AIDS and Behavior最新文献

{"title":"A Syndemic Clustering of Adversities on Suicide Risk among YMSM Living with HIV in Bangkok: A Causal Latent Class Analysis.","authors":"Doug H Cheung, Worawalan Waratworawan, Yamol Kongjareon, Kai J Jonas, Sin How Lim, Alexis N Reeves, Thomas E Guadamuz","doi":"10.1007/s10461-024-04516-7","DOIUrl":"https://doi.org/10.1007/s10461-024-04516-7","url":null,"abstract":"<p><p>This study investigated the clustering of psychosocial adversities and their synergistic effect with depression on suicidality in a 12-month prospective cohort (N = 214) of YMSM living with HIV in Bangkok, Thailand. Latent class analysis identified subgroups with distinct combinations of adversities, including bullying, intimate partner violence, substance use, HIV stigma, low social support, histories of sex work, and below-income status. Significant interactive synergism were found as hypothesized, supporting a syndemic effect with qualitatively increasing levels of adversities on suicidality (score range: 3-17) over the 12 months. The interaction between moderate adversity clustering and depression (β_ow = 2.50, 95% CI: 1.12-3.88) and high adversity clustering and depression (β_ow = 3.61, 95% CI: 1.12-6.09) indicated that the impact of depression on suicidality was modified by pre-existing adversities. The findings suggest that, while a multi-component intervention addressing psychosocial problems is ideal, effective depression treatment alone could significantly reduce suicidality among YMSM living with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942539","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":"Employment Status and HIV Viral Load in Chilean Adult Population: A Propensity Score Analysis.","authors":"Ignacio Leiva-Escobar, Claudia P Cortes, Angelo Lamadrid","doi":"10.1007/s10461-024-04600-y","DOIUrl":"https://doi.org/10.1007/s10461-024-04600-y","url":null,"abstract":"<p><p>We set out to investigate the potential impact of unemployment on HIV viral load in individuals living with HIV at the biggest HIV-related healthcare centre in Chile. We analysed a cross-sectional dataset of 803 adults living with HIV on antiretroviral therapy. The main exposure was employment status. The outcome, detectable HIV viral load, was operationalised using a cut-off of HIV viral load at 20 copies/mL. We applied a propensity score method, the inverse probability of treatment weighting to control for measured confounders. We found that 219 (27.3%) of participants were unemployed. Being unemployed was associated with increased odds of being detectable (OR = 1.78, 95%CI = 1.18-2.71) compared to being employed. Additionally, we found that those unemployed and non-adherents have higher odds of being detectable (OR = 2.53, 95%CI = 1.18-5.41). Unemployment status may influence HIV viral load. However, further research is needed to determine and understand the social structure behind those relationships in the Chilean people living with HIV.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942541","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":"Long-Acting Injectable Prep for People Who Inject Drugs at a Syringe Services Program: A Qualitative Acceptability and Feasibility Study.","authors":"Edward Suarez, Hansel E Tookes, Marissa Coppola, Marina Plesons, David Serota, Sara M St George, Tyler S Bartholomew","doi":"10.1007/s10461-024-04598-3","DOIUrl":"https://doi.org/10.1007/s10461-024-04598-3","url":null,"abstract":"<p><p>Although people who inject drugs (PWID) are at high risk of acquiring HIV, knowledge and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among this population remain low due to numerous psychosocial and structural barriers. Multiple implementation strategies have been proposed to address this gap, notably providing long-acting injectable (LAI) formulations of PrEP and offering PrEP at syringe services programs (SSPs). This qualitative study explores the acceptability and feasibility of offering LAI-PrEP for PWID at risk for HIV at Florida's first legal SSP. In-depth semi-structured interviews were conducted with PWID (n = 25) and healthcare providers (n = 5), and transcripts were analyzed using iterative thematic analysis. The provision of LAI-PrEP at the SSP was overwhelmingly acceptable to both PWID and providers, and specific advantages and disadvantages of LAI-PrEP compared to oral PrEP among this population were elucidated. Likewise, PWID and providers identified facilitators and barriers to offering LAI-PrEP at the SSP and proposed recommendations for implementation. Overall, this study adds to the growing evidence that provision of LAI-PrEP at SSPs is acceptable and feasible and holds promise in expanding access to and uptake of HIV prevention services among PWID.