Global Mental Health最新文献

{"title":"Training needs of informal caregivers of persons with dementia in rural southwestern Uganda: A qualitative formative study.","authors":"Joyce Namwase, Julius Kyomya, Amos Oyuru, Emmanuel Maleka, Abraham Muhwezi, John Semuwemba, Christine K Karungi, Celestino Obua, Edith K Wakida","doi":"10.1017/gmh.2026.10279","DOIUrl":"10.1017/gmh.2026.10279","url":null,"abstract":"<p><p>Dementia is a global public health concern with increasing prevalence, especially in low- and middle-income countries (LMICs) where care is primarily provided by informal family caregivers. This study identified the specific training needs of informal caregivers of persons with dementia in rural southwestern Uganda to inform the development of contextually appropriate caregiver training interventions. We conducted 20 in-depth interviews with 17 caregivers and 3 key informants affiliated with Reach One Touch One Ministries (ROTOM), a community-based organization supporting older persons in Rukiga District, Uganda. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically using an inductive approach. Caregivers demonstrated limited knowledge of dementia, often attributing it to normal aging, spiritual causes, or stress. They faced substantial physical, emotional, and financial burdens, and relied on faith, social support, and adaptive caregiving strategies. All expressed willingness to attend group-based, in-person training focused on practical skills, including communication, managing dementia-related behaviors, personal hygiene, nutrition, and medication administration. Key informants highlighted the importance of community awareness to address misconceptions. Informal caregivers in rural Uganda experience high caregiving burden and unmet training needs. The identified training priorities closely align with World Health Organization (WHO) iSupport domains, supporting adaptation of the program for rural Ugandan caregivers.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e171"},"PeriodicalIF":3.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating effect of alexisomia between childhood abuse and depression/stress in a sample of Lebanese adults: A cross-sectional study.","authors":"Christian Salameh, Diana Malaeb, Muna Barakat, Fouad Sakr, Mariam Dabbous, Souheil Hallit, Feten Fekih-Romdhane, Sahar Obeid","doi":"10.1017/gmh.2026.10275","DOIUrl":"10.1017/gmh.2026.10275","url":null,"abstract":"<p><p>Mental health outcomes, such as depression and stress, are shaped by various factors, including childhood abuse, emotional and physical awareness deficits like alexisomia and sociodemographic influences. This study aimed to investigate the mediating role of alexisomia in the relationship between childhood abuse and mental health outcomes, specifically depression and stress, among Lebanese adults. A cross-sectional study was conducted in July 2024, enrolling 1,205 participants via a snowball sampling technique from various Lebanese regions. Higher childhood abuse was significantly associated with greater alexisomia, depression and stress. Mediation analyses with adjustment for covariates (gender, smoking, socioeconomic status, etc.) revealed that alexisomia mediated the association between childhood abuse and both depression (Beta = 0.018; Boot CI: 0.002-0.034) and stress (Beta = 0.005; Boot CI: 0.001-0.009). Higher childhood abuse was significantly associated with higher alexisomia and directly associated with higher depression/stress. Higher alexisomia was significantly associated with higher depression/stress. The findings suggest the need for greater clinical focus and targeted interventions to enhance emotional and physical awareness and improve mental health outcomes, particularly for individuals with a history of trauma.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e165"},"PeriodicalIF":3.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of non-specialist training and delivery of a brief cognitive-behavioral therapy-based transdiagnostic intervention for adolescents with depression and anxiety in Nairobi, Kenya.","authors":"Teresia Mutavi, Tessa Concepcion, Mansurat Raji, Anne Mbwayo, Stella Waruinge, Shannon Dorsey, Brandon A Kohrt, Gloria Pedersen, Alison Schafer, Muthoni Mathai, Pamela Y Collins","doi":"10.1017/gmh.2026.10273","DOIUrl":"10.1017/gmh.2026.10273","url":null,"abstract":"<p><p>This study evaluated 1) foundational helping competencies for Non-Specialist Providers (NSPs) trained in a transdiagnostic CBT-based intervention (PRO-ACT) for adolescents with anxiety and depression in Nairobi, Kenya and 2) preliminary clinical outcomes for adolescents receiving PRO-ACT. Seventeen NSPs were trained and assessed using role plays at pre-training, post-training, and post-supervision using the Enhancing Assessment of Common Therapeutic Factors (ENACT) tool, via a pre-post design (no control group). Eighteen adolescents were enrolled, received 4-6 PRO-ACT sessions, and assessed using the Patient Health Questionnaire-9 (PHQ-9) and Revised Children's Anxiety and