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BMI, Psychosocial Correlates, Pain and Activities of Daily Living in Sickle Cell Disease Patients 镰状细胞病患者的身体质量指数、社会心理相关因素、疼痛和日常生活活动
Pub Date : 2018-06-01 DOI: 10.1097/pp9.0000000000000019
K. Kaufman, Shao-Hua Chin, C. Kahathuduwa, M. Wood, M. Feliu, LaBarron K Hill, C. Barker, R. Reif, A. Keys, C. Edwards, M. Binks
Pain, psychosocial issues and impaired activities of daily living (ADLs) are common in sickle cell disease (SCD). Improved longevity may be leading to increases in body mass index (BMI). We both describe an SCD clinic population and determine if BMI, psychosocial distress, and pain predict impairments in ADLs. Archival data from 252 adult African American SCD clinic patients were examined (ie gender, BMI, SCD type, psychosocial status via Symptom Checklist-90-Revised; pain via Short-form McGill Pain Questionnaire: Sensory Pain, Affective Pain (AP), Present Pain Intensity and ADLs. In total, 44% of the sample was overweight (BMI ≥ 25 kg/m2). Depression, anxiety, and Symptom Checklist-90-Revised Global Severity Index were in the clinical range. Patients with HbS&bgr;+-thalassemia and hemoglobin SC disease had higher BMIs than those with HbSS (P < 0.001). AP and age-predicted impaired ADLs. In an OW/OB subsample, AP, age, and SCD severity predicted impaired ADLs. The consistent relationship of AP to ADL impairment suggests targeting AP via behavioral pain management may improve functioning.
疼痛、社会心理问题和日常生活活动障碍(adl)在镰状细胞病(SCD)中很常见。寿命的延长可能会导致身体质量指数(BMI)的增加。我们描述了SCD临床人群,并确定BMI、社会心理困扰和疼痛是否能预测adl的损害。对252例成年非裔美国人SCD临床患者的档案资料(包括性别、BMI、SCD类型、社会心理状况)通过《症状检查表-90-修订版》进行检查;通过简短的McGill疼痛问卷:感觉疼痛,情感性疼痛(AP),当前疼痛强度和adl。总共有44%的样本超重(BMI≥25 kg/m2)。抑郁、焦虑和症状检查表-90-修订整体严重程度指数均在临床范围内。HbS&bgr +-地中海贫血和血红蛋白SC患者的bmi高于HbSS患者(P < 0.001)。AP和年龄预测的adl受损。在OW/OB亚样本中,AP、年龄和SCD严重程度预测ADLs受损。AP与ADL损害的一致关系表明,通过行为疼痛管理靶向AP可能改善功能。
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引用次数: 10
“Isfahan Healthy Heart Program”: A Practical Model of Implementation in a Developing Country “伊斯法罕健康心脏计划”:一个在发展中国家实施的实用模式
Pub Date : 2018-05-01 DOI: 10.1097/pp9.0000000000000014
N. Sarrafzadegan, T. Laatikainen, N. Mohammadifard, Ibtihal Fadhel, D. Yach, P. Puska
There are few models that describe the experience of implementing multisectoral community-based programs of noncommunicable diseases prevention in developing countries. We describe the barriers and facilitators in implementing the “Isfahan Healthy Heart Program” (IHHP) interventions. The IHHP was conducted from 2000 to 2007 in Iran. The program consisted of 10 multidisciplinary intervention projects using both population and high risk approaches. Multiple organizations contributed to the implementation of the different interventions, including health centers, schools, worksites, food industries, academic institutes, nongovernmental organizations, and the media. To consider how to scale up this project for possible national implementation, we conducted a qualitative study that included interviewing all project managers about the facilitators and barriers they experienced. Factors that facilitated IHHP implementation included ownership and leadership, political will, existing capacity and infrastructure, good managerial relations, dedicated human resources, community empowerment, provider and user acceptance and cooperation, external collaboration, and flexibility of the interventions. Barriers included nonsupportive and unstable policies and environments, absence of universal health insurance coverage for noncommunicable disease primary prevention, “best buys” that were not applicable in different situations or cultures, failure in communication, sociopolitical and economic factors, and lack of connection between researchers and knowledge users. More intersectoral collaboration and adaptation to the continuous dynamic changes and interactions between and among the different components of interventions could overcome some of the barriers experienced. Identifying the barriers and facilitators of implementing community-based program can provide critically important information for large-scale implementation and development of new programs.
