Pub Date : 2024-08-26DOI: 10.1101/2024.08.26.24312597
Léo Moutet, Paquito Bernard, Rosemary Green, James Milner, Andy Haines, Rémy Slama, Laura TEMIME, Kévin Jean
Moving toward carbon-neutral societies is projected to provide health co-benefits, yet their magnitude is not well-documented and may be context-specific. Synthesizing the evidence on these co-benefits could enhance the engagement of decision-makers and populations. We performed a systematic review including 55 quantitative studies exploring 121 scenarios. Across air quality, physical activity and dietary changes pathways, substantial health co-benefits were found, with half of scenarios showing a mortality reduction by more than 1.5%, in addition to benefits directly related to climate stabilization. However, these co-benefits varied with explored emission sectors, decarbonization levers, modelling approaches and locations. Among studies including a cost-benefit analysis, 11 out of 13 estimated that monetized benefits outweighed the costs of implementing climate policies. This review highlights the need for a standardised framework to assess and compare health impacts of climate mitigation actions across sectors, and confirms that achieving net-zero goals represent far-reaching public health policies.
{"title":"The public health co-benefits of strategies consistent with net-zero emissions: a systematic review of quantitative studies","authors":"Léo Moutet, Paquito Bernard, Rosemary Green, James Milner, Andy Haines, Rémy Slama, Laura TEMIME, Kévin Jean","doi":"10.1101/2024.08.26.24312597","DOIUrl":"https://doi.org/10.1101/2024.08.26.24312597","url":null,"abstract":"Moving toward carbon-neutral societies is projected to provide health co-benefits, yet their magnitude is not well-documented and may be context-specific. Synthesizing the evidence on these co-benefits could enhance the engagement of decision-makers and populations. We performed a systematic review including 55 quantitative studies exploring 121 scenarios. Across air quality, physical activity and dietary changes pathways, substantial health co-benefits were found, with half of scenarios showing a mortality reduction by more than 1.5%, in addition to benefits directly related to climate stabilization. However, these co-benefits varied with explored emission sectors, decarbonization levers, modelling approaches and locations. Among studies including a cost-benefit analysis, 11 out of 13 estimated that monetized benefits outweighed the costs of implementing climate policies. This review highlights the need for a standardised framework to assess and compare health impacts of climate mitigation actions across sectors, and confirms that achieving net-zero goals represent far-reaching public health policies.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193527","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}
Pub Date : 2024-08-26DOI: 10.1101/2024.08.26.24312577
Kathrin Maria Bogensberger, Dagmar Schaffler-Schaden, Eva Perl, Markus Ritter, Wolfgang Hitzl, Bibiane Steinecker-Frohnwieser, Antje van der Zee-Neuen
Introduction: Globally, osteoarthritis (OA) is the most prevalent musculoskeletal disease, affecting approximately 600 million people. It is characterised by progressive degeneration of the articular cartilage, osteophyte formation, and asymmetric joint space narrowing, leading to pain, stiffness, and functional impairment. The current focus of disease management is on symptom relief and functional improvement. However, these interventions frequently do not provide adequate outcomes. This may be attributed to a lack of consideration for contextual factors, including the presence of comorbidities such as depression. Several studies indicate that depression is highly prevalent, affecting up to 20% of OA patients. As depression is known to be a multifactorial disorder, there are various risk factors that may increase the likelihood of comorbid depression in patients with OA. Consequently, the scoping review`s objective is to map the existing literature on risk factors for comorbid depression in individuals with OA. Furthermore, the review is expected to provide important information for further in-depth investigation and the development of predictive tools to support the early identification of patients with OA at risk of comorbid depression. Methods and Analysis: The intended review will target studies reporting risk factors for comorbid depression in individuals with OA. All available primary and grey literature will be considered for inclusion. Only articles published in English or German will be included in the review. The review will follow the format specified by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the JBI Manual for Evidence Synthesis. Original research in published and unpublished literature from inception until August 2024 will be included into the review. The databases to be searched will include PubMed, EMBASE, PsychInfo, and Web of Science. In addition, further literature will be identified by searching the reference lists of the included studies. Three reviewers will independently screen the identified studies for final inclusion. The data will be extracted and presented in tabular form and in a narrative summary that aligns with the review`s objective. Furthermore, a quality assessment of the included studies will be conducted using appropriate tools, and the results will be incorporated into the synthesis. Any disagreements that arise between the reviewers will be resolved through discussion or with an additional reviewer. Ethics and Dissemination: Ethics committee approval will not be required because only published and publicly available data will be examined to answer the research question of the scoping review. We will not collect any personal information or any information that requires ethical approval. Keywords: osteoarthritis, depression, risk factors, epidemiology, comorbidity
