Journal of Epidemiology and Community Health最新文献

{"title":"Racial and economic segregation and diabetes mortality in the USA, 2016-2020.","authors":"Ryan Saelee, Dayna S Alexander, Jacob T Wittman, Meda E Pavkov, Darrell L Hudson, Kai McKeever Bullard","doi":"10.1136/jech-2024-222178","DOIUrl":"10.1136/jech-2024-222178","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to examine the association between racial and economic segregation and diabetes mortality among US counties from 2016 to 2020.</p><p><strong>Methods: </strong>We conducted a cross-sectional ecological study that combined county-level diabetes mortality data from the National Vital Statistics System and sociodemographic information drawn from the 2016-2020 American Community Survey (n=2380 counties in the USA). Racialized economic segregation was measured using the Index Concentration at the Extremes (ICE) for income (ICE_income), race (ICE_race) and combined income and race (ICE_combined). ICE measures were categorised into quintiles, Q1 representing the highest concentration and Q5 the lowest concentration of low-income, non-Hispanic (NH) black and low-income NH black households, respectively. Diabetes was ascertained as the underlying cause of death. County-level covariates included the percentage of people aged ≥65 years, metropolitan designation and population size. Multilevel Poisson regression was used to estimate the adjusted mean mortality rate and adjusted risk ratios (aRR) comparing Q1 and Q5.</p><p><strong>Results: </strong>Adjusted mean diabetes mortality rate was consistently greater in counties with higher concentrations of low-income (ICE_income) and low-income NH black households (ICE_combined). Compared with counties with the lowest concentration (Q1), counties with the highest concentration (Q5) of low-income (aRR 1.96; 95% CI 1.81 to 2.11 for ICE_income), NH black (aRR 1.32; 95% CI 1.18 to 1.47 for ICE_race) and low-income NH black households (aRR 1.70; 95% CI 1.56 to 1.84 for ICE_combined) had greater diabetes mortality.</p><p><strong>Conclusion: </strong>Racial and economic segregation is associated with diabetes mortality across US counties.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"793-798"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753398","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":"Screen exposure, mental health and emotional well-being in the adolescent population: is it time for governments to take action<b>?</b>","authors":"Miguel Angel Alvarez de Mon, Almudena Sánchez-Villegas, Luis Gutiérrez-Rojas, Miguel A Martinez-Gonzalez","doi":"10.1136/jech-2023-220577","DOIUrl":"10.1136/jech-2023-220577","url":null,"abstract":"<p><p>During the last decade, a multitude of epidemiological studies with different designs have been published assessing the association between the use of digital media and psychological well-being, including the incidence of mental disorders and suicidal behaviours. Particularly, available research has very often focused on smartphone use in teenagers, with highly addictive potential, coining the term 'problematic smartphone use' and developing specific scales to measure the addictive or problematic use of smartphones. Available studies, despite some methodological limitations and gaps in knowledge, suggest that higher screen time is associated with impaired psychological well-being, lower self-esteem, higher levels of body dissatisfaction, higher incidence of eating disorders, poorer sleeping outcomes and higher odds of depressive symptoms in adolescents. Moreover, a significant association has also been found between screen time and higher suicide risk. Finally, problematic pornography has been shown to be highly prevalent and it is a strong cause of concern to many public health departments and national governments because it might be eventually associated with aggressive sexual behaviours.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"759-763"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536021","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":"Changing relationship between income inequality and mortality.","authors":"Michael Murphy","doi":"10.1136/jech-2024-223088","DOIUrl":"10.1136/jech-2024-223088","url":null,"abstract":"<p><p>The recent paper by Dunn <i>et al</i> showed that the positive relationship between US state-level income inequality and mortality was small in the 1950s, rose to a large value around 1990 but had largely disappeared by 2019. We consider these findings in the context of the mechanisms that have been advanced for reasons why a positive relationship might be expected, and in relation to studies using alternative methods included in systematic reviews that fail to confirm an independent inequality/mortality relationship. Ecological studies, such as by Dunn <i>et al</i>, using subnational data have advantages compared with similar studies using cross-national data, but controls are typically confined to those available from sources such as decennial census, so scope for incorporating lagged effects and life course factors is limited. However, they are often the only studies with the statistical power to identify subnational differentials and time trends so they are complementary to rarely available sources such as high-quality long-term individual-level microdata data required for causal analyses. Income equality can arise not only due to citizens' positive preferences but also to external choices such as economic decline and globalisation, so examining the wider context is important when explaining excess levels of 'deaths of despair' in low-inequality US states. The apparent increasingly strong association between income levels and low mortality with a weakening inequality/mortality relationship has implications for policy recommendations.