Pub Date : 2024-09-21eCollection Date: 2024-01-01DOI: 10.1155/2024/7858899
Olugbenga Olusola Abiodun, Tina Anya, Victor Tunde Adekanmbi, Dike Ojji
Introduction: Studies on the relationship between a family history of hypertension and left ventricular hypertrophy are sparse. We evaluated this relationship in patients with essential hypertension.
Methods: A total of 1668 patients with essential hypertension were consecutively enrolled in the prospective Federal Medical Centre Abuja Hypertension Registry. First-degree family history was defined by the presence of a known history of hypertension in any or both parents, siblings, and children. Echocardiographic left ventricular hypertrophy was diagnosed using the criteria of the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Results: The prevalence of a family history of hypertension, echocardiographic, and electrocardiographic left ventricular hypertrophy were 61.7%, 46.8%, and 30.8%, respectively. After multivariable adjustment, paternal history of hypertension [OR: 1.56, CI: 1.20-2.05, p=0.001] was associated with an increased risk of echocardiographic left ventricular hypertrophy, while maternal history of hypertension [OR: 0.72, CI 0.58-0.91, p=0.006] was associated with a reduced risk. Age ≥50 years (p=0.026), duration of hypertension ≥1 year (p=0.047), and heart failure (p < 0.001) were associated with an increased risk of left ventricular hypertrophy, while male sex (p < 0.001) was associated with a reduced risk.
Conclusion: Our study showed that a paternal history of hypertension is associated with an increased left ventricular hypertrophy risk among patients with essential hypertension, while maternal history is protective.
{"title":"Family History of Hypertension and Echocardiographic Left Ventricular Hypertrophy in Hypertensive Nigerians.","authors":"Olugbenga Olusola Abiodun, Tina Anya, Victor Tunde Adekanmbi, Dike Ojji","doi":"10.1155/2024/7858899","DOIUrl":"10.1155/2024/7858899","url":null,"abstract":"<p><strong>Introduction: </strong>Studies on the relationship between a family history of hypertension and left ventricular hypertrophy are sparse. We evaluated this relationship in patients with essential hypertension.</p><p><strong>Methods: </strong>A total of 1668 patients with essential hypertension were consecutively enrolled in the prospective Federal Medical Centre Abuja Hypertension Registry. First-degree family history was defined by the presence of a known history of hypertension in any or both parents, siblings, and children. Echocardiographic left ventricular hypertrophy was diagnosed using the criteria of the American Society of Echocardiography and the European Association of Cardiovascular Imaging.</p><p><strong>Results: </strong>The prevalence of a family history of hypertension, echocardiographic, and electrocardiographic left ventricular hypertrophy were 61.7%, 46.8%, and 30.8%, respectively. After multivariable adjustment, paternal history of hypertension [OR: 1.56, CI: 1.20-2.05, <i>p</i>=0.001] was associated with an increased risk of echocardiographic left ventricular hypertrophy, while maternal history of hypertension [OR: 0.72, CI 0.58-0.91, <i>p</i>=0.006] was associated with a reduced risk. Age ≥50 years (<i>p</i>=0.026), duration of hypertension ≥1 year (<i>p</i>=0.047), and heart failure (<i>p</i> < 0.001) were associated with an increased risk of left ventricular hypertrophy, while male sex (<i>p</i> < 0.001) was associated with a reduced risk.</p><p><strong>Conclusion: </strong>Our study showed that a paternal history of hypertension is associated with an increased left ventricular hypertrophy risk among patients with essential hypertension, while maternal history is protective.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"7858899"},"PeriodicalIF":1.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Neonatal sepsis contributes substantially to neonatal mortality and morbidity and is an ongoing major global public health problem particularly in developing countries. A significant proportion of mothers give birth in primary health care, but studies regarding neonatal sepsis and its associated factors among admitted neonates are limited to the hospital which may not be generalized to the primary health care unit. Therefore, this study aimed to assess the proportion of neonatal sepsis and associated factors in the study areas.
Objective: To assess the magnitude of neonatal sepsis and its associated factors among neonates admitted to Neonatal Intensive Care Units (NICUs) of Hawzen Primary Hospital, Eastern Zone, Tigray, North Ethiopia, 2020.
Methods: An institution-based cross-sectional study design was carried out among 290 study participants in Hawzen Primary Hospital in January-March/2020. A systematic random sampling method was applied to select the study participants, and pretested and structured questionnaires were used to collect data. The collected data were coded, entered, cleaned, and analyzed using SPSS version 20.0 software. Binary logistic regression analyses with a confidence interval of 95% were used to select determinant factors. Statistically significant factors were identified using the adjusted odds ratio (AOR). Statistical significance was determined at p value <0.05. Binary and multivariable logistic regression analyses were applied to see the association of the variables at a p < 0.05.
Results: In this study, the overall proportion of neonatal sepsis was (60.2%) 95% CI (56, 68)]. Birth asphyxia [AOR = 2.04; 95%CI (1.07, 3.93)], maternal age of 15-19 [AOR = 2.00; 95% CI (1.81, 11.93)], duration of labor greater or equal to 24 hours [AOR = 3.00; 95% CI (2.67, 14.21)], history of oxygen administration [AOR = 2.37; 95% CI (1.18, 4.75)], neonatal age of greater or equal to seven days [AOR = 4.0595% CI (1.07, 3.93), and home delivery [AOR = 5.00; 95% CI (2.34, 18.92)] were the predictor variables for neonatal sepsis.
