Public health challenges最新文献

{"title":"SWOT Analysis of Communicable Disease Surveillance in Sudan.","authors":"Alhadi Khogali, Rahaf AbuKoura, Nada Abdelmagid, Mona Ibrahim, Ruwan Ratnayake, Maysoon Dahab","doi":"10.1002/puh2.70024","DOIUrl":"10.1002/puh2.70024","url":null,"abstract":"<p><p>Effective communicable disease surveillance is critical in Sudan to addressing the compounded health impacts of concurrent epidemics, health systems collapse and acute conflict. This article aims to map the strengths, weaknesses, opportunities and threats of Sudan's communicable disease surveillance systems before the current conflict to inform future health system rebuilding efforts. Despite existing for 50 years, little is published on Sudan's disease surveillance systems. We conducted a scoping review to map the existing evidence on Sudan's surveillance systems and utilized a strength, weakness, opportunities and threats (SWOT) analysis to identify current and future gaps and opportunities to improve the performance of these systems for communicable diseases in Sudan. Our review shows that, prior to the conflict, disease-specific surveillance and response activities were fragmented across various divisions of the Federal Ministry of Health, hindering a clear national-level hierarchy. Sudan has committed to strengthening its disease surveillance system as part of its national health sector policy. Efforts to bolster pandemic preparedness and response were and continue to be recognized as critical. Chiefly among them is the need to invest in a fit-for-purpose national surveillance system that can operate against a background of acute crisis. Greater transparency and data sharing, clear guidelines for communication and collaboration and a centralized data management system can enhance the effectiveness of Sudan's communicable disease surveillance systems. Investment in a consolidated national surveillance system can support more efficient and coordinated responses to outbreaks and other health emergencies, with a view to future health system reconstruction.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70024"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268095","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":"Opioid-Related Challenges Faced by Palliative Healthcare Providers in Both Hospital and Home Care Settings: A Multi-Center-Based Descriptive Cross-Sectional Study.","authors":"Mastura Kashmeeri, A N M Shamsul Islam, Palash Chandra Banik","doi":"10.1002/puh2.70013","DOIUrl":"10.1002/puh2.70013","url":null,"abstract":"<p><strong>Background: </strong>Palliative care aims to alleviate suffering and improve the quality of life for patients with life-limiting illnesses through effective pain management with opioids. Despite its global importance, opioid use in palliative care faces significant challenges, particularly in resource-poor settings like Bangladesh. In Bangladesh, opioid use is notably low, with disparities between urban and rural areas. Cultural stigmas, strict regulations, and inadequate healthcare provider training further obstruct effective pain management.</p><p><strong>Objective: </strong>This study aims to explore the challenges healthcare providers face regarding opioid use in both hospital and home-based palliative care settings.</p><p><strong>Method: </strong>A descriptive cross-sectional study was conducted using face-to-face semistructured interviews with 135 licensed healthcare providers from August to September 2022.</p><p><strong>Results: </strong>The respondents, predominantly young (57% aged 20-39) and female (68.9%), primarily manage late-stage cancer patients (98.5%), with pain (100%) being the primary symptom treated. Morphine syrup is commonly used (68.1%), whereas oxycodone and buprenorphine are unavailable. Side effects such as deep sedation (43.7%) and addiction (34.1%) highlight the need for careful monitoring. Limited awareness (10.4%) of national opioid policies results in inconsistent practices (<i>p</i> = 0.001) and (<i>p</i> = 0.004). Prescribing restrictions (60.7%) and dispensing rights issues contribute to operational challenges, affecting patient access to pain management. Misconceptions about palliative care (32.6%) and inter-departmental non-cooperation (38.5%) hinder patient referrals (<i>p</i> = 0.001) and continuity of care.</p><p><strong>Conclusion: </strong>Inconsistent awareness of opioid policies causes varied practices and attitudes. Addressing referral challenges and prescribing restrictions requires interdisciplinary solutions, enhanced education, better policy dissemination, and standardized guidelines for effective palliative care opioid management.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70013"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268079","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":"Building Trust and Resilience: Bhutan's Approach to Risk Communication During the COVID-19 Pandemic.","authors":"Ugyen Tshering, Tandin Dendup, Sonam Wangda, Sonam Wangdi","doi":"10.1002/puh2.70039","DOIUrl":"10.1002/puh2.70039","url":null,"abstract":"<p><p>Throughout the COVID-19 pandemic, effective risk communication emerged as pivotal in fostering positive behavioral changes that aligned with the evolving evidence and stages of the pandemic. It stood alongside key strategies like enhanced surveillance, extensive testing, stringent quarantine, and strategic case management in Bhutan's response. Over the last 3 years of the pandemic, we have gained profound insights into risk communication's impact. This article aims to illuminate diverse approaches in managing public information during the pandemic. The authors also suggest potential research agendas and policy and system-level reforms in the realm of risk communication.