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942551","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":"The Impacts of Substance Use and Depression on HIV Pre-Exposure Prophylaxis Use and Adherence Among Sexual and Gender Minority Adolescents and Young Adults in the Keeping it LITE Cohort.","authors":"Sara N Levintow, Pedro A Serrano, Courtney N Maierhofer, Audrey L French, Sybil Hosek, Kimberly A Powers","doi":"10.1007/s10461-024-04584-9","DOIUrl":"https://doi.org/10.1007/s10461-024-04584-9","url":null,"abstract":"<p><p>Substance use and depression are prevalent in sexual and gender minorities (SGM), but evidence about their impacts on HIV pre-exposure prophylaxis (PrEP) use is mixed. We assessed these impacts in a US-based cohort of 3,330 young SGM who tested negative for HIV and completed baseline and semiannual assessments on substance use (cocaine, methamphetamine, or heroin), depression, and PrEP use and adherence. We estimated prevalence differences (PDs) to compare baseline and 12-month PrEP use and adherence between participants with and without substance use and depression, separately and jointly. At baseline, 8% of participants reported substance use and depression, 7% reported substance use only, 38% reported depression only, and 47% reported neither. PrEP use was reported by 22%, with 78% reporting prior-day adherence. Compared to participants without depression or substance use, participants with substance use alone were more likely to report PrEP use at baseline (PD = 18.9; 95% CI: 7.6, 30.2) and 12 months (PD = 15.9, 95% CI: 5.1, 26.7), without adherence differences. Depression alone was associated with lower baseline PrEP use (PD=-3.6, 95% CI: -6.7, -0.4) and adherence (PD=-10.0, 95% CI: -18.4, -1.6), but associations attenuated over 12 months. Those with both substance use and depression (vs. neither) reported higher baseline PrEP use (PD = 6.5, 95% CI: -0.6, 13.5) and lower adherence (PD=-12.9, 95% CI: -26.2, 0.5), with associations weakening over 12 months. Substance use and depression had opposing relationships with PrEP use and adherence. In addition to its mental health benefits, depression treatment may improve PrEP uptake and adherence in young SGM.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942474","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":"The Association of HIV Criminalization Law and Disparities in Transplant Education among People with HIV.","authors":"Eleanor G Mancini, Brittany A Shelton, Ellen Oakes, Lillian Neville, Henna Budhwani","doi":"10.1007/s10461-024-04593-8","DOIUrl":"https://doi.org/10.1007/s10461-024-04593-8","url":null,"abstract":"<p><p>While people with HIV (PWH) experience high rates of end-stage kidney disease (ESKD), they were historically denied kidney transplantation and prohibited from organ donation, both elements of treating ESKD. It remains unknown to what extent such HIV criminalization laws correlate with the provision of transplantation education to PWH. We conducted this study to elucidate the relationship between these structural-level policies and individual-level outcomes. State-level HIV criminalization laws were linked with the United States Renal Data System (2017-2020) to examine the association between HIV criminalization laws, HIV-status, and transplant education using logistic regression, and the association between transplant education, mortality, waitlisting, and transplantation using Cox proportional hazards regression. There were 164,223 incident ESKD patients in 2017 (PWH = 2,051). PWH had significantly higher odds of education than people without HIV in states without HIV criminalization laws (OR: 1.78, 95% confidence interval [CI]: 1.48-2.13, p-value < 0.001). Within states with HIV criminalization laws, there was no significant difference in odds of education by HIV-status (OR: 1.22, 95% CI: 0.98-1.53), suggesting that PWH residing in states with HIV criminalization laws were significantly less likely to receive transplant education than PWH residing in states without such laws (interaction OR: 0.76, CI: 0.61-0.96, p < 0.001). While many states have revised or overturned their HIV criminalization laws to permit organ donation from PWH, such laws remain in effect in others and disproportionately limit access to care for PWH. Eliminating laws limiting PWH's ability to participate in organ donation may benefit the health of PWH with ESKD residing in those states.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942560","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":"Evaluating the Implementation of Home-Based Sexual Health Care Among Men Who Have Sex with Men: Limburg4zero.","authors":"Cornelia Johanna Dorothy Goense, Ymke J Evers, Jonas Manait, Christian J P A Hoebe, Inge H M van Loo, Dirk Posthouwer, Robin Ackens, Roland van Hooren, Rocxanne Theuerzeit, Rik Crutzen, Sarah E Stutterheim, Nicole H T M Dukers-Muijrers","doi":"10.1007/s10461-024-04579-6","DOIUrl":"https://doi.org/10.1007/s10461-024-04579-6","url":null,"abstract":"<p><p>Home-based sexual health care (including self-sampling testing) could reduce barriers to clinic-based testing. This study systematically evaluated the implementation of home-based sexual health care ('Limburg4Zero') among men who have sex with men (MSM) in a mixed urban-rural region of the Netherlands. We systematically assessed implementation outcomes (contextual domains, population reached, effectiveness, adoption by health care providers (HCP), implementation fidelity, and maintenance) using the