Chantel T. Ebrahimi , Hannah Song , Monica Machado , Pamela Segura , Adriana Espinosa , Lillian Polanco-Roman
{"title":"Racism-related experiences and substance use: A systematic and meta-analytic review","authors":"Chantel T. Ebrahimi , Hannah Song , Monica Machado , Pamela Segura , Adriana Espinosa , Lillian Polanco-Roman","doi":"10.1016/j.socscimed.2024.117434","DOIUrl":"10.1016/j.socscimed.2024.117434","url":null,"abstract":"<div><div>Examinations highlighting interpersonal racism-related experiences as risk factors for substance use are well documented, particularly for alcohol use. The associations between racism-related experiences across other levels of influence (e.g., historical trauma, online, internalized) and use of other types of substances, while emerging, have yielded mixed findings. The present systematic review and meta-analyses examined the associations between multilevel racism-related experiences and different types of substances including substance use overall, alcohol, binge drinking, tobacco/nicotine, cannabis, illicit drugs, and polysubstance use among ethnoracially minoritized adolescents and emerging adults (12–29 years old). A systematic literature search and the Newcastle-Ottawa Scale (NOS) were used to identify, assess quality, and bias of included articles. Random-effects meta-analyses estimated pooled effect sizes for seven substance use outcomes and by age, sex, and race/ethnicity. Out of a total of 3190 articles, 91 (<em>N</em> = 190,065 participants) met inclusion criteria, 79 of which were included in the meta-analysis. The studies included were predominantly cross-sectional, school-based samples, and focused on Black individuals. Most examined interpersonal racism and few examined online and historical forms of racism. Meta-analyses demonstrated a significant positive association, with a small pooled effect size, between racism-related experiences and each substance use outcome. Moderations by age, sex, and race/ethnicity were found. Racism-related experiences are a risk factor for substance use among ethnoracially minoritized adolescents and emerging adults. Interventions addressing racism-related experiences across multiple dimensions are critical for the prevention and treatment of substance use among ethnoracially minoritized communities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117434"},"PeriodicalIF":4.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511367","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}
Yihong Bai , Qiaoge Li , Qian Liu , Michael R. Veall
{"title":"Chinese minimum wages and health","authors":"Yihong Bai , Qiaoge Li , Qian Liu , Michael R. Veall","doi":"10.1016/j.socscimed.2024.117430","DOIUrl":"10.1016/j.socscimed.2024.117430","url":null,"abstract":"<div><div>Variation in the timing of changes in the minimum wage across provinces in China is exploited using individual/household longitudinal survey data from 2010 to 2018 to examine potential health effects on working age individuals in households that are likely affected by minimum wages. Minimum wage increases are estimated to improve self-reported health particularly by reducing the incidence of self-reported overall poor health. There is also reasonably strong evidence that they reduce unhappiness and lower dissatisfaction with less robust evidence that they improve mental health and lower recent discomfort. Importantly, there is a type of “dose-response” effect: the estimates indicate no health effects of minimum wage increases on those in households likely not affected financially by the minimum wage with health effects increasing the more likely the household is financially affected. The results are driven by the findings for males.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117430"},"PeriodicalIF":4.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631011","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}
Timothy De Ver Dye , Zahira Quiñones Tavárez , Ivelisse Rivera , Nancy Cardona Cordero
{"title":"Social determinants of participation in genetic research among Puerto Ricans and in the Puerto Rican diaspora","authors":"Timothy De Ver Dye , Zahira Quiñones Tavárez , Ivelisse Rivera , Nancy Cardona Cordero","doi":"10.1016/j.socscimed.2024.117437","DOIUrl":"10.1016/j.socscimed.2024.117437","url":null,"abstract":"<div><div>Puerto Ricans are underrepresented in genetic research. This underrepresentation denies Puerto Ricans the benefit from therapeutic developments that could mitigate health disparities arising from conditions for which genetically-derived treatments exist. The Puerto Rican diaspora, especially post-2017 due to economic and environmental crises, has expanded within the USA. Prior research suggests that Latin American diaspora communities are less likely to participate in genetic research. We hypothesized, specifically, that the Puerto Rican diaspora in the USA would be less likely to participate in genetic research than would Puerto Ricans in their homeland's archipelago, and that accounting for social and cultural determinants related to the diaspora experience would mitigate this disparity. We implemented an analytical cross-sectional study of archipelago-residing Puerto Ricans and of the USA-residing diaspora to evaluate this hypothesis. With 1582 Puerto Ricans (723 in Puerto Rico, 859 in the USA), we found that while most participants would participate in genetic research, participation rates varied significantly by diaspora status. Puerto Ricans born and living in the USA were initially more likely to decline participation compared to those in Puerto Rico (OR = 1.54, p < 0.01). However, once adjusted for social and cultural variables, this difference was eliminated (aOR = 1.08, p = n.s.). The factors influencing non-participation include oppression, discrimination, distrust, and social determinants, aligning with the theory of minoritization. An important community in the USA and in the world, Puerto Ricans have the right to participate in well-conducted research and to benefit from its findings, particularly around topics that could help address existing disparities in health outcomes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117437"},"PeriodicalIF":4.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511299","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}