Depression Scale (RCADS-25). There were no significant changes in NSPs' competencies from pre- to post-training. From pre-training to post-supervision, NSPs' Level 1 (Potentially harmful) scores significantly decreased (-1.12 items; 95% CI: -2.10, -0.15; <i>p</i> = 0.026) and Level 3 or 4 (\"Basic\" or \"Advanced competency\") significantly increased (2.12; 95% CI: 1.21, 3.04; <i>p</i> < 0.001). Adolescents had no significant change in mean PHQ-9 scores. RCADS scores decreased significantly for depression (-3.00 points; 95% CI: -5.45, -0.55; <i>p</i> = 0.020) and anxiety (-3.39 points; 95% CI: -6.17, -0.61; <i>p</i> = 0.020). NSPs' foundational helping competencies improved significantly during clinical supervision. Client outcomes were promising, warranting a larger rigorous trial.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e169"},"PeriodicalIF":3.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome measurement in trauma-informed care education across healthcare settings: A scoping review.","authors":"Analpa Vishwanath, Louloua Ashikhusein Waliji, Abdullah Bengali, Sabina Rajkumar, Negar Sayrefidazeh, Sophie Soklaridis, Dana C Ross","doi":"10.1017/gmh.2026.10277","DOIUrl":"10.1017/gmh.2026.10277","url":null,"abstract":"<p><p>As trauma-informed care (TIC) becomes more integrated into healthcare systems, consistent and meaningful evaluation remains limited. Educational interventions are central to implementation, yet outcome measures vary widely. This scoping review systematically mapped outcome measures used to evaluate TIC educational interventions in healthcare settings to identify current practices, methodological gaps and opportunities for more coherent and context-sensitive assessment. The review followed PRISMA-ScR guidelines. Five databases (MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC) were searched from database inception to October 2024. Eligible studies described TIC educational interventions for healthcare providers and reported at least one outcome related to knowledge, attitudes, confidence, competence, or behavior. Two reviewers independently screened and extracted data on study design, participants, intervention characteristics and outcome measures. Outcomes were categorized using Moore's Expanded Outcomes Framework, which includes seven hierarchical levels from participation to patient or community health outcomes. Twenty-eight studies met inclusion criteria, most published after 2020 and conducted in the United States. Outcome measurement was dominated by self-reported data, primarily custom pre-post surveys assessing knowledge, confidence or attitudes. Only eight studies used validated tools, most commonly the ARTIC-35 or ARTIC-45. Few assessed behavioral or system-level change, and none directly measured patient outcomes. Educational formats ranged from brief online modules to multi-session interdisciplinary trainings. A small subset explored relational or equity-oriented outcomes such as empathy or cultural humility, often using qualitative methods. This review highlights the field's reliance on short-term, self-reported outcomes and limited use of validated or standardized measures. Developing accessible, equity-informed tools that capture behavioral and system-level change is essential to advance research, guide policy and sustain trauma-informed transformation across healthcare systems.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e164"},"PeriodicalIF":3.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health and psychosocial support interventions for individuals affected by gender-based violence in fragile contexts: A systematic review.","authors":"Tanya Ann Antony, Eamonn Whelan, Andrea Finnegan, Frédérique Vallières, Laurene Barlet, Meg Ryan, Esperanza Escorza, Geraldine Fitzgerald, Kristin Hadfield","doi":"10.1017/gmh.2026.10272","DOIUrl":"10.1017/gmh.2026.10272","url":null,"abstract":"<p><p>Gender-based violence (GBV) is a global public health crisis exacerbated in fragile settings by gender inequalities, displacement, and resource scarcity. While mental health and psychosocial support (MHPSS) interventions aim to support people with experience of GBV, research on their effectiveness across diverse fragile contexts remains limited. In this review, we answer the following questions: (1) What type(s) of MHPSS interventions are commonly implemented with survivors of GBV in humanitarian/fragile settings? (2) What outcome(s) are targeted by MHPSS interventions implemented for those exposed to GBV in fragile settings? (3) What is the reported effectiveness of these interventions in addressing these specified outcomes? Seven electronic databases (PubMed, PsycINFO, Cochrane, CINAHL, ERIC, ProQuest, and Web of Science) and grey literature were searched for studies published up to July 2024. Following screening of 2,268 titles and abstracts, 157 full texts were screened (20% independently), with included studies analysed using narrative synthesis. Quality of studies was assessed using the Quality Assessment with Diverse