practical, robust implementation and sustainability model. We used a mixed-methods research design that combined survey and in-depth interview data from our priority population (MSM) and implementers with insights from our community advisory board and field notes from monthly meetings with the implementers. Of 1076 requested tests, 906 MSM received a (self-sampling STI/HIV) test kit and sexual health information. Most participants (median age 31) had a university or college degree and had a Western ethnicity. The return rate for laboratory testing was 67%. Home-based care participants more often never tested HIV before (39%) compared to STI clinic attendees (28%). Adoption by HCP was highly acceptable, although perceived pragmatic and technical challenges were experienced. Key elements of the home-based care service were implemented as designed, with co-created adjustments for optimization during the implementation. Maintaining the innovation in the long term was desirable, although future recommendations for efficient continuation should be considered. Implementation of home-based sexual health care has demonstrably increased care accessibility for MSM who had never previously been tested. Therefore, a systematic approach is crucial to foster the impact of home-based sexual health care.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942543","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":"\"We Need Gentleness\": Isolation, Loneliness, and Implications for Psychosocial Counseling Among People with HIV who are on Methadone Maintenance Treatment and Experience Common Mental Disorders in Vietnam.","authors":"Teresa R Filipowicz, Ha Viet Tran, Ha Thi Thuy Nong, Thuy Thi Thu Tran, Kelsey R Landrum, Minh X Nguyen, Ruth Verhey, Dixon Chibanda, Vivian Fei-Ling Go, Brian Wells Pence, Bradley N Gaynes","doi":"10.1007/s10461-024-04591-w","DOIUrl":"https://doi.org/10.1007/s10461-024-04591-w","url":null,"abstract":"<p><p>The psychological experiences and needs of people with human immunodeficiency virus (HIV) who use methadone maintenance treatment and have common mental disorders in Hanoi, Vietnam remain unknown. Due to limited services for common mental disorders, optimal delivery methods for psychotherapy are also unknown. Accordingly, this qualitive study explored both symptoms of common mental disorders among this population and the preferred qualifications and characteristics of a mental health counselor. We interviewed patients, their family members and caretakers, clinic providers, and clinic directors to answer these questions. Feelings of loneliness, isolation, sadness, hopelessness, and a general lack of motivation were common among patient participants. Patient participants had no preference among counselor professional qualifications. Three key qualities‒gentleness, enthusiasm, and understanding ‒ emerged as preferred counselor characteristics. The results from this work will help inform the future tailoring of mental health interventions among a population with unique care needs in Hanoi as well as other populations of people with HIV with common mental disorders.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942537","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":"Perspectives on Clinical Pharmacist-Delivered Contingency Management to Promote Smoking Abstinence Among Individuals with HIV: A Qualitative Study.","authors":"Poyani Bavishi, Dini Harsono, Colleen Mistler, David M Ledgerwood, Krysten W Bold, Keith Sigel, June Weiss, Jessica E Yager, Steven L Bernstein, E Jennifer Edelman","doi":"10.1007/s10461-024-04592-9","DOIUrl":"10.1007/s10461-024-04592-9","url":null,"abstract":"<p><p>Contingency management (CM), an evidence-based behavioral strategy that rewards positive behavior change including tobacco cessation, is rarely offered to support people with HIV (PWH) who smoke. In this study, we explored perspectives among patients and research staff engaged in a multi-site randomized clinical trial involving clinical pharmacist-delivered CM within HIV clinics. Between February and September 2023, we conducted 1:1 interviews with 12 PWH randomized to receive CM and one focus group with 8 staff (i.e., clinical pharmacists and research coordinators). Qualitative data collection and analysis were grounded in the Promoting Action on Research Implementation in Health Services (PARIHS) implementation science framework to understand barriers and facilitators related to evidence (perspectives on CM for smoking cessation), context (HIV clinics), and facilitation (promoting effectiveness and sustainability). Regarding evidence, PWH and staff had limited prior experience with CM and supported the use of exhaled carbon monoxide to promote accountability. PWH and staff thought CM was useful in bolstering internal motivation, but differed on ideal target behaviors (i.e., cessation vs. reduction). Regarding context, clinical pharmacist-delivered tobacco treatment within HIV clinics was viewed favorably, with mixed perspectives regarding optimal visit schedules and utility of remote CM. Regarding facilitation, PWH and research staff discussed strategies to increase participant engagement and retention such as incorporating behavioral counseling services. PWH endorsed application of CM beyond smoking cessation and for people without HIV. Future efforts should consider expanding the use of CM to target smoking cessation and related health behaviors and tailoring the intervention to individual needs and goals.