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"782-784"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332652","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":"State-level association between income inequality and mortality in the USA, 1989-2019: ecological study.","authors":"James R Dunn, Gum-Ryeong Park, Robbie Brydon, Michael Veall, Lyndsey A Rolheiser, Michael Wolfson, Arjumand Siddiqi, Nancy A Ross","doi":"10.1136/jech-2024-222262","DOIUrl":"10.1136/jech-2024-222262","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have shown a positive relationship between income inequality and population-level mortality. This study investigates whether the relationship between US state-level income inequality and all-cause mortality persisted from 1989 to 2019 and whether changes in income inequality were correlated with changes in mortality rates.</p><p><strong>Methods: </strong>We perform repeated cross-sectional regressions of mortality on state-level inequality measures (Gini coefficients) at 10-year intervals. We also estimate the correlation between within-state changes in income inequality and changes in mortality rates using two time-series models, one with state- and year-fixed effects and one with a lagged dependent variable. Our primary regressions control for median income and are weighted by population.</p><p><strong>Main outcome measures: </strong>The two primary outcomes are male and female age-adjusted mortality rates for the working-age (25-64) population in each state. The secondary outcome is all-age mortality.</p><p><strong>Results: </strong>There is a strong positive correlation between Gini and mortality in 1989. A 0.01 increase in Gini is associated with more deaths: 9.6/100 000 (95% CI 5.7, 13.5, p<0.01) for working-age females and 29.1 (21.2, 36.9, p<0.01) for working-age males. This correlation disappears or reverses by 2019 when a 0.01 increase in Gini is associated with fewer deaths: -6.7 (-12.2, -1.2, p<0.05) for working-age females and -6.2 (-15.5, 3.1, p>0.1) for working-age males. The correlation between the change in Gini and change in mortality is also negative for all outcomes using either time-series method. These results are generally robust for a range of income inequality measures.</p><p><strong>Conclusion: </strong>The absence or reversal of correlation after 1989 and the presence of an inverse correlation between change in inequality and change in all-cause mortality represents a significant reversal from the findings of a number of other studies. It also raises questions about the conditions under which income inequality may be an important policy target for improving population health.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"772-778"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146847","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":"Socioeconomic status across the early life course predicts gene expression signatures of disease and senescence.","authors":"Cecilia Potente, Julien Bodelet, Hira Himeri, Steve Cole, Kathleen Harris, Michael Shanahan","doi":"10.1136/jech-2023-221812","DOIUrl":"10.1136/jech-2023-221812","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic status (SES) is associated with many chronic diseases, indicators of senescence and mortality. However, the changing salience of SES in the prediction of adult health is not well understood. Using mRNA-seq abundance data from wave V of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examine the extent to which SES across the early life course is related to gene expression-based signatures for chronic diseases, senescence and inflammation in the late 30s.</p><p><strong>Methods: </strong>We use Bayesian methods to identify the most likely model of life course epidemiology (critical, sensitive and accumulation models) that characterises the changing importance of parental SES and SES during young (ages 27-30) and mid-adulthood (ages 36-39) in the prediction of the signatures.</p><p><strong>Results: </strong>For most signatures, SES is an important predictor in all periods, although parental SES or SES during young adulthood are often the most predictive. For three signatures (components of diabetes, inflammation and ageing), critical period models involving the exclusive salience of SES in young adulthood (for diabetes) or parental SES (for inflammation and ageing) are most probable. The observed associations are likely mediated by body mass index.</p><p><strong>Conclusion: </strong>Models of life course patterns of SES may inform efforts to identify age-specific mechanisms by which SES is associated with health at different points in life and they also suggest an enhanced approach to prediction models that recognise the changing salience of risk factors.