Stigma and Health最新文献

{"title":"Assessing associations between stigma and mental health among pre-exposure prophylaxis users in Guatemala.","authors":"Sophia Bartels, Cesar Galindo, Gustavo Angeles, Clare Barrington","doi":"10.1037/sah0000429","DOIUrl":"10.1037/sah0000429","url":null,"abstract":"<p><strong>Introduction: </strong>The mental health of gay and bisexual men (GBM) who use pre-exposure prophylaxis (PrEP) may be negatively impacted by experiences of stigma.</p><p><strong>Methods: </strong>To assess the relationship between stigma and mental health among GBM who use PrEP in Guatemala, we conducted a survey with 162 PrEP users recruited in a community-based PrEP clinic.</p><p><strong>Results: </strong>In multiple linear regression analyses, greater internalized (ß=1.94, SE=0.85, p=0.023) and enacted sexual orientation stigma (ß=0.50, SE=0.12, p<0.001) were associated with greater depressive symptoms. Greater internalized (ß=1.82, SE=0.80, p=0.023) and enacted sexual orientation stigma (ß=1.33, SE=0.11, p=0.003) were also associated with greater anxiety symptoms. Additionally, individuals with high social support and high anticipated PrEP stigma had fewer depressive symptoms than individuals with low social support and high anticipated PrEP stigma (ß=-3.25, SE=1.40, p=0.022). This relationship was marginally significant for anxiety (ß=-2.54, SE=1.31, p=0.055).</p><p><strong>Conclusion: </strong>Sexual orientation and PrEP stigma may affect PrEP users' mental health. Interventions addressing stigma are needed to support uptake and sustained PrEP use in this population.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":"31 1","pages":"575-581"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90382552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination against Gay and Bisexual Patients in Prostate Cancer Treatment: Results from the <i>Restore-2</i> Study.","authors":"Alex J Bates, Michael W Ross, B R Simon Rosser, Christopher W Wheldon, Elizabeth J Polter, Kristine M C Talley, Ryan Haggart, Morgan M Wright, Darryl Mitteldorf, William West, Badrinath R Konety","doi":"10.1037/sah0000467","DOIUrl":"10.1037/sah0000467","url":null,"abstract":"<p><p>The purpose of this study was to examine the experiences of discrimination during prostate cancer treatment and assess the association with health-related quality of life (HRQOL) in a cohort of gay and bisexual men (GBM) prostate cancer survivors. This is a cross-sectional analysis of the 24-month follow-up survey from the <i>Restore-2</i> clinical trial that tested the effectiveness of an online rehabilitation program tailored for GBM prostate cancer survivors in the U.S. This analysis uses data from the 347 participants who completed all items of the Everyday Discrimination Scale (EDS) at the 24-month follow-up. A log-binomial regression model estimated the risk of experiencing discrimination across treatment received and demographic characteristics. Multivariable linear regression models estimated mean differences in HRQOL measures with discrimination as a binary variable after adjustment for relevant covariates. Nearly half (49.3%) of participants endorsed at least one experience of discrimination during prostate cancer treatment. About half (52%) of these rated the discrimination as \"rare\" (total EDS = 1-3), while 48% reported it as more common (total EDS ≥ 4). Most attributed the discrimination to their sexual orientation (35.5%) or to their provider's attributes (29.6%). Those who underwent systemic/combined treatment (vs. either surgery or radiation only) and those with less than a bachelor's or graduate-level degree (vs. bachelor's degree) were more likely to report discrimination. Experiencing any discrimination was associated with significantly worse HRQOL outcomes. Discrimination during prostate cancer treatment appears to be a common experience for GBM patients and may result in poorer treatment outcomes.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":"9 4","pages":"506-517"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and Gender Minority University Students Report Distress Due to Discriminatory Health Care Policies.","authors":"Gray Babbs, Hill Landon Wolfe, Michael R Ulrich, Julia Raifman, Sarah Ketchen Lipson","doi":"10.1037/sah0000459","DOIUrl":"10.1037/sah0000459","url":null,"abstract":"<p><p>\"Religious conscience\" or \"healthcare denial\" policies allow healthcare providers and institutions to refuse to provide services in the name of religious freedom. Denial policies are a form of structural stigma that could impede access to healthcare for sexual and gender minority (SGM) populations, particularly SGM young adults. This study describes SGM university students' response to policies permitting healthcare providers to deny care based on their religious beliefs. Data were obtained from 8,322 SGM students at 38 colleges and universities who participated in the spring 2020 Healthy Minds Study. Descriptive statistics are reported for the level of distress due to the denial policies and likelihood to avoid identity disclosure. Over 90% of SGM students report distress knowing about denial policies (sexual minority: 6.95/10; gender minority: 8.05/10). Students also reported similarly high distress imagining that they had been denied care (sexual minority: 8.05/10; gender minority: 8.57/10). The majority of sexual (69.2%) and gender minority (82.2%) students agreed the policy would make them less likely to disclose their identity to a new provider. Experiencing, or even anticipating, discrimination in healthcare settings through denial policies has negative impacts on the health of SGM populations and has the potential to exacerbate existing mental health disparities for SGM young adults.