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942556","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":"Exposure to COVID-19 Pandemic-Related Stressors and Their Association With Distress, Psychological Growth and Drug Use in People With HIV in Nouvelle Aquitaine, France (ANRS CO3 AQUIVIH-NA Cohort-QuAliV-QuAliCOV Study).","authors":"Jihane Ben Farhat, Mojgan Hessamfar, Didier Neau, Sophie Farbos, Estibaliz Lazaro, Pierre Duffau, Nicolas Rouanes, Charles Cazanave, Thierry Pistone, Patrick Rispal, Marie-Anne Vandenhende, Camille Krzyzanowsky, Olivier Leleux, Linda Wittkop, Fabrice Bonnet, Diana Barger","doi":"10.1007/s10461-024-04588-5","DOIUrl":"https://doi.org/10.1007/s10461-024-04588-5","url":null,"abstract":"<p><p>We investigated people living with HIV (PLWH)'s exposure to COVID-19 pandemic stressors and their association with distress, psychological growth, and substance use. PLWH in the ANRS CO3 AQUIVIH-NA cohort's QuAliV study (Nouvelle Aquitaine, France) completed an adapted CAIR Lab Pandemic Impact Questionnaire (C-PIQ) and reported substance use between 9/2021 to 3/2022. We described cumulative stressor exposure (score 0-16) and explored variation by PLWH characteristics (demographic, HIV-related, risk factors, psychosocial). Associations with distress (score 0-23), psychological growth (score 0-20), and substance use were assessed using regression models. Participants reported exposure to a median of 2 (IQR: 1-4) stressors. Stressor exposure was higher in working-age (<60) and psychosocially vulnerable PLWH. Exposure to an additional stressor correlated with a 0.7-point increase in distress scores (95% C.I. 0.5-1.0, p<0.001), a 0.04-point increase (95% C.I. 0.01-0.07, p=0.002) in psychological growth scores in working-age PLWH. In older PLWH, additional stressor correlated with a 0.8-point (95% C.I. 0.4-1.2, p<0.001) increase in distress and a 0.1-point increase (95% C.I. 0.06-0.2, p=0.001) in growth scores. Each additional stressor was associated with 1.2 (95% C.I. 1.0-1.4, p=0.02) higher adjusted odds of cannabis use in working-age PLWH, and 1.2 (95% C.I. 1.0-1.4, p=0.004) higher adjusted odds of drug use. Exposure to stressors was linked to increased distress, cannabis and drug use but also growth. Providers should not only be aware of risk (of severe COVID-19) but also be mindful of the social and psychological challenges PLWH face as these may affect their retention in care, especially during challenging times.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930413","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":"Activity Space Mapping and Pre-Exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Sexual Minority Men in Small Cities and Towns in the United States.","authors":"Bryce Puesta Takenaka, Russell Barbour, Sally J Kirklewski, Erin Nicholson, Cecil Tengatenga, Nathan B Hansen, Trace Kershaw","doi":"10.1007/s10461-024-04601-x","DOIUrl":"https://doi.org/10.1007/s10461-024-04601-x","url":null,"abstract":"<p><p>In the US, gay, bisexual, and other sexual minoritized men (GBSMM) remain disproportionately impacted by HIV, and continue to experience unmet needs for pre-exposure prophylaxis (PrEP). A growing body of literature has underscored the need to consider the geographic factors of HIV prevention, particularly beyond administrative boundaries and towards localized spaces that influence the accessibility and utilization of health-promoting resources. Therefore, the purpose of this study is to examine the associations of driving times from activity spaces to PrEP offering facilities and individual PrEP uptake. A total of 218 GBSMM (ages 18-34) from Connecticut and Georgia were sampled from a longitudinal cohort study. We used the getis-ord-gi statistic to examine the spatial clustering of PrEP offering facilities, and generalized estimating equations (GEE) and post-hoc moderation analyses to explore the state interactions on driving time and PrEP uptake. Our main findings suggest that for participants in Connecticut, state of residence was a significant moderator on driving time and ever hearing of PrEP and ever taking PrEP. Whereas for participants in Georgia, state of residence moderated the likelihood of returning to activity spaces of participants in both Connecticut and Georgia on PrEP uptake. These findings provide important direction for geographic inequities on PrEP use, but also a pragmatic method for co-creating and re-imagining place-health research. These results also offer an avenue to leverage the dynamic nuance of activity spaces as indicators to inform structural interventions for PrEP that are more equitable for GBSMM in small cities and towns in the U.S.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913711","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}