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"752-758"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114907","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":"Does stress from incarceration of family and friends contribute to signs of early vascular ageing in African American women?","authors":"Nicole D Fields, Zachary T Martin, Lori S Hoggard, Christy L Erving, Shivika Udaipuria, Kennedy M Blevins, Jordan E Parker, Jaylah Goodson, Raphiel J Murden, Renee H Moore, Rachel Parker, LaKeia Culler, Bianca Booker, Emma Barinas-Mitchell, Arshed Quyyumi, Viola Vaccarino, Tené T Lewis","doi":"10.1136/jech-2024-222227","DOIUrl":"10.1136/jech-2024-222227","url":null,"abstract":"<p><strong>Background: </strong>Early vascular ageing (EVA) contributes to elevated risk of cardiovascular disease (CVD), which disproportionately affects African American women. Incarceration, an event disproportionately impacting African Americans, may be a stressor contributing to EVA in African American women. Further, the subjective perspective, commonly referred to as appraisal, of incarceration may also be important for health. We hypothesised that having family and/or friends incarcerated and appraising the incarceration as upsetting would be associated with indices of EVA.</p><p><strong>Methods: </strong>In a community-based cohort of African American women aged 30-46 living in Atlanta, Georgia (n=391), participants were asked, at baseline, about family and/or friend incarceration and to appraise how upsetting the incarceration was. Multivariable linear regression examined associations between: (1) family and/or friend incarceration and indices of EVA (pulse wave velocity, augmentation index, central systolic blood pressure (SBP) and pulse pressure amplification) and (2) appraisal of incarceration and EVA indices.</p><p><strong>Results: </strong>45% of participants (n=174) reported having a loved one incarcerated, and 59% (n=102) reported the incarceration as upsetting. Having a loved one incarcerated was associated with a higher central SBP (b=4.30; 95% CI 1.61, 6.99) and augmentation index (b=2.29; 95% CI 0.26, 4.33). Appraisal of incarceration was only associated with central SBP.</p><p><strong>Conclusions: </strong>Family or friend incarceration was highly prevalent in this cohort of African American women and associated with indices of EVA. Mass incarceration of others may affect the physical health of African American women which may contribute to CVD disparities.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"745-751"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914622","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":"Downstream healthcare use following breast cancer screening: a register-based cohort study.","authors":"Emma Grundtvig Gram, Volkert Siersma, Dagný Rós Nicolaisdóttir, John Brandt Brodersen","doi":"10.1136/jech-2024-222818","DOIUrl":"https://doi.org/10.1136/jech-2024-222818","url":null,"abstract":"<p><strong>Background: </strong>For evaluation of breast cancer screening and informed prioritisation, it is important to examine the downstream healthcare use associated to participation. The objective of this study is to determine the healthcare use among breast cancer screening participants compared with screening-naïve controls.</p><p><strong>Methods: </strong>The study is a register-based cohort study with 14 years of follow-up. We compare healthcare use among women who participated in the initial phase of the stepwise breast cancer screening implementation in Denmark (stratified on screening result: normal, false positive and breast cancer) compared with those invited in subsequent phases.</p><p><strong>Results: </strong>Screening participants, especially those with false-positive results, tended to use primary healthcare services more than the screening-naïve group. Women with breast cancer and false positives received more breast imaging compared with the screening-naïve group. False positives consistently had the highest use of drugs compared with the control group. All screening groups had significantly higher use of outpatient clinic visits in the year of and following screening compared with the screening-naïve group. Screening groups were more likely to receive additional diagnoses in the years following screening than the screening-naïve group. There were no significant differences in medical procedures and days of hospitalisation.</p><p><strong>Conclusions: </strong>The study highlights differences in primary healthcare use among screening groups compared with the screening-naïve group. Since use of primary care services is at the discretion of the women, this implies increased worries about health. Thus, these results indicate increased healthcare-seeking behaviour, especially among women with false-positive results.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632924","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":"Morbidity among resettled refugees at arrival in Ontario, Canada (1994-2017): a controlled interrupted time series study examining the effect of the Immigration Refugee Protection Act, 2002.","authors":"Susitha Wanigaratne, Therese Stukel, Hong Lu, Jun Guan, Michaela Hynie, Natasha Ruth Saunders, Astrid Guttmann","doi":"10.1136/jech-2024-222947","DOIUrl":"https://doi.org/10.1136/jech-2024-222947","url":null,"abstract":"<p><strong>Background: </strong>Immigration inadmissibility on medical grounds is common among high-income countries. In Canada, the Immigrant and Refugee Protection Act (IRPA) became law in 2002. With humanitarian protection as a priority, IRPA removed medical inadmissibility based on exceeding a cost threshold for the projected use of health and social services for resettled refugees. Our objective was to determine whether resettled refugees arriving in Ontario after IRPA became law (2004-2017) were more likely to exceed the cost threshold than those who arrived before (1994-2002).