Kokoro Harii , Kosuke Inoue , Adrian M. Bacong , Naoki Kondo
{"title":"State-level anti-Asian hate crimes and mental health among Asian and other racial groups in the US","authors":"Kokoro Harii , Kosuke Inoue , Adrian M. Bacong , Naoki Kondo","doi":"10.1016/j.socscimed.2024.117494","DOIUrl":"10.1016/j.socscimed.2024.117494","url":null,"abstract":"<div><div>Although racism and anti-Asian sentiments have been long-standing public health issues in the United States, evidence is lacking regarding anti-Asian hate crimes and their spillover effect on not only Asian populations but also other racial and ethnic populations. We aimed to investigate the association between state-level anti-Asian hate crimes and the individual mental health of Asians and how it varies by other race and ethnicity groups. This cross-sectional study analyzed data from 1,921,984 participants from the Behavioral Risk Factor Surveillance System survey and the Federal Bureau of Investigation Uniform Crime Reports between 2015 and 2021. We performed multivariable logistic regressions to obtain adjusted odds ratio (aOR) and 95% confidence interval (CI) for depression and poor mental health by state-level anti-Asian hate crimes rate per 10,000 population across different racial groups. Of the 1,921,984 participants (Asian 49,481 [2.6%], Hispanic 167,655 [8.7%], non-Hispanic Black 152,898 [8.0%], non-Hispanic White 1,496,965 [78%], and Others 81,985 [4.3%]), 364,636 (19%) reported a history of depression, and 640,675 (34%) reported at least one day of poor mental health in the past 30 days. State-level anti-Asian hate crime rates were associated with depression among Asian people (aOR [95%CI] = 1.41 [1.17–1.69]). The association was also observed among Hispanic (aOR [95%CI] = 1.73 [1.48–2.04]) and non-Hispanic White people (aOR [95%CI] = 1.12 [1.05–1.19]) but not among non-Hispanic Black people (aOR [95%CI] = 1.10 [0.85–1.43]). We observed the association with poor mental health only among Hispanics (adjusted OR [95%CI] = 1.28 [1.12 to 1.45]) accounting for individual-level and state-level covariates. Using a nationwide cohort of US adults, we found an association between state-level rates of hate crimes targeting Asian people and depression among Asian and non-Asian US adults. These findings suggest that such hate crimes may have an adverse impact on mental health, extending their reach beyond the direct victims.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"364 ","pages":"Article 117494"},"PeriodicalIF":4.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699597","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}
Seoyoun Kim , Cal Halvorsen , Claire Potter , Jessica Faul
{"title":"Does volunteering reduce epigenetic age acceleration among retired and working older adults? Results from the Health and Retirement Study","authors":"Seoyoun Kim , Cal Halvorsen , Claire Potter , Jessica Faul","doi":"10.1016/j.socscimed.2024.117501","DOIUrl":"10.1016/j.socscimed.2024.117501","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study aims to explore the relationship between the frequency of volunteering and biological aging, as measured by epigenetic age acceleration. It also investigates whether this relationship differs between retired and working older adults. Understanding this connection could inform interventions promoting healthy aging and reducing age-related chronic health conditions.</div></div><div><h3>Method</h3><div>Data were derived from the Health and Retirement Study (HRS), including pre-treatment covariates (2012), volunteer frequency and work status (2014), and five DNA methylation measures (2016) (N = 2,605). Generalized linear models were estimated to examine the relationship between volunteering and epigenetic age acceleration, stratified by retirement status. The analyses adjusted for relevant covariates and utilized energy balancing weights to account for selection into volunteering.</div></div><div><h3>Results</h3><div>Findings show that volunteering, especially for 1–49 h per year and 200+ hours per year, was linked to less epigenetic age acceleration, with significant effects on DNA methylation measures PhenoAge, GrimAge, and DunedinPACE clocks. Among retired individuals, moderate volunteering was significantly associated with decelerated epigenetic age acceleration, indicating greater benefits for retirees compared to working individuals.</div></div><div><h3>Conclusions</h3><div>The study found that frequent volunteering may lead to decelerated epigenetic aging, potentially offering a public health intervention to enhance health and quality of life among older adults. Further research is needed to confirm these findings and to understand how volunteering might differentially impact retired and working individuals. Such insights could guide the development of targeted strategies to promote healthy aging and address age-related health disparities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"364 ","pages":"Article 117501"},"PeriodicalIF":4.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fire and fury: North Korean threats and South Korean adolescent health","authors":"Dirk Bethmann , Jae Il Cho","doi":"10.1016/j.socscimed.2024.117503","DOIUrl":"10.1016/j.socscimed.2024.117503","url":null,"abstract":"<div><h3>Purpose</h3><div>We determine the impact of the increased risk of war resulting from the inter-Korean tensions of 2016, which culminated in two nuclear tests by North Korea, on the health of South Korean adolescents. Our health indicators are mental symptoms of depression and aggression, but also physical symptoms such as headaches and fever.