diseases (EPDs) in Guinea and identify their strengths and weaknesses to guide future improvements.</div></div><div><h3>Study design</h3><div>A cross-sectional evaluation of epidemic-prone disease (EPD) management systems was performed through a sample of actors involved in the response.</div></div><div><h3>Method</h3><div>ology: This descriptive cross-sectional evaluative study involved 356 response actors from Guinea's eight administrative regions. Data were collected via structured questionnaires organized around three main components: structure, process, and results. Subcomponent scores were analyzed, and the main components were classified into three levels of appreciation: good, average, or poor. An analysis of strengths and weaknesses was also conducted.</div></div><div><h3>Results</h3><div>Among the 356 actors interviewed, 76.40 % were female, and the majority (51 %) were aged between 40 and 60 years. A total of 89.9 % had a university-level education. The structure component achieved an overall score of 61 %, reflecting average appreciation. The subcomponents included human resources (69 %), logistics and health products (81 %), and health financing (32 %). The process component scored 60 %, with strong leadership and coordination (81 %) but weaknesses in care delivery (48 %) and logistics (35 %). The results component scored 88 %, which was considered good, with significant improvements in care (89 %), surveillance (96 %), diagnostic efficiency (78 %), and satisfaction with management (96 %).</div></div><div><h3>Conclusion</h3><div>Guinea's response systems for epidemic-prone diseases show average performance with encouraging outcomes. However, structural and procedural gaps persist. Strengthening human resources, timely diagnostics, continuity of care for severe cases, and sustainable financing are essential to improve future epidemic management.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"35 ","pages":"Article 102120"},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632590","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":"Corrigendum to “Neuro-musculoskeletal side effects related to COVID-19 vaccines; A cross sectional study in Iranian healthcare workers” [Clin Epidemiol Glob Health 30 (2024) 101691]","authors":"Masoumeh ZoghAli ,&nbsp;Fateme Hojjati ,&nbsp;Maryam Sadat Mirenayat ,&nbsp;Seyed Mansoor Rayegani","doi":"10.1016/j.cegh.2025.102049","DOIUrl":"10.1016/j.cegh.2025.102049","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102049"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696708","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":"Complete utilization of maternal and child health continuum of care among mothers of children aged 9–18 months in Habru district, Northeast Ethiopia","authors":"Habtamu Asefa ,&nbsp;Mastewal Arefaynie ,&nbsp;Mulugeta Desalegn ,&nbsp;Birhanu Wagaye ,&nbsp;Tadesse Gure Eticha ,&nbsp;Dawit Firdisa","doi":"10.1016/j.cegh.2025.102023","DOIUrl":"10.1016/j.cegh.2025.102023","url":null,"abstract":"<div><h3>Background</h3><div>The maternal and child health (MCH) continuum of care is crucial for reducing maternal and child mortality. However, MCH service utilization in Ethiopia remains low. This study aimed to assess the utilization of the MCH continuum of care and identify associated factors among mothers in Habru district, northeast Ethiopia.</div></div><div><h3>Methods</h3><div>A community-based cross-sectional study was conducted from January 10 to February 17, 2023. A multi-stage sampling method was used to select mothers with children aged 9–18 months. Data were collected using an interviewer-administered questionnaire and analyzed using SPSS version 26.</div></div><div><h3>Results</h3><div>The prevalence of mothers who completed the MCH continuum of care was 25.3 % (95 % CI: 22.2 %, 28.5 %). Factors significantly associated with completion included education level, residence, access to healthcare within 60 min, early initiation of antenatal care (ANC), awareness of MCH services, mode of delivery, and birth preparedness planning.</div></div><div><h3>Conclusion</h3><div>MCH continuum of care completion remains low in the study area. Education, early initiation of ANC, and awareness of MCH services were significant determinants. Strengthening these factors through targeted interventions is crucial to improve MCH service utilization in the region.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102023"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571771","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":"Effectiveness of Tai Chi balance exercise on fall risk in older adults with cataracts in rural Indonesia: Original research","authors":"Asri Wahyuni Arsyad ,&nbsp;Andi Masyitha Irwan ,&nbsp;Yuliana Syam ,&nbsp;Sakul Changmai ,&nbsp;Amy Buckenmeyer","doi":"10.1016/j.cegh.2025.102110","DOIUrl":"10.1016/j.cegh.2025.102110","url":null,"abstract":"<div><h3>Problem considered</h3><div>Cataracts, a leading cause of blindness, affect 12 million people globally. Among older adults, the decline in the ocular vestibular system and reduced balance control increase the risk of fall. Although the effectiveness of Tai Chi in older adults with cataracts remains unclear, its emphasis on physical strength, coordinated breathing, and balance may help mitigate this risk. This study aimed to assess the efficacy of Tai Chi in reducing fall risk among older adults with cataracts.