Conclusion: In this study, neonatal sepsis was high. Birth asphyxia, intranasal oxygen administration, age of the mother, home delivery, and duration of labor were associated with neonatal sepsis.
{"title":"Magnitude of Neonatal Sepsis and Factors Associated with It among Neonates Admitted to the Intensive Care Units of Neonate in the Primary Hospital of Hawzen, Tigray, Ethiopia, 2020.","authors":"Fre Gebremeskel, Haftay Gebremedhin, Medhin Mehari","doi":"10.1155/2024/7393056","DOIUrl":"10.1155/2024/7393056","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal sepsis contributes substantially to neonatal mortality and morbidity and is an ongoing major global public health problem particularly in developing countries. A significant proportion of mothers give birth in primary health care, but studies regarding neonatal sepsis and its associated factors among admitted neonates are limited to the hospital which may not be generalized to the primary health care unit. Therefore, this study aimed to assess the proportion of neonatal sepsis and associated factors in the study areas.</p><p><strong>Objective: </strong>To assess the magnitude of neonatal sepsis and its associated factors among neonates admitted to Neonatal Intensive Care Units (NICUs) of Hawzen Primary Hospital, Eastern Zone, Tigray, North Ethiopia, 2020.</p><p><strong>Methods: </strong>An institution-based cross-sectional study design was carried out among 290 study participants in Hawzen Primary Hospital in January-March/2020. A systematic random sampling method was applied to select the study participants, and pretested and structured questionnaires were used to collect data. The collected data were coded, entered, cleaned, and analyzed using SPSS version 20.0 software. Binary logistic regression analyses with a confidence interval of 95% were used to select determinant factors. Statistically significant factors were identified using the adjusted odds ratio (AOR). Statistical significance was determined at <i>p</i> value <0.05. Binary and multivariable logistic regression analyses were applied to see the association of the variables at a <i>p</i> < 0.05.</p><p><strong>Results: </strong>In this study, the overall proportion of neonatal sepsis was (60.2%) 95% CI (56, 68)]. Birth asphyxia [AOR = 2.04; 95%CI (1.07, 3.93)], maternal age of 15-19 [AOR = 2.00; 95% CI (1.81, 11.93)], duration of labor greater or equal to 24 hours [AOR = 3.00; 95% CI (2.67, 14.21)], history of oxygen administration [AOR = 2.37; 95% CI (1.18, 4.75)], neonatal age of greater or equal to seven days [AOR = 4.0595% CI (1.07, 3.93<b>)</b>, and home delivery [AOR = 5.00; 95% CI (2.34, 18.92)] were the predictor variables for neonatal sepsis.</p><p><strong>Conclusion: </strong>In this study, neonatal sepsis was high. Birth asphyxia, intranasal oxygen administration, age of the mother, home delivery, and duration of labor were associated with neonatal sepsis.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"7393056"},"PeriodicalIF":1.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Despite the well-known adverse health effects of tobacco, shisha use among students in tertiary institutions remains a public health concern. In Kenya, the literature on status of shisha after the 2017 ban is scanty. This study sought to ascertain actual shisha use among university students along the coastal strip.
Methods: We investigated confirmed and self-reported shisha use. Using proportionate-to-size and snowball sampling methods, 380 respondents were enrolled from three universities. Sociodemographic characteristics and self-reported history of shisha use were documented using a participant-assisted questionnaire. Actual shisha use was determined qualitatively using 6 panel plus alcohol saliva test kit that detected cotinine use among other selected drugs.
Results: Of the 380 participants, 278 (73%) were males and their median (IQR) age was 22 (20-23) years. This study reports 29% current use based on testing positive for cotinine. Among those who reported current ever use of shisha, 19% tested positive for cotinine, respectively. In the multivariable analysis, being separated (adjusted risk ratio (aRR): 2.06 (95% CI: 1.45-2.94)) compared to being single and studying for a degree compared to a diploma (aRR: 1.32 (95% CI: 1.10-1.58)) were associated with cotinine positive. The 4th year of study (aRR: 1.68 (95% CI: 1.22-2.33)) compared to the 1st year and reported knowledge of shisha (aRR: 1.84 (95% CI: 1.18-2.87)) were associated with cotinine positive.
Conclusion: Nearly one-third of university students along the Kenyan coast are active shisha users. Saliva testing for cotinine is a more reliable method of reporting tobacco use. We recommend upscaling of health education, re-enforcement of the current ban on shisha consumption by concerned authorities, and saliva testing for cotinine while assessing current tobacco use.
