Global Epidemiology最新文献

{"title":"Modelling seizure-related predictors of epilepsy diagnostic gap in two urban informal settlements of Nairobi using machine learning","authors":"Daniel Mwanga ,&nbsp;Frederick Murunga Wekesah ,&nbsp;Frank Ouma ,&nbsp;Symon M. Kariuki ,&nbsp;Joan Kinuthia ,&nbsp;Peter Otieno ,&nbsp;Thomas Kwasa ,&nbsp;Quincy Mongare ,&nbsp;Abigael Machuka ,&nbsp;Steve Cygu ,&nbsp;Samuel Iddi ,&nbsp;Gabriel Davis Jones ,&nbsp;Arjune Sen ,&nbsp;Charles R. Newton ,&nbsp;Gershim Asiki ,&nbsp;Damazo T. Kadengye ,&nbsp;for the EPInA Study Group","doi":"10.1016/j.gloepi.2025.100241","DOIUrl":"10.1016/j.gloepi.2025.100241","url":null,"abstract":"<div><h3>Background</h3><div>There is a wide gap in epilepsy diagnosis, particularly in low- and middle-income countries. We used machine learning models to identify seizure-related factors associated with the epilepsy diagnostic gap within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), Kenya, to inform effective community-level interventions.</div></div><div><h3>Methods</h3><div>Data were drawn from a two-stage, population-based census. In Stage-I, 56,425 residents of NUHDSS were screened for possible convulsive and non-convulsive epilepsy using a standardized questionnaire. In Stage-II, individuals who screened positive were invited for clinical assessment and diagnostic confirmation by neurologists. We used latent class analysis to classify symptom patterns. Seven machine learning models were trained, with extreme gradient boost and random forest models achieving the highest area under the receiver operating characteristic curve (98 %).</div></div><div><h3>Results</h3><div>A total of 528 individuals were diagnosed with epilepsy, among whom 80 % (<em>n</em> = 420) had not been previously diagnosed. The epilepsy diagnostic gap was 100 % (<em>n</em> = 160/160) in persons with non-convulsive epilepsy, meaning that none of them had been diagnosed before the survey. Among those with convulsive epilepsy, the diagnostic gap was 71 % (<em>n</em> = 260/368). Experiencing fewer types of seizure symptoms, non-convulsive seizures, or seizures with subtle features, such as those involving only one body part and those whose first experience of a seizure was recent, were associated with a wider epilepsy diagnostic gap.</div></div><div><h3>Conclusion</h3><div>There is critically huge diagnostic gap for epilepsy in Nairobi's informal settlements. People with subtle, fewer or less obvious seizure types are more likely to be undiagnosed. These findings highlight the importance of seizure symptom characteristics in understanding patterns of underdiagnosis. Thus, approaches to reducing the diagnostic gap should take into consideration subtle and non-convulsive seizure presentations, such as training on symptom recognition and timely care-seeking.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of social support, risk behaviors, and HIV health service use among adolescent and young males and females in Lusaka, Zambia","authors":"Sanjana Batabyal ,&nbsp;Ronald Mungoni ,&nbsp;Drosin Mulenga ,&nbsp;Nachela Chelwa ,&nbsp;Michael Mbizvo ,&nbsp;Laura Nyblade ,&nbsp;Yevgeniya Kaganova ,&nbsp;Sonja Hoover ,&nbsp;Sujha Subramanian","doi":"10.1016/j.gloepi.2025.100240","DOIUrl":"10.1016/j.gloepi.2025.100240","url":null,"abstract":"<div><h3>Background</h3><div>Human immunodeficiency virus (HIV) remains the leading cause of death in Zambia. While females are disproportionately affected by HIV, males – especially young males – are vulnerable to the disease due to a variety of risk factors. This study aimed to understand what, if any, sex-related differences exist between young females and males on social support, risk behavior, and HIV healthcare utilization issues.</div></div><div><h3>Methods</h3><div>Baseline survey responses from an implementation trial (<span><span>NCT03995953</span><svg><path></path></svg></span>) were examined for 863 females and 302 males affected by HIV between ages 15 and 26. We created summary statistics related to peer and familial support, risk factors (i.e., physical safety, economic security, mental health, substance abuse, and sexual behavior), and HIV healthcare utilization. Summary statistics were evaluated for statistical significance through Pearson Chi-Square testing.</div></div><div><h3>Findings</h3><div>Females and males, regardless of HIV status, have higher average confidence in familial support (67 %) than peer support (40 %). Across HIV status, females and males had similar rates of physical safety risk. Regardless of HIV status, about half the participants reported worrying about running out of food. Substance abuse risk is higher among males; 15 % of males at risk of HIV and 7 % of males living with HIV report drug usage other than alcohol or marijuana compared to just 1 % of all females. Among individuals at risk of HIV, there are differences in rates of HIV testing by sex: 27.7 % among males vs. 6.7 % among females.