导言：在全球范围内，骨关节炎（OA）是最普遍的肌肉骨骼疾病，影响着大约 6 亿人。其特点是关节软骨逐渐退化、骨质增生形成和不对称的关节间隙变窄，从而导致疼痛、僵硬和功能障碍。目前，疾病管理的重点是缓解症状和改善功能。然而，这些干预措施往往无法提供足够的疗效。这可能是由于缺乏对背景因素的考虑，包括抑郁症等合并症的存在。多项研究表明，抑郁症的发病率很高，高达 20% 的 OA 患者会受到抑郁症的影响。众所周知，抑郁症是一种多因素疾病，因此有各种风险因素可能会增加 OA 患者合并抑郁症的可能性。因此，此次范围界定综述的目的是对现有文献进行梳理，了解 OA 患者合并抑郁症的风险因素。此外，该综述有望为进一步深入调查和开发预测工具提供重要信息，以支持早期识别有合并抑郁症风险的 OA 患者。方法与分析：本综述将以报告 OA 患者合并抑郁症风险因素的研究为目标。所有可用的原始文献和灰色文献都将被纳入考虑范围。综述将只纳入以英语或德语发表的文章。综述将遵循《系统综述和荟萃分析扩展范围综述的首选报告项目》（PRISMA-ScR）和《JBI 证据综合手册》规定的格式。从开始到 2024 年 8 月的已发表和未发表文献中的原创研究将纳入综述。将检索的数据库包括 PubMed、EMBASE、PsychInfo 和 Web of Science。此外，还将通过检索所纳入研究的参考文献目录来确定更多文献。三位审稿人将独立筛选所确定的研究，以便最终纳入。数据将被提取出来，并以表格和符合综述目标的叙述性摘要的形式呈现。此外，还将使用适当的工具对纳入的研究进行质量评估，并将评估结果纳入综述。审稿人之间出现的任何分歧都将通过讨论或与其他审稿人共同解决。伦理与传播：我们无需获得伦理委员会的批准，因为我们将只审查已公布和公开的数据，以回答范围界定审查的研究问题。我们不会收集任何个人信息或任何需要伦理批准的信息。关键词：骨关节炎、抑郁症、风险因素、流行病学、合并症
{"title":"Exploring Risk Factors for Comorbid Depression in Osteoarthritis: A Scoping Review Protocol","authors":"Kathrin Maria Bogensberger, Dagmar Schaffler-Schaden, Eva Perl, Markus Ritter, Wolfgang Hitzl, Bibiane Steinecker-Frohnwieser, Antje van der Zee-Neuen","doi":"10.1101/2024.08.26.24312577","DOIUrl":"https://doi.org/10.1101/2024.08.26.24312577","url":null,"abstract":"Introduction: Globally, osteoarthritis (OA) is the most prevalent musculoskeletal disease, affecting approximately 600 million people. It is characterised by progressive degeneration of the articular cartilage, osteophyte formation, and asymmetric joint space narrowing, leading to pain, stiffness, and functional impairment. The current focus of disease management is on symptom relief and functional improvement. However, these interventions frequently do not provide adequate outcomes. This may be attributed to a lack of consideration for contextual factors, including the presence of comorbidities such as depression. Several studies indicate that depression is highly prevalent, affecting up to 20% of OA patients. As depression is known to be a multifactorial disorder, there are various risk factors that may increase the likelihood of comorbid depression in patients with OA. Consequently, the scoping review`s objective is to map the existing literature on risk factors for comorbid depression in individuals with OA. Furthermore, the review is expected to provide important information for further in-depth investigation and the development of predictive tools to support the early identification of patients with OA at risk of comorbid depression. Methods and Analysis: The intended review will target studies reporting risk factors for comorbid depression in individuals with OA. All available primary and grey literature will be considered for inclusion. Only articles published in English or German will be included in the review. The review will follow the format specified by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the JBI Manual for Evidence Synthesis. Original research in published and unpublished literature from inception until August 2024 will be included into the review. The databases to be searched will include PubMed, EMBASE, PsychInfo, and Web of Science. In addition, further literature will be identified by searching the reference lists of the included studies. Three reviewers will independently screen the identified studies for final inclusion. The data will be extracted and presented in tabular form and in a narrative summary that aligns with the review`s objective. Furthermore, a quality assessment of the included studies will be conducted using appropriate tools, and the results will be incorporated into the synthesis. Any disagreements that arise between the reviewers will be resolved through discussion or with an additional reviewer. Ethics and Dissemination: Ethics committee approval will not be required because only published and publicly available data will be examined to answer the research question of the scoping review. We will not collect any personal information or any information that requires ethical approval. Keywords: osteoarthritis, depression, risk factors, epidemiology, comorbidity","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224880","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}
Introduction: Access to adequate energy in the home is necessary for a healthy and well life, however current energy use, particularly in high-income countries, is unsustainable. Decarbonisation of home energy can benefit climate mitigation and health but there is the potential to create new, or compound existing, inequalities in health if not implemented equitably. Mapping the theoretical causal pathways between home decarbonisation and health will contribute to further understanding of these mechanisms. Aims: Firstly, to identify theoretical pathways between decarbonisation of home energy and health and health inequalities in high-income countries, and secondly, to synthesise these into a putative causal evidence map. Inclusion criteria: All populations in high-income countries are included, as defined by the World Bank in 2023/24. Included concepts are decarbonisation of home energy, and health and health inequalities. Context for this review comprises of the inclusion of a clear theory linking the concepts. All study designs are included. Methods: This protocol is for a review of theories rather than of intervention effectiveness. Medline/OVID, Scopus, and EconLit will be searched, with no limitation on date. Relevant international policy websites will also be searched. The search is limited to papers in English. Citation tracing may identify further relevant papers. Abstracts and full texts will be screened using Rayyan. At least 10% will be double-screened, and the rest screened by one author, and included full texts will be screened until data saturation is reached. Study inclusion is based on consistency with the inclusion criteria, with some flexibility allowed due to the theoretical nature of this review. Data extracted from papers will be used to develop a diagrammatic map of pathways.