{"title":"Shisha Consumption and Presence of Cotinine in Saliva Samples among Students in Public Universities in Coastal Kenya.","authors":"Abdulrehman Halima Allahdad, Moses Ngari, Cromwell Mwiti Kibiti, Rahma Udu Yusuf, Sylvia Mutua, Valentine Budambula","doi":"10.1155/2024/5653709","DOIUrl":"https://doi.org/10.1155/2024/5653709","url":null,"abstract":"<p><strong>Background: </strong>Despite the well-known adverse health effects of tobacco, shisha use among students in tertiary institutions remains a public health concern. In Kenya, the literature on status of shisha after the 2017 ban is scanty. This study sought to ascertain actual shisha use among university students along the coastal strip.</p><p><strong>Methods: </strong>We investigated confirmed and self-reported shisha use. Using proportionate-to-size and snowball sampling methods, 380 respondents were enrolled from three universities. Sociodemographic characteristics and self-reported history of shisha use were documented using a participant-assisted questionnaire. Actual shisha use was determined qualitatively using 6 panel plus alcohol saliva test kit that detected cotinine use among other selected drugs.</p><p><strong>Results: </strong>Of the 380 participants, 278 (73%) were males and their median (IQR) age was 22 (20-23) years. This study reports 29% current use based on testing positive for cotinine. Among those who reported current ever use of shisha, 19% tested positive for cotinine, respectively. In the multivariable analysis, being separated (adjusted risk ratio (aRR): 2.06 (95% CI: 1.45-2.94)) compared to being single and studying for a degree compared to a diploma (aRR: 1.32 (95% CI: 1.10-1.58)) were associated with cotinine positive. The 4<sup>th</sup> year of study (aRR: 1.68 (95% CI: 1.22-2.33)) compared to the 1<sup>st</sup> year and reported knowledge of shisha (aRR: 1.84 (95% CI: 1.18-2.87)) were associated with cotinine positive.</p><p><strong>Conclusion: </strong>Nearly one-third of university students along the Kenyan coast are active shisha users. Saliva testing for cotinine is a more reliable method of reporting tobacco use. We recommend upscaling of health education, re-enforcement of the current ban on shisha consumption by concerned authorities, and saliva testing for cotinine while assessing current tobacco use.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"5653709"},"PeriodicalIF":1.1,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11357821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-20eCollection Date: 2024-01-01DOI: 10.1155/2024/6103589
Raymundo Ordoñez-Sierra, Gabriela Domínguez-Cortinas, Iván Yassmany Hernández-Paniagua, José Luis Expósito-Castillo, Miguel A Gómez-Albores, María Guadalupe Rodríguez-Reyes, Brisa Violeta Carrasco-Gallegos, Luis Ricardo Manzano-Solís
This research presents a time-series study in one of the most polluted regions in Mexico, the southern part of the Mezquital Valley. Three mortality causes related to areas highly contaminated by industrial activities were considered to carry out this model, namely, ischemic cardiomyopathy, mesothelioma, and pneumoconiosis. The pollutant exposure factors used in the maximum entropy modeling were distance to rivers, distance to industries, particulate matter less than 2.5 microns (PM < 2.5 µm), and the digital elevation model (DEM). A model that expresses the presence of the disease by areas of exposure to pollutants was also obtained. In addition, the odds ratio was calculated to evaluate the level of association of ischemic cardiomyopathy (OR = 3.37 and 95% CI: 3.05-3.6) and mesothelioma (OR = 4.79 and 95% CI: 3.5-6.08) by areas of exposure. In the case of pneumoconiosis, only cases in the very high exposure category were recorded, so it was not comparable with the remaining areas. It is important to mention that particulate matter in the municipalities of the Mezquital Valley presented values above 20 μg/m3 and that in accordance with the provisions of the Norma Oficial Mexicana de Salud Ambiental or NOM (translated as Mexican Official Standard for Environmental Health) and the Agency for Toxic Substances and the Disease Registry (ATSDR), high concentrations of particulate matter can have a severe impact on the development of some diseases. In the studied area, ischemic cardiomyopathy and mesothelioma were attributed to pollution in 70.3% and 79.1%, respectively; therefore, pollution mitigation could prevent the occurrence of these two diseases.
{"title":"Regionalization of the Mortality Risk from Cardiomyopathy and Respiratory Diseases Based on the Maximum Entropy Model.","authors":"Raymundo Ordoñez-Sierra, Gabriela Domínguez-Cortinas, Iván Yassmany Hernández-Paniagua, José Luis Expósito-Castillo, Miguel A Gómez-Albores, María Guadalupe Rodríguez-Reyes, Brisa Violeta Carrasco-Gallegos, Luis Ricardo Manzano-Solís","doi":"10.1155/2024/6103589","DOIUrl":"10.1155/2024/6103589","url":null,"abstract":"<p><p>This research presents a time-series study in one of the most polluted regions in Mexico, the southern part of the Mezquital Valley. Three mortality causes related to areas highly contaminated by industrial activities were considered to carry out this model, namely, ischemic cardiomyopathy, mesothelioma, and pneumoconiosis. The pollutant exposure factors used in the maximum entropy modeling were distance to rivers, distance to industries, particulate matter less than 2.5 microns (PM < 2.5 <i>µ</i>m), and the digital elevation model (DEM). A model that expresses the presence of the disease by areas of exposure to pollutants was also obtained. In addition, the odds ratio was calculated to evaluate the level of association of ischemic cardiomyopathy (OR = 3.37 and 95% CI: 3.05-3.6) and mesothelioma (OR = 4.79 and 95% CI: 3.5-6.08) by areas of exposure. In the case of pneumoconiosis, only cases in the very high exposure category were recorded, so it was not comparable with the remaining areas. It is important to mention that particulate matter in the municipalities of the Mezquital Valley presented values above 20 <i>μ</i>g/m<sup>3</sup> and that in accordance with the provisions of the Norma Oficial Mexicana de Salud Ambiental or NOM (translated as Mexican Official Standard for Environmental Health) and the Agency for Toxic Substances and the Disease Registry (ATSDR), high concentrations of particulate matter can have a severe impact on the development of some diseases. In the studied area, ischemic cardiomyopathy and mesothelioma were attributed to pollution in 70.3% and 79.1%, respectively; therefore, pollution mitigation could prevent the occurrence of these two diseases.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"6103589"},"PeriodicalIF":1.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05eCollection Date: 2024-01-01DOI: 10.1155/2024/8862660