</div></div><div><h3>Interpretations</h3><div>While there are some differences, the many similarities between young females and males suggest that joint interventions which incorporate familial support could be beneficial to address shared risk factors. These joint interventions can be supplemented with sex-specific interventions related to substance abuse for males and HIV testing for females.</div></div><div><h3>Funding</h3><div>Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute Of Child Health &amp; Human Development of the National Institutes of Health under Award Number UH3HD096908. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and regional determinants of optimal antenatal care utilization among women in South and Central Somalia","authors":"Mohamed Abdirahim Omar ,&nbsp;Yahye Sheikh Abdulle Hassan ,&nbsp;Abdirasak Sharif Ali ,&nbsp;Mohamed Mustaf Ahmed","doi":"10.1016/j.gloepi.2025.100239","DOIUrl":"10.1016/j.gloepi.2025.100239","url":null,"abstract":"<div><h3>Background</h3><div>Somalia faces one of the world's highest maternal mortality ratios, and fewer than one in sixteen pregnant women obtain the previously recommended minimum of four antenatal care (ANC) visits. Understanding the drivers of low ANC use is essential for responsive policy. We investigated the prevalence and determinants of optimal ANC use (≥4 visits) among women in South and Central Somalia using nationally representative survey data.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of the 2020 Somali Health and Demographic Survey. The weighted analytic sample comprised 4124 women aged 15–49 years with complete data. Survey-adjusted descriptive statistics characterized ANC use. Bivariate associations and multivariable survey logistic regression identified independent predictors; adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) are reported.</div></div><div><h3>Results</h3><div>Only 5.7 % of women (95 % CI 4.3–7.6) had four or more ANC visits. After adjustment, secondary education (aOR 2.33, 95 % CI 1.01–5.40) and higher education (aOR 5.36, 95 % CI 1.58–18.15) were associated with optimal ANC. Household wealth showed a graded increase, with the richest quintile having nearly 30 times the odds compared with the poorest (aOR 29.66, 95 % CI 8.51–101.27). Home delivery was associated with lower odds of optimal ANC (aOR 0.29, 95 % CI 0.18–0.47). Regional disparities persisted: women in Bay (aOR 4.07, 95 % CI 1.22–13.60) and Galgaduud (aOR 2.74, 95 % CI 1.13–6.64) had higher odds than those in Mudug.</div></div><div><h3>Conclusion</h3><div>Optimal ANC coverage in South and Central Somalia remains critically low. Priorities include reducing financial and geographic barriers to care, strengthening facility-based services, and promoting female education to improve maternal and neonatal outcomes.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100239"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undetected circulation of monkeypox virus in Portugal: Evidence for a 50-day gap before first detection","authors":"Rita Cordeiro ,&nbsp;Fernando da Conceição Batista ,&nbsp;Ana Pelerito ,&nbsp;Isabel Lopes de Carvalho ,&nbsp;Sílvia Lopo ,&nbsp;Raquel Neves ,&nbsp;Raquel Rocha ,&nbsp;Paula Palminha ,&nbsp;Maria José Borrego ,&nbsp;Maria Sofia Núncio ,&nbsp;João Paulo Gomes","doi":"10.1016/j.gloepi.2025.100238","DOIUrl":"10.1016/j.gloepi.2025.100238","url":null,"abstract":"<div><div>As mpox continues to spread globally, proactive monitoring and preparedness are crucial to minimize impact and enhance response strategies. Using a mathematical model combining a negative binomial distribution with Richards' logistic curve, we reconstructed the hidden phase of mpox transmission in Portugal, offering insights into the timing and dynamics of the initial outbreak. The analysis of 950 PCR-positive and 986 negative cases suggested that symptom onset occurred between March 24 and April 2, 2022, with March 27 identified as the most probable date. This study delineates the likely period of silent circulation of MPXV in Portugal, providing a clearer understanding of early outbreak dynamics and surveillance performance. Possible imperfections in early diagnostic testing and limited awareness of mpox may have contributed to delayed recognition of the outbreak. By demonstrating how retrospective mathematical modelling can estimate undetected transmission periods, our findings highlight the value of such approaches in epidemic reconstruction and underscore the importance of strengthening early surveillance systems to detect undiagnosed transmission of mpox in non-endemic countries.