{"title":"Protocol for a scoping review of theorised pathways between home energy decarbonisation and health and health inequalities","authors":"Vicki Ponce Hardy, Amy Stevenson, Gerry McCartney, Alison Heppenstall, Petra Meier","doi":"10.1101/2024.08.23.24312045","DOIUrl":"https://doi.org/10.1101/2024.08.23.24312045","url":null,"abstract":"Introduction: Access to adequate energy in the home is necessary for a healthy and well life, however current energy use, particularly in high-income countries, is unsustainable. Decarbonisation of home energy can benefit climate mitigation and health but there is the potential to create new, or compound existing, inequalities in health if not implemented equitably. Mapping the theoretical causal pathways between home decarbonisation and health will contribute to further understanding of these mechanisms. Aims: Firstly, to identify theoretical pathways between decarbonisation of home energy and health and health inequalities in high-income countries, and secondly, to synthesise these into a putative causal evidence map. Inclusion criteria: All populations in high-income countries are included, as defined by the World Bank in 2023/24. Included concepts are decarbonisation of home energy, and health and health inequalities. Context for this review comprises of the inclusion of a clear theory linking the concepts. All study designs are included. Methods: This protocol is for a review of theories rather than of intervention effectiveness. Medline/OVID, Scopus, and EconLit will be searched, with no limitation on date. Relevant international policy websites will also be searched. The search is limited to papers in English. Citation tracing may identify further relevant papers. Abstracts and full texts will be screened using Rayyan. At least 10% will be double-screened, and the rest screened by one author, and included full texts will be screened until data saturation is reached. Study inclusion is based on consistency with the inclusion criteria, with some flexibility allowed due to the theoretical nature of this review. Data extracted from papers will be used to develop a diagrammatic map of pathways.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193510","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}
The COVID-19 pandemic has drastically altered urban travel patterns, particularly in public transportation systems like subways. This study examines the effects of the pandemic on subway ridership in Beijing by analyzing the influence of 19 factors, including demographics, land use, network metrics, and weather conditions, before and during the pandemic. Data was collected from June 2019 and June 2020, covering 335 subway stations and over 258 million trips. Using a three-stage analytical framework - comprising Light Gradient Boosting Machine (LightGBM) for fitting, Meta-Learners for causal analysis, and SHapley Additive exPlanations (SHAP) for interpretation - we observed a substantial decline in ridership, with approximately 10,000 fewer passengers per station daily, especially in densely populated areas. Our findings reveal significant shifts in influential factors such as centrality, housing prices, and restaurant density. The spatiotemporal analysis highlights the dynamic nature of these changes. This study underscores the need for adaptive urban planning and provides insights for public health strategies to enhance urban resilience in future pandemics.
{"title":"Unraveling the impact of COVID-19 on urban mobility: A Causal Machine Learning Analysis of Beijing's Subway System","authors":"Linmu Zou, Yanhua Chen, Rui Guo, Peicheng Wang, Yanrong He, Shiyu Chen, Zijia Wang, Jiming Zhu","doi":"10.1101/2024.08.22.24312324","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312324","url":null,"abstract":"The COVID-19 pandemic has drastically altered urban travel patterns, particularly in public transportation systems like subways. This study examines the effects of the pandemic on subway ridership in Beijing by analyzing the influence of 19 factors, including demographics, land use, network metrics, and weather conditions, before and during the pandemic. Data was collected from June 2019 and June 2020, covering 335 subway stations and over 258 million trips. Using a three-stage analytical framework - comprising Light Gradient Boosting Machine (LightGBM) for fitting, Meta-Learners for causal analysis, and SHapley Additive exPlanations (SHAP) for interpretation - we observed a substantial decline in ridership, with approximately 10,000 fewer passengers per station daily, especially in densely populated areas. Our findings reveal significant shifts in influential factors such as centrality, housing prices, and restaurant density. The spatiotemporal analysis highlights the dynamic nature of these changes. This study underscores the need for adaptive urban planning and provides insights for public health strategies to enhance urban resilience in future pandemics.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193501","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}
Pub Date : 2024-08-23DOI: 10.1101/2024.08.22.24312444
Caitlin G Niven, Mahfuza Islam, Anna Nguyen, Andrew Mertens, Amy J Pickering, Laura H Kwong, Mahfuja Alam, Debashis Sen, Sharmin Islam, Mahbubur Rahman, Leanne Unicomb, Alan E Hubbard, Stephen P Luby, Jessica A Grembi, John M Colford, Benjamin F Arnold, Jade Benjamin-Chung, Ayse Ercumen
Weather events associated with climate change can influence the environmental spread and survival of fecal pathogens, potentially impacting the efficacy of water, sanitation, and hygiene (WASH) interventions. We used longitudinal data from a randomized controlled trial in Bangladesh to assess whether rainfall and temperature modified the effect of an on-site sanitation intervention on fecal contamination. Over 3.5 years, we enumerated E. coli in household samples along eight fecal-oral pathways (n=23,238 samples) and obtained daily weather data. The intervention included the provision of double-pit latrines, child potties, and scoops for removing child and animal feces, along with behavior change promotion. The intervention was associated with larger reductions in E. coli in/on mother hands, child hands, ponds, and flies (0.10-log to 0.91-log) following higher rainfall and in/on food, mother hands, child hands, soil, and ponds (0.11-log to 0.40-log) following higher temperatures, compared to drier and colder periods. The intervention slightly reduced E. coli in stored drinking water and had no consistent effect on E. coli in tubewell water, regardless of weather. Our findings suggest that sanitation interventions can help mitigate the effects of increased rainfall and temperature on environmental fecal contamination. Previous analyses of these data without stratification by daily weather only found small (approximately 0.10-log) reductions in E. coli in/on stored drinking water and child hands. Future WASH trials should incorporate weather data to identify periods of differential intervention effectiveness to understand how weather variability influences the outcomes of public health interventions and develop strategies to enhance resilience against climate change impacts in vulnerable communities.