很少有模型能够描述在发展中国家实施以社区为基础的多部门非传染性疾病预防方案的经验。我们描述了实施“伊斯法罕健康心脏计划”(IHHP)干预措施的障碍和推动者。IHHP于2000年至2007年在伊朗进行。该项目由10个多学科干预项目组成,采用人群和高风险方法。多个组织为实施不同的干预措施做出了贡献,包括卫生中心、学校、工作场所、食品行业、学术机构、非政府组织和媒体。为了考虑如何扩大该项目的规模,以便在全国范围内实施,我们进行了一项定性研究,其中包括采访所有项目经理,了解他们所经历的促进者和障碍。促进IHHP实施的因素包括所有权和领导力、政治意愿、现有能力和基础设施、良好的管理关系、专门的人力资源、社区赋权、供应商和用户的接受与合作、外部合作以及干预措施的灵活性。障碍包括不支持和不稳定的政策和环境,缺乏非传染性疾病初级预防的全民健康保险,不适用于不同情况或文化的“最佳购买”,沟通失败,社会政治和经济因素,以及研究人员和知识用户之间缺乏联系。更多的部门间合作和适应干预措施不同组成部分之间的持续动态变化和互动,可以克服所遇到的一些障碍。确定实施基于社区的计划的障碍和促进因素,可以为新计划的大规模实施和发展提供至关重要的信息。
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引用次数: 9
Physical Activity and the Development of Substance Use Disorders: Current Knowledge and Future Directions. 身体活动和物质使用障碍的发展:目前的知识和未来的方向。
Pub Date : 2018-05-01 DOI: 10.1097/pp9.0000000000000018
Angelique G Brellenthin, Duck-Chul Lee

Physical activity and exercise are positive health behaviors that have been shown to reduce the risk of physical and psychological diseases. There is a strong rationale that physical activity could be a protective factor against the development of substance use disorders (SUDs), which include some of the most common mental health conditions such as tobacco and alcohol use disorder. This review examined the epidemiological literature to describe the associations of physical activity and substance use across the lifespan. The findings indicated that physical activity is positively associated with current and future alcohol use but negatively associated with tobacco and other drug use, with the strongest support originating from adolescent and young adult samples. Considerably less data exist on physical activity and other drug use in later life. Limitations in previous studies, such as the indeterminate measurement of physical activity and absence of clinical SUD endpoints, should be addressed in future investigations to provide clarity regarding the strength and directions of these relationships among different substances and populations.

体育活动和锻炼是积极的健康行为,已被证明可以减少身体和心理疾病的风险。有一个强有力的理由表明,体育活动可能是防止物质使用障碍(sud)发展的保护因素,其中包括一些最常见的精神健康状况,如烟草和酒精使用障碍。本文回顾了流行病学文献,以描述在整个生命周期中体力活动和物质使用的关系。研究结果表明,身体活动与当前和未来的饮酒呈正相关,但与烟草和其他药物使用负相关,来自青少年和青年样本的最有力支持。关于晚年身体活动和其他药物使用的数据少得多。以往研究的局限性,如体力活动测量的不确定和缺乏临床SUD终点,应该在未来的研究中加以解决,以明确不同物质和人群之间这些关系的强度和方向。
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引用次数: 23
Fitness and Fatness as Health Markers through the Lifespan: An Overview of Current Knowledge. 健康和肥胖是贯穿一生的健康标志:当前知识综述。
Pub Date : 2018-04-02 eCollection Date: 2018-04-01 DOI: 10.1097/pp9.0000000000000013
Francisco B Ortega, Cristina Cadenas-Sanchez, Duck-Chul Lee, Jonatan R Ruiz, Steven N Blair, Xuemei Sui

There is an increasing body of evidence supporting that both fitness and fatness levels relate to current and future individuals' health status. In this article, we discuss the meaning of fitness and fatness/obesity, and make an overview of what is currently known about fitness and fatness as potentially modifiable risk factors related to health and disease from preschool children to older adults. We describe the methods available for fitness assessment in each age group, providing reference/criterion values when available. Most of the existing previous reviews are focused on specific age groups with the advantage of allowing more in-depth analysis of the evidence, but the disadvantage of losing the overall understanding of the fitness and fatness binomial through the human lifespan, which is the ultimate goal of the present article.

