International Health最新文献

{"title":"Sputum culture conversion and its predictors among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia.","authors":"Mulugeta Gamachu, Alemayehu Deressa, Lemma Demissei Regassa, Miesso Bayu, Ibsa Mussa, Fekede Asefa Kumsa, Tariku Dingeta","doi":"10.1093/inthealth/ihae059","DOIUrl":"https://doi.org/10.1093/inthealth/ihae059","url":null,"abstract":"<p><strong>Background: </strong>Evidence of time to culture conversion is used to predict the time of cure from the disease and the overall drug-resistant tuberculosis (TB) treatment duration. Even though evidence about sputum culture conversion is enormous in TB treatment, no study has yet been done in our areas, where cases are common. The study aimed to assess the time to sputum conversion and its predictors among drug-resistant TB patients from October 2013 to September 2021 in eastern Ethiopia.</p><p><strong>Methodology: </strong>A retrospective cohort study was conducted in eastern Ethiopia among 273 drug-resistant TB patients who were treated from October 2013 to September 2021 at Dire Dawa City and Harari regional treatment centres. The Kaplan-Meier method was used to estimate the median time of sputum culture conversion. Cox proportional hazards regression was employed to detect the predictors of sputum culture conversion. An adjusted hazard ratio (aHR) with 95% confidence interval (CI) was used to determine the strength and significance of the association.</p><p><strong>Results: </strong>Of the 273 drug-resistant TB patients, the sputum culture of 216 (79.12%) patients became negative in a median time of 3 months (interquartile range 2-7). The time to sputum culture conversion was negatively associated with underweight (aHR 0.65 [95% CI 0.49 to 0.90]) and poor adherence (aHR 0.41 [95% CI 0.24 to 0.69]). The time to sputum culture conversion was also positively associated with patients resistant to two or more drugs (aHR 1.58 [95% CI 1.07 to 2.32]) and patients receiving a short treatment regimen (aHR 2.24 [95% CI 1.10 to 2.55]).</p><p><strong>Conclusions: </strong>A shorter culture conversion rate was observed compared with the median time recommended by the World Health Organization. Being underweight, poor adherence to treatment, resistance to two or more drugs and receiving a short treatment regimen were found to be predictors of time to sputum culture conversion. Implementing nutrition assessment, counselling and support of drug adherence may improve sputum culture conversion.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Risk factors associated with multidrug-resistant tuberculosis in areas with a moderate tuberculosis burden.","authors":"John Patrick C Toledo","doi":"10.1093/inthealth/ihae060","DOIUrl":"https://doi.org/10.1093/inthealth/ihae060","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders attending public hospitals in Addis Ababa, Ethiopia: a cross-sectional study.","authors":"Jerman Dereje, Abenet Kassaye, Abiy Mulugeta, Girmaw Medfu, Shegaye Shumet, Tilahun Kassew","doi":"10.1093/inthealth/ihae055","DOIUrl":"https://doi.org/10.1093/inthealth/ihae055","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disorders are a set of disorders that negatively affect the acquisition of skills in a variety of developmental domains, including motor function, learning, socialization, language and cognition. However, there is no information available on the standard of living of Ethiopian primary caregivers of children and adolescents with neurodevelopmental disorders. Therefore, this study aimed to assess the quality of life (QOL) and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted during 1-30 May 2022. Systematic random sampling was used to obtain 352 samples. QOL was measured using the WHO Quality of Life Brief. The gathered information was coded, entered into EpiData 4.6.0.2 and analyzed with SPSS version 26. Multiple linear regression analysis was used to identify the correlates of QOL and the strength of the correlation was measured by β coefficient with 95% CI.</p><p><strong>Results: </strong>The mean score of the overall QOL was 62.61 with a SD of 5.17. The mean (±SD) scores for the physical health, psychological, environmental and social relationship domains of primary caregivers were 57.36±9.98, 66.98±9.39, 66.06±12.91 and 60.02±9.14, respectively. Age was significantly associated with physical domain (β=-0.25, 95% CI -0.43 to -0.07) and with environmental domain (β=-4.57, 95% CI -9.06 to -0.09). Being divorced/widowed was negatively associated with psychological health (β=-2.99, 95% CI -5.82 to -0.17) and social health (β=-0.62, 95% CI -1.33 to -0.10). The presence of medical illness was negatively associated with the physical health domain (β=-4.32, 95% CI -7.64 to -2.91) and the environmental domain (β=-3.11, 95% CI -5.71 to -0.51). Poor social support was negatively associated with psychological health (β=-3.25, 95% CI -5.89 to -0.61) and the social health domain (β=-3.39, 95% CI -11.3 to 4.6), and moderate social support (β=8.62, 95% CI 3.15 to 14.09) was positively associated with physical health. Depression (β=-6.32, 95% CI -11.96 to -0.67) and anxiety (β =-3.07, 95% CI -5.80 to -0.34) were negatively associated with physical health and the psychological health domain, respectively.