{"title":"Rainfall and Temperature Modify Effects of On-Site Sanitation Intervention on E. coli Contamination in Bangladeshi Households","authors":"Caitlin G Niven, Mahfuza Islam, Anna Nguyen, Andrew Mertens, Amy J Pickering, Laura H Kwong, Mahfuja Alam, Debashis Sen, Sharmin Islam, Mahbubur Rahman, Leanne Unicomb, Alan E Hubbard, Stephen P Luby, Jessica A Grembi, John M Colford, Benjamin F Arnold, Jade Benjamin-Chung, Ayse Ercumen","doi":"10.1101/2024.08.22.24312444","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312444","url":null,"abstract":"Weather events associated with climate change can influence the environmental spread and survival of fecal pathogens, potentially impacting the efficacy of water, sanitation, and hygiene (WASH) interventions. We used longitudinal data from a randomized controlled trial in Bangladesh to assess whether rainfall and temperature modified the effect of an on-site sanitation intervention on fecal contamination. Over 3.5 years, we enumerated E. coli in household samples along eight fecal-oral pathways (n=23,238 samples) and obtained daily weather data. The intervention included the provision of double-pit latrines, child potties, and scoops for removing child and animal feces, along with behavior change promotion. The intervention was associated with larger reductions in E. coli in/on mother hands, child hands, ponds, and flies (0.10-log to 0.91-log) following higher rainfall and in/on food, mother hands, child hands, soil, and ponds (0.11-log to 0.40-log) following higher temperatures, compared to drier and colder periods. The intervention slightly reduced E. coli in stored drinking water and had no consistent effect on E. coli in tubewell water, regardless of weather. Our findings suggest that sanitation interventions can help mitigate the effects of increased rainfall and temperature on environmental fecal contamination. Previous analyses of these data without stratification by daily weather only found small (approximately 0.10-log) reductions in E. coli in/on stored drinking water and child hands. Future WASH trials should incorporate weather data to identify periods of differential intervention effectiveness to understand how weather variability influences the outcomes of public health interventions and develop strategies to enhance resilience against climate change impacts in vulnerable communities.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193511","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}
Pub Date : 2024-08-22DOI: 10.1101/2024.08.22.24312424
Alexandra Christine Graf, Berthold Reichardt, Christine Wagenlechner, Pavla Krotka, Denise Traxler-Weidenauer, Michael Mildner, Julia Mascherbauer, Clemens Aigner, Johann Auer, Ralph Wendt, Hendrik Jan Ankersmit
Limited data are available on long-term morbidity and mortality after COVID-19 hospitalization. In this population-based study, we investigated the long-term mortality and morbidity after COVID-19 hospitalization and associations with baseline drug treatments. Data were provided on hospitalized COVID-19 patients in 2020 and matched controls by the Austrian Health Insurance Funds. The primary outcome was all-cause mortality. Secondary outcomes were all-cause mortality conditional on COVID-hospital survival and re-hospitalization due to any reason. The median follow-up was 600 days. 22 571 patients aged >18 years were hospitalized in Austria in 2020 due to COVID-19. The risk of all-cause mortality was significantly higher with polypharmacy. With the exception of the youngest age group (19-40 years), antiepileptics, antipsychotics and the medicament group of iron supplements, erythropoietic stimulating agents, Vitamin B12, and folic acid were significantly associated with a higher risk of death (all p<0,001). For Non-steroidal anti-inflammatory drugs and other anti-inflammatory drugs, significantly increased survival was observed (all p<0,001). Patients had a higher drug prescription load than the control population. Long-term mortality and the risk of re-hospitalization due to any reason were also significantly greater in the patients. Antipsychotics are assumed to be an underrecognized medication group linked to worse outcomes after COVID-19 hospitalization.