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100238"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling hidden heterogeneity and inequalities in the continuum of care for reproductive, maternal, and child health services in sub-Saharan Africa: A multilevel latent class analysis approach","authors":"Abebew Aklog Asmare ,&nbsp;Awoke Seyoum Tegegne ,&nbsp;Denekew Bitew Belay","doi":"10.1016/j.gloepi.2025.100237","DOIUrl":"10.1016/j.gloepi.2025.100237","url":null,"abstract":"<div><div>Improving reproductive, maternal, newborn, and child health (RMNCH) services is vital for achieving the Sustainable Development Goals (SDGs) for maternal and child survival. This study utilized multilevel latent class analysis (MLCA) on Demographic and Health Surveys (DHS) data from 29 sub-Saharan African (sSA) countries to identify RMNCH service utilization patterns, examine covariate effects, and assess coverage inequalities. Secondary data from the most recent DHS conducted in 29 sSA countries from 2015 to 2024 were used. MLCA was performed on 12 RMNCH service indicators to account for the hierarchical structure of the data. Summary inequality indicators were used to assess differences in posterior class membership for lower-level classes across wealth quintiles, maternal education, maternal occupation, and place of residence. Women's RMNCH service utilization was divided into two categories: optimal and suboptimal users, and two higher-level categories: high and low coverage. Higher maternal education, household wealth, media access, and early antenatal care were related to a higher likelihood of being in the optimal utilizer class. In contrast, rural location and a longer distance to health services were associated with a lower likelihood. Inequality indices revealed significant differences among optimal utilizers, particularly in terms of mother education and household wealth. Targeted interventions are urgently required to promote RMNCH service utilization in sSA by addressing persistent socioeconomic disparities, particularly among women with no education, lower incomes, and low access to health care.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AlzStack: Forecasting early-onset Alzheimer's with an explainable AI system using multiple data balancing techniques","authors":"Venkata Aditi Modali ,&nbsp;Manohar Pavanya ,&nbsp;R. Vijaya Arjunan ,&nbsp;D. Cenitta ,&nbsp;Niranjana Sampathila ,&nbsp;Radhika Kamath ,&nbsp;Krishnaraj Chadaga","doi":"10.1016/j.gloepi.2025.100235","DOIUrl":"10.1016/j.gloepi.2025.100235","url":null,"abstract":"<div><div>Alzheimer's disease (AD) is a degenerative neurological disease that progresses over time, making early detection crucial for effective intervention and better patient prognosis. Traditional diagnostic methods such as cognitive assessments, neuroimaging, and biomarker analysis can be time-consuming, costly, and inconsistent. We introduce AlzStack, a soft voting ensemble model to classify AD from a richly detailed dataset containing 2149 patients across demographic, medical, lifestyle, and cognitive variables. To resolve class imbalance, we implemented a pipeline 5-fold cross-validation, randomized search for hyper parameter tuning and advanced resampling methods such as SMOTE (Synthetic Minority Oversampling Technique), ADASYN, BorderlineSMOTE, and SVMSMOTE. Soft Vote Classifier surpassed both stacking ensembles and hard voting with an AUC value of 94.27 %, accuracy of 93.26 %, precision of 89.17 %, a recall of 92.11 %, and F1-score value of 90.61 %.A secondary experiment with only resampling methods applied to data to all base models served as a baseline for comparison confirming the superior performance of cross-validation AlzStack configuration. To improve interpretability, we utilized a wide range of Explainable Artificial Intelligence (XAI methods) and these approaches yielded global and local explanations about model behavior, emphasizing key features like MMSE scores, functional measures, and behavioral markers. Combining robust predictive performance with explainable decision-making makes AlzStack is a healthcare decision-support algorithm for the early detection of AD.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of alcohol use and alcohol use disorders among the population of Buea, south west region, Cameroon: A survey study","authors":"Nadège Emégam Kouémou,&nbsp;Ven-Laura Atem Yega,&nbsp;Franklin Mbeboh Savo,&nbsp;Ndzweng Linda Tamanji","doi":"10.1016/j.gloepi.2025.100236","DOIUrl":"10.1016/j.gloepi.2025.100236","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol consumption worldwide is associated with a range of health and societal problems. Epidemiology data are valuable tools for predicting the outcome of a given behaviour on the general population's health. This study aimed to evaluate the patterns of alcohol consumption among Buea inhabitants.