Studies (QuADS). Forty-seven studies are included in this review. MHPSS interventions addressed four broad categories of outcomes: mental health, incidences of GBV, social and community outcomes, and women's economic empowerment. MHPSS interventions for GBV survivors in fragile settings show promising mental health benefits, with the highest quality evidence found for cognitive behavioural therapy-based approaches in reducing post-traumatic stress, depression, and anxiety. Economic and psychosocial empowerment interventions also led to reduced incidences of intimate partner violence, enhanced financial autonomy, and shifts in social norms, though some interventions yielded mixed or non-significant effects. While many MHPSS interventions for people who had experienced GBV led to meaningful improvements in mental health, GBV reduction and economic empowerment, variability in effectiveness highlights the need for culturally adapted, context-specific approaches and further research on long-term effects in fragile settings.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e161"},"PeriodicalIF":3.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary effectiveness of the youth empowerment digital intervention (YEDI): A pilot clustered community study of a group cognitive behavioral therapy intervention with digital reinforcement among youth in Kenya's informal settlements.","authors":"William Byansi, Catherine Mawia Musyoka, Christopher E Baidoo, Michael Galvin, Wilberforce Kurevakwesu, Moses Okumu, Sung Seek Moon, Maurice A Kalande, Muthoni Mathai","doi":"10.1017/gmh.2026.10278","DOIUrl":"10.1017/gmh.2026.10278","url":null,"abstract":"<p><p>Substance use and mental health symptoms frequently co-occur among youth in Nairobi's informal settlements, yet scalable interventions remain limited. This pilot study evaluated the Youth Empowerment Digital Intervention (YEDI), a brief group cognitive-behavioral therapy model supported by mobile reinforcement. A clustered-community randomized pilot study enrolled 94 adolescents and young adults aged 15-24 years (treatment = 49; control = 45). The intervention group received seven weekly 1-hour manualized group cognitive-behavioral therapy sessions supplemented by mobile skill reinforcement, while control participants received standard health materials. Alcohol, cannabis, and tobacco use risk, along with depression, anxiety, and stress symptoms, were assessed at baseline, 3 months, and 6 months using linear mixed-effects models. YEDI demonstrated promising short-term reductions in alcohol risk, cannabis risk, and depressive symptoms at 3 months, although these differences were not sustained at 6 months. Tobacco risk did not differ between groups, and stress showed counterintuitive relative effects due to reductions in the control group. Delivering YEDI in informal settlements is feasible and provides a proof of concept for brief, early mental health support. Preliminary findings indicate that brief, skill-based models alone cannot offset severe structural stressors. Multi-level interventions integrating behavioral strategies with ongoing community support are required. .</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e170"},"PeriodicalIF":3.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The growing and urgent need for interventions to mitigate cancer-related stigma in sub-Saharan Africa.","authors":"Huda Haque, Brandon Knettel, Judith Mwobobia, Megan J Huchko, Kim Madundo, Furaha Serventi, Blandina Theophil Mmbaga, Kristin Schroeder, Nosayaba Osazuwa-Peters","doi":"10.1017/gmh.2026.10252","DOIUrl":"10.1017/gmh.2026.10252","url":null,"abstract":"<p><p>Cancer stigma, both underaddressed and understudied, remains a pervasive challenge in sub-Saharan Africa. Currently, the region is experiencing rising cancer incidence alongside some of the lowest cancer survival rates worldwide. With complex and multifaceted sociocultural factors contributing to this stigma and subsequent lack of screening, low treatment adherence and poorer health outcomes, it is critical to implement effective interventions in the region, at both the clinical and policy levels. To achieve a path forward, it is necessary to create targeted efforts that incorporate existing infrastructure and key cultural contexts.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e166"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent advisory groups in the ALIVE study: Feasibility and acceptability in global mental health prevention research.","authors":"Annette Bauer, Shari Baddan Ortiz, Juan Castellano, Maria Dedios, Emily Garman, Roxanne Jacobs, Nagendra Luitel, Crick Lund, Zoleka Maqina, Nabeel Petersen, Kamal Gautam, Rakesh Singh, Katherine Sorsdahl, Daniela Trujillo, Valentina Yepes, Mark J D Jordans","doi":"10.1017/gmh.2026.10274","DOIUrl":"10.1017/gmh.2026.10274","url":null,"abstract":"<p><p>Adolescent involvement in mental health prevention research remains limited in low-resource settings. This study examined the feasibility, acceptability, processes and perceived