{"title":"Baseline drug treatments and long-term outcomes in COVID-19-hospitalized patients: results of the 2020 AUTCOV study","authors":"Alexandra Christine Graf, Berthold Reichardt, Christine Wagenlechner, Pavla Krotka, Denise Traxler-Weidenauer, Michael Mildner, Julia Mascherbauer, Clemens Aigner, Johann Auer, Ralph Wendt, Hendrik Jan Ankersmit","doi":"10.1101/2024.08.22.24312424","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312424","url":null,"abstract":"Limited data are available on long-term morbidity and mortality after COVID-19 hospitalization. In this population-based study, we investigated the long-term mortality and morbidity after COVID-19 hospitalization and associations with baseline drug treatments. Data were provided on hospitalized COVID-19 patients in 2020 and matched controls by the Austrian Health Insurance Funds. The primary outcome was all-cause mortality. Secondary outcomes were all-cause mortality conditional on COVID-hospital survival and re-hospitalization due to any reason. The median follow-up was 600 days. 22 571 patients aged >18 years were hospitalized in Austria in 2020 due to COVID-19. The risk of all-cause mortality was significantly higher with polypharmacy. With the exception of the youngest age group (19-40 years), antiepileptics, antipsychotics and the medicament group of iron supplements, erythropoietic stimulating agents, Vitamin B12, and folic acid were significantly associated with a higher risk of death (all p<0,001). For Non-steroidal anti-inflammatory drugs and other anti-inflammatory drugs, significantly increased survival was observed (all p<0,001). Patients had a higher drug prescription load than the control population. Long-term mortality and the risk of re-hospitalization due to any reason were also significantly greater in the patients. Antipsychotics are assumed to be an underrecognized medication group linked to worse outcomes after COVID-19 hospitalization.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193502","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}
Pub Date : 2024-08-21DOI: 10.1101/2024.08.20.24312313
Clara MacLeod, Katherine Davies, Mwamba Mwenge, Jenala Chipungu, Oliver Cumming, Robert Dreibelbis
Introduction: Behaviour change interventions have the potential to improve sanitation and hygiene practices in urban settings. However, the evidence on which behaviour change interventions are effective is unclear. This scoping review assesses the effectiveness of behaviour change interventions on sanitation and hygiene practices in urban settings. Methods: We performed electronic searches across five databases and one grey literature database to identify relevant studies published between 1 January 1990 and 20 November 2023 in English. Eligible study designs included randomised and non-randomised controlled trials with a concurrent control. Studies were eligible for inclusion if they reported a behaviour change intervention for improving sanitation and/or hygiene practices in an urban setting. Individual behaviour change intervention components were mapped to one of nine intervention functions of the capabilities, opportunities, motivations, and behaviour (COM-B) framework. Risk of bias was assessed for each study using an adapted Newcastle-Ottawa scale. Results: After de-duplication, 8,249 documents were screened by abstract and title, with 79 documents retrieved for full-text screening. We included 13 studies ranging from low- to high-quality. The behaviour change interventions had mixed effects on sanitation and hygiene practices in urban settings. Specifically, interventions improved latrine quality but not safe child faeces disposal. Interventions often improved handwashing with soap at key times and sometimes increased the presence of soap and water at the handwashing facility. There is limited evidence on the effect on food hygiene practices. Most study outcomes were measured between 6 and 12 months after intervention implementation, which may undermine the sustainability of behaviour change interventions. Conclusion: Despite mixed effects on sanitation and hygiene outcomes, behaviour change interventions can improve certain practices in urban settings, such as latrine quality improvements and handwashing with soap at the household or compound level. More ambitious behaviour change interventions are needed to reduce disparities in sanitation and hygiene access in urban areas globally.
{"title":"Household behaviour change interventions to improve sanitation and hygiene practices in urban settings: a scoping review","authors":"Clara MacLeod, Katherine Davies, Mwamba Mwenge, Jenala Chipungu, Oliver Cumming, Robert Dreibelbis","doi":"10.1101/2024.08.20.24312313","DOIUrl":"https://doi.org/10.1101/2024.08.20.24312313","url":null,"abstract":"Introduction: Behaviour change interventions have the potential to improve sanitation and hygiene practices in urban settings. However, the evidence on which behaviour change interventions are effective is unclear. This scoping review assesses the effectiveness of behaviour change interventions on sanitation and hygiene practices in urban settings. Methods: We performed electronic searches across five databases and one grey literature database to identify relevant studies published between 1 January 1990 and 20 November 2023 in English. Eligible study designs included randomised and non-randomised controlled trials with a concurrent control. Studies were eligible for inclusion if they reported a behaviour change intervention for improving sanitation and/or hygiene practices in an urban setting. Individual behaviour change intervention components were mapped to one of nine intervention functions of the capabilities, opportunities, motivations, and behaviour (COM-B) framework. Risk of bias was assessed for each study using an adapted Newcastle-Ottawa scale. Results: After de-duplication, 8,249 documents were screened by abstract and title, with 79 documents retrieved for full-text screening. We included 13 studies ranging from low- to high-quality. The behaviour change interventions had mixed effects on sanitation and hygiene practices in urban settings. Specifically, interventions improved latrine quality but not safe child faeces disposal. Interventions often improved handwashing with soap at key times and sometimes increased the presence of soap and water at the handwashing facility. There is limited evidence on the effect on food hygiene practices. Most study outcomes were measured between 6 and 12 months after intervention implementation, which may undermine the sustainability of behaviour change interventions. Conclusion: Despite mixed effects on sanitation and hygiene outcomes, behaviour change interventions can improve certain practices in urban settings, such as latrine quality improvements and handwashing with soap at the household or compound level. More ambitious behaviour change interventions are needed to reduce disparities in sanitation and hygiene access in urban areas globally.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193512","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}
Pub Date : 2024-08-21DOI: 10.1101/2024.08.21.24311866
Steven J. Balogh, George B. Sprouse, Kenneth B. Beckman, Ray H.B. Watson, Darrell M. Johnson, Lee D. Pinkerton, Yabing H. Nollet, Adam W. Sealock, Walter S.C. Atkins, Laura M. Selenke, Joseph A. Kinney, Patrick J.R. Grady, Brandon Vanderbush, Jerry J. Daniel
Wastewater surveillance offers an objective, comprehensive, and cost-effective means of monitoring the prevalence and genomic heterogeneity of pathogens circulating in a community. Here, a novel two-step extraction procedure for the direct capture of SARS-CoV-2 RNA from raw wastewater is presented. Combined with reverse transcription-droplet digital polymerase chain reaction (RT-ddPCR) detection, the method provides a fast and sensitive method for measuring viral RNA concentrations in wastewater. The method was used to measure the concentration of SARS-CoV-2 RNA in daily samples of wastewater entering a major metropolitan wastewater treatment plant over the course of 32 months, from November 2020 through June 2023. In addition, targeted mutation assays were used with RT-ddPCR to characterize the evolving presence and prevalence of specific SARS-CoV-2 variant sub-lineages in the wastewater stream over time. The results demonstrate the utility of these methods to accurately measure the total load of SARS-CoV-2 RNA, and chronicle its evolving variant composition, in wastewater treatment plant influent, providing near-real-time characterization of COVID-19 disease prevalence and trends in the served community.
