BMJ Global Health最新文献

{"title":"Contrasting the impact and cost-effectiveness of successive intervention strategies in response to Ebola in the Democratic Republic of the Congo, 2018-2020.","authors":"Thibaut Jombart, Wu Zeng, Michel Yao, Anne Cori, Steve Ahuka-Mundeke, Hadia Samaha, Thomas Wilkinson, Mathias Mossoko, Jean-Pierre Lokonga, Dominique Baabo, Fatima El Kadiri El Yamini, Patrick Hoang-Vu Eozenou, Sylvain Yuma, Linda Mobula","doi":"10.1136/bmjgh-2024-015822","DOIUrl":"10.1136/bmjgh-2024-015822","url":null,"abstract":"<p><strong>Introduction: </strong>The 10th outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo (DRC) in 2018-2020 was the largest in DRC's history and the second largest worldwide. Different strategic response plans (SRPs) were implemented, and the outbreak was eventually stopped after a large scale-up of operations with the SRP 4, which benefited from all public health measures deployed during SRPs 1-3, upon which it developed a more holistic approach including community engagement, logistics and security.</p><p><strong>Methods: </strong>We used modelling to characterise EVD transmission and assess the epidemiological impact of the two main response strategies (SRPs 1-3 vs SRP 4). We simulated potential future epidemics with different intervention scenarios, combined with a costing model to evaluate the incremental cost-effectiveness of different strategies.</p><p><strong>Results: </strong>We estimated a mean effective reproduction number <i>R</i> of 1.19 (credible interval (95% CrI) = (1.13 ; 1.25)). The spatial spread was moderate with an average 4.4% (95% CrI = (3.5%; 5.4%)) of transmissions moving to different health zones. The scale-up of operations in SRP 4 coincided with a threefold reduction in transmission, and 30% faster control of EVD waves. In simulations, SRP 4 appears cost-saving, although most simulated outbreaks remain small even with SRPs 1-3.</p><p><strong>Conclusion: </strong>Most EVD outbreaks are expected to be small and can be contained with SRPs 1-3. In outbreaks with increased transmissibility or in the presence of insecurity, rapid scale-up to SRP 4 is likely to save lives and be cost-effective.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954033","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":"Government purchase of private health services in the Eastern Mediterranean region: opportunities and challenges for stewarding towards a universal health coverage focus.","authors":"Shehla Zaidi, Aya Thabet, Hassan Salah, David Clarke, Awad Mataria","doi":"10.1136/bmjgh-2024-017435","DOIUrl":"10.1136/bmjgh-2024-017435","url":null,"abstract":"<p><strong>Background: </strong>Proliferation in government purchase of private healthcare requires stewardship support for impactful alignment to Universal Health Coverage (UHC) goals. This paper provides a synthesis of country purchasing initiatives involving the private sector from the Eastern Mediterranean region (EMR) identifying drivers, stewardship challenges and country aspirations for strengthening purchasing initiatives.</p><p><strong>Methods: </strong>Findings are drawn from 19 in-depth mixed methods country case studies commissioned by the WHO, guided by a standardised data collection tool for desk review and country stakeholder interviews. Case study synthesis approach was applied to draw on commonalities and emphasising important differences across country contexts. Extraction and analysis into country income groups allowed thematic comparisons.</p><p><strong>Results: </strong>Significant proliferation in the purchase of private healthcare has been driven by contextual opportunities provided by political momentum, local adaptive designs, unlocking of domestic financing and initial operational groundwork particularly in middle-income EMR countries. Common challenges include (1) steering constrained by conflicting ideologies, role dispersion and a focus on UHC schemes rather than the UHC vision; (2) implementation challenges of weak contract management expertise, uncertain quality compliance; and (3) private sector engagement hampered by insufficient communication and trust. Less resourced countries also face challenges of private sector fragmentation impeding purchasing. We found common interest across countries to better integrate the private sector for UHC. Prioritised future needs included (1) national Private Sector Engagement (PSE) planning to inform purchasing arrangements, (2) evidence for better understanding, (3) leadership structures, (4) formal dialogue platforms and (5) social-behavioural incentives for quality and data reporting compliance. Middle-income and high-income countries additionally prioritised payment controls, whereas lesser resourced countries emphasised sustainable fiscal mobilisation.</p><p><strong>Conclusion: </strong>The synthesis importantly highlights new directional and relational needs alongside traditional structural, and expertise needs to guide a re-imagined stewardship agenda for strengthening the purchase of private health services in the EMR. Future socio-behavioural research on private sector motivations for partnerships and behaviour under purchasing arrangements will be beneficial for stewarding PSE within local eco-systems.