Canadian Journal of Public Health-Revue Canadienne De Sante Publique最新文献

{"title":"Sur la route des surdoses: un portrait canadien.","authors":"André-Anne Parent, Antoine Bertrand-Deschênes","doi":"10.17269/s41997-025-01001-z","DOIUrl":"https://doi.org/10.17269/s41997-025-01001-z","url":null,"abstract":"<p><strong>Objectives: </strong>The overdose crisis continues to grow in Canada, and those involved in intervention must innovate to propose solutions. This exploratory research aims to paint a portrait of the situation, understand prevention efforts, and hear the experiences of people who have lived an overdose and those who intervene in this context.</p><p><strong>Methods: </strong>A qualitative, descriptive-interpretive approach was adopted. Data collection took place in 2021 and 2022 in four Canadian provinces and 11 cities. A variety of data collection methods were used, including a logbook, periods of participant observation, and semi-structured interviews with 39 caregivers, 10 peer caregivers, and 11 service users. A thematic analysis of the material was carried out.</p><p><strong>Results: </strong>Mobilizing Nancy Fraser's critical theory, our results present an inequitable distribution of resources, the exclusion of representation mechanisms, and institutionalized denials of recognition. Several interventions implemented in response to overdoses or transformed to better address the crisis are identified. We situate them according to the recognition and redistribution of solutions, whether more corrective or more radical.</p><p><strong>Conclusion: </strong>Structural reforms aimed at improving the recognition and redistribution of resources are essential if interventions are to retain their innovative potential in the context of the overdose crisis, while being part of a longer-term aim of social transformation.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568787","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":"HIV and related health inequities affecting Black communities in Canada: Towards transformative understanding and action.","authors":"Louise Potvin, Winston Husbands","doi":"10.17269/s41997-025-01004-w","DOIUrl":"https://doi.org/10.17269/s41997-025-01004-w","url":null,"abstract":"","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544507","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":"Integrating Afrocentric praxis in intimate partner violence and HIV care for African, Caribbean, and Black women: Navigating disclosure and access to services.","authors":"Watetu Mercy Gichuki, Ameil Joseph, Mirna Carranza, Ingrid Waldron, Tomilola Joseph, Wangari Tharao, Amber Dawe, Shane Joseph, Chris Leonard, Denise Johnson, Tanisha Bryan, Donna Joyette, Carrie Campbell, Laurie Samuels, Azra-Begum Manji, Marvelous Muchenje","doi":"10.17269/s41997-025-00999-6","DOIUrl":"https://doi.org/10.17269/s41997-025-00999-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the intersection of intimate partner violence (IPV) and human immunodeficiency virus (HIV) among African, Caribbean, and Black women in the Greater Toronto Area (GTA). It investigates the barriers African, Caribbean, and Black women face in accessing services and examines the effectiveness of Afrocentric praxis in providing culturally informed services.</p><p><strong>Methods: </strong>Participants included African, Caribbean, and Black women aged 18-64, IPV survivors who had experience with healthcare and social services in the GTA, and healthcare professionals and social service providers knowledgeable about IPV and HIV in African, Caribbean, and Black communities. Convenience and snowball sampling were used to recruit participants through social media, and community organizations. Six talking circles and 18 semi-structured interviews were conducted. Content analysis was applied to identify key themes and patterns related to IPV, HIV, Afrocentric approaches, and service access. Ethical guidelines, including informed consent and confidentiality, were followed.</p><p><strong>Results: </strong>Analysis revealed several themes: systemic barriers to accessing IPV and HIV services, fear of disclosure and stigmatization, and the impact of the \"Strong Black Woman\" schema. The study highlighted the importance of inclusive, safe spaces and the protective role of spirituality and culturally informed therapy. Afrocentric praxis emerged as essential for effective support, emphasizing community engagement, cultural context, and collective responsibility (Ujima) in addressing IPV and HIV.</p><p><strong>Conclusion: </strong>Addressing the intersection of IPV and HIV among African, Caribbean, and Black women requires culturally informed and empowering approaches. Integrating Afrocentric values and perspectives into care is crucial for creating supportive environments that recognize and address the unique challenges faced by African, Caribbean, and Black women.