</div></div><div><h3>Methods</h3><div>Using a quasi-experimental pre-posttest design, 56 older adults diagnosed with cataracts were assigned to the intervention or control groups. Tai Chi was conducted three times weekly for one month, with each session lasting 35–45 min.</div></div><div><h3>Results</h3><div>In <em>the pre–post control</em> (within groups), the risk of falls was not significant (p &gt; 0.05), whereas in the <em>pre–post intervention</em>, the risk of falls decreased (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Tai Chi may be an effective strategy to improve balance and prevent falls in this population.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102110"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557080","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":"Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach","authors":"Ajith K. Remesan ,&nbsp;Varalakshmi Chandra Sekaran ,&nbsp;Satyanarayana Poojari ,&nbsp;Teddy Andrews Jaihind Jothikaran ,&nbsp;Vani Lakshmi R ,&nbsp;Lena Ashok","doi":"10.1016/j.cegh.2025.102114","DOIUrl":"10.1016/j.cegh.2025.102114","url":null,"abstract":"<div><h3>Background</h3><div>Adverse childhood experiences (ACEs) refer to various types of abuse, neglect, and household dysfunction that individuals may experience in childhood. These experiences can lead to significant long-term effects on mental health and behavior. Individuals with higher ACE scores are more likely to experience psychological distress and the uptake of substances. This study aimed to explore the relationship between ACEs, psychological distress, and substance use among emerging adults.</div></div><div><h3>Methods</h3><div>The cross-sectional study was conducted in the Udupi district of Karnataka, India. The undergraduate colleges associated with Mangalore University were the sampling units. A multi-stage cluster random sampling method was employed to select 12 colleges from the undergraduate institutions in the district affiliated with Mangalore University based on their various courses. Data was collected in a classroom setting among 957 emerging adults between June 2023 and October 2023.</div></div><div><h3>Results</h3><div>Among the participants, 18.91 % reported ACEs. Additionally, the prevalence of psychological distress and substance use were noted to be 27.03 % and 17.97 %, respectively. Tobacco and alcohol were having a higher prevalence in comparison with other substances. Furthermore, emerging adults who have experienced ACEs are significantly more prone to experiencing psychological distress.</div></div><div><h3>Conclusion</h3><div>The study highlights the connection between ACEs, psychological distress, and substance use in emerging adults. It calls for integrating ACEs into interventions and policies, emphasizing the need for global research, particularly in India, to foster social cohesion and well-being through prevention and early detection strategies.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102114"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580869","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":"Fostering empathy through Experience: Assessing the outcomes of the Family Adoption Program (FAP) among indian medical graduates","authors":"Priyanka Gupta,&nbsp;Nandini Sharma,&nbsp;Deepanshi Saxena","doi":"10.1016/j.cegh.2025.102112","DOIUrl":"10.1016/j.cegh.2025.102112","url":null,"abstract":"<div><h3>Introduction</h3><div>The Family Adoption Program (FAP) is integrated into India's Competency-Based Medical Education to enhance medical students' understanding of community health by assigning them to adopt families, thereby fostering empathy and improving patient care. Thus, the study aimed to assess and evaluate its outcomes among medical students and its impact on adopted families.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving medical students and their adopted families in FAP in Gurugram, Haryana. Data were collected through structured questionnaires focusing on the program's influence on both the students and their adopted families. The university priority health card was issued to all adopted families. Descriptive analysis was done using SPSS v. 28 software.</div></div><div><h3>Results</h3><div>In this study, 123 students and 369 adopted families were included. The majority, (115, 93.5 %) of students reported enhanced communication skills. Most 93.8 % of the adopted families considered FAP as a good initiative. A total of 321 (87 %) families appreciated university priority health cards with the benefits of free services.</div></div><div><h3>Conclusion</h3><div>FAP significantly benefits medical students by enriching their educational experience and fostering empathy. Concurrently, it positively impacts adopted families by improving their health awareness and access to care, highlighting the program's dual advantage in medical education and community health. Since the study was conducted over a brief period without extended follow-up, it was not possible to evaluate the long-term benefits for students and families.