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"8 Suppl 5","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964979","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":"Benefit-cost analysis of an integrated package of interventions during preconception, pregnancy and early childhood in India.","authors":"Tarun Shankar Choudhary, Sarmila Mazumder, Sunita Taneja, Ranadip Chowdhury, Ravi Prakash Upadhyay, Sitanshi Sharma, Neeta Dhabhai, Ole Frithjof Norheim, Nita Bhandari, Kjell Arne Johansson","doi":"10.1136/bmjgh-2023-013659","DOIUrl":"https://doi.org/10.1136/bmjgh-2023-013659","url":null,"abstract":"<p><strong>Background: </strong>We have previously shown that an integrated intervention package delivered during preconception, pregnancy and early childhood substantially reduces low birth weight and stunting at 24 months of age compared with routine care. Now we conduct a benefit-cost analysis to estimate the return on investment of this integrated approach in India. This increases the policy relevance of trial results, given the low investment in healthcare in India.</p><p><strong>Methods: </strong>We used data from 13 500 participants in the Women and Infant Integrated Interventions for Growth Study (WINGS). Integrated delivery of healthcare, nutrition, water, sanitation and hygiene (WaSH), and psychosocial care interventions during preconception period, or pregnancy and early childhood, or both (full package), was compared with routine care. We converted reduction in mortality, morbidity and increase in productivity to monetary values and calculated the benefit-cost ratio. We used primary and secondary trial health outcomes from the WINGS trial to calculate benefits, and we collected costs prospectively during the trial. Uncertainty was explored in a one-way sensitivity analysis. We applied a discount rate of 3% per annum to both costs and benefits, considering the purchasing power parity (PPP) of US dollars in 2021.</p><p><strong>Results: </strong>Every dollar invested returned 6.1$ PPP for interventions during preconception, 9.9$ PPP for pregnancy and early childhood interventions and 3.7$ PPP for the full package of interventions compared with routine care in the base case scenario. The return to investment was positive (>4.6$ PPP per 1$ PPP invested) for pregnancy and early childhood interventions in all scenarios of the sensitivity analysis. The net monetary benefits of the interventions ranged between 7364 and 25 917$ PPP.</p><p><strong>Conclusion: </strong>Our results suggest that integrated and concurrent delivery of healthcare, nutrition, WaSH and psychosocial care interventions during pregnancy and early childhood yield positive economic returns.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973830","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":"Community resilience to health emergencies: a scoping review.","authors":"Gisela van Kessel, Steve Milanese, Janine Dizon, Daniel H de Vries, Hayley MacGregor, Sharon Abramowitz, Luisa Enria, Doris Burtscher, Eng-Kiong Yeoh, Beena E Thomas, Rim Kwang, Joao Rangel de Almeida, Nina Gobat","doi":"10.1136/bmjgh-2024-016963","DOIUrl":"10.1136/bmjgh-2024-016963","url":null,"abstract":"<p><strong>Background: </strong>There is recognition of the importance of community resilience in mitigating long-term effects of health emergencies on communities. To guide policy and practice, conceptual clarity is needed on what community resilience involves and how it can be operationalised for community protection in ways that empower and strengthen local agency.</p><p><strong>Objectives: </strong>To identify the core components of community resilience to health emergencies using a scoping review methodology.</p><p><strong>Search methods: </strong>PubMed, EMCARE, Scopus, Web of Science, PTSDpubs, APO and ProQuest Dissertations were systematically searched to identify review studies published from 2014.</p><p><strong>Selection criteria: </strong>Studies were included if they reported a review of original research papers investigating community resilience in the context of a health emergency.</p><p><strong>Data collection and analysis: </strong>Data were extracted from included studies using a specially developed data extraction form. Qualitative data were subjected to a meta-synthesis consisting of three levels of analysis.</p><p><strong>Main results: </strong>38 evidence reviews were included. Analysis identified recurring characteristics of community resilience. Six studies reported 10 abilities required for community resilience including: adapt, transform, absorb, anticipate, prepare, prevent, self-organise, include, connect and cope. 25 studies reported 11 types of resources: social, economic, environmental, governance, physical infrastructure, institutional, communication, human capital, health, emergency management and socioeconomic.