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544509","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":"Sexual identity, child maltreatment, mental health, and substance use among emerging adults aged 18 to 23 years.","authors":"Tracie O Afifi, Ana Osorio, Janique Fortier, Ashley Stewart-Tufescu, Tamara L Taillieu, Julie-Anne McCarthy","doi":"10.17269/s41997-024-00992-5","DOIUrl":"https://doi.org/10.17269/s41997-024-00992-5","url":null,"abstract":"<p><strong>Objectives: </strong>Although past studies have identified sex differences in child maltreatment experiences and poor mental and physical health‒related outcomes, more research is needed to understand child maltreatment among sexual minorities (i.e., those who identify as other than heterosexual) and how child maltreatment and sexual identity are related to depression, anxiety, and at-risk alcohol and cannabis use among emerging adults.</p><p><strong>Methods: </strong>Data were drawn from the longitudinal Well-Being and Experiences (WE) Study collected from 2017 (14 to 17 years) to 2022 (18 to 23 years) from Manitoba, Canada (n = 584). Descriptive statistics and logistic regression models were computed.</p><p><strong>Results: </strong>Compared to heterosexual or straight sexual identity: homosexual, gay or lesbian; bisexual; and different or other identity were associated with an increased likelihood of experiencing child maltreatment, with the most robust relationships for bisexual identity and all child maltreatment outcomes. Indicating \"I don't know\" for sexual identity compared to heterosexual identity was associated with 7.45 increased odds of exposure to intimate partner violence in adjusted models. Bisexual identity compared to heterosexual identity had the most robust association, with increased odds of depression, anxiety, at-risk alcohol use, and at-risk cannabis use. Findings provide some evidence to suggest that trends may be worse for some mental health and substance use outcomes among sexual minorities who also experience child maltreatment.</p><p><strong>Conclusion: </strong>Preventing child maltreatment among all children, including youth identifying as other than heterosexual, is a public health priority. Such efforts will work towards optimizing mental health and reducing substance use in early adulthood.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525064","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":"Healthcare lived experiences of African, Caribbean, and Black individuals in Alberta living with HIV/AIDS: A phenomenological study.","authors":"Joseph Osuji, Alyssa Domingo, Funke Olokude","doi":"10.17269/s41997-024-00993-4","DOIUrl":"https://doi.org/10.17269/s41997-024-00993-4","url":null,"abstract":"<p><strong>Objective: </strong>This study explores the lived experiences of African, Caribbean, and Black (ACB) individuals in Alberta living with HIV/AIDS and the issues they encounter when accessing services.</p><p><strong>Methods: </strong>Interpretive phenomenological analysis (IPA) provided the underlying philosophy, data collection, and analysis methods. Participants self-identified after responding to recruitment posters posted at HIV/AIDS-supporting agencies in Alberta and on related social media pages. A total of 22 research informants were recruited and interviewed. Texts resulting from audio-taped interviews constituted data for analysis.</p><p><strong>Results: </strong>Data analysis yielded four broad themes, with stigma, discrimination, and racism serving as common threads in the lived experiences of ACB individuals accessing HIV/AIDS services in Alberta. These themes were organized into four categories: (a) health literacy and empowerment, (b) non-belonging and invisibility, (c) barriers to care and adherence, and (d) psychosocial life impacts.</p><p><strong>Conclusion: </strong>The findings suggest the need for greater sensitivity and knowledge among healthcare and service providers, such as providing culturally appropriate support services for the ACB population living with HIV/AIDS. Moreover, a comprehensive community awareness program is necessary to address discrimination, anti-Black racism, and stigma. Expanded efforts to recognize and mitigate barriers to care, such as poverty, accessibility, and settlement issues, are also critical. This perspective advocates for intentional policy and practice changes that focus on diversity, equity, and inclusivity in protocols governing how ACB individuals access HIV/AIDS care in Alberta.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494685","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":"Post-arrival HIV acquisition patterns: Insights from African, Caribbean, and Black immigrant communities in Canada.","authors":"Wangari Tharao, Thabani Nyoni, Amrita Daftary, Sandra Bullock, Soraya Blot, Valerie Pierre-Pierre, Mona Loutfy, Rupert Kaul, Darrell Tan, Anita Rachlis, Curtis Cooper, Irving Salit, Henry Luyombya, Shannon Thomas Ryan, Liviana Calzavara","doi":"10.17269/s41997-024-00991-6","DOIUrl":"https://doi.org/10.17269/s41997-024-00991-6","url":null,"abstract":"<p><strong>Objectives: </strong>This mixed methods study examines post-migration HIV acquisition patterns and sexual health behaviours among African, Caribbean, and Black (ACB) immigrant men who have sex with men (MSM), as well as heterosexual men and women in Ontario, Canada.</p><p><strong>Methods: </strong>Data were collected from the MSAFIRI Study, including a cross-sectional quantitative survey (n = 108) and in-depth semi-structured interviews (n = 44). Participants were recruited from the Ontario HIV Treatment Network Cohort Study (OCS) through a purposive sampling of individuals who contracted HIV after migration. Data collection occurred between 2015 and 2017. Quantitative analyses using Fisher's exact tests examined associations between gender and HIV acquisition patterns, while qualitative content analysis identified themes around sexual relationships, HIV disclosure, and health decision-making.