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70039"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268143","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":"Understanding Health Inequality, Disparity and Inequity in Africa: A Rapid Review of Concepts, Root Causes, and Strategic Solutions.","authors":"Gabriel Ilerioluwa Oke, Olivier Sibomana","doi":"10.1002/puh2.70040","DOIUrl":"10.1002/puh2.70040","url":null,"abstract":"<p><strong>Introduction: </strong>Health inequality, disparity, and inequity are critical global health challenges, particularly in low- and middle-income countries (LMICs). Africa's healthcare systems have been profoundly impacted by these issues for decades, leading to severe and far-reaching consequences. This rapid review aims to explore the concepts of health inequality, disparity, and inequity in Africa, identify their root causes, and propose practical recommendations to address them.</p><p><strong>Methodology: </strong>A comprehensive search was conducted across PubMed, Google Scholar, the Directory of Open Access Journals (DOAJ), and through manual searches on Google to identify literature on health inequalities, disparities, and inequities in Africa. Key terms, such as \"Health inequality,\" \"Health disparity,\" \"Health inequity,\" \"Health injustice,\" \"Health unfairness,\" \"Healthcare access,\" and \"Health challenges,\" were employed. The identified literature was carefully reviewed, and relevant sources were selected to discuss the concepts, causes, and potential solutions to these differences in health outcomes across Africa.</p><p><strong>Results: </strong>Although some aspects of health inequality are linked to unmodifiable factors, health disparities and inequities are often the result of preventable and modifiable factors and can be addressed through targeted efforts. The root causes of health inequality, disparity, and inequity in Africa include poverty, inadequate education, corruption, poor governance, geographic isolation, unsupportive environmental conditions, cultural norms, and international influences. Solutions to these differences in health outcome lie in reversing the root causes.</p><p><strong>Conclusion: </strong>Addressing health inequality, disparity, and inequity in Africa requires a multifaceted approach, including improving education, healthcare infrastructure, and gender equality, alleviating poverty, and ensuring fair governance to achieve equitable health outcomes.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70040"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268107","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":"Understanding the Determinants of Adolescent Pregnancy among an Indigenous Community in Rural Nepal: A Qualitative Exploration.","authors":"Kusumsheela Bhatta, Pratiksha Pathak, Madhusudan Subedi","doi":"10.1002/puh2.70041","DOIUrl":"10.1002/puh2.70041","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent pregnancy is a global concern, with a higher occurrence among more disadvantaged groups. Within Nepal's highly marginalized Chepang community, adolescent pregnancies are notably more prevalent. This study aimed to understand the determinants of adolescent pregnancy among Chepang community in Raksirang Rural Municipality, Makwanpur District of Nepal using qualitative methods.</p><p><strong>Methods: </strong>The study was conducted from September 2022 to April 2023. Twenty participants (10 in-depth interviews and 10 key informant interviews) were recruited through judgmental sampling. An interview guide was used for interviewing the participants. All interviews were audio-recorded, transcribed, translated, and analyzed using R-based Qualitative Data Analysis package. Braun and Clarke's six-step thematic analysis was used to perform analysis.</p><p><strong>Results: </strong>Six key themes were identified as determinants of adolescent pregnancy among Chepang community: (i) inadequate access to and use of sexual and reproductive health services, (ii) gaps in programmatic implementation, (iii) elopement marriage as a form of escape, (iv) discontinuation of education, (v) limited knowledge and understanding of marriage, pregnancy, and childbirth, and (vi) early pregnancy as a sign of prosperity. Challenges such as difficult geographical terrain, limited access to adolescent-friendly healthcare, gender inequality, child labor, weak enforcement of child marriage laws, and societal stigma exacerbated these determinants.</p><p><strong>Conclusion: </strong>A multifaceted approach, including improved access to adolescent-friendly healthcare, enforcement of child marriage laws, access to secondary education, efforts to raise awareness of sexual and reproductive health, and a shift in sociocultural norms, should be implemented to reduce adolescent pregnancy in the Chepang community.