</div></div><div><h3>Material and methods</h3><div>This cross-sectional study involves 422 participants (244 men and 178 women) aged 15 years and above who have been residents of the Buea municipality for more than a year. This study was conducted from March to May 2019 using a semi-structured questionnaire. The questionnaire included socio-demographic information and the 10 items of the Alcohol Use Disorder Identification Test (AUDIT).</div></div><div><h3>Results</h3><div>The results obtained showed that many of the alcohol misusers were men. 34.6 % of the participants indicated drinking above the recommended levels. 93.8 % of the respondents admitted to consuming alcohol in the company of others, mostly in bars. Beer was the leading alcoholic beverage consumed in Buea. Alcohol intake for pleasure and to relieve stress were among the leading causes of alcohol drinking in the study population. The vast majority of participants reported misbehavior after alcohol intake. The number of women with AUDIT C score greater than 5 was also significant. Aggressivity, memory loss, and falls after drinking were also recorded in the study population.</div></div><div><h3>Conclusion</h3><div>The alcohol consumption patterns in Buea are associated with many behavioral misconducts. Therefore, there is a need for community education to curve the incidence of neurological diseases and alcohol addiction behaviour in the Buea municipality.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to <Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19, Clinical Characteristics: A Multi-Center Observational Study from Jordan> <[9 (2025), 100185]>","authors":"Marwan Shalabi ,&nbsp;Salam Ghanem ,&nbsp;Iyad Al-Ammouri ,&nbsp;Amirah Daher ,&nbsp;Enas Al-zayadneh ,&nbsp;Alaa Alsmadi ,&nbsp;Mais Ayyoub ,&nbsp;Samah Abughanam ,&nbsp;Mariam Jabr ,&nbsp;Montaha AL-Iede","doi":"10.1016/j.gloepi.2025.100215","DOIUrl":"10.1016/j.gloepi.2025.100215","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Mathematical modelling and time series clustering of Mpox outbreak: A comparative study of the top 10 affected countries and implications for future outbreak management’ [Global Epidemiology 10 (2025) 100214]","authors":"Mark-Daniels Tamakloe ,&nbsp;Ametus Kuuwill ,&nbsp;Ibrahim Osumanu ,&nbsp;Helina Siripi","doi":"10.1016/j.gloepi.2025.100216","DOIUrl":"10.1016/j.gloepi.2025.100216","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer burden in India: A descriptive epidemiological study and policy insights","authors":"Khushwant Singh ,&nbsp;Ashoo Grover ,&nbsp;Kavitha Dhanasekaran","doi":"10.1016/j.gloepi.2025.100233","DOIUrl":"10.1016/j.gloepi.2025.100233","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains a major global health issue, particularly in low- and middle-income countries (LMICs). Although human papillomavirus (HPV) vaccination and screening are proven preventive strategies, LMICs, including India, face significant implementation challenges.</div></div><div><h3>Methods</h3><div>This observational, descriptive epidemiological study analyzes cervical cancer burden across WHO regions sourcing data from GLOBOCAN 2022, GBD, and GHO. India-specific state-level analysis was conducted using GBD data. Joinpoint regression assessed death trends, and a comparative analysis examined the impact of India's 2016 national cervical cancer screening and management policies.</div></div><div><h3>Findings</h3><div>The Southeast Asia Region (SEARO) accounts for the second-highest cervical cancer incident (new cases) and death rate among WHO regions, with India contributing over 65 % of the burden. National screening coverage remains alarmingly low, with only 1.9 % of women aged 30–49 undergoing screening, far below developed nations. Despite the adoption of Visual Inspection with Acetic Acid (VIA) as primary screening method in 2016, India's cervical cancer death rates have continued to rise, increasing from 6.06 to 6.78 per 100,000 women (2012–2016) to 6.82–6.91 (2016–2019). However, death annual percentage change declined from 3.84 % (2012–2015) to 0.46 % (2016–2019), indicates slowdown in death acceleration but not a reversal.</div></div><div><h3>Conclusion</h3><div>India's burden remains high due to low screening coverage, reliance on subjective screening test, and limited HPV vaccination. While many countries like Australia and Bhutan have successfully reduced incidence and death through HPV-based screening and vaccination, India's slow progress underscores the urgent need for policy shifts towards HPV-DNA testing with self-sampling option and national HPV-vaccination programs implementation to curb cervical cancer burden effectively.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}