</p><p><strong>Results: </strong>Findings highlighted gender and orientation-specific differences in HIV acquisition and associated behaviours. Quantitatively, a higher proportion of men than women could not identify their likely source partner (LSP), frequently describing these relationships as casual. Qualitative insights revealed that LSPs often concealed their HIV status, resulting in unintentional post-diagnosis disclosures. Inconsistent condom use was common, with gendered rationales: heterosexual women often cited partner disapproval or relationship exclusivity, while heterosexual men and MSM cited personal aversion and focus on sexual satisfaction.</p><p><strong>Conclusion: </strong>These findings underscore the distinct post-migration HIV acquisition risks among ACB immigrants in Canada. They suggest the need for culturally responsive public health interventions that consider gender-specific barriers, address stigma, and support health decision-making for ACB migrant communities navigating the complex intersections of migration, health, and relationships.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493686","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":"Perinatal mental illness in Ontario (2007-2021): A population-based repeated cross-sectional surveillance study.","authors":"Simone N Vigod, Amreen Babujee, Anjie Huang, Kinwah Fung, Kelsey Vercammen, Jennifer Lye, Susie Dzakpasu, Wei Luo","doi":"10.17269/s41997-024-00987-2","DOIUrl":"10.17269/s41997-024-00987-2","url":null,"abstract":"<p><strong>Objective: </strong>Perinatal mental illness can negatively impact pregnant and postpartum women and gender-diverse birthing persons, their children, and families. This study aimed to describe population-level trends in perinatal mental health service use, including outpatient and acute care contacts, to guide decisions about investments in evidence-based treatment.</p><p><strong>Methods: </strong>In this repeated cross-sectional population-based surveillance study in Ontario, Canada, we measured monthly rates of mental health service use for perinatal people (conception to 1 year postpartum) from January 2007 to December 2021. Event rates were calculated by dividing the number of contacts in a given month by the total eligible perinatal time for that month expressed in per 1000 person-months. Rates by service type (outpatient, acute care), diagnosis, and sociodemographic characteristics, and by history of pre-existing mental illness were also calculated.</p><p><strong>Results: </strong>In total, 22-28% of perinatal people had perinatal mental health service use annually (10-15% in pregnancy, 17-21% in postpartum). Perinatal mental health outpatient care rates decreased initially (2007-2012), stabilized, and then increased after March 2020. Acute care rates were stable from 2007 to 2015, then increased (especially for anxiety and substance/alcohol use disorders). Across all contact types, the highest rates were in postpartum vs. pregnancy, those aged < 25 and > 40 years, non-immigrants, urban-dwellers, and those with pre-existing mental illness.</p><p><strong>Conclusion: </strong>Ensuring rapid access to evidence-based supports and services for perinatal mental illness is essential. Groups with increased need based on sociodemographic and clinical characteristics may benefit from targeted supports and services to ensure optimal treatment and prevent adverse outcomes.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493760","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":"Food insecurity and youth suicidal behaviours: Evidence from the Canadian Health Survey of Children and Youth.","authors":"Lilia Lounis, Lovena Jacqdom, Frank J Elgar","doi":"10.17269/s41997-025-00998-7","DOIUrl":"https://doi.org/10.17269/s41997-025-00998-7","url":null,"abstract":"<p><strong>Objective: </strong>Youth suicide, a major cause of death, is linked to poverty and other adverse experiences. Evidence of its association with food insecurity is unclear due to inadequate controls for household income in previous research. This cross-sectional study used independent reports of household income, food insecurity, and suicidal behaviours to examine these associations in a population-based sample.</p><p><strong>Methods: </strong>The 2019 Canadian Health Survey on Children and Youth surveyed 6735 youth (15-17 years), gathering data on sadness/hopelessness, suicidal ideation, and suicide attempts. Adults provided information on household food insecurity using a multi-item scale and about diagnosed mood disorders in youth. Household income data were provided by government tax records. We used Poisson regressions to estimate the relative risk (RR) of each suicidal behaviour attributed to household food insecurity, adjusting for household income and other covariates.