</p><p><strong>Methods: </strong>We linked population-based immigration (1994-2017) and healthcare data (1994-2019) in Ontario, Canada and conducted interrupted and controlled interrupted time series (ITS and CITS, respectively) analyses using segmented regression. We examined morbidity prevalence (a proxy for exceeding the cost threshold), in the pre-IRPA and post-IRPA periods among resettled refugees and three control groups-successful asylum seekers, economic immigrants and other Ontario residents. Morbidity prevalence levels and slopes across years were estimated comparing the post-IRPA to pre-IRPA period within resettled refugees and each control group (ITS), and for resettled refugees relative to each control group comparing the same periods (CITS).</p><p><strong>Results: </strong>Morbidity prevalence levels and slopes did not increase significantly within resettled refugees arriving after compared with before IRPA, nor when compared with control groups. Increasing morbidity prevalence among all immigrant groups post-IRPA suggested that subsequent policy changes linked to excessive demand policies may have impacted morbidity.</p><p><strong>Conclusion: </strong>Evolving medical inadmissibility policies suggest the need to provide a fulsome evaluation, balancing possible implications with the documented contributions immigrants make to Canada.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606982","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":"Objective and subjective accounts of urban exposures for epidemiological research on mental health. Measurement and analysis.","authors":"Mikel Subiza-Pérez, Gonzalo García-Baquero, Ainhoa Bereziartua, Jesús Ibarluzea","doi":"10.1136/jech-2023-220669","DOIUrl":"10.1136/jech-2023-220669","url":null,"abstract":"<p><p>The interest in the impact of urban environmental exposures (UrbEEs) on mental health has greatly increased in the last two decades. Researchers have tended to measure said exposures either via objective measurement procedures (eg, air pollution campaigns and geographic information systems computations) or by self-reported techniques such as the use of scales and questionnaires. It has been suggested that studying both the objective features of the environments and people's perceptions are key to understand environmental determinants of health and might be needed to tailor effective interventions. However, there is little guidance on how to approach this matter, the comparability between objective and subjective accounts of UrbEEs and, more importantly, suitable statistical procedures to deal with the practicalities of this kind of data. In this essay, we aim to build the case for the joint use of both sets of variables in epidemiological studies and propose socioecological models as a valid theoretical framework to accommodate these. In the methodological sphere, we will also review current literature to select examples of (un)appropriate subjective accounts of urban exposures and propose a series of statistical procedures to estimate the total, direct and indirect effects of UrbEEs on mental health and the potential associations between objective and subjective UrbEEs accounts.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"700-704"},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861702","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":"Precarious employment and the workplace transmission of COVID-19: evidence from workers' compensation claims in Ontario, Canada.","authors":"Faraz V Shahidi, Qing Liao, Victoria Landsman, Cameron A Mustard, Lynda Robson, Aviroop Biswas, Peter M Smith","doi":"10.1136/jech-2024-222373","DOIUrl":"10.1136/jech-2024-222373","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between precarious employment and risk of work-related COVID-19 infection in Ontario, Canada.</p><p><strong>Methods: </strong>We combined data from an administrative census of workers' compensation claims with corresponding labour force statistics to estimate rates of work-related COVID-19 infection between April 2020 and April 2022. Precarious employment was imputed using a job exposure matrix capturing temporary employment, low wages, irregular hours, involuntary part-time employment and a multidimensional indicator of 'low', 'medium', 'high' and 'very high' overall exposure to precarious employment. We used negative binomial regression models to quantify associations between precarious employment and accepted compensation claims for COVID-19.</p><p><strong>Results: </strong>We observed a monotonic association between precarious employment and work-related COVID-19 claims. Workers with 'very high' exposure to precarious employment presented a nearly fivefold claim risk in models controlling for age, sex and pandemic wave (rate ratio (RR): 4.90, 95% CI 4.07 to 5.89). Further controlling for occupational exposures (public facing work, working in close proximity to others, indoor work) somewhat attenuated observed associations. After accounting for these factors, workers with 'very high' exposure to precarious employment were still nearly four times as likely to file a successful claim for COVID-19 (RR: 3.78, 95% CI 3.28 to 4.36).</p><p><strong>Conclusions: </strong>During the first 2 years of the pandemic, precariously employed workers were more likely to acquire a work-related COVID-19 infection resulting in a successful lost-time compensation claim. Strategies aiming to promote an equitable and sustained recovery from the pandemic should consider and address the notable risks associated with precarious employment.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"675-681"},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876725","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}