</p><p><strong>Conclusions: </strong>The findings from this study indicate that all dimensions of QOL of primary caregivers of children and adolescents with neurodevelopmental disorders in this study setting were compromised. Being divorced or widowed, lack of formal education, age, average monthly income, poor social support, depression, anxiety and the presence of medical illness were factors associated with QOL in all domains. This requires integrating a bio-psychosocial perspective, a positive mental health strategy and pharmaceutical therapies to enhance QOL for caregivers of children and adolescents with neurodevelopmental disorders.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine wastage in private and public healthcare facilities in KwaZulu-Natal, South Africa","authors":"Viloshini Krishna Manickum, Lehlohonolo John Mathibe","doi":"10.1093/inthealth/ihae056","DOIUrl":"https://doi.org/10.1093/inthealth/ihae056","url":null,"abstract":"Background In KwaZulu-Natal (KZN), South Africa, COVID-19 vaccinations commenced in May 2021. This study investigated the extent and reasons for COVID-19 vaccine (C19V) wastage in KZN and strategies undertaken to mitigate loss. Methods This two-phase multicenter study was conducted at private and public healthcare facilities from May 2021 to July 2022. Results KZN reported 2% Pfizer and 1% Janssen C19V wasted, mainly due to expiry. C19V waste-minimization strategies reported by 100% public and private sector vaccination leads included cold chain monitoring, designated trained staff and the use of stock-management systems. Conclusions The WHO’s risk-mitigation factors should be implemented continuously to minimize vaccine wastage.","PeriodicalId":49060,"journal":{"name":"International Health","volume":"1 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community health workers to reduce unmet surgical needs in an urban slum in India: an implementation study.","authors":"Kranti Vora, Falguni Salvi, Shahin Saiyed, Chinmayi Desai, Rajendra Joshi, Keyur Buch, Dileep Mavalankar, Rahul M Jindal","doi":"10.1093/inthealth/ihad072","DOIUrl":"10.1093/inthealth/ihad072","url":null,"abstract":"<p><strong>Background: </strong>The Surgical Accredited & Trained Healthcare Initiative (SATHI) project demonstrates how community healthcare workers (CHWs) with merely 8 y of formal schooling and training for a short period can reduce unmet surgical needs.</p><p><strong>Methods: </strong>A pilot study was carried out in the slums of a metropolitan city in India to know the effectiveness of a SATHI in reducing the burden of unmet surgical needs. In total, 12 730 people from 3000 households were included in the study for a duration of 6 months.</p><p><strong>Results: </strong>We found 10% surgical needs (n=293) out of which 57% had unmet surgical needs. Out of total surgical needs, about half of the needs were cataract and abdominal, followed by extremities and chest conditions. SATHIs were able to convert 99 patients (60%) from unmet to met needs, who underwent surgery/treatment. The conversion from unmet to met among all surgery needs was highest for abdominal conditions (29%) followed by cataracts (17%).</p><p><strong>Conclusions: </strong>SATHIs with short training can reduce the burden of unmet surgical needs. SATHIs were able to convert a significant proportion of unmet to met needs by trust building, facilitating access to healthcare and ensuring post-operative adherence. Scaling up could help in the achievement of equitable healthcare across India.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"523-528"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10500844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Season, household registry and isolated birth defects: a population-based case-control study in Danyang, China.","authors":"Shuhan Miao, Liqun Liu, Yanlin Tang, Hongyan Ge","doi":"10.1093/inthealth/ihae034","DOIUrl":"10.1093/inthealth/ihae034","url":null,"abstract":"<p><strong>Background: </strong>A birth population-based study was conducted in Danyang, Jiangsu Province, to evaluate major birth defects in emerging regions in China with similar maternal and neonatal care conditions.</p><p><strong>Methods: </strong>We conducted a population-based study in a cohort of infants born in Danyang from 2014 to 2021, including 55 709 perinatal infants. Four categories of isolated birth defects were defined as cases: congenital heart defects (CHDs; n=2138), polydactyly (n=145), cleft lip with or without palate (CL/P; n=76) and accessory auricles (n=93). Infants with congenital malformations were identified by the Chinese Birth Defects Monitoring Network.