Richard Okyere Boadu, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Godwin Adzakpah, Fortune Afaglo, Rosemary Bermaa Abrefa, Emmanuella Aryee, Nancy Gyamena Botwe, Dinah Baiden-Amissah, Dennis Bless Ashiavor, Larry Lee Mensah, Lovemond Kojo Asamoah, Judith Obiri-Yeboah
<p><strong>Background: </strong>The impact of contracting coronavirus on healthcare providers (HCPs) affects their ability to combat the infection. The virus can be transmitted through droplets from sneezing, coughing, and yelling, making it essential for HCPs to plan ahead when dealing with patients with respiratory symptoms. The need to assess healthcare providers' perceived adherence to COVID-19 Prevention and Control Practices (PCP) in Health Records and Information Management is vital for optimizing healthcare operations and ensuring the safety of both patients and providers. This study assesses healthcare providers' perceived adherence to COVID-19 PCP in Health Records and Information Management. <i>Subjects and Method</i>. A cross-sectional survey was conducted to collect data from 1268 HCPs working in eight randomly selected hospitals across five regions in Ghana. The survey was carried out from May 15, 2022, to August 13, 2022. Simple random sampling was used to choose these eight facilities from a total of 204 hospitals. Within each facility, HCPs from various departments were selected using simple random sampling. The EpiInfo 7 software's StatCalc tool was used to choose a total sample size of 1268 from an estimated 4482 HCP-PR from the eight hospitals. Compliance with COVID-19 PCP was assessed using a 3-point scale, ranging from one (Yes always) to three (No). Cronbach's alpha reliability coefficient was used to examine the statistical reliability of the variables in the dataset. Cronbach's alpha was 0.73 overall, suggesting strong reliability. Bartlett's test for equal variances was used for comparative analysis of health facility and overall mean COVID-19 PCP in different areas of health facilities. IBM SPSS (version 23) statistical software was used for the data analysis process.</p><p><strong>Results: </strong>A total of 1268 HCP-PR participated in the survey, resulting in a 99.6% response rate. Findings reveal that 760 healthcare professionals who handle patients' records (HCP-PR), constituting 60%, consistently followed COVID-19 protocols in the registration and clinic preparation zones. Another 390 individuals (30.7%) adhered to these protocols occasionally, while 119 (9.4%) failed to comply. Similarly, in the filing area, 739 respondents (58.3%) consistently adhered to COVID-19 protocols, 358 (28.3%) occasionally did so, and 170 (13.4%) did not follow the protocols at all. Regarding handling health records cautiously, 540 participants (42.5%) always did, 448 (35.3%) did so sometimes, and 280 (22.2%) neglected these precautions. Additionally, 520 respondents (41.0%) consistently followed COVID-19 precautions when handling computers and other equipment, 393 (31.0%) did so occasionally, and 355 (28.0%) did not adhere to these precautions.</p><p><strong>Conclusion: </strong>The majority of respondents showed good compliance with COVID-19 protocol in the registration and clinic preparation areas. However, in the filing area, just o
{"title":"Healthcare Providers' Adherence to COVID-19 Prevention and Control Practices in Health Records and Information Management, Ghana.","authors":"Richard Okyere Boadu, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Godwin Adzakpah, Fortune Afaglo, Rosemary Bermaa Abrefa, Emmanuella Aryee, Nancy Gyamena Botwe, Dinah Baiden-Amissah, Dennis Bless Ashiavor, Larry Lee Mensah, Lovemond Kojo Asamoah, Judith Obiri-Yeboah","doi":"10.1155/2024/8862660","DOIUrl":"10.1155/2024/8862660","url":null,"abstract":"<p><strong>Background: </strong>The impact of contracting coronavirus on healthcare providers (HCPs) affects their ability to combat the infection. The virus can be transmitted through droplets from sneezing, coughing, and yelling, making it essential for HCPs to plan ahead when dealing with patients with respiratory symptoms. The need to assess healthcare providers' perceived adherence to COVID-19 Prevention and Control Practices (PCP) in Health Records and Information Management is vital for optimizing healthcare operations and ensuring the safety of both patients and providers. This study assesses healthcare providers' perceived adherence to COVID-19 PCP in Health Records and Information Management. <i>Subjects and Method</i>. A cross-sectional survey was conducted to collect data from 1268 HCPs working in eight randomly selected hospitals across five regions in Ghana. The survey was carried out from May 15, 2022, to August 13, 2022. Simple random sampling was used to choose these eight facilities from a total of 204 hospitals. Within each facility, HCPs from various departments were selected using simple random sampling. The EpiInfo 7 software's StatCalc tool was used to choose a total sample size of 1268 from an estimated 4482 HCP-PR from the eight hospitals. Compliance with COVID-19 PCP was assessed using a 3-point scale, ranging from one (Yes always) to three (No). Cronbach's alpha reliability coefficient was used to examine the statistical reliability of the variables in the dataset. Cronbach's alpha was 0.73 overall, suggesting strong reliability. Bartlett's test for equal variances was used for comparative analysis of health facility and overall mean COVID-19 PCP in different areas of health facilities. IBM SPSS (version 23) statistical software was used for the data analysis process.