{"title":"Long-term monitoring of SARS-CoV-2 load and variant composition at a large metropolitan wastewater treatment plant using a simple two-step direct capture RNA extraction, droplet digital PCR, and targeted mutation assays","authors":"Steven J. Balogh, George B. Sprouse, Kenneth B. Beckman, Ray H.B. Watson, Darrell M. Johnson, Lee D. Pinkerton, Yabing H. Nollet, Adam W. Sealock, Walter S.C. Atkins, Laura M. Selenke, Joseph A. Kinney, Patrick J.R. Grady, Brandon Vanderbush, Jerry J. Daniel","doi":"10.1101/2024.08.21.24311866","DOIUrl":"https://doi.org/10.1101/2024.08.21.24311866","url":null,"abstract":"Wastewater surveillance offers an objective, comprehensive, and cost-effective means of monitoring the prevalence and genomic heterogeneity of pathogens circulating in a community. Here, a novel two-step extraction procedure for the direct capture of SARS-CoV-2 RNA from raw wastewater is presented. Combined with reverse transcription-droplet digital polymerase chain reaction (RT-ddPCR) detection, the method provides a fast and sensitive method for measuring viral RNA concentrations in wastewater. The method was used to measure the concentration of SARS-CoV-2 RNA in daily samples of wastewater entering a major metropolitan wastewater treatment plant over the course of 32 months, from November 2020 through June 2023. In addition, targeted mutation assays were used with RT-ddPCR to characterize the evolving presence and prevalence of specific SARS-CoV-2 variant sub-lineages in the wastewater stream over time. The results demonstrate the utility of these methods to accurately measure the total load of SARS-CoV-2 RNA, and chronicle its evolving variant composition, in wastewater treatment plant influent, providing near-real-time characterization of COVID-19 disease prevalence and trends in the served community.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193503","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}
Pub Date : 2024-08-21DOI: 10.1101/2024.08.21.24312334
Emmanuel Asampong, Franklin Glozah, Adanna Nwameme, Ruby Hornuvo, Philip Teg-Nefaah Tabong, Edward Mberu Kamau
Background In Sub-Saharan Africa (SSA), HIV infection is the main factor contributing to adult premature death. The prevalence of HIV in the region could also be associated with recent increases in Female Genital Schistosomiasis (FGS) globally. The fast-rising prevalence of FGS in SSA nations including Ghana, which has led to the emergence of dual HIV-FGS conditions, provides evidence of the trend. As such the WHO is advocating for integrated services of HIV and FGS care. This study explored stakeholders’ perspectives of the integration of prevention and control measures for Female Genital Schistosomiasis and HIV care in FGS endemic settings in Ghana. Methods The study was conducted in the Ga South Municipality in the Greater Accra region of Ghana. Using qualitative research methods, Focus Group Discussion was conducted with Community Health Officers (n=9) and Key Informant Interviews with stakeholders including health care professionals and providers at the Regional, District and community levels (n=13) to explore the feasibility, challenges, and opportunities of integrating FGS prevention and control package with HIV continuum of care in communities. In-depth interviews were also conducted among Persons with FGS and HIV (n=13), Female Households (n=10), Community Health Management Committee members and Community leader (n=7) to explore their views on the facilitators and barriers of the integration of FGS into HIV care into the Primary Health Care (PHC) in Ghana. All study participants were purposively sampled to achieve the study objective. All audio-recorded data were transcribed verbatim, a codebook developed, and the data was thematically analysed with the aid of NVivo software version 13. Results The study identified a knowledge gap regarding Female Genital Schistosomiasis (FGS) compared to HIV. The majority of Community Health Officers (CHOs) exhibited limited knowledge about FGS. Additionally, health workers misconstrued FGS as sexually transmitted infections. Community members who expressed knowledge of FGS were about gynecological symptoms of FGS. Three main health outlets; health facilities, herbal centers, and spiritual centers are utilized either concurrently or in sequence. This health seeking behaviour negatively affected the early detection and management of FGS among HIV clients. Integration of HIV and FGS may be affected by the limited awareness and knowledge, resource constraints, stigma and discrimination, healthcare providers’ attitudes and practices, and cultural beliefs. Conclusions The study finds that knowledge of FGS was usually low among both community members and Community Health Officers. This was having a detrimental effect on regular screening of females for genital schistosomiasis. Integration of FGS and HIV has the potential to help Ghana achieve HIV eradication; however, before such a program is launched, implementation barriers such as stigma, knowledge gap, unavailability of needed logistics at health faciliti