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102112"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557081","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":"Menstrual challenges and quality of life among medicals students - a cross sectional study","authors":"Deepa Singh ,&nbsp;Sujata Deo ,&nbsp;Vandana Solanki ,&nbsp;Pratibha Kumari ,&nbsp;Shweta Singh","doi":"10.1016/j.cegh.2025.102100","DOIUrl":"10.1016/j.cegh.2025.102100","url":null,"abstract":"<div><h3>Background</h3><div>Menstrual cycle abnormalities and irregularities have a substantial impact on women's quality of life. Because of their intense academic environments, female medical undergraduates are particularly sensitive to stress-induced menstrual problems. This study explores the effect of irregular menstrual cycle on quality of life among female medical undergraduates due to their stressful academic environment.</div></div><div><h3>Methods</h3><div>A cross-sectional study was done at King George's Medical University, Lucknow, India from March 2023 to March 2024. Aged 18–25 years among 625 female undergraduate students were participated. To collect data WHOQOL-BREF and PSST-A tools were used for quality of life and severity of menstrual syndrome respectively along with menstrual assessment abnormalities. SPSS version 22.0 was used for statistical analysis, P value &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>The mean age of participants was 21.22 ± 1.30 years. The majority of participants (83.2 %) belonged to the upper middle class and from urban area (97.7 %). Menarche occurred at an average age of 12.45 years. 72.5 % reported having regular menstrual cycle, whereas 17 % reported having infrequent cycle. Dysmenorrhea was reported by 91.4 % of participants with moderate pain being the most common. Premenstrual syndrome was prevalent in 90.9 % of subjects, with 41.3 % of them had moderate to severe symptoms. Irregular menstrual cycle had an effect on the social, psychological and physical aspect of quality of life.</div></div><div><h3>Conclusion</h3><div>The High prevalence of dysmenorrhea, premenstrual syndrome and menstrual irregularities indicated that there is a need for interdisciplinary action to understand the persistent impact on medical students and make their lives easier.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102100"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514194","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":"Mental health literacy and its determinants among late adolescents in South India: A cross-sectional study","authors":"Sooraj Kookal ,&nbsp;Jyothi Chakrabarty ,&nbsp;Linu Sara George ,&nbsp;Samir Kumar Praharaj ,&nbsp;Judith Angelitta Noronha ,&nbsp;Baby S. Nayak ,&nbsp;R. Vani Lakshmi ,&nbsp;Soyuz John","doi":"10.1016/j.cegh.2025.102101","DOIUrl":"10.1016/j.cegh.2025.102101","url":null,"abstract":"<div><h3>Background</h3><div>Mental health literacy (MHL) plays an integral role in addressing mental health challenges, reducing stigma, and promoting well-being among adolescents. This study intended to assess the MHL level and identify its socio-demographic determinants among late adolescents in India, which has the world's largest adolescent population.</div></div><div><h3>Methods</h3><div>A cross-sectional study was carried out among 1536 late adolescents enrolled in undergraduate programs at institutions affiliated with Mangalore University in the Udupi district, Karnataka. Multistage cluster random sampling was used to recruit participants. Data were collected using the standardized Mental Health Literacy questionnaire -Young Adults and a socio-demographic proforma. One-way ANOVA and unpaired t-tests were used to compare MHL scores across demographic variables. Ordinal logistic regression was performed to identify the key determinants of MHL.</div></div><div><h3>Results</h3><div>The mean global MHL score was 96.4 <span><math><mrow><mo>±</mo></mrow></math></span> 9.4, indicating moderate MHL. Among participants,83 % had moderate,15 % low, and 2 % high MHL. Higher MHL scores were associated with females (<em>P</em> &lt; .001), urban residence (<em>P</em> = .04), study streams (<em>P</em> &lt; .001), academic year (<em>P</em> &lt; .001), fathers' (<em>P</em> &lt; .001) and mothers' education (<em>P</em> &lt; .001), fathers' (<em>P</em> = .003) and mothers' occupation (<em>P</em> &lt; .001) and monthly family income (<em>P</em> = .01). Ordinal logistic regression identified sex, study streams, parental education, and mothers’ occupation as the key determinants of MHL.</div></div><div><h3>Conclusion</h3><div>The study found moderate MHL among the participants with significant socio-demographic disparities. Integrating MHL interventions into academic curricula, conducting campus-wide MHL campaigns, and improving mental health services in remote areas are essential to bridge these gaps.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102101"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514195","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}