</p><p><strong>Conclusions: </strong>21 components have been identified that can be used as a basis for operationalising and measuring community resilience. In contexts of disaster management, community resilience is a fairly mature concept that reflects a community's inherent capacity/abilities to withstand and recover from shocks. There is a need to incorporate a 'resource' perspective that speaks to a wider enabling environment. There is scope to investigate whether the same set of components identified here has relevance in public health emergencies emanating from disease or human acts of aggression and to articulate resilience logics to critical endpoints for health emergency management.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973766","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":"Transforming partnerships through transboundary research.","authors":"Alfredo Mayor, Lemu Golassa, Hamtandi Magloire Natama, Alberto L Garcia-Basteiro, Tacilta Nhampossa","doi":"10.1136/bmjgh-2024-017602","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-017602","url":null,"abstract":"<p><p>Research partnerships are a key entry point for addressing the asymmetries that pervade global health. However, highly competitive and fast-paced science limits the kind of innovation and transformative change needed to reduce the imbalances that undermine the independence and academic freedom of research partners. The goal of this piece is to present a transformative lens for partnerships in which participating research organisations are willing to be mutually influenced through genuine collaborative efforts. In contrast to transactional partnerships, a transformative collaboration identifies a set of goals toward which the partnership wishes to work and agrees on the process for achieving them together. First, reflexivity and awareness of positionality are needed to recognise the power relations embedded in research and how these relations may not serve all people equally. Second, solidarity and togetherness create an interconnected view that transcends differences. Third, collective reflection on how and why the desired changes will occur is needed to guide the planning of 'who will do what, how and when' to advance equity-centred actions. Finally, shared responsibility for actions and outcomes will ensure mutual trust and a productive working relationship among partners. Implementing these principles requires some partners to relinquish control and step back when necessary, others to take ownership and greater leadership, and all partners to act with solidarity, accountability and trust. These complementary attitudes underpin the success of transformative partnerships in realising the full societal value of global health research.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973797","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":"Time for action: the critical role of research and data in achieving the targets of the second UN Decade of Action for Road Safety.","authors":"Abdulgafoor M Bachani, Hanaa Ahsan, Jagnoor Jagnoor, Olive Kobusingye, Nhan Tran, Margaret Peden","doi":"10.1136/bmjgh-2024-017488","DOIUrl":"10.1136/bmjgh-2024-017488","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977353","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":"Is 'gender equality in health' the right goal? Exploring issues of definition and measurement.","authors":"Angela Y Chang, Sarah Hawkes, Kent Buse, Virginia Zarulli","doi":"10.1136/bmjgh-2024-017900","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-017900","url":null,"abstract":"<p><p>Achieving 'gender equality in health' has been advocated by many as a key goal in health globally; however, we observe this goal has been defined differently by different users. In this paper, we explore the question of how progress towards gender equality in health has been defined and measured, and how the selection of indicators and targets can influence perceptions of who in a population is suffering disadvantage. We summarise the common population health measures-such as life expectancy and risk exposure-and illustrate how each of these measures may lead to different conclusions about gender equality in health. We call for more specificity when defining and measuring gender inequality in health, and propose expanding the focus from 'gender inequalities' (comparison between genders) to also addressing 'within-gender inequities' (a focus that incorporates addressing inequities within different gender identity groups).</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966570","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":"Tuberculosis and the climate crisis in Latin America: a predicament of poverty, migration and displacement.","authors":"Lara Goscé, Julia M Pescarini, Rein M G J Houben, Christopher Finn McQuaid","doi":"10.1136/bmjgh-2024-018674","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-018674","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980238","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":"Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis.","authors":"Kwabena Asare, Lara Lewis, Johan van der Molen, Yukteshwar Sookrajh, Thokozani Khubone, Thulani Ngwenya, Ntokozo Siyabonga Mkhize, Richard John Lessells, Kogieleum Naidoo, Phelelani Sosibo, Christian Bottomley, Nigel Garrett, Jienchi Dorward","doi":"10.1136/bmjgh-2024-016631","DOIUrl":"10.1136/bmjgh-2024-016631","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the impact of increasing CD4 count eligibility for antiretroviral therapy (ART) initiation on advanced HIV disease (AHD) and tuberculosis (TB) prevalence and incidence among people living with HIV (PLHIV) in South Africa.