S. Hassan , C. Thompson , J. Adams , M. Chang , D. Derbyshire , M. Keeble , B. Liu , O.T. Mytton , J. Rahilly , B. Savory , R. Smith , M. White , T. Burgoine , S. Cummins
{"title":"The adoption and implementation of local government planning policy to manage hot food takeaways near schools in England: A qualitative process evaluation","authors":"S. Hassan , C. Thompson , J. Adams , M. Chang , D. Derbyshire , M. Keeble , B. Liu , O.T. Mytton , J. Rahilly , B. Savory , R. Smith , M. White , T. Burgoine , S. Cummins","doi":"10.1016/j.socscimed.2024.117431","DOIUrl":"10.1016/j.socscimed.2024.117431","url":null,"abstract":"<div><h3>Introduction</h3><div>Access to hot food takeaways, particularly near schools, is of growing concern for policymakers seeking to reduce childhood obesity globally. In England, United Kingdom (UK), local government jurisdictions are implementing planning policies to reduce access by restricting or denying planning permission for new takeaway outlets near schools. We used a qualitative approach to explore local government officers’ perspectives on the barriers to and facilitators of the adoption, implementation, and perceived effectiveness of these policies.</div></div><div><h3>Methods</h3><div>In 2021–2022, we conducted semi-structured interviews with 29 local planning (‘planners’) and public health government officers from 15 different local authorities across England who adopted a policy to restrict new takeaways. Data were analysed thematically.</div></div><div><h3>Results</h3><div>Participants explained that they mostly thought the policies facilitated the refusal of applications for new takeaways near schools. However, participants speculated that businesses identified alternative opportunities to operate including functioning as ‘restaurants’ or within other locations. Effective working relationships between planners and public health officers were important for adoption and implementation, although planning and public health agendas did not always align and there were tensions between economic development and health improvement goals. The policy was adapted to suit local needs and priorities; in some cases, the policy was not used in areas where economic growth was prioritised. Clarity in policy wording and establishing a formal process for implementing policies including a designated individual responsible for checking and reviewing takeaway applications helped ensure consistency and confidence in policy implementation.</div></div><div><h3>Conclusion</h3><div>Although sometimes challenging, the policies were commonly described as feasible to implement. However, they may not completely prevent new takeaways opening, particularly where takeaways are relied upon to enhance local economies or where takeaway businesses find alternative ways to operate. Nevertheless, the policies can serve to shift the balance of power that currently favours commercial interests over public health priorities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117431"},"PeriodicalIF":4.9,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511301","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":"Assessing momentary stress responses to dynamic real-time greenspace exposure: Unveiling algorithmic uncertainty and the temporality of exposure context","authors":"Changda Yu , Mei-Po Kwan , Yang Liu","doi":"10.1016/j.socscimed.2024.117411","DOIUrl":"10.1016/j.socscimed.2024.117411","url":null,"abstract":"<div><div>Mental stress issues are emerging among residents of modern cities. Among environmental factors associated with stress mitigation, greenspace has consistently been shown to have significant stress-reducing properties. However, the temporality of greenspace exposure, particularly the cumulative threshold effect in urban environments, has been largely neglected in past studies. In addition, different algorithms and their related measurements of greenspace have led to inconsistent mental health outcomes. To address both gaps, we evaluated the dynamic greenspace exposure of 221 Hong Kong residents by integrating three distinct green space measurements: the Normalized Difference Vegetation Index (NDVI), the Green Space Area Ratio (GSAR), and the Eye-level Green View Index (GVI) based on individual real-time GPS data. We subsequently gauged individual momentary stress levels via Ecological Momentary Assessment (EMA) and modeled its association with dynamic green space exposure using mixed ordinal logistic regression across diverse cumulative time frames. The results reveal great disparities in greenspace-stress association between different greenspace measurements and different cumulative time frames: (1) Among the three measurements, GVI is the most robust and effective measurement in assessing the stress-reducing effect in urban environments. (2) Within specific time frames, cumulative exposure has a more pronounced stress-reducing influence than momentary exposure. (3) The stress-reducing effects of cumulative eye-level greenspace exposure exhibit two temporal phases: A continuous exposure spanning 12–36 min leads to a progressive enhancement in the stress-mitigating effect of eye-level greenspace, peaking initially and then diminishing after 36 min. Upon extended exposure reaching 2.3 h, the stress-alleviating impact of eye-level green space peaks once again before gradually waning. Our research underscores the need for multiple measurements of environmental exposure to address the algorithmic uncertainty in environmental health research and deeper insights into the temporality of the greenspace-mental relationship.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"363 ","pages":"Article 117411"},"PeriodicalIF":4.9,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677572","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}