</p><p><strong>Results: </strong>Compared with autumn, conception in spring (OR=1.31 [1.16-1.48]) and winter (OR=1.39 [1.23-1.58]) was associated with an increased risk of CHD. Increased risk of CHD, CL/P and accessory auricles was significantly associated with non-local registered residence (OR=1.17 [1.07-1.28], OR=2.73 [1.52-4.88] and OR=2.11 [1.20-3.71], respectively). Individuals of Han nationality were less likely to have polydactyly (OR=0.23 [0.05-0.98]).</p><p><strong>Conclusions: </strong>The season of pregnancy was significantly associated with CHDs. Offspring of mothers with non-local registered hometown had greater risks of CHDs, CL/P and accessory auricles.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"562-567"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between women's empowerment and fertility preferences in Ghana.","authors":"Louis Kobina Dadzie, Hilda Yengnone, James Boadu Frimpong, Ebenezer Agbaglo, Abdul-Aziz Seidu, Bright Opoku Ahinkorah","doi":"10.1093/inthealth/ihae043","DOIUrl":"10.1093/inthealth/ihae043","url":null,"abstract":"<p><p>As Ghana has embraced the concept of women's empowerment as a vital tool for sustainable development, it has become crucial to evaluate the role that women's empowerment plays in the fertility preferences of married and cohabiting women in the country. The study's objective was to examine the association between women's empowerment, the ideal number of children and women's ability to have their desired number of children. This cross-sectional study used data from the 2014 Ghana Demographic and Health Survey. Both Poisson and binary logistic regression analyses were carried out. Women who had justification for wife-beating (incidence rate ratio [IRR] 0.98 [95% confidence interval {CI} 0.96 to 0.99]) and those who were autonomous (IRR 0.94 [95% CI 0.93 to 0.95]) had lower rates of having the ideal number of children. Moreover, women who had justification for wife-beating (adjusted odds ratio [aOR] 1.25 [95% CI 1.13 to 1.39]) and those who were involved in decision-making (aOR 1.31 [95% CI 1.19 to 1.44]) had higher odds of having the ability to have the desired number of children. However, autonomous women (aOR 0.78 [95% CI 0.71 to 0.86]) had lower odds of having the ability to have the desired number of children. Significant associations were found between women's empowerment (women's attitude towards justification for wife-beating, autonomy), an ideal number of children and the ability to have the desired number of children. These findings present target areas for policies and interventions aimed at determining Ghanaian women's fertility preferences and empowering them.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"512-522"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a count regression model to identify the risk factors of under-five child morbidity in Bangladesh.","authors":"Md Ismail Hossain, Abu Sayed Md Ripon Rouf, Md Rukonozzaman Rukon, Shuvongkar Sarkar, Iqramul Haq, Md Jakaria Habib, Faozia Afia Zinia, Tanha Akther Tithy, Asiqul Islam, Md Amit Hasan, Mir Moshiur, Md Shakil Ahmed Hisbullah","doi":"10.1093/inthealth/ihad107","DOIUrl":"10.1093/inthealth/ihad107","url":null,"abstract":"<p><strong>Background: </strong>Bangladesh has seen a significant decline in child mortality in recent decades, but morbidity among children <5 y of age remains high. The aim of this analysis was to examine trends and identify risk factors related to child morbidity in Bangladesh.</p><p><strong>Methods: </strong>This analysis is based on data from four successive cross-sectional Bangladesh Demographic and Health Surveys for the years 2007, 2011, 2014 and 2017-18. Several count regression models were fitted and the best model was used to identify risk factors associated with morbidity in children <5 y of age.</p><p><strong>Results: </strong>According to the results of the trend analysis, the prevalence of non-symptomatic children increased and the prevalence of fever, diarrhoea and acute respiratory infections (ARIs) decreased over the years. The Vuong's non-nested test indicated that Poisson regression could be used as the best model. From the results of the Poisson regression model, child age, sex, underweight, wasted, stunting, maternal education, wealth status, religion and region were the important determinants associated with the risk of child morbidity. The risk was considerably higher among women with a primary education compared with women with a secondary or greater education in Bangladesh.</p><p><strong>Conclusions: </strong>This analysis concluded that child morbidity is still a major public health problem for Bangladesh. Thus it is important to take the necessary measures to reduce child morbidity (particularly fever, diarrhoea and ARI) by improving significant influencing factors.