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70041"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268108","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":"A Conceptual Framework for Psychosocial Support of Orphaned and Vulnerable Children in the Vhembe District, South Africa.","authors":"Livhuwani Precious Matshepete, Lufuno Makhado, Ntsieni Stella Mashau","doi":"10.1002/puh2.70045","DOIUrl":"10.1002/puh2.70045","url":null,"abstract":"<p><strong>Background: </strong>The lack of a conceptual framework (CF) that can be utilized to manage the psychosocial well-being of orphans and vulnerable children present a challenge in the Vhembe district, South Africa.</p><p><strong>Aim: </strong>This article sought to provide a CF for psychosocial support of OVC in the Vhembe district, South Africa using Practice-Oriented Theory and Donabedian's structure Outcome Model features.</p><p><strong>Method: </strong>The study incorporated a four-phased research strategy using a multiphase mixed methods approach. An exploratory, descriptive design was used for the study. The practice-oriented theory of Dickoff et al. and Donabedian's SPO model provided a starting point in the ultimate development of the framework. Data were collected from three sources, orphans and vulnerable children <i>n</i> = 34, to explore and describe the experiences conducted with community-based workers working with orphaned and vulnerable children within the Vhembe district to explore possible approaches for psychosocial support towards orphans and vulnerable children <i>n</i> = 4, CBOS, and social workers <i>n</i> = 10 working with OVC in the Vhembe district to explore the possible approaches for psychosocial support towards OVC until data saturation.</p><p><strong>Results: </strong>The study revealed that OVC faces many challenges including loss/absence of parents, living arrangements, deprivation and neglect, abuse and alienation. Challenges exist and this was confirmed by the qualitative findings with community-based workers and social workers, including lack of resources, lack of proper training, lack of funding and poor relationship between stakeholders and the absence of the CF that guide the provision of psychosocial support to OVC.</p><p><strong>Conclusion: </strong>The study findings were conceptualized to describe and develop a framework for psychosocial support of OVC in order to improve the psychosocial well-being of OVC.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70045"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268140","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":"Loss of Pregnancy-Related Medicaid Coverage Is Associated With Unmet Need for Health Care, Medical Financial Hardship, and Lower Health Care Use in Postpartum Women.","authors":"Namrata Sanjeevi, Luciana E Hebert, Bidisha Mandal, Pablo Monsivais","doi":"10.1002/puh2.70044","DOIUrl":"10.1002/puh2.70044","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the association of loss of pregnancy-related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use in postpartum women participating in a nationally representative household survey.</p><p><strong>Design: </strong>Cross-sectional study design.</p><p><strong>Sample and measurements: </strong>Using 2012-2018 National Health Interview Survey data, we classified postpartum women as either (1) having Medicaid coverage or (2) uninsured due to loss of pregnancy-related Medicaid coverage. We examined the relationship of loss of pregnancy-related Medicaid coverage with unmet health care needs, medical financial hardship, and health care use.</p><p><strong>Results: </strong>Compared to Medicaid-insured postpartum women, uninsured women who lost pregnancy-related Medicaid coverage had significantly greater odds of delaying medical care due to cost, as well as greater odds of unmet need for medical care, mental health care, and prescriptions. Uninsured postpartum women who lost pregnancy-related Medicaid coverage also had significantly greater odds of medical financial hardship and lower odds of health care use.</p><p><strong>Conclusions: </strong>Findings suggest that continued Medicaid coverage during postpartum could improve health care access among uninsured women experiencing loss of pregnancy-related Medicaid eligibility. These results hold important implications for the public health impact of recent policy efforts to extend Medicaid eligibility into the postpartum period.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70044"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268077","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":"Barriers to Skin Cancer Diagnosis and Treatment in Low- and Middle-Income Countries and Solutions: A Literature Review.","authors":"Christopher Maatouk, Don Eliseo Lucero-Prisno","doi":"10.1002/puh2.70042","DOIUrl":"10.1002/puh2.70042","url":null,"abstract":"<p><p>Skin cancer mortality disproportionately affects low- and lower-middle-income regions despite the prevalence being lower than in high-income countries. Considering the need to diagnose it early for the best outcomes, this review addresses the barriers preventing it from being diagnosed and treated promptly and proposes possible solutions. Some of the barriers we found include the low number of dermatologists and pathologists, inadequate facilities, lack of education, the cost of healthcare, the denial of needing professional help, the fear and stigmatization of a skin cancer diagnosis, and the reliance on non-medical therapies. Meanwhile, solutions we identified are training programs for healthcare professionals and the public, technological advancements (including nanotechnology-based treatments, telemedicine, and social media use, the development and implementation of artificial intelligence programs), international collaborations, research, and increasing the number of cancer registries and national cancer control plans. Despite these solutions not being foolproof, they will lead to earlier cancer diagnosis, more individuals seeking skin check-ups, better knowledge of skin cancer, improving the quality of life of vulnerable populations, and decrease in mortality.