Mari Tvaliashvili , Lela Sulaberidze , Catherine Goodman , Kara Hanson , George Gotsadze
{"title":"Exploring the risks of fragmentation in health care markets – An analysis of inpatient care in Georgia","authors":"Mari Tvaliashvili , Lela Sulaberidze , Catherine Goodman , Kara Hanson , George Gotsadze","doi":"10.1016/j.socscimed.2024.117428","DOIUrl":"10.1016/j.socscimed.2024.117428","url":null,"abstract":"<div><div>Private providers play an important role in health systems in low-and middle-income countries. In many such contexts, markets are characterized by a high number of relatively small private facilities. The potential risks from highly concentrated healthcare markets are well-researched, and feature in the “Theories of Harm” investigated by competition regulators. However, there is limited evidence on markets that exhibit substantial harms as a result of very low concentration. This paper explores the risks associated with such market fragmentation, drawing on the example of Georgia, which has a largely privatized provider network.</div><div>We used a mixed-method study design to analyze the inpatient market in Georgia. Market structure was described using administrative data on bed capacity and discharge numbers and geo-location data on travel time between facilities. The implications of the market structure were explored through in-depth interviews (n = 35) with policymakers, healthcare managers, and local experts and an anonymous online survey of similar groups (n = 97).</div><div>Georgia's inpatient sector is characterized by a high number of small hospitals in terms of bed numbers and inpatient volumes, mitigated to a limited degree by the presence of provider networks. Travel time to the 3<sup>rd</sup> nearest competitor was extremely short, ranging from 3 to 5 min in big cities to 10 min in small towns and 33 min in remote locations. The fragmented nature of the market, together with inadequate regulatory and purchasing mechanisms, was argued to exacerbate challenges in the availability and competence of clinical staff, while the financial challenges caused by intense competition encouraged wasteful marketing, harmful cost-cutting measures, and demand inducement.</div><div>We present “Theories of Harm” from market fragmentation, and argue that an effective policy response requires market-shaping activities using regulatory, financing, and purchasing mechanisms to encourage appropriate levels of market consolidation and so enhance quality, efficiency, and effective governance.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117428"},"PeriodicalIF":4.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523397","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}
Julija Simpson , Viviana Albani , Andrew Kingston , Clare Bambra
{"title":"Closing the life expectancy gap: An ecological study of the factors associated with smaller regional health inequalities in post-reunification Germany","authors":"Julija Simpson , Viviana Albani , Andrew Kingston , Clare Bambra","doi":"10.1016/j.socscimed.2024.117436","DOIUrl":"10.1016/j.socscimed.2024.117436","url":null,"abstract":"<div><div>Regional health inequalities are rising globally. The case of German reunification offers a unique opportunity to explore how such inequalities can be reduced, or even eliminated: following reunification, a long-standing life expectancy gap between East and West Germany was closed for women and markedly reduced for men in less than 15 years.</div><div>We used data from official national statistics covering the period 1994–2020 for 15 regions in East and West Germany. Using fixed-effects models with an interaction term for regions in the East, we investigated whether within-region changes in key hypothesised factors (social security expenditure, healthcare improvements, changes in alcohol consumption, and life satisfaction), have had differential impacts on life expectancy at birth and at 65 years.</div><div>Our results show that increases in social security benefits in the East following reunification has been the most important factor for lowering inequalities between the two parts of Germany: for every 10% increase in social security benefits, life expectancy at birth increased by an additional 1.05 [0.68; 1.41] months for males and by 0.57 [0.18; 0.97] months for females in East relative to West Germany. We find the protective effect of social security benefits also for women at 65 years (additional 0.38 [0.06; 0.70] months) but not for men.</div><div>Our findings suggest that increasing social security expenditure could be an effective policy tool for reducing health inequalities across regions with different levels of economic development. This provides additional support for the materialist hypothesis and the political economy theory of the root causes of health inequalities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117436"},"PeriodicalIF":4.