</p><p><strong>Results: </strong>A total of 1268 HCP-PR participated in the survey, resulting in a 99.6% response rate. Findings reveal that 760 healthcare professionals who handle patients' records (HCP-PR), constituting 60%, consistently followed COVID-19 protocols in the registration and clinic preparation zones. Another 390 individuals (30.7%) adhered to these protocols occasionally, while 119 (9.4%) failed to comply. Similarly, in the filing area, 739 respondents (58.3%) consistently adhered to COVID-19 protocols, 358 (28.3%) occasionally did so, and 170 (13.4%) did not follow the protocols at all. Regarding handling health records cautiously, 540 participants (42.5%) always did, 448 (35.3%) did so sometimes, and 280 (22.2%) neglected these precautions. Additionally, 520 respondents (41.0%) consistently followed COVID-19 precautions when handling computers and other equipment, 393 (31.0%) did so occasionally, and 355 (28.0%) did not adhere to these precautions.</p><p><strong>Conclusion: </strong>The majority of respondents showed good compliance with COVID-19 protocol in the registration and clinic preparation areas. However, in the filing area, just o","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"8862660"},"PeriodicalIF":1.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11245336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study utilized integrative bioinformatics' tools together with phenotypic assays to understand the whole-genome features of a carbapenem-resistant international clone II Acinetobacter baumannii AB073. Overall, we found the isolate to be resistant to seven antibiotic classes, penicillins, β-lactam/β-lactamase inhibitor combinations, cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and folate pathway antagonists. These resistance phenotypes are related to various chromosomal-located antibiotic resistance determinants involved in different mechanisms such as reduced permeability, antibiotic target protection, antibiotic target alteration, antibiotic inactivation, and antibiotic efflux. IC2 A. baumannii AB073 could not transfer antibiotic resistance by conjugation experiments. Likewise, mobilome analysis found that AB073 did not carry genetic determinants involving horizontal gene transfer. Moreover, this isolate also carried multiple genes associated with the ability of iron uptake, biofilm formation, immune invasion, virulence regulations, and serum resistance. In addition, the genomic epidemiological study showed that AB073-like strains were successful pathogens widespread in various geographic locations and clinical sources. In conclusion, the comprehensive analysis demonstrated that AB073 contained multiple genomic determinants which were important characteristics to classify this isolate as a successful international clone II obtained from Thailand.
本研究利用综合生物信息学工具和表型测定法来了解耐碳青霉烯类的国际克隆 II 鲍曼不动杆菌 AB073 的全基因组特征。总体而言,我们发现该分离株对七类抗生素具有耐药性,包括青霉素类、β-内酰胺/β-内酰胺酶抑制剂组合、头孢菌素类、碳青霉烯类、氨基糖苷类、氟喹诺酮类和叶酸途径拮抗剂。这些耐药性表型与位于染色体上的各种抗生素耐药性决定因子有关,它们参与了不同的机制,如渗透性降低、抗生素靶点保护、抗生素靶点改变、抗生素失活和抗生素外流。IC2 鲍曼尼杆菌 AB073 无法通过共轭实验转移抗生素耐药性。同样,mobilome 分析发现 AB073 也没有携带涉及水平基因转移的遗传决定因子。此外,该分离株还携带与铁吸收能力、生物膜形成、免疫侵袭、毒力调节和血清抗性相关的多个基因。此外,基因组流行病学研究表明,AB073 样株是成功的病原体,广泛存在于不同的地理位置和临床来源。总之,综合分析表明 AB073 包含多种基因组决定因素,这些因素是将该分离株归类为从泰国获得的成功国际克隆 II 的重要特征。
{"title":"Genomic Landscape Reveals Chromosomally-Mediated Antimicrobial Resistome and Virulome of a High-Risk International Clone II <i>Acinetobacter baumannii</i> AB073 from Thailand.","authors":"Rattiya Cheewapat, Jadsadaporn Redkimned, Sirikran Lekuthai, Thawatchai Kitti, Kannipa Tasanapak, Aunchalee Thanwisai, Sutthirat Sitthisak, Thanet Sornda, Hathaichanok Impheng, Sudarat Onsurathum, Udomluk Leungtongkam, Supaporn Lamlertthon, Siriwat Kucharoenphaibul, Jintana Wongwigkarn, Pantira Singkum, Pattrarat Chanchaithong, Rapee Thummeepak","doi":"10.1155/2024/8872463","DOIUrl":"10.1155/2024/8872463","url":null,"abstract":"<p><p>This study utilized integrative bioinformatics' tools together with phenotypic assays to understand the whole-genome features of a carbapenem-resistant international clone II <i>Acinetobacter baumannii</i> AB073. Overall, we found the isolate to be resistant to seven antibiotic classes, penicillins, <i>β</i>-lactam/<i>β</i>-lactamase inhibitor combinations, cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and folate pathway antagonists. These resistance phenotypes are related to various chromosomal-located antibiotic resistance determinants involved in different mechanisms such as reduced permeability, antibiotic target protection, antibiotic target alteration, antibiotic inactivation, and antibiotic efflux. IC2 <i>A. baumannii</i> AB073 could not transfer antibiotic resistance by conjugation experiments. Likewise, mobilome analysis found that AB073 did not carry genetic determinants involving horizontal gene transfer. Moreover, this isolate also carried multiple genes associated with the ability of iron uptake, biofilm formation, immune invasion, virulence regulations, and serum resistance. In addition, the genomic epidemiological study showed that AB073-like strains were successful pathogens widespread in various geographic locations and clinical sources. In conclusion, the comprehensive analysis demonstrated that AB073 contained multiple genomic determinants which were important characteristics to classify this isolate as a successful international clone II obtained from Thailand.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"8872463"},"PeriodicalIF":1.1,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11074871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-18eCollection Date: 2024-01-01DOI: 10.1155/2024/9570798
Soukaina Kannane, Samia Boussaa, Jamila El Mendili, Oulaid Touloun
Background: Congenital malformations (CMs) are a group of structural or functional anomalies present at birth. These anomalies result in a high rate of mortality, morbidity, and disability in children. CMs are a major public health problem and place a heavy burden on healthcare systems in both developed and developing countries including Morocco, which has had a CMs surveillance system in place since 2011. The aim of this study is to determine the prevalence of CMs in Morocco.
