BMJ Global Health最新文献

{"title":"Evaluating the impact of two next-generation long-lasting insecticidal nets on malaria incidence in Uganda: an interrupted time-series analysis using routine health facility data.","authors":"Adrienne Epstein, Samuel Gonahasa, Jane Frances Namuganga, Martha J Nassali, Catherine Maiteki-Sebuguzi, Isaiah Nabende, Katherine Snyman, Joaniter I Nankabirwa, Jimmy Opigo, Martin J Donnelly, Sarah G Staedke, Moses R Kamya, Grant Dorsey","doi":"10.1136/bmjgh-2024-017106","DOIUrl":"10.1136/bmjgh-2024-017106","url":null,"abstract":"<p><strong>Introduction: </strong>Malaria remains a significant public health challenge globally, particularly in sub-Saharan Africa, where progress has stalled in recent years. Long-lasting insecticidal nets (LLINs) are a critical preventive tool against malaria. This study investigated the effectiveness of newer-generation LLINs following a universal coverage campaign in Uganda.</p><p><strong>Methods: </strong>Health facility data collected 36 months prior to LLIN distribution and 24 months after LLIN distribution were used from 64 sites that took part in a cluster-randomised trial comparing two newer-generation LLINs (pyrethroid-piperonyl butoxide and pyrethroid-pyriproxyfen). Using an interrupted time-series approach, we compared observed malaria incidence with counterfactual scenarios if no LLINs were distributed, adjusting for precipitation, vegetation, seasonality and care-seeking behaviour. Analyses were also stratified by LLIN type and study-site level estimates of transmission intensity.</p><p><strong>Results: </strong>Overall, malaria incidence decreased from 827 cases per 1000 person-years in the predistribution period to 538 per 1000 person-years in the postdistribution period. Interrupted time-series analyses estimated a 23% reduction in malaria incidence (incidence rate ratio [IRR]=0.77, 95% CI 0.65 to 0.91) in the first 12 months following distribution relative to what would be expected had no distribution occurred, which was not sustained in the 13-24 month post-distribution period (IRR=0.97, 95% CI 0.75 to 1.28). Findings were similar when stratified by LLIN type. In the first 12 months following distribution, LLIN effectiveness was greater in the high-transmission sites (IRR=0.67, 95% CI 0.54 to 0.86) compared with the medium- (IRR=0.74, 95% CI 0.59 to 0.92) and low-transmission sites (IRR=0.87, 95% CI 0.56 to 1.32).</p><p><strong>Conclusion: </strong>This study demonstrated a modest reduction in malaria incidence following the distribution of newer-generation LLINs that was sustained for only 12 months, highlighting the need for improved strategies to maintain net effectiveness. Adjusting the frequency of universal coverage campaigns based on local malaria transmission intensity may enhance control efforts.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603739","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":"Can solidarity in global health curb the next outbreak? A commentary on mpox.","authors":"Natalie Tegama, Julian Natukunda, Imogen Alexandra Fiona Brown, Caesar Alimisnya Atuire","doi":"10.1136/bmjgh-2024-018116","DOIUrl":"10.1136/bmjgh-2024-018116","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584655","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":"The burden of acute respiratory infection in children under 5 attributable to economic inequality in low- and middle-income countries.","authors":"Hailu Zhu, Ke Huang, Xueyan Han, Zhaoyang Pan, Hanchao Cheng, Qi Wang, Yicong Wang, Wei Sun, Jiarun Mi, Ting Yang, Tianjia Guan, Tao Xue, Chen Wang","doi":"10.1136/bmjgh-2024-017409","DOIUrl":"10.1136/bmjgh-2024-017409","url":null,"abstract":"<p><strong>Background: </strong>Quantifying the disease burden among children that could potentially be reduced through improvements in individual economic status and regional economic equality can greatly benefit policy making and resource allocation. However, such quantification has rarely been done. This study aimed to assess the inequality-related burden of acute respiratory infection (ARI) (the leading cause of child mortality in low- and middle-income countries (LMICs)) among under five children.</p><p><strong>Methods: </strong>This study integrated the Demographic and Health Survey data from 53 countries and linked individual records to a novel proxy of economic development status, the satellite night-time light (NTL). We assessed the number of children affected by ARI attributable to within-country economic disparities (eg, NTL<the country-specific 90th percentile) or within-country inequality (eg, NTL<the annual country-specific 90th percentile) from 2001 to 2019 in 133 LMICs, based on the exposure-response relationship between NTL and ARI derived from the study participants.