越来越多的证据表明,健康和肥胖水平都与个人当前和未来的健康状况有关。在这篇文章中,我们讨论了健康和肥胖/肥胖的意义,并概述了目前已知的健康和肥胖是与学龄前儿童到老年人的健康和疾病相关的潜在可改变的风险因素。我们描述了每个年龄组可用的健康评估方法,并在可用时提供参考/标准值。现有的以往综述大多集中在特定年龄组,其优点是可以对证据进行更深入的分析,但缺点是失去了通过人类寿命对健康和肥胖二项的总体理解,这是本文的最终目的。
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引用次数: 53
World Health Organization and Physical Activity 世界卫生组织和体育活动
Pub Date : 2018-03-01 DOI: 10.1097/pp9.0000000000000012
I. Vuori
The World Health Organization (WHO) is a respected name as the global leader in the fight against critical health challenges such as malaria, tuberculosis, HIV, and noncommunicable diseases. Because of the great impact of WHO in influencing various health matters, there is wide interest and intensive effort to include new and important health issues in the working processes of WHO for acceptance to its agenda. One of these issues is promotion of physical activity to improve health. This article describes some key aspects of the structure and decision-making processes of WHO at mainly global level by examining the growth in the WHO’s emphasis on promoting physical activity over the last 5 decades. Initially, there was only weak and temporary interest in physical activity beginning in the 1960s, but currently, it is a topic that has warranted a comprehensive global action plan. The article comments on some of the key factors of this progress, including the increase during the 1980s and 1990s in the WHO’s emphasis on health promotion; the recognition of noncommunicable diseases as one of the main global health challenges in the 2000s; the widening of the understanding of the contents of and opportunities offered by physical activity for health; increased scientific evidence of the multiple benefits of physical activity to individual, population, community and environmental health, and persistent advocacy of a great number of leading researchers and established organizations around the world.
世界卫生组织(世界卫生组织)是抗击疟疾、结核病、艾滋病毒和非传染性疾病等重大健康挑战的全球领导者,是一个受人尊敬的名字。由于世界卫生组织在影响各种卫生事项方面的巨大影响,人们广泛关注并加紧努力将新的和重要的卫生问题纳入世界卫生组织的工作进程,以便接受其议程。其中一个问题是促进体育活动以改善健康。本文介绍了世界卫生组织主要在全球层面的结构和决策过程的一些关键方面,通过审查世界卫生组织在过去50年中对促进体育活动的重视程度的增长。最初,从20世纪60年代开始,人们对体育活动的兴趣很弱,只是暂时的,但目前,这是一个需要制定全面全球行动计划的主题。文章评论了这一进展的一些关键因素,包括世界卫生组织在1980年代和1990年代加强了对促进健康的重视;认识到非传染性疾病是2000年代全球卫生面临的主要挑战之一;扩大对体育活动的内容和为健康提供的机会的理解;越来越多的科学证据表明体育活动对个人、人口、社区和环境健康有多种益处,以及世界各地大量领先研究人员和知名组织的持续倡导。
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引用次数: 30
Traditional Knowledge-based Medicine: A Review of History, Principles, and Relevance in the Present Context of P4 Systems Medicine 传统的以知识为基础的医学:P4系统医学的历史、原则和相关性的回顾
Pub Date : 2017-12-01 DOI: 10.1097/pp9.0000000000000011
N. Lemonnier, Guang-Biao Zhou, Bhavana Prasher, M. Mukerji, Zhu Chen, S. Brahmachari, D. Noble, C. Auffray, M. Sagner
Wellness and healing are the challenges traditionally addressed by medicine, empirically shaped along with the evolution of civilizations. Western medicine (WM) originates from Middle-Eastern and Mediterranean medicine (during the Egyptian, Greek, and Roman empires) and has established itself as the reference in most countries with undisputable benefits on health and life expectancy. Traditional medicines (TMs) are millennia old and offer empirical practices including medication with natural elements and focus on overall wellness. Although the purpose of relief is similar in WM and TM approaches, the philosophies and methodologies differ. TM emphasizes the consideration of the patient body and mind as a whole for diagnosis, prevention, and treatment; WM focuses on the suppression of symptoms on targeted parts of the body. The acceptance of TM by the scientific community is limited by the lack of ground-breaking scientific evidence of its benefits and efficiency, coupled to the ignorance of its inherent medical basis. We review the origins and concepts of TM from Southern and Eastern Asia, as compared with WM, and believe it can help to create a modern systems biology-based approach to health and healing, in the sense of predictive, preventive, personalized, and participatory (P4) medicine.
健康和治疗是传统上由医学解决的挑战,随着文明的演变而形成。西医(WM)起源于中东和地中海医学(在埃及、希腊和罗