Methods: In this study, the epidemiology of CMs in Morocco was assessed retrospectively using the national surveillance system data gathered from case notification forms from 2017 to 2021.
Results: The main results showed that the prevalence of CMs in Morocco is 3.91/1000 live births (LBs), and the minimum annual prevalence of CMs was reached in 2017 (3.10/1000 LBs) while the maximum annual prevalence was recorded in 2018 (4.55/1000 LBs). The majority of CMs are unspecified CMs (68.55%), neural tube defects (NTDs) account for (21.13%), and orofacial clefts (OFCs) account for (10.32%). In addition, the majority of CMs (61.73%) were from rural areas. According to region, the Dakhla-Oued Eddahab region recorded the highest prevalence of CMs in Morocco, with 8.81/1000 LBs, while the lowest prevalence was recorded in the Rabat-Sale-Kenitra region, with 2.02/1000 LB.
Conclusions: This study reveals that the national prevalence of CMs is high and may be underestimated, as most of the CMS reported is unspecified. The use of a CM registry with detailed reporting of all CMs and the promotion of preventive measures are urgently recommended.
{"title":"Congenital Malformations in the Moroccan Surveillance System: Contribution to Prevalence Estimation.","authors":"Soukaina Kannane, Samia Boussaa, Jamila El Mendili, Oulaid Touloun","doi":"10.1155/2024/9570798","DOIUrl":"10.1155/2024/9570798","url":null,"abstract":"<p><strong>Background: </strong>Congenital malformations (CMs) are a group of structural or functional anomalies present at birth. These anomalies result in a high rate of mortality, morbidity, and disability in children. CMs are a major public health problem and place a heavy burden on healthcare systems in both developed and developing countries including Morocco, which has had a CMs surveillance system in place since 2011. The aim of this study is to determine the prevalence of CMs in Morocco.</p><p><strong>Methods: </strong>In this study, the epidemiology of CMs in Morocco was assessed retrospectively using the national surveillance system data gathered from case notification forms from 2017 to 2021.</p><p><strong>Results: </strong>The main results showed that the prevalence of CMs in Morocco is 3.91/1000 live births (LBs), and the minimum annual prevalence of CMs was reached in 2017 (3.10/1000 LBs) while the maximum annual prevalence was recorded in 2018 (4.55/1000 LBs). The majority of CMs are unspecified CMs (68.55%), neural tube defects (NTDs) account for (21.13%), and orofacial clefts (OFCs) account for (10.32%). In addition, the majority of CMs (61.73%) were from rural areas. According to region, the Dakhla-Oued Eddahab region recorded the highest prevalence of CMs in Morocco, with 8.81/1000 LBs, while the lowest prevalence was recorded in the Rabat-Sale-Kenitra region, with 2.02/1000 LB.</p><p><strong>Conclusions: </strong>This study reveals that the national prevalence of CMs is high and may be underestimated, as most of the CMS reported is unspecified. The use of a CM registry with detailed reporting of all CMs and the promotion of preventive measures are urgently recommended.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"9570798"},"PeriodicalIF":1.1,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10963113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-19eCollection Date: 2024-01-01DOI: 10.1155/2024/9293896
Sebastián Jaurretche, Santiago Alonso, Mónica Calvo, Sebastián Fernandez, Heber Figueredo, Beatriz Galli, Ivanna Marin, Andrés Martinez, Silvia Mattausch, Fernando Perretta, Juan Politei, Juan Ignacio Rolon, Esteban Calabrese
Fabry disease (FD) is a multisystem lysosomal storage disorder induced by genetic variants in the alpha-galactosidase A (αGalA) gene. Some FD patients have GLA variants with a reduction in overall αGalA enzymatic activity due to mutated proteins with reduced stability, caused by protein misfolding and premature degradation, but the αGalA catalytic activity remains conserved ("amenable" genetic variants). To correct this misfolding and to prevent premature degradation, migalastat, a small iminosugar molecule was developed. We report the clinical characteristics of FD "amenable" cohort patients from Argentina, prior to starting treatment with migalastat. Seventeen Fabry adult patients were recruited from 13 Argentinian Centers; 8 males (47.1%) and 9 females (52.9%) were included. All genotypes included were missense-type "amenables" mutations. Some classic FD typical early manifestations were more frequent in patients with "classic" versus "late-onset" FD phenotype (pain, p=0.002; cornea verticillata, p=0.019). There was a statistically significant difference in estimated glomerular filtration rate in the "classic" versus "late-onset" phenotype (p=0.026) but no difference between genders (p=0.695). Left ventricular mass was similar between genders (p=0.145) and phenotypes (p=0.303). Cardiovascular risk factors were present among "late-onset" females (obesity 50% and smoke 25%). In patients who started "de novo" migalastat, the main indications were (i) heart disease, (ii) kidney damage, and (iii) pain, while in "switched from prior enzyme replacement therapy" patients, the most frequent indication was "patient decision;" this coincides with publications by other authors.