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"544-552"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persons 'never treated' in mass drug administration for lymphatic filariasis: identifying programmatic and research needs from a series of research review meetings 2020-2021.","authors":"Molly A Brady, Emily Toubali, Margaret Baker, Elizabeth Long, Caitlin Worrell, Kapa Ramaiah, Patricia Graves, T Deirdre Hollingsworth, Louise Kelly-Hope, Diana Stukel, Bhupendra Tripathi, Arianna Rubin Means, Sultani Hadley Matendechero, Alison Krentel","doi":"10.1093/inthealth/ihad091","DOIUrl":"10.1093/inthealth/ihad091","url":null,"abstract":"<p><p>As neglected tropical disease programs rely on participation in rounds of mass drug administration (MDA), there is concern that individuals who have never been treated could contribute to ongoing transmission, posing a barrier to elimination. Previous research has suggested that the size and characteristics of the never-treated population may be important but have not been sufficiently explored. To address this critical knowledge gap, four meetings were held from December 2020 to May 2021 to compile expert knowledge on never treatment in lymphatic filariasis (LF) MDA programs. The meetings explored four questions: the number and proportion of people never treated, their sociodemographic characteristics, their infection status and the reasons why they were not treated. Meeting discussions noted key issues requiring further exploration, including how to standardize measurement of the never treated, adapt and use existing tools to capture never-treated data and ensure representation of never-treated people in data collection. Recognizing that patterns of never treatment are situation specific, participants noted measurement should be quick, inexpensive and focused on local solutions. Furthermore, programs should use existing data to generate mathematical models to understand what levels of never treatment may compromise LF elimination goals or trigger programmatic action.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"479-486"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11021373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global knowledge and attitudes towards mpox (monkeypox) among healthcare workers: a systematic review and meta-analysis.","authors":"Abdolreza Sotoodeh Jahromi, Mohammad Jokar, Nader Sharifi, Sirus Kashkooli, Karamatollah Rahmanian, Vahid Rahmanian","doi":"10.1093/inthealth/ihad094","DOIUrl":"10.1093/inthealth/ihad094","url":null,"abstract":"<p><strong>Background: </strong>The recent increase in human mpox (monkeypox) cases emphasizes the importance of early detection, prompt response and preventive management to control the spread of the disease. Healthcare workers (HCWs) play a crucial role in this process. This study aimed to determine the global knowledge and attitudes towards mpox among HCWs.</p><p><strong>Methods: </strong>This study searched multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, Embase, Springer and ProQuest, to locate various publications. The search was limited to English-language articles published between May 2022 (when the increase in mpox incidence was reported) and August 2023. The Joanna Briggs Institute (JBI) quality checklist was utilized to evaluate the quality of the included studies. Data were obtained using a Microsoft Excel spreadsheet and subsequently scrutinized through STATA software, version 14. The heterogeneity of the studies was assessed using the inverse variance and Cochran Q statistics based on the I2 test statistics. The Dersimonian and Liard random effects models were used where heterogeneity existed. Subgroup analysis and univariate and multivariable metaregression techniques were used to examine the causes of heterogeneity.</p><p><strong>Results: </strong>A total of 22 studies, including 22 studies for knowledge (27 731 HCWs) and 6 studies for attitudes (14 388 HCWs), were included in the meta-analysis. The pooled estimates for good knowledge and positive attitudes among HCWs were 26.0% (95% confidence interval [CI] 17.8 to 34.2) and 34.6% (95% CI 19.0 to 50.2), respectively. Moreover, the knowledge was 34.8% (95% CI 24.1 to 45.6) among HCWs with <5 y of work experience and 41.6% (95% CI 33.1 to 50) among individuals possessing >5 y of professional background.</p><p><strong>Conclusions: </strong>Good knowledge of HCWs is at a low level. It is suggested that training sessions should be tailored towards younger HCWs with less healthcare experience. Additionally, it is essential to identify strategies on how to improve the knowledge and attitudes for better practice about the disease in HCWs worldwide.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"487-498"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}