</div></div><div><h3>Method</h3><div>We use representative data from the Korean Children and Youth Panel Survey (KCYPS) for the Seoul Capital Area in 2014, 2015 and 2016 (N = 1745). In our regression analysis, we apply a difference-in-differences approach and use adolescents living near the border with North Korea in 2016 as the treatment group.</div></div><div><h3>Results</h3><div>We find that adolescents residing in the border regions with North Korea during the crisis year 2016 had 3.67 percent more depressive and 5.52 percent more aggressive symptoms, but also more physical problems such as headaches (6.82 percent) and fever (5.44 percent), findings that are more pronounced for females.</div></div><div><h3>Discussion</h3><div>We call on policymakers to keep the health of adolescents, especially young women, in mind during times of crisis. Schools in geopolitically tense areas can help build resilience.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"364 ","pages":"Article 117503"},"PeriodicalIF":4.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Douwe van der Meer, Thomas van Huizen, Janneke Plantenga
{"title":"‘No manner of hurt was found upon him’. The role of religiousness in the mental health effect of job insecurity","authors":"Peter Douwe van der Meer, Thomas van Huizen, Janneke Plantenga","doi":"10.1016/j.socscimed.2024.117502","DOIUrl":"10.1016/j.socscimed.2024.117502","url":null,"abstract":"<div><div>This study examines how religiousness moderates the mental health effect of job insecurity, a prevalent stressor in modern societies. We use panel data from a representative, large sample of Dutch employees from 2008 to 2018. Exploiting the longitudinal nature of the data, we control for time-invariant unobserved heterogeneity. Our main results indicate that job insecurity negatively affects men's but not women's mental health. Religious employees, however, are shielded from the adverse mental health effects of job insecurity. The protective effect of religiousness seems to be different for Catholics and Protestants: Protestant employees are shielded from the adverse mental health effects of job insecurity, whereas Catholic employees are not. Differences in work ethic and social network that religiousness may provide cannot explain the protective effect of religiousness. The mechanism at work appears to be a firm belief in God, as well as belief in life after death, in particular in combination with frequent attendance of religious gatherings or daily prayer. Unlike belief in God's existence, which shields only the religious, belief in life after death shields the religious and non-religious alike. The confluence of increasing job insecurity and increasing secularisation poses a risk to public mental health. Our results contribute to identifying employees who are particularly at risk and could, by shedding light on the mechanisms, suggest directions for potential preventive and curative interventions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"364 ","pages":"Article 117502"},"PeriodicalIF":4.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695820","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":"Pain and the risk of social isolation and loneliness in older Chinese adults: Do gender, age, and education make a difference?","authors":"Dan Zhang","doi":"10.1016/j.socscimed.2024.117486","DOIUrl":"10.1016/j.socscimed.2024.117486","url":null,"abstract":"<div><h3>Objective</h3><div>Pain has long been known to affect the health and well-being of older adults. However, no longitudinal study has examined the associations between pain, social isolation, and loneliness among older adults in China. This study aims to explore the relationships between pain and older Chinese adults’ social isolation (family isolation and friend isolation) and loneliness, and whether these associations are moderated by gender, age, and education groups.</div></div><div><h3>Method</h3><div>Data derived from the four waves of the China Longitudinal Aging Social Survey (CLASS, 2014–2020). The sample included 18,692 respondents (aged 60 years and older), and mixed-effects logistic models were used.</div></div><div><h3>Results</h3><div>Pain is not significantly associated with family isolation. In contrast, pain increases the risk of friend isolation and loneliness. Regarding the moderating roles of gender, age, and education, the results show that the relationship between pain and friend isolation is stronger among older women compared to their male counterparts. The association between pain and the risk of friend isolation is stronger among young-old adults (60–69 years) than among their older counterparts (70 years and older). Conversely, the oldest old adults (80+ years) are more likely to experience loneliness combined with pain than their younger counterparts. In addition, the negative effect of pain on the risk of loneliness is stronger among the more educated than among the less educated older adults.</div></div><div><h3>Conclusions</h3><div>The findings underscore the pivotal role of pain in shaping the social well-being of older adults, and highlight the need to consider sociodemographics and socioeconomic status when developing pain prevention and management strategies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117486"},"PeriodicalIF":4.