{"title":"Stakeholders Perspective of Integrating Female Genital Schistosomiasis into HIV Care: A Qualitative Study in Ghana","authors":"Emmanuel Asampong, Franklin Glozah, Adanna Nwameme, Ruby Hornuvo, Philip Teg-Nefaah Tabong, Edward Mberu Kamau","doi":"10.1101/2024.08.21.24312334","DOIUrl":"https://doi.org/10.1101/2024.08.21.24312334","url":null,"abstract":"Background\u0000In Sub-Saharan Africa (SSA), HIV infection is the main factor contributing to adult premature death. The prevalence of HIV in the region could also be associated with recent increases in Female Genital Schistosomiasis (FGS) globally. The fast-rising prevalence of FGS in SSA nations including Ghana, which has led to the emergence of dual HIV-FGS conditions, provides evidence of the trend. As such the WHO is advocating for integrated services of HIV and FGS care. This study explored stakeholders’ perspectives of the integration of prevention and control measures for Female Genital Schistosomiasis and HIV care in FGS endemic settings in Ghana.\u0000Methods\u0000The study was conducted in the Ga South Municipality in the Greater Accra region of Ghana. Using qualitative research methods, Focus Group Discussion was conducted with Community Health Officers (n=9) and Key Informant Interviews with stakeholders including health care professionals and providers at the Regional, District and community levels (n=13) to explore the feasibility, challenges, and opportunities of integrating FGS prevention and control package with HIV continuum of care in communities. In-depth interviews were also conducted among Persons with FGS and HIV (n=13), Female Households (n=10), Community Health Management Committee members and Community leader (n=7) to explore their views on the facilitators and barriers of the integration of FGS into HIV care into the Primary Health Care (PHC) in Ghana. All study participants were purposively sampled to achieve the study objective. All audio-recorded data were transcribed verbatim, a codebook developed, and the data was thematically analysed with the aid of NVivo software version 13. Results\u0000The study identified a knowledge gap regarding Female Genital Schistosomiasis (FGS) compared to HIV. The majority of Community Health Officers (CHOs) exhibited limited knowledge about FGS. Additionally, health workers misconstrued FGS as sexually transmitted infections. Community members who expressed knowledge of FGS were about gynecological symptoms of FGS. Three main health outlets; health facilities, herbal centers, and spiritual centers are utilized either concurrently or in sequence. This health seeking behaviour negatively affected the early detection and management of FGS among HIV clients. Integration of HIV and FGS may be affected by the limited awareness and knowledge, resource constraints, stigma and discrimination, healthcare providers’ attitudes and practices, and cultural beliefs.\u0000Conclusions\u0000The study finds that knowledge of FGS was usually low among both community members and Community Health Officers. This was having a detrimental effect on regular screening of females for genital schistosomiasis. Integration of FGS and HIV has the potential to help Ghana achieve HIV eradication; however, before such a program is launched, implementation barriers such as stigma, knowledge gap, unavailability of needed logistics at health faciliti","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193504","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}
Pub Date : 2024-08-21DOI: 10.1101/2024.08.21.24312122
Jane Wilbur, Doug Ruuska, Shahpara Nawaz, Julian Natukunda
People with disabilities face significant disparities in access to water, sanitation, and hygiene (WASH) services, negatively affecting their health. Climate change exacerbates this by damaging WASH infrastructure and disrupting behaviours. Despite their heightened vulnerability, the needs of people with disabilities are often overlooked in climate change response strategies, putting them at greater risk. This study explored how climate change impacts WASH services and behaviours and whether climate-resilient WASH interventions are disability-inclusive and gender equitable in low and middle income countries. Nine online databases were searched in July 2023 and May 2024 to identify peer-reviewed papers (CINAHL Complete, Embase, Global Health; Web of Science; ECONLIT; DESASTRES, GreenFILE, MEDLINE via PubMed, Education Resources Information Centre). Grey literature was identified through OPENGrey, WHO, AHRQ, BASE and Google Scholar. Eligible papers included data on the impact of weather or climate on WASH services and behaviours, particularly for people with disabilities and women. Studies focused on community-based WASH interventions in LMICs and were published between 2000 and 2023 in English. Twenty two studies were included. Thirteen included results about women and girls; two considered disability. Only two evaluated climate resilient WASH interventions (rainwater harvesting), and neither focused on disability. Most studies examined rainfall uncertainty and drought, covering diverse locations, including South Asia and East Africa. Most studies were published after 2020. Results show that climate change is exacerbating WASH inequalities, particularly affecting women and people with disabilities, while also adversely impacting public health by disrupting water availability, quality, and sanitation services. Variability in rainfall, droughts, floods, and saltwater intrusion significantly affect water reliability, quantity, and quality, leading to increased waterborne diseases, mental health issues, and other health problems. Social capital and kinship networks are critical during water scarcity. People with disabilities are especially vulnerable, often relying on people feeling morally obligated to support water collection. To cope, people diversify their water sources and prioritise water use for agriculture and livelihood security over hygiene, which elevates health risks. Extreme weather events further complicate the situation by damaging sanitation facilities, leading to increased open defecation and the spread of diseases. Rebuilding sanitation facilities is often deprioritised due to repeated damage, mental fatigue of constant reconstruction, and immediate survival needs. Water is frequently prioritised for agriculture over proper sanitation and hygiene practices, resulting in higher rates of open defecation and declining hygiene, as water use for handwashing, cleaning utensils, laundry, and menstrual hygiene is restricted. Consuming saline