</p><p><strong>Results: </strong>The odds of experiencing ARI were decreased significantly (3.5% ((95% confidence interval (CI) 1.4% to 4.4%)) for every 10-digit number increase in NTL. The exposure-response function showed constant decreasing in the risk of ARI as NTL level increases. It is estimated that within-country economic disparities contributed to 11.0% (95% CI 6.1% to 15.6%) of all children affected by ARI in 2001, which was decreased to 8.1% (95% CI 4.2% to 11.8%) in 2019. In contrast, the inequality-related burden remained stable. In sub-Saharan Africa, it increased from 4.8% (95% CI 1.7% to 8.0%) in 2001 to 6.8% (95% CI 3.0%-9.8%) in 2019. Eliminating within-country inequality would have avoided 522 136 (95% CI 2 66 760 to 7 57 414) cases of ARI among children across the 133 LMICs in 2019.</p><p><strong>Conclusion: </strong>Our study revealed a protective effect of economic status on preventing ARI in children under 5 years of age. The considerable burden of childhood ARI was attributable to the economic inequality in LMICs. Optimising the allocation of economic resources can safeguard child health.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584656","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":"Gender bias in health financing methods: metrics and data.","authors":"Kalipso Chalkidou, Richard Sullivan","doi":"10.1136/bmjgh-2024-016746","DOIUrl":"10.1136/bmjgh-2024-016746","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571643","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":"Healthcare utilisation for febrile diseases in northern Tanzania: a randomised population-based cluster survey.","authors":"Deng B Madut, Matthew P Rubach, Julian T Hertz, Rebecca Bodenham, Gwamaka William, Timothy A Peter, Kajiru G Kilonzo, Blandina T Mmbaga, Venance P Maro, John A Crump","doi":"10.1136/bmjgh-2024-017913","DOIUrl":"10.1136/bmjgh-2024-017913","url":null,"abstract":"<p><strong>Background: </strong>We conducted a randomised population-based cluster survey in northern Tanzania to assess care-seeking behaviours in the context of a febrile illness. Our objectives were to determine the most effective points for intervention during initial fever case management and to characterise factors associated with care-seeking.</p><p><strong>Methods: </strong>The primary sampling unit, or cluster, was the village, and the secondary sampling unit was the household. Villages were selected in a population-weighted fashion, and households were randomly selected within each village. At each household, surveys were administered to determine hypothetical healthcare utilisation patterns for the following febrile syndromes: (1) fever, (2) fever >3 days, (3) fever with diarrhoea, (4) fever with difficulty breathing and (5) fever with confusion. Descriptive analyses were used to evaluate healthcare utilisation for each syndrome at the level of the individual household member, and multivariable logistic regression models were constructed to identify factors associated with care-seeking at a hospital for fever with difficulty breathing or confusion.</p><p><strong>Results: </strong>From February through October 2018, we enrolled 718 households with a total of 2744 household members. Dispensaries were the leading site of care-seeking for fever (n=1167, 42.5%), fever >3 days (n=1318, 48.0%) and fever with diarrhoea (n=1218, 44.4%). In contrast, hospitals were the leading site for care-seeking for fever with difficulty breathing (n=1436, 52.3%) and fever with confusion (n=1521, 55.4%). Households in the highest wealth quartile had higher odds of reporting that household members would seek hospital care for fever with difficulty breathing or confusion.</p><p><strong>Conclusion: </strong>In summary, our results suggest that lower-level health facilities, such as dispensaries, play an important role in the initial management of most febrile syndromes. Further research is needed to define the quality of fever case management within such facilities. Finally, our findings provide further evidence that socioeconomic status modifies health-seeking patterns.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571665","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":"Addressing systemic inequities in humanitarian response: a framework for coordinated response in Sudan's neglected health crisis.","authors":"Nada Fadul","doi":"10.1136/bmjgh-2024-017533","DOIUrl":"10.1136/bmjgh-2024-017533","url":null,"abstract":"","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571620","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":"Factors driving adolescent tuberculosis incidence by age and sex in 30 high-tuberculosis burden countries: a mathematical modelling study.","authors":"Silvia S Chiang, Megan B Murray, Alexander W Kay, Peter J Dodd","doi":"10.1136/bmjgh-2024-015368","DOIUrl":"10.1136/bmjgh-2024-015368","url":null,"abstract":"<p><strong>Introduction: </strong>During adolescence, tuberculosis incidence rises, with a greater increase in males compared with females. Tuberculosis notifications and estimates infrequently disaggregate adolescent age groups. Moreover, the factors that drive the increases in overall incidence and the male-to-female (MF) ratio remain unclear.