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Deciphering the COVID-19 density puzzle: A meta-analysis approach","authors":"Pratik Kumar Singh, Alok Kumar Mishra","doi":"10.1016/j.socscimed.2024.117485","DOIUrl":"10.1016/j.socscimed.2024.117485","url":null,"abstract":"<div><div>The COVID-19 pandemic has sparked widespread efforts to mitigate its transmission, raising questions about the role of urban density in the spread of the virus. Understanding how city density affects the severity of communicable diseases like COVID-19 is crucial for designing sustainable, pandemic-resilient cities. However, recent studies on this issue have yielded inconsistent and conflicting results. This study addresses this gap by employing a comprehensive meta-analytic approach, synthesizing data across diverse regions and urban contexts to offer a broader, more nuanced perspective on the impact of city density. A systematic meta-analysis was conducted, initially screening 2,452 studies from Google Scholar, Scopus, and Avery Index databases (up to August 31, 2023), and narrowing down to 63 eligible studies. Using the restricted maximum likelihood (REML) method with a random effects model, the study accounted for variations across different studies. Statistical tests, file drawer analysis, and influence measure analysis were performed, along with assessments of heterogeneity and publication bias through forest and funnel plots. Despite this extensive analysis, the findings indicate that city density has a negligible effect on the severity of COVID-19, challenging the prevailing assumptions in the literature.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117485"},"PeriodicalIF":4.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yen Hong Thi Nguyen , Rogier van Doorn , Jennifer Ilo Van Nuil , Sonia Lewycka
{"title":"Dilemmas of care: Healthcare seeking behaviours and antibiotic use among women in rural communities in Nam Dinh Province, Vietnam","authors":"Yen Hong Thi Nguyen , Rogier van Doorn , Jennifer Ilo Van Nuil , Sonia Lewycka","doi":"10.1016/j.socscimed.2024.117483","DOIUrl":"10.1016/j.socscimed.2024.117483","url":null,"abstract":"<div><div>Antimicrobial resistance is a silent pandemic to cause an estimated ten million deaths by 2050. Self-medication with antibiotics in low- and middle-income countries has been identified as a driver of antibiotic resistance. Interventions targeting solely individual behaviour change around antibiotic practices are often unsuccessful as they fail to address socio-cultural and structural causes of the problem. Understanding the context of antibiotic use in communities will better inform interventions addressing the misuse and overuse of antibiotics. Vietnam faces a growing threat of antimicrobial resistance due to inappropriate use of antibiotics in the healthcare system, farming and food production, and in the community. To understand the roots of this problem, we conducted qualitative research in 2020, with one component focusing on the community. This included fifteen in-depth interviews with women and four months of participant observation in three districts in Nam Dinh Province to explore the healthcare seeking practices and perceptions of medicine and antibiotic use. We argue that even when participants understood antibiotic resistance and were willing to adjust their care practices with antibiotics, there were cultural and structural challenges demotivating changes. The participants faced what we term “dilemmas of care”. For example, while public health messaging promoted appropriate antibiotic practices, the healthcare system did not provide a suitable environment to support appropriate use. Besides, the introduction of biomedicines into the long-standing traditional medical system caused confusions in community health practices, leading to issues such as poor adherence to treatment. At an individual level, participants faced challenges in accessing healthcare knowledge, adhering to social expectations surrounding care, and financial issues. We argue that the misuse of medicines and antibiotics in communities are responses to a deficient healthcare system and unequal access to quality healthcare.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117483"},"PeriodicalIF":4.9,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631015","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}
Udodirim N. Onwubiko , Sarah M. Murray , Amrita Rao , Allison T. Chamberlain , Travis H. Sanchez , David Benkeser , David P. Holland , Samuel M. Jenness , Stefan D. Baral
{"title":"Individual & joint associations of sexual stigma and mental distress with PrEP uptake, adherence and persistence among US gay and bisexual men","authors":"Udodirim N. Onwubiko , Sarah M. Murray , Amrita Rao , Allison T. Chamberlain , Travis H. Sanchez , David Benkeser , David P. Holland , Samuel M. Jenness , Stefan D. Baral","doi":"10.1016/j.socscimed.2024.117493","DOIUrl":"10.1016/j.socscimed.2024.117493","url":null,"abstract":"<div><h3>Background</h3><div>Sexual stigma, mental health disorders, and socioeconomic disparities present important yet incompletely understood barriers to PrEP adoption among gay men and other men who have sex with men (MSM). This study examines how these factors interact and affect PrEP uptake, adherence, and persistence among MSM.</div></div><div><h3>Methods</h3><div>Data from the 2018 and 2019 American Men's Internet Survey cycles, involving 6907 adult MSM eligible for PrEP, were analyzed. We assessed sexual stigma heterogeneity among this group using latent class analysis and investigated individual relationships between i) stigma class membership, ii) mental distress, and PrEP engagement (past-year use, adherence, and persistence) using Poisson regression with a robust error variance, considering potential variations based on poverty status. The combined associations of sexual stigma and mental distress with PrEP engagement was evaluated using inverse probability weighting.