残疾人在获得水、环境卫生和个人卫生（WASH）服务方面面临巨大差距，对他们的健康产生了负面影响。气候变化破坏了讲卫生运动的基础设施，扰乱了人们的行为，从而加剧了这种状况。尽管残疾人更容易受到伤害，但他们的需求往往在气候变化应对战略中被忽视，使他们面临更大的风险。本研究探讨了气候变化如何影响中低收入国家的讲卫生运动服务和行为，以及抵御气候变化的讲卫生运动干预措施是否兼顾残疾问题和性别平等。2023 年 7 月和 2024 年 5 月，研究人员检索了九个在线数据库，以确定经同行评审的论文（CINAHL Complete、Embase、Global Health、Web of Science、ECONLIT、DESASTRES、GreenFILE、MEDLINE via PubMed、教育资源信息中心）。灰色文献通过 OPENGrey、WHO、AHRQ、BASE 和 Google Scholar 进行鉴定。符合条件的论文包括有关天气或气候对讲卫生运动服务和行为的影响的数据，尤其是对残疾人和妇女的影响。研究重点关注低收入和中等收入国家基于社区的饮水、环卫和讲卫生运动干预措施，并在 2000 年至 2023 年期间以英文发表。共纳入 22 项研究。其中 13 项包含了有关妇女和女童的结果；两项考虑了残疾问题。只有两项研究评估了具有气候复原力的水、环境卫生和个人卫生干预措施（雨水收集），这两项研究都没有关注残疾问题。大多数研究探讨了降雨的不确定性和干旱问题，涉及不同地区，包括南亚和东非。大多数研究发表于 2020 年之后。研究结果表明，气候变化加剧了讲卫生运动中的不平等现象，尤其影响到妇女和残疾人，同时还通过破坏水的供应、质量和卫生服务对公众健康产生不利影响。降雨量的变化、干旱、洪水和盐水入侵严重影响了水的可靠性、水量和水质，导致水传播疾病、精神健康问题和其他健康问题增加。社会资本和亲属网络在缺水期间至关重要。残疾人尤其容易受到影响，他们往往认为人们在道义上有义务支持他们取水。为了应对这种情况，人们将水源多样化，并将农业用水和生计保障置于卫生之上，从而增加了健康风险。极端天气事件破坏了卫生设施，导致露天排便增多和疾病传播，从而使情况进一步复杂化。由于反复损坏、不断重建的精神疲劳以及紧迫的生存需要，重建卫生设施往往被置于次要地位。农业用水往往优先于适当的环境卫生和个人卫生习惯，导致露天排便率上升，个人卫生水平下降，因为洗手、清洗餐具、洗衣和经期卫生用水受到限制。饮用盐水与高血压、高血脂、先兆子痫和呼吸道感染有关。用生理盐水清洗经期用品和洗澡的妇女和女孩有皮肤灼伤、皮疹、水泡和尿路感染的风险。政府和服务提供商在促进适应方面的作用不一致，缺乏对社区参与和公平提供服务的重视。气候变化对弱势群体获得讲卫生服务的影响尤为严重。本报告强调，迫切需要对具有气候适应能力的讲卫生运动干预措施进行研究，尤其是针对残疾人需求的干预措施。有针对性的支持、可持续的管理和有力的证据对于建立复原力和平等至关重要。
{"title":"Climate Risks to Water, Sanitation and Hygiene Services and Evidence of Inclusive and Effective Interventions in Low and Middle-Income Countries: A Scoping Review","authors":"Jane Wilbur, Doug Ruuska, Shahpara Nawaz, Julian Natukunda","doi":"10.1101/2024.08.21.24312122","DOIUrl":"https://doi.org/10.1101/2024.08.21.24312122","url":null,"abstract":"People with disabilities face significant disparities in access to water, sanitation, and hygiene (WASH) services, negatively affecting their health. Climate change exacerbates this by damaging WASH infrastructure and disrupting behaviours. Despite their heightened vulnerability, the needs of people with disabilities are often overlooked in climate change response strategies, putting them at greater risk. This study explored how climate change impacts WASH services and behaviours and whether climate-resilient WASH interventions are disability-inclusive and gender equitable in low and middle income countries. Nine online databases were searched in July 2023 and May 2024 to identify peer-reviewed papers (CINAHL Complete, Embase, Global Health; Web of Science; ECONLIT; DESASTRES, GreenFILE, MEDLINE via PubMed, Education Resources Information Centre). Grey literature was identified through OPENGrey, WHO, AHRQ, BASE and Google Scholar. Eligible papers included data on the impact of weather or climate on WASH services and behaviours, particularly for people with disabilities and women. Studies focused on community-based WASH interventions in LMICs and were published between 2000 and 2023 in English. Twenty two studies were included. Thirteen included results about women and girls; two considered disability. Only two evaluated climate resilient WASH interventions (rainwater harvesting), and neither focused on disability. Most studies examined rainfall uncertainty and drought, covering diverse locations, including South Asia and East Africa. Most studies were published after 2020. Results show that climate change is exacerbating WASH inequalities, particularly affecting women and people with disabilities, while also adversely impacting public health by disrupting water availability, quality, and sanitation services. Variability in rainfall, droughts, floods, and saltwater intrusion significantly affect water reliability, quantity, and quality, leading to increased waterborne diseases, mental health issues, and other health problems. Social capital and kinship networks are critical during water scarcity. People with disabilities are especially vulnerable, often relying on people feeling morally obligated to support water collection. To cope, people diversify their water sources and prioritise water use for agriculture and livelihood security over hygiene, which elevates health risks. Extreme weather events further complicate the situation by damaging sanitation facilities, leading to increased open defecation and the spread of diseases. Rebuilding sanitation facilities is often deprioritised due to repeated damage, mental fatigue of constant reconstruction, and immediate survival needs. Water is frequently prioritised for agriculture over proper sanitation and hygiene practices, resulting in higher rates of open defecation and declining hygiene, as water use for handwashing, cleaning utensils, laundry, and menstrual hygiene is restricted. Consuming saline","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224882","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：