</p><p><strong>Methods: </strong>We conducted an interrupted time series analysis with de-identified data of PLHIV aged ≥15 years initiating ART between April 2012 and February 2020 at 65 primary healthcare clinics in KwaZulu-Natal, South Africa. Outcomes included monthly proportions of new ART initiators presenting with AHD (CD4 count <200 cells/µL) and TB disease. We created a cohort of monthly ART initiators without TB and evaluated the cumulative incidence of TB within 12 months follow-up. We used segmented binomial regression models to estimate relative risks (RR) of outcomes, allowing for a step and slope change after expanding the ART initiation CD4 count eligibility from <350 to <500 cells/µL in January 2015 and following Universal Test and Treat (UTT) implementation in September 2016.</p><p><strong>Results: </strong>Among 209 984 participants, median age was 32 (range: 26-38), and 141 499 (67.4%) were female. After January 2015, the risk of AHD at initiation decreased in step by 25.0% (RR=0.750, 95% CI 0.688 to 0.812) and further reduced by 26.9% following UTT implementation (RR=0.731, 95% CI 0.681 to 0.781). The risk of TB at initiation also decreased in step by 27.6% after January 2015 (RR=0.724, 95% CI 0.651 to 0.797) and further decreased by 17.4% after UTT implementation (RR=0.826, 95% CI 0.711 to 0.941) but remained stable among initiators with AHD. Among the incidence cohort, we saw a step decrease in the risk of new TB by 31.4% (RR=0.686, 95% CI 0.465 to 0.907) following UTT implementation. Among the incidence cohort with AHD, there was weak evidence of a step decrease in the risk of new TB (RR=0.755, 95% CI 0.489 to 1.021), but the slope decreased by 9.7% per month (RR=0.903, 95% CI 0.872 to 0.934) following UTT implementation.</p><p><strong>Conclusions: </strong>Our data support the added benefit of decreased TB co-burden with expanded ART access. Early diagnosis and immediate linkage to care should be prioritised among PLHIV.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958700","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":"Estimating the effects of interventions on increasing vaccination: systematic review and meta-analysis.","authors":"Jiayan Liu, Yingli Zhang, Haochun Zhang, Hao Tan","doi":"10.1136/bmjgh-2024-017142","DOIUrl":"https://doi.org/10.1136/bmjgh-2024-017142","url":null,"abstract":"<p><p>As global vaccination rates have reached their lowest point in nearly 15 years, effective interventions are being required globally to promote vaccination; however, there is a lack of rigorous evaluation of the effect of various interventions. Through a global synthesis, we analysed data from approximately 6 125 795 participants across 319 studies in 41 countries to reveal the global landscape of four intervention themes and to assess their effectiveness in increasing vaccination rates. We found an overall positive effect of the interventions across four main themes on improving vaccination. Specifically, dialogue-based interventions increased vaccination rates by 43.1% (95% CI: 29.8 to 57.9%, with effect sizes measured as relative risks (RRs)), though they may not always be effective in adolescents or in the sample with a higher percentage of male participants. Incentive-based interventions, whether implemented alone or combined with other intervention themes, failed to demonstrate a significant effect in children. Reminder/recall-based interventions were also effective for promoting vaccination (38.5% increase, 95% CI: 28.9 to 48.9%), particularly for completing vaccine series. Multi-component interventions exhibited excellent effectiveness in vaccination (54.3% increase, 95% CI: 40.5 to 69.6%), with the combination of dialogue, incentive and reminder/recall proving more effective than other multi-component interventions, but showing no significant effects in populations with high initial vaccination rates. However, we found that in most cases combining additional interventions with a single intervention may not significantly improve their effectiveness, especially for incentive-based interventions, but dialogue-based and reminder/recall-based interventions appear to be beneficial in some specific combinations. These findings underscore the importance of governments, public health officials and advocacy groups implementing appropriate vaccine interventions by selecting interventions tailored to specific populations, strategically promoting the completion of vaccine series and effectively combining interventions to promote global vaccination and save more lives.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 4","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973789","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}