</div></div><div><h3>Results</h3><div>Four distinct sexual stigma classes were identified, each exhibiting varied associations with PrEP engagement. Associations with mental distress lost statistical significance after adjusting for confounders. However, having both mental distress and sexual stigma was associated with lower past-year PrEP use, with the strongest association observed for those with anticipated healthcare stigma class membership and mental distress (aPR 0.53 [95% CI: 0.37, 0.76]). Sexual stigma accompanied by mental distress was also associated with significantly increased poor PrEP adherence, particularly among those with family and general social stigma class membership (aPR 2.31 [95% CI: 1.08, 4.97]).</div></div><div><h3>Conclusions</h3><div>Psychosocial factors exert synergistic impacts on PrEP engagement among MSM. Tailored interventions addressing these subtleties may effectively optimize PrEP uptake and improve consistency of use among MSM.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117493"},"PeriodicalIF":4.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yiyun Shou , David Smith , Jun Xuan Ng , Malcolm Battersby , Cynthia Chen , Ngan Phoon Fong
{"title":"Assessing disease self-management in multi-ethnic patients with chronic conditions and evaluating psychometric properties of the Partners in Health scale","authors":"Yiyun Shou , David Smith , Jun Xuan Ng , Malcolm Battersby , Cynthia Chen , Ngan Phoon Fong","doi":"10.1016/j.socscimed.2024.117490","DOIUrl":"10.1016/j.socscimed.2024.117490","url":null,"abstract":"<div><div>The increasing prevalence of chronic diseases globally has resulted in increased healthcare utilization. Patients’ self-management of chronic diseases is important for efficient healthcare and improving patient health outcomes. This study aims to evaluate the psychometric properties of the Partners in Health (PIH) scale in a representative, multi-ethnic sample of patients with chronic diseases in Singapore and examine factors that can contribute to chronic disease self-management. A cross-sectional household survey included the PIH scale administered to 502 patients aged 40 and above who reported having at least one chronic condition. Bayesian Confirmatory Factor Analysis was applied to evaluate the factor structure and gender measurement invariance of PIH. The results suggested that a four-factor structure fit the Singaporean sample and had approximate measurement equivalence between males and females for most of the PIH items. The PIH scale and subscales also demonstrated criterion validity by having expected correlations with conceptually relevant constructs. Finally, sociodemographic characteristics and satisfaction with healthcare are significantly related to self-management based on the PIH scale. Satisfaction with healthcare also attenuated the reduction of self-management in patients from minority ethnic groups or those with lower education. This suggested that those groups can benefit from high satisfaction towards care providers in enhancing their disease management. In conclusion, this study demonstrated that PIH can be a promising tool for assessing patient self-management in the Singaporean population.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117490"},"PeriodicalIF":4.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marie-Anne Boujaoude , Kim Dalziel , Richard Cookson , Nancy Devlin , Natalie Carvalho
{"title":"Aversion to income, ethnic, and geographic related health inequality: Evidence from Australia","authors":"Marie-Anne Boujaoude , Kim Dalziel , Richard Cookson , Nancy Devlin , Natalie Carvalho","doi":"10.1016/j.socscimed.2024.117495","DOIUrl":"10.1016/j.socscimed.2024.117495","url":null,"abstract":"<div><div>This study investigated the Australian general public's views on trade-offs between reducing health inequalities and improving total health. It elicited relative equity weights, comparing inequalities in life expectancy at birth across three equity-relevant dimensions: income (comparing poorest versus richest fifth), ethnic (comparing Indigenous versus non-Indigenous), and geographic (comparing rural/remote versus major cities). A benefit trade-off exercise was administered via online survey to a sample of Australian adults (n = 3105) using quota sampling to ensure population representativeness across key demographic variables (age, gender, state of residence, household income and education level). When comparing income groups, 88% (95% Confidence Interval (CI): 82%–92%) of the respondents were health inequality averse, with 42% (95% CI: 34%–51%) demonstrating extreme inequality aversion. When considering Indigenous status, 85% (95% CI: 79%–90%) showed inequality aversion, and 40% (95% CI: 31%–49%) displayed extreme aversion. Lastly, looking at different geographic locations, 74% (95% CI: 66%–80%) of the respondents were inequality averse, with 37% (95% CI: 29%–46%) showing extreme inequality aversion. The relative equity weights were calculated, allowing for varying baseline inequalities in life expectancy – proportional gaps of 10.8%, 5.1% and 6.3%, respectively. The results imply that the public is willing to weight incremental health gains to the poorest fifth five times more than to the richest fifth, six times more for Indigenous versus non-Indigenous, and four times more for people living in rural and remote areas compared to major cities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"364 ","pages":"Article 117495"},"PeriodicalIF":4.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699584","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}