{"title":"Baseline Characteristics of Fabry Disease \"Amenable\" Migalastat Patients in Argentinian Cohort.","authors":"Sebastián Jaurretche, Santiago Alonso, Mónica Calvo, Sebastián Fernandez, Heber Figueredo, Beatriz Galli, Ivanna Marin, Andrés Martinez, Silvia Mattausch, Fernando Perretta, Juan Politei, Juan Ignacio Rolon, Esteban Calabrese","doi":"10.1155/2024/9293896","DOIUrl":"10.1155/2024/9293896","url":null,"abstract":"<p><p>Fabry disease (FD) is a multisystem lysosomal storage disorder induced by genetic variants in the alpha-galactosidase A (<i>α</i>GalA) gene. Some FD patients have GLA variants with a reduction in overall <i>α</i>GalA enzymatic activity due to mutated proteins with reduced stability, caused by protein misfolding and premature degradation, but the <i>α</i>GalA catalytic activity remains conserved (\"amenable\" genetic variants). To correct this misfolding and to prevent premature degradation, migalastat, a small iminosugar molecule was developed. We report the clinical characteristics of FD \"amenable\" cohort patients from Argentina, prior to starting treatment with migalastat. Seventeen Fabry adult patients were recruited from 13 Argentinian Centers; 8 males (47.1%) and 9 females (52.9%) were included. All genotypes included were missense-type \"amenables\" mutations. Some classic FD typical early manifestations were more frequent in patients with \"classic\" versus \"late-onset\" FD phenotype (pain, <i>p</i>=0.002; cornea verticillata, <i>p</i>=0.019). There was a statistically significant difference in estimated glomerular filtration rate in the \"classic\" versus \"late-onset\" phenotype (<i>p</i>=0.026) but no difference between genders (<i>p</i>=0.695). Left ventricular mass was similar between genders (<i>p</i>=0.145) and phenotypes (<i>p</i>=0.303). Cardiovascular risk factors were present among \"late-onset\" females (obesity 50% and smoke 25%). In patients who started \"de novo\" migalastat, the main indications were (i) heart disease, (ii) kidney damage, and (iii) pain, while in \"switched from prior enzyme replacement therapy\" patients, the most frequent indication was \"patient decision;\" this coincides with publications by other authors.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"9293896"},"PeriodicalIF":1.1,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-06eCollection Date: 2024-01-01DOI: 10.1155/2024/3623555
Myriam Abboud, Cyrille Nacouzi, Zeina Chahine, Angelica Atallah, Mira Hleyhel
Little is known about the dietary knowledge (DK) and eating habits (EHs) of patients with type 2 diabetes (T2D) in Lebanon. Therefore, the aim of this study was to assess the DK and EH of the population with T2D and determine their associated factors. A cross-sectional survey enrolling 351 patients with T2D was carried out, using the snowball sampling technique. The survey used the UK Diabetes and Diet Questionnaire and the Dietary Knowledge questionnaire to assess participants' EH including the frequency of consumption of certain foods and their knowledge of food groups and food choices. While a higher DK index indicated better knowledge, a higher EH index indicated less healthy EH. Independent sample T-test and Mann-Whitney test were used for dichotomous variables, and ANOVA and Kruskal-Wallis tests were used for polytomous variables. Correlation analysis tested the association between two continuous variables. Two multiple linear regression models were used to identify factors associated with DK and EH. Overall, 67% of participants had good or adequate DK, and around 25% and 75% of them had healthy and less healthy EH, respectively. Better knowledge was significantly related to occupation, BMI, presence of comorbidities, and HbA1c testing during the last 3 months. Higher family income, physical activity, family history of diabetes, receiving help in medication administration from family or friends, and higher DK level were factors associated with healthier EH. Nutrition education and awareness campaigns aimed at patients and their families are needed to empower patients with adequate DK and skills to facilitate the adoption of healthy EH.