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70042"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268142","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":"Development and Validation Study of a Screening Questionnaire to Identify People Who Are Physically Inactive.","authors":"Eero Kenttä, Harri Sievänen, Anastasiya Verho, Minna Paajanen, Timo Lukkarinen, Henri Vähä-Ypyä, Jani Raitanen, Kari Tokola, Tommi Vasankari, Jari Parkkari","doi":"10.1002/puh2.70037","DOIUrl":"10.1002/puh2.70037","url":null,"abstract":"<p><strong>Objective: </strong>Insufficient physical activity (PA) is a well-known risk factor for many non-communicable diseases. This study aimed to develop a screening tool, the Helsinki Physical Activity Questionnaire (HPAQ), to identify physically inactive people at the population level and to help social and health care professionals promote PA among people at risk.</p><p><strong>Methods: </strong>Eighty-five healthy adults wore a hip-worn accelerometer for 7 days, after which they completed several PA questionnaires. These included some novel and several validated questions on PA. The reliability of individual questions to identify physically inactive people was assessed by correlation analysis. Logistic regression analysis was used to find the combination of questions that best identified physically inactive people.</p><p><strong>Results: </strong>The highest correlation of the screening questionnaire with the accelerometer was 0.46 (<i>p</i> < 0.001) for sedentary behavior (SB) and 0.42 (<i>p</i> < 0.001) for the total amount of moderate-to-vigorous physical activity (MVPA), respectively. The best pair of questions on total PA identified 64% of all inactive subjects (MVPA < 150 min/week) based on accelerometer data.</p><p><strong>Conclusions: </strong>The questionnaires developed for screening PA have a poor correlation with the accelerometer data. The screening questionnaires roughly describe PA level among middle-aged participants, but if a more sensitive or specific method is needed, device-based measurements are recommended.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70037"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268074","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":"Reductions in Blood Lead Level Screening During Peak COVID-19 Restrictions and Beyond.","authors":"Meghan L McCarthy, Jonah Bradenday, Elizabeth Chen, Mark R Zonfrillo, Indra Neil Sarkar","doi":"10.1002/puh2.70021","DOIUrl":"10.1002/puh2.70021","url":null,"abstract":"<p><strong>Background and objectives: </strong>Among the multitude of health effects on children associated with the COVID-19 pandemic, there have been significant interruptions in the provision of routine pediatric primary care, including blood lead level (BLL) screening. We aimed to investigate trends in BLL screening before and during the pandemic era using patient-level electronic health record data extracted from CurrentCare, Rhode Island's statewide health information exchange (HIE).</p><p><strong>Methods: </strong>De-identified data were analyzed from CurrentCare for the study period January 2018 to December 2021. We utilized ATLAS, a web-based analytics platform from the Observational Health Data Sciences and Informatics (OHDSI) community, to extract and stratify BLL by variables of interest from the CurrentCare data, standardized to OHDSI's Observational Medical Outcomes Partnership common data model.</p><p><strong>Results: </strong>A decrease in BLL screening occurred in the spring of 2020, aligning with initial periods of shelter-in-place in response to the novel coronavirus outbreak; there was a 48% decrease comparing quarter 2 (April to June) of 2019 and 2020. BLL screening rebounded in the summer of 2020, however, it remained 16% lower overall in 2020 than in 2019. In 2021, BLL screening fell again to 23% lower than in 2019. Although overall numbers of BLL screenings were reduced, the proportion of abnormal BLLs was higher, particularly in the range of 3.5-5.0 µg/dL.</p><p><strong>Conclusions: </strong>Leveraging statewide HIE data, we found that significant deficiencies in BLL screening remain unresolved since the beginning of the COVID-19 pandemic. The disruption of children's lives by the COVID-19 pandemic appears to have greatly affected lead screening and exposure in Rhode Island.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"4 1","pages":"e70021"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268090","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}