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511363","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":"Healthcare providers’ psychological investment in clinical recommendations: Investigating the role of implicit racial attitudes","authors":"Conor M.C. Duffy , Emerson Do Bú , Cícero Roberto Pereira , Filipa Madeira , Nao Hagiwara","doi":"10.1016/j.socscimed.2024.117435","DOIUrl":"10.1016/j.socscimed.2024.117435","url":null,"abstract":"<div><div>Racial disparities in clinical recommendations can result in racial disparities in health. While healthcare providers' implicit racial attitudes (affective component of bias) are theorized to be one major factor contributing to racial disparities in clinical recommendations, empirical evidence to support the link is lacking. This study aimed to bridge this gap by moving beyond the standard approach of operationalizing the quality of clinical recommendations as a guideline-consistent vs. -inconsistent dichotomy. The present secondary study examined the role of provider implicit racial attitudes in the quality of clinical recommendations, operationalized as behaviors reflecting providers’ psychological investment in patient care (i.e., number of words used to describe clinical recommendations, and number of treatment options recommended). Two-hundred-and-ten White medical trainees reviewed a clinical vignette of either a White or Black male patient and provided clinical recommendations. Their implicit racial attitudes were evaluated using the Implicit Association Test. Participants with more biased implicit racial attitudes (i.e., stronger implicit preference for White vs. Black individuals) used fewer words to describe their clinical recommendations and provided fewer clinical recommendations for the Black (vs. White) patient, while there were no significant differences between Black and White patients among participants with less biased implicit racial attitudes. These results illustrate the insidious impact of implicit racial attitudes in healthcare provision and underscore the need for researchers to consider the complex, nuanced ways in which provider implicit racial attitudes might manifest in clinical decision-making.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117435"},"PeriodicalIF":4.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511365","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":"Sex-specific co-developmental trajectories of childhood victimization among elementary school students: Relations to social behavior","authors":"Ruorong Jin , E. Scott Huebner , Lili Tian","doi":"10.1016/j.socscimed.2024.117432","DOIUrl":"10.1016/j.socscimed.2024.117432","url":null,"abstract":"<div><div>This study aimed to identify sex-specific co-developmental trajectories of multiple forms of childhood victimization: family maltreatment (FM), psychological maltreatment by teachers (PMT), and peer victimization (PV), and their relations to prosocial and delinquent behaviors among elementary school students. A total of 4378 Chinese elementary school students (Mage = 9.93; SD = 0.92; 55.14% boys) participated in assessments on five occasions, using six-month intervals. Parallel process latent class growth model analyses revealed three trajectories for boys: Congruent-low (75.64%), High-PV, Moderate-FM and PMT (14.62%), and Moderate-PV, High-FM and PMT (9.74%). Similarly, girls exhibited three trajectories: Congruent-low (81.11%), Moderate-PMT, High-FM and PV (10.54%), and High-PMT, Moderate-FM and PV (8.35%). The results indicated that boys were more susceptible than girls to three forms of childhood victimization. Furthermore, boys were especially vulnerable to co-occurring FM and PMT. In contrast, girls were more vulnerable to co-occurring FM and PV. Additionally, after experiencing childhood victimization, girls showed a greater hindrance in prosocial behavior development, whereas boys exhibited a more significant increase in delinquent behavior. These findings underscore the importance of considering sex differences in understanding multiple forms of childhood victimization and provide important insights for prevention and intervention efforts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117432"},"PeriodicalIF":4.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511368","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}
Sara Evans-Lacko , Paulino Font Gilabert , Martin Knapp
{"title":"The double disadvantage faced by adolescents from low socioeconomic backgrounds with mental health problems affects earnings up to mid-life","authors":"Sara Evans-Lacko , Paulino Font Gilabert , Martin Knapp","doi":"10.1016/j.socscimed.2024.117385","DOIUrl":"10.1016/j.socscimed.2024.117385","url":null,"abstract":"<div><div>Early childhood socioeconomic disadvantage and mental health problems are both important determinants of adult social and economic experiences, but little is known about how they interact in this respect. We aimed to assess whether poor mental health in adolescence exacerbates labour market inequalities originating from low socioeconomic status (SES) in childhood. We use a birth cohort of individuals born in 1958 in England and follow their employment experiences and cumulative earnings up to age 55. We proxy low SES in childhood with father's occupational class at the time the respondent was aged 11, and use caregiver (usually, parent) ratings of the Rutter inventory at age 16 to identify mental health problems in adolescence. We fit ordinary least squares (OLS) models to estimate the effect of growing up in a low-SES family and experiencing mental health problems (conduct or emotional problems) in adolescence on cumulative earnings (log-transformed). We use an interaction term to test whether the association between mental health problems (conduct and emotional separately) and earnings differed by socioeconomic group. Individuals who experienced conduct problems in adolescence had lower cumulative earnings and employment levels up to age of 55. Moreover, the association between mental health problems and cumulative earnings was higher among individuals who also experienced low SES in childhood. Families from a higher socioeconomic group may have more effective means to counteract the adverse impacts of adolescent mental health problems, likely due to broader access to resources, support systems and opportunities. This underscores the role of structural supports in addressing socioeconomic inequalities in mental health outcomes and their long-terms implications.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"362 ","pages":"Article 117385"},"PeriodicalIF":4.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478705","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}