{"title":"Dietary Knowledge and Eating Habits among Patients with Type 2 Diabetes in Lebanon.","authors":"Myriam Abboud, Cyrille Nacouzi, Zeina Chahine, Angelica Atallah, Mira Hleyhel","doi":"10.1155/2024/3623555","DOIUrl":"10.1155/2024/3623555","url":null,"abstract":"<p><p>Little is known about the dietary knowledge (DK) and eating habits (EHs) of patients with type 2 diabetes (T2D) in Lebanon. Therefore, the aim of this study was to assess the DK and EH of the population with T2D and determine their associated factors. A cross-sectional survey enrolling 351 patients with T2D was carried out, using the snowball sampling technique. The survey used the UK Diabetes and Diet Questionnaire and the Dietary Knowledge questionnaire to assess participants' EH including the frequency of consumption of certain foods and their knowledge of food groups and food choices. While a higher DK index indicated better knowledge, a higher EH index indicated less healthy EH. Independent sample <i>T</i>-test and Mann-Whitney test were used for dichotomous variables, and ANOVA and Kruskal-Wallis tests were used for polytomous variables. Correlation analysis tested the association between two continuous variables. Two multiple linear regression models were used to identify factors associated with DK and EH. Overall, 67% of participants had good or adequate DK, and around 25% and 75% of them had healthy and less healthy EH, respectively. Better knowledge was significantly related to occupation, BMI, presence of comorbidities, and HbA1c testing during the last 3 months. Higher family income, physical activity, family history of diabetes, receiving help in medication administration from family or friends, and higher DK level were factors associated with healthier EH. Nutrition education and awareness campaigns aimed at patients and their families are needed to empower patients with adequate DK and skills to facilitate the adoption of healthy EH.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2024 ","pages":"3623555"},"PeriodicalIF":1.1,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-29eCollection Date: 2023-01-01DOI: 10.1155/2023/2957278
Deekshanta Sitaula, Aarati Dhakal, Nimesh Lageju, Amisha Silwal, Samjhana Kshetri Basnet, Niki Shrestha, B C Anup Bikram, Niraj Phoju
Background: Overweight and obesity are major risk factors for chronic diseases and are the leading cause of mortality worldwide. Obesity during adolescence is strongly associated with adulthood obesity leading to increased morbidities and mortality. As a developing country undergoing rapid urbanization, Nepal is in a transitional phase where undernutrition coexists with obesity; however, there is a dearth of literature on the status of adolescent obesity in the rural section of Nepal. The aim of this study was to determine the prevalence of adolescent obesity in a rural district of Nepal and find out its associated factors.
Methods: An institution-based cross-sectional study was conducted among the adolescent students studying in classes 8, 9, and 10 in four secondary schools of Gosaikunda rural municipality of Rasuwa district, Nepal. Total enumerative sampling was used, and Global School-based Health Survey (GSHS) standard questionnaires were used in collecting the information. Height and weight measurements were taken, and the body mass index was classified according to Asia-Pacific criteria. The collected data were analyzed using "SPSS" version 22. Logistic regression analysis was used to evaluate the associated factors, and a p value of ≤0.05 was considered statistically significant.
Results: Out of 267 adolescents, 14.6% were obese and 14.6% were overweight. Of the female participants, 39.6% were either obese or overweight, while 12.6% of the male adolescents were overweight/obese. Among the total participants, 16.5% were underweight, including 14.0% females and 20.4% males. Female adolescents were about five times (AOR: 5.2, 95% CI (2.5-10.9), p < 0.01) more likely of being overweight/obese than male adolescents.
Conclusions: More than one-quarter of the adolescents were found to be obese/overweight, and the prevalence was significantly more among female adolescents. It emphasizes the necessity of school-based programs promoting a healthy lifestyle among students to maintain healthy weight status.
{"title":"Prevalence and Associated Factors of Adolescent Obesity among Rural School Adolescents in Nepal: A Cross-Sectional Study.","authors":"Deekshanta Sitaula, Aarati Dhakal, Nimesh Lageju, Amisha Silwal, Samjhana Kshetri Basnet, Niki Shrestha, B C Anup Bikram, Niraj Phoju","doi":"10.1155/2023/2957278","DOIUrl":"10.1155/2023/2957278","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity are major risk factors for chronic diseases and are the leading cause of mortality worldwide. Obesity during adolescence is strongly associated with adulthood obesity leading to increased morbidities and mortality. As a developing country undergoing rapid urbanization, Nepal is in a transitional phase where undernutrition coexists with obesity; however, there is a dearth of literature on the status of adolescent obesity in the rural section of Nepal. The aim of this study was to determine the prevalence of adolescent obesity in a rural district of Nepal and find out its associated factors.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted among the adolescent students studying in classes 8, 9, and 10 in four secondary schools of Gosaikunda rural municipality of Rasuwa district, Nepal. Total enumerative sampling was used, and Global School-based Health Survey (GSHS) standard questionnaires were used in collecting the information. Height and weight measurements were taken, and the body mass index was classified according to Asia-Pacific criteria. The collected data were analyzed using \"SPSS\" version 22. Logistic regression analysis was used to evaluate the associated factors, and a <i>p</i> value of ≤0.05 was considered statistically significant.</p><p><strong>Results: </strong>Out of 267 adolescents, 14.6% were obese and 14.6% were overweight. Of the female participants, 39.6% were either obese or overweight, while 12.6% of the male adolescents were overweight/obese. Among the total participants, 16.5% were underweight, including 14.0% females and 20.4% males. Female adolescents were about five times (AOR: 5.2, 95% CI (2.5-10.9), <i>p</i> < 0.01) more likely of being overweight/obese than male adolescents.</p><p><strong>Conclusions: </strong>More than one-quarter of the adolescents were found to be obese/overweight, and the prevalence was significantly more among female adolescents. It emphasizes the necessity of school-based programs promoting a healthy lifestyle among students to maintain healthy weight status.</p>","PeriodicalId":44052,"journal":{"name":"Global Health Epidemiology and Genomics","volume":"2023 ","pages":"2957278"},"PeriodicalIF":1.9,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10558264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}