</p><p><strong>Methods: </strong>We constructed a mechanistic model to estimate cumulative <i>Mycobacterium tuberculosis</i> infection and tuberculosis disease incidence in the WHO's 30 high-tuberculosis burden countries (HBCs), which represent 86%-90% of global tuberculosis incidence. We derived infection risk from tuberculosis prevalence and assortative social mixing based on sex and age (10-14 years vs 15-19 years old). We adjusted age subgroup-specific risks of disease progression by age- and sex-specific risks of low body mass index (BMI), pregnancy and postpartum period (PPP) and HIV coinfection. We calculated population attributable fractions (PAFs) to these factors.</p><p><strong>Results: </strong>In 2019, 91.2 million (95% uncertainty interval (UI) 83.9 to 99.3 million) adolescents in the 30 HBCs had been infected with <i>M. tuberculosis</i>, and an estimated 1.0 million (95% UI 0.8 to 1.2 million) developed tuberculosis disease. The median PAF of tuberculosis disease to HIV, modified by antiretroviral therapy, was 1% and highest in Southern Africa. The median PAF for PPP among older adolescents of both sexes was 2.6%. The median PAF to low BMI was 16% and highest in South Asia. The MF risk ratio of tuberculosis disease was 1.2-fold higher among older adolescents, relative to young adolescents. The widening MF risk ratio was attributable mostly to low BMI, with a smaller contribution from sex-assortative social mixing.</p><p><strong>Conclusion: </strong>Globally, large numbers of adolescents have been infected by <i>M. tuberculosis</i> and develop tuberculosis disease. Low BMI is the most important contributor to the overall incidence of tuberculosis disease, as well as to the sex difference that widens with age.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566122","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":"Global burden of osteoarthritis among postmenopausal women in 204 countries and territories: a systematic analysis for the Global Burden of Disease Study 2021.","authors":"Huadong Xu, Wenfeng Xiao, Chan Ding, Jiarong Zou, Dan Zhou, Jing Wang, Lilu Ding, Chenggang Jin, Lingling Sun, Yingjun Li","doi":"10.1136/bmjgh-2024-017198","DOIUrl":"10.1136/bmjgh-2024-017198","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to provide global burden and temporal trends in the incidence, prevalence, and disability-adjusted life-years (DALYs) of osteoarthritis (OA) among postmenopausal women from 1990 to 2021.</p><p><strong>Methods: </strong>The study employed data from the Global Burden of Disease (GBD) Study 2021. Four subtypes of OA affecting the hip, knee, hand, and other joints among postmenopausal women were included. Age-standardised rates (ASRs) were derived with reference to the global age standard, and temporal patterns were scrutinised through estimated annual percentage change (EAPC) assessments. The impact of age, body mass index (BMI), and Socio-demographic Index (SDI) were all considered.</p><p><strong>Results: </strong>From 1990 to 2021, there were more than 1.3-fold increases in OA incidence, prevalence, and DALYs among postmenopausal women globally, with EAPCs of 0.211, 0.356, and 0.395, respectively. Knee OA carried the heaviest burden, while hip OA bore the least. Higher SDI regions had higher burden, and inequalities linked to SDI among countries had intensified over time. East Asia and high-income Asia Pacific experienced the most substantial increments in OA burden. High BMI significantly influences the burden of OA, especially in countries within high, high-middle, and middle SDI, where DALYs attributed to high BMI exceed 20%.</p><p><strong>Conclusions: </strong>The burden of OA among postmenopausal women continues to escalate, highlighting its significant impact on the global health of postmenopausal women. Necessarily, effective monitoring and management of risk factors, targeted lifestyle adjustments for BMI, and policy interventions accounting for demographic disparities are required to ease OA in postmenopausal women.