impacts of adolescent advisory groups (AAGs) within the ALIVE research in Colombia, Nepal and South Africa. Using a convergent mixed-methods design, we analysed data collected between October 2022 and August 2025 using surveys with adolescents (t1: n = 33; t2: n = 26), focus group discussions (n = 6 with adolescents; n = 2 with caregivers), interviews (n = 8 with adolescents; n = 5 with facilitators), process documents (n = 58) and post-session feedback (n = 7). Participation was highly valued by most adolescents, who were motivated by altruism, peer connection, skill development and project incentives. Most adolescents strongly agreed they could express their views freely (t1: 79%; t2: 81%) and felt listened to (t1:76%; t2: 81%, respectively). Participants reported experiences of trust, confidence and collective agency; challenges included stigma, unequal participation and logistical barriers. Facilitators' relational and adaptive support appeared central to sustaining engagement. Adolescent members contributed in important ways to the ALIVE research. Adolescent involvement in prevention research in low-resource settings is feasible and can be experienced by participants as valuable.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e167"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health outcomes of a peer support programme for prosthesis and orthosis users in Cambodia: An explanatory sequential mixed-methods study.","authors":"Paul Best, Alan Maddock, Thearith Heang, Nil Ean, Sisary Kheng, Nerrolyn Ramstrand","doi":"10.1017/gmh.2026.10276","DOIUrl":"10.1017/gmh.2026.10276","url":null,"abstract":"<p><p>People with physical disabilities in low- and middle-income countries experience elevated rates of psychological distress. This study explored the impact of a peer support intervention ('friendship group') for people with disabilities attending prosthetic and orthotic clinics in Cambodia. A total of 462 individuals were screened using the Kessler Psychological Distress Scale (K10), 47 met inclusion criteria (scores 20-29). Of these, 27 enrolled in the intervention, while 20 did not participate. Psychological distress was assessed across four domains of the K10 (nervousness, agitation, fatigue and negative affect). Intervention participants were measured at three time points (2 baseline measures and 1 follow-up), non-participants contributed baseline data only. Quantitative data were analysed using linear mixed-effects models, qualitative data from post-intervention focus groups (<i>n</i> = 21) were analysed thematically. Reductions in K10 scores were observed across all domains following the intervention (<i>p</i> < 0.001). Qualitative findings highlighted perceived benefits including restored family and community roles, emotional relief and improved self-regulation. Given the pre-post design without a full comparator group, findings should be interpreted cautiously. This exploratory study suggests that peer support may offer a feasible and culturally acceptable route to support people with disabilities in low-resource settings.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e163"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global country-level network analysis of mental disorders.","authors":"Mohammadreza Balooch Hasankhani, Shoboo Rahmati, Mark J M Sullman, Tania Dehesh","doi":"10.1017/gmh.2026.10244","DOIUrl":"10.1017/gmh.2026.10244","url":null,"abstract":"<p><p>Mental disorders are major contributors to the global burden of disease and may show correlated incidence patterns across countries. We characterized the country-level ecological network of age-standardized incidence rates for 10 mental disorders, identified statistically central disorders and examined how individual countries influenced estimated network connectivity. Data for 204 countries and territories, including Sociodemographic Index values, were obtained from the Global Burden of Disease Study 2023. A regularized network model using the mgm framework estimated conditional associations among country-level variables. Strength centrality and case-deletion delta-centrality analyses assessed disorder connectedness and country influence, with bootstrap procedures evaluating stability. Approximately 400 million incident cases of the studied disorders were estimated globally in 2023. Anorexia nervosa and bipolar disorder had the highest strength centrality, indicating broader conditional connections with other disorders. Australia, the United States, Iran, China and Finland showed relatively large delta-centrality values, suggesting greater influence on estimated centrality than most countries. Strength centrality stability was acceptable but modest. These findings provide a descriptive, hypothesis-generating view of how modeled incidence rates covary across countries and should not be interpreted as individual-level comorbidity, causal influence or direct policy priority.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"13 ","pages":"e168"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}