</p><p><strong>Results: </strong>Approximately one in five (19.8%) youth experienced marginal (5.2%), moderate (7.9%), or severe (3.3%) food insecurity. Moderate or severe food insecurity was associated with increased risks of sadness/hopelessness, mood disorder, suicide ideation, and suicide attempts (RRs 1.30-2.17) after controlling for household income differences and other covariates. Generally, more severe food insecurity was positively associated with suicide behaviours.</p><p><strong>Conclusion: </strong>Household food insecurity is associated with youth suicidal behaviours, independently of household income. Its underlying pathway to youth mental health includes social and psychological factors that require targeted policy intervention.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494682","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":"Novel adulterants in unregulated opioids and their associations with adverse events.","authors":"Samuel Tobias, Jennifer Angelucci, Evan Wood, Jane A Buxton, Lianping Ti","doi":"10.17269/s41997-024-00990-7","DOIUrl":"https://doi.org/10.17269/s41997-024-00990-7","url":null,"abstract":"<p><strong>Objective: </strong>In recent years, Canada's unregulated drug supply has become permeated by novel adulterants (e.g., fentanyl analogues, benzodiazepines, xylazine). While fentanyl has been shown to be associated with overdose mortality and other non-fatal health outcomes, adverse events (AE) associated with these adulterants remain poorly described. This study seeks to identify whether common adulterants identified through drug checking services are associated with increased prevalence of specific adverse events reportedly experienced by people who use drugs.</p><p><strong>Methods: </strong>Drug checking samples were analyzed using Fourier-transform infrared spectroscopy and immunoassay strips at harm reduction sites in British Columbia. Self-reported AE (e.g., non-fatal overdose, prolonged sedation, seizures) were recorded from individuals who checked opioids post-consumption. Adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI) of AE among common adulterants were calculated using generalized linear models with a Poisson distribution, controlled for presence of other adulterants, expected drug, geographic location, and month.</p><p><strong>Results: </strong>Between February 2022 and May 2024, 80,415 samples were analyzed at community sites. Among eligible samples, 36.1% were expected opioids, 42.2% of which were checked post-consumption. AE were noted among 10.7% of post-consumption opioid drug checks. After adjustment, the presence of benzodiazepines in opioid samples was associated with increased prevalence of any AE (aPR 1.97; 95% CI 1.70-2.27), as was the presence of xylazine (aPR 1.50; 95% CI 1.09-2.07). Considering specific AE, benzodiazepines were associated with increased prevalence of overdose (aPR 2.05; 95% CI 1.68-2.51) and prolonged sedation (aPR 3.35; 95% CI 2.54-4.43).</p><p><strong>Conclusion: </strong>Non-fatal AE associated with unregulated opioids have been largely undescribed. Our findings report specific AE associated with different adulterants in the unregulated opioid supply. With this information, tailored public health interventions and services focused on these adulterants can be developed.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493754","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":"HIV testing among heterosexual Black men in Toronto: What are the determinants?","authors":"Roger Antabe, Yujiro Sano, Egbe B Etowa, Joseph Bertrand Nguemo Djiometio, Mandana Vahabi, Kenneth Po-Lun Fung, Josephine Pui-Hing Wong, Winston Husbands","doi":"10.17269/s41997-024-00983-6","DOIUrl":"https://doi.org/10.17269/s41997-024-00983-6","url":null,"abstract":"<p><strong>Objectives: </strong>African, Caribbean, and Black (ACB) men in Canada face a higher risk of HIV infection relative to other men. Despite this concern, these are nascent studies focused on the usage of HIV testing services among ACB men. To contribute to health policy in Canada, we seek to understand the prevalence and predictors of HIV testing among heterosexual ACB men living in Toronto.</p><p><strong>Methods: </strong>We used a sample of 325 self-identified heterosexual Black men in Toronto, Ontario, who participated in the weSpeak study, which examined HIV vulnerability among ACB men. Guided by Andersen's framework of health services utilization, we fitted negative log-log regression models to cross-sectional data of ACB men 16 years or older.</p><p><strong>Results: </strong>The findings indicate that (1) ACB men with secondary or lower levels of educational attainment (OR = 0.57, p < 0.1) were less likely to have ever been tested for HIV compared to their counterparts with a university education or higher, (2) foreign-born men were more likely to have ever been tested for HIV than their Canadian-born counterparts (OR = 3.14, p < 0.01), and (3) ACB men who report multiple sexual partners were more likely to have ever been tested for HIV compared to colleagues with one sexual partner (OR = 2.76, p < 0.01).</p><p><strong>Conclusion: </strong>Based on these findings, we recommend further research to understand the barriers to HIV testing among non-priority risk groups and the design of a more nuanced population-based approach to HIV testing that incorporates case management or various incentives.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460918","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}