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555911","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":"Proof-of-principle of a technology transfer of a dried blood virus neutralisation assay to a Gavi-eligible country.","authors":"Evangeline Obodai, Jonne Terstappen, Jude Yayra Mensah, Anouk Versnel, Comfort Nuamah Antwi, Louis J Bont, Daniela Cianci, Eveline M Delemarre, John Kofi Odoom, Peter M van de Ven, Natalie I Mazur","doi":"10.1136/bmjgh-2024-016916","DOIUrl":"10.1136/bmjgh-2024-016916","url":null,"abstract":"<p><strong>Background: </strong>Global health clinical research is commonly led by high-income countries (HICs) as low- and middle-income countries (LMICs) face barriers to participate, including lack of financial and human capacity and lack of research environment. Respiratory syncytial virus (RSV) vaccine development is also led by HICs, while LMICs carry the burden of life-threatening disease. Representative trials and research capacity strengthening in LMICs are needed to ensure global vaccine access and equity. This study aims to transfer an RSV neutralisation assay, which uses live cells and virus with inherent high variation, to a country eligible to receive support from the Gavi, the Vaccine Alliance.</p><p><strong>Methods: </strong>Using a train-the-trainer approach, a Ghanaian researcher was trained in the Netherlands on the dried blood-based RSV neutralisation assay. Subsequently, a Dutch researcher visited Ghana to support the process of adapting the technique to the Ghanaian setting. In a previously validated RSV neutralisation assay on dried blood, Hep-2 cells were infected with a serial dilution of sample-virus mixture to determine the half-maximal inhibitory concentration. Fifty-one dried blood and serum samples were tested in parallel in both countries to assess concordance.</p><p><strong>Results: </strong>Training and technology transfer was deemed successful, which was defined as neutralisation measurements by the Ghana team and high concordance (Lin's concordance correlation coefficient (CCC)>0.8). Neutralising capacity measured in identical samples in Ghana and the Netherlands correlated highly (Lin's CCC=0.87; Spearman rho=0.89) but was systematically lower in Ghana than the Netherlands.</p><p><strong>Conclusion: </strong>We show successful transfer of an RSV neutralisation assay, thereby strengthening the laboratory research capacity in a Gavi-eligible country. Reliable measurement of RSV neutralising antibodies in a Gavi-eligible country and the use of dried blood can contribute to inclusion of LMICs in RSV vaccine development and access.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555914","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":"Coverage, timeliness of measles immunisation and its predictors in Pakistan: an analysis of 6.2 million children enrolled in the Provincial Electronic Immunisation Registry.","authors":"Manaksha Memon, Danya Arif Siddiqi, Vijay Kumar Dharma, Mubarak Taighoon Shah, Sundus Iftikhar, Hamidreza Setayesh, Subhash Chandir","doi":"10.1136/bmjgh-2024-016717","DOIUrl":"10.1136/bmjgh-2024-016717","url":null,"abstract":"<p><strong>Background: </strong>Measles-related morbidity and mortality persists due to suboptimal and delayed vaccination, predominantly in low- and middle-income countries where more than 95% of global measles deaths occur. We evaluated the coverage, timeliness of measles vaccination and its predictors for children aged 12-23 months in Sindh, Pakistan.</p><p><strong>Methods: </strong>We analysed immunisation data from Sindh Province's Electronic Immunisation Registry for 6.2 million children aged 12-23 months. We assessed vaccination coverage at specific ages, calculated timeliness using Expanded Programme on Immunisation-Sindh criteria and examined predictors for timely vaccination using Cox proportional hazard regression. Spatial mapping was used to identify zero-dose measles hotspots.</p><p><strong>Results: </strong>Among 6 227 450 children aged 12-23 months, 80.6% received the first measles vaccine dose and only 58.1% of those vaccinated children aged 15-23 months received the second dose. Only 36.6% and 31.4% of children received measles-1 and 2 at the recommended age range (measles-1: 270-301 days; measles-2: 453-484 days). Subnational analysis identified 26.5% of Union Councils with ≥25% measles unvaccinated children. Children of educated mothers (≥11 years) compared with uneducated mothers had a higher timely measles vaccination likelihood (measles-1: HR=1.24; 95% CI: 1.23 to 1.26; p=0.010 and measles-2: HR=1.19; 95% CI: 1.18 to 1.21; p<0.001), while children who received the last vaccination at an outreach compared with a fixed site had a lower timely measles vaccination likelihood (measles-1: HR=0.91; 95% CI: 0.90 to 0.91; p<0.001 and measles-2: HR=0.93; 95% CI: 0.93 to 0.94; p<0.001).</p><p><strong>Conclusion: </strong>Suboptimal and delayed measles vaccination coverage casts serious doubts on attaining measles elimination by 2030, as stated in the Immunisation Agenda. Continued high-level national commitment and implementation of targeted strategies are imperative to achieving global measles immunisation goals.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540173","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}