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":"128 1","pages":"601-604"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79556372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"You Always Worry About What Other People Think\": Experiences of Antitrans Stigma Among Trans Youth and Their Siblings in the Northeastern United States.","authors":"Eli Glen Godwin, L B Moore, Sabra L Katz-Wise","doi":"10.1037/sah0000564","DOIUrl":"10.1037/sah0000564","url":null,"abstract":"<p><p>Transgender (trans) and nonbinary youth (TNY) and, by extension, their family members, are currently facing widespread and virulent anti-trans stigma and discrimination in the United States (US), which have been associated with negative impacts on health. While research focused on families of TNY has increased in recent years, siblings' perspectives are rarely included. This qualitative analysis sought to address this gap and learn more about how adolescent and young adult TNY and their siblings experienced and managed anti-trans stigma across different settings and over time. Using a reflexive thematic analysis and template organizing approach, we analyzed one-on-one, semi-structured, separate interviews (N=88) with 10 TNY and their 10 siblings (N=20) who completed at least four of five waves of the Trans Teen and Family Narratives Project, a mixed-methods, longitudinal study of TNY and their families in the New England region of the US, conducted from 2016-2019. TNY and their siblings engaged in meaning making about the TNY's (and for some siblings, their own) susceptibility to anti-trans stigma within their families, communities, and nation and with respect to a shifting sociopolitical climate and the TNY's gender affirmation trajectory. Four themes were generated: exercising agency, schemas for understanding stigma, \"passing,\" and awareness of their spatio-temporal and relational positionality. Recommendations for interventions to support TNY and their siblings include fostering access to other TNB/siblings facing anti-trans stigma; advocating for safe and affirming school environments; increasing/restoring access to gender-affirming medical care for those who want it; and conducting explicitly trans liberatory research.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":"9 4","pages":"492-504"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight bias and preparedness to treat higher-weight patients: Understanding the role of motivation to respond without weight-based prejudice among resident physicians.","authors":"Erin C Standen, Samantha R Philip, John F Dovidio, Michelle van Ryn, Sean M Phelan","doi":"10.1037/sah0000582","DOIUrl":"10.1037/sah0000582","url":null,"abstract":"<p><p>Weight stigma is widely recognized as a significant concern in healthcare. Studies indicate that as medical trainees advance through their training, their levels of weight bias may intensify. Such prejudices can lead to inferior care for higher-weight patients, underscoring the urgency for research that identifies factors that are protective against the development of weight bias. Prior findings have shown that the motivation to respond without prejudice is a key determinant of explicit bias across various contexts, yet its role concerning weight bias remains underexplored. In a one-year longitudinal study of U.S. resident physicians (<i>N</i> = 3,507), we examined the associations between participants' internal motivation (i.e., based on personal values) and external motivation (i.e., based on social pressures) to respond without weight-based prejudice on self-reported explicit weight bias, self-rated preparedness to treat higher-weight patients, and participation in bias-related training. We found that internal motivation predicted lower weight bias (across three measures) and greater self-rated preparedness to treat higher-weight patients (<i>p</i>s ≤ 0.001), whereas external motivation predicted higher weight bias (<i>p</i>s < 0.001). Participants' internal motivation also predicted their participation in bias-related training during the following year (<i>p</i>s ≤ 0.01). Each of these findings held when controlling for demographic variables and BMI. Participants were young and predominantly white, so further research will be needed to generalize these findings to the broader population of healthcare providers. Taken together, these findings suggest that internal motivation to respond without weight-based prejudice may be a useful target for future bias-reduction intervention efforts.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates and Predictors of Emotional Well-Being Among Latinxs With a Substance Use Disorder.","authors":"Coralee Pérez-Pedrogo, Bianca Y Planas-García, Carmen E Albizu-García","doi":"10.1037/sah0000584","DOIUrl":"10.1037/sah0000584","url":null,"abstract":"<p><p>Self-stigma among persons with substance use disorders (SUDs) represents a significant barrier to patient recovery. Numerous studies have identified that experienced or enacted stigma deters people from seeking health treatment, impacting their well-being. Considering that chronic exposure to SUD-related stereotypes is associated with the internalization of such stereotypes and that self-stigma has been linked to lower levels of self-efficacy, the present study examined the association of experienced or enacted substance use stigma, self-efficacy, and self-stigma with emotional well-being among Latinxs with SUD. The sample consisted of secondary data from (<i>N</i> = 412) people aged 21 years or older with a history of SUD. In the original study, participants were recruited by availability from two settings in Puerto Rico: correctional facilities (<i>n</i> = 311) and community programs that provide primary care services to people living with HIV and SUD (<i>n</i> = 101), many of whom have a history of imprisonment. Hierarchical regression was performed to determine the statistically significant variance of emotional well-being explained by experienced or enacted stigma, self-efficacy, and self-stigma. The full model with experienced or enacted stigma, self-efficacy, and self-stigma accounted for 31.8% of the variance in emotional well-being. These findings suggest the need for longitudinal studies examining how self-stigma and self-efficacy contribute to emotional well-being to inform patient-centered behavioral interventions that offer providers insightful knowledge to treat this population appropriately.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of disease- and race-based discrimination in healthcare on pain outcomes among adults living with sickle cell disease in the United States: The mediating roles of internalized stigma and depressive symptoms.","authors":"Lakeya S McGill, Mayra L Sánchez González, Shawn M Bediako, Sophie M Lanzkron, Lan Yu, Mary Catherine Beach, Claudia M Campbell","doi":"10.1037/sah0000581","DOIUrl":"10.1037/sah0000581","url":null,"abstract":"<p><p>Studies have shown that disease- and race-based discrimination in healthcare exacerbate pain, yet little is known about the role of psychological processes and symptoms, such as internalized stigma and depressive symptoms, in the relationship between discrimination (i.e., enacted stigma) and pain. In a sample of 284 Black adults living with sickle cell disease (SCD) (54% women, M_age = 35.37), we examined internalized stigma and depressive symptoms as mediators between disease- and race-based discrimination in healthcare and pain severity and interference. Disease-based but not race-based discrimination in healthcare was associated with internalized stigma, depressive symptoms, and pain severity and interference. Furthermore, internalized stigma and depressive symptoms partially mediated the association between disease-based discrimination in healthcare and pain severity and interference. Results suggest that individuals with SCD who experience discrimination, including based on their SCD status, may internalize these discriminatory messages from others, leading to negative thoughts and feelings about having SCD. These negative internalized beliefs may then contribute to depressive symptoms and subsequent worse pain. Internalized stigma and depressive symptoms may be potential treatment targets in behavioral and psychological interventions. More research is needed to understand the impact of intersecting experiences of discrimination and stigma on health outcomes in adults living with SCD.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Direct and Mediated Associations Between Perceived Discrimination and Prescription Opioid Misuse Among Individuals with Chronic Pain.","authors":"Patricia Timmons, Lakeya S McGill, Rachel V Aaron, Andrew H Rogers, Stephen T Wegener, Claudia M Campbell, Chung Jung Mun","doi":"10.1037/sah0000573","DOIUrl":"10.1037/sah0000573","url":null,"abstract":"<p><strong>Objective: </strong>Experiences of discrimination, a notable psychosocial stressor, are considered an important risk factor for problematic opioid use. We examined whether pain severity, pain interference, anxiety, and depressive symptoms are pathways through which discrimination may be associated with increased prescription opioid misuse behaviors among individuals with chronic pain.</p><p><strong>Method: </strong>A total of 234 participants who reported being prescribed opioids for chronic pain management were included from a parent longitudinal study collected from Amazon's MTurk. Study variables were collected at baseline and 12-month follow-up. Path analyses tested the hypothesized model, with socio-demographic variables and outcomes measured at baseline included as covariates. Mediated effects were examined using percentile bootstrap method.</p><p><strong>Results: </strong>After controlling for socio-demographic covariates, pain severity, pain interference, anxiety, and depressive symptoms, baseline discrimination was significantly associated with greater prescription opioid misuse behaviors (<i>p</i>=.020) at 12 months. Baseline discrimination was also significantly associated with anxiety (<i>p</i><.001) and depressive symptoms (<i>p</i><.001) at 12 months. However, pain severity, pain interference, anxiety, and depressive symptoms were not significantly associated with prescription opioid misuse at 12 months. Mediation analyses indicated no significant effects.</p><p><strong>Conclusions: </strong>Discrimination may play an important role in prescription opioid misuse behaviors among individuals with chronic pain. Furthermore, discrimination is a risk factor contributing to elevated anxiety and depressive symptoms, with broad clinical implications for individuals coping with chronic pain. However, pain severity, pain interference, anxiety and depressive symptoms did not emerge as underlying mechanisms that link discrimination and prescription opioid misuse. Replication and extension in future studies are warranted.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Homophobia and Suicidal Ideation and Behavior Among Sexual and Gender Minority Adolescents.","authors":"Ya-Wen Chang, Elizabeth Schumacher, Rachel M Martino, Anne J Maheux, Sophia Choukas-Bradley, Rachel H Salk, Brian C Thoma","doi":"10.1037/sah0000576","DOIUrl":"10.1037/sah0000576","url":null,"abstract":"<p><p>Sexual and gender minority (SGM) adolescents have high risk for suicidal behavior, and structural homophobia could contribute to inequities in suicidal ideation and behavior among SGM youth. Limited prior research has examined how comprehensive indicators of structural homophobia are related to suicidal ideation and behavior among SGM adolescents. Anti-gay legislation has been increasing in many states, and studies that enhance our understanding of the associations between structural homophobia and risk for suicidal behavior among SGM youth must be prioritized. We examined associations between structural homophobia at the state level and suicidal thoughts and behaviors in a nationwide sample of SGM adolescents ages 14-18 in the United States (<i>n</i> = 1837) who completed a cross-sectional online survey. Participants were diverse with regard to race, ethnicity, and geographic location. SGM adolescents who lived in states with higher levels of structural homophobia had higher odds of reporting lifetime suicidal ideation (aOR=1.22; <i>p</i>=.047) and suicidal planning (aOR=1.24; <i>p</i>=.013) after adjusting for demographic variables. Lifetime suicide attempt was not related to structural homophobia. Results indicate that SGM youth living in states with more structural homophobia had a higher likelihood of experiencing lifetime suicidal ideation and suicidal planning but not higher suicidal behavior directly. Reducing risk for suicidal behavior among SGM youth is a pressing public health concern. Public policies, societal conditions, and public attitudes that contribute to an affirming and inclusive environment for SGM youth have the potential to reduce suicidal ideation and planning among SGM adolescents.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Stereotypes on Relationships and Interpersonal Functioning: An Investigation of Social Anxiety Disorder.","authors":"Chavez R Rodriguez, Katya Fernandez, Thomas L Rodebaugh","doi":"10.1037/sah0000585","DOIUrl":"10.1037/sah0000585","url":null,"abstract":"<p><p>In this study, we explored the associations between endorsing two stereotypes of people with social anxiety disorder (SAD; i.e., the social inhibition stereotype and the oddity stereotype), and interpersonal outcomes. We performed a secondary data analysis on a sample of participants with SAD (<i>n</i> = 75) and without SAD (<i>n</i> = 60) who completed multiple study visits, including diagnostic interviews, and brought friends (<i>n</i> = 91) and romantic partners (<i>n</i> = 61) into the study. To investigate effects of endorsing stereotypes of SAD on relationship satisfaction, we examined participant self-report ratings of relationship satisfaction as well as friend- and romantic partner-reported ratings. Higher endorsement of the social inhibition stereotype was associated with lower participant self-reported friendship satisfaction but was not associated with friend-reported ratings. Neither endorsement of social inhibition nor endorsement of oddity predicted participant-reported or partner-reported romantic relationship ratings. Neither endorsement of the social inhibition nor oddity stereotype was associated with self-reported number of interpersonal problems due to coldness, but higher endorsement of the social inhibition stereotype was associated with more self-reported interpersonal problems due to submissiveness. Our results suggest that: (1) of the two stereotypes, the social inhibition stereotype may be more predictive of interpersonal variables among those with SAD; (2) SAD stereotype endorsement is associated with self-reported relationship satisfaction among those with SAD, but is not associated with partner-reported ratings; and (3) SAD stereotype endorsement may not predict interpersonal outcomes among individuals with SAD to the extent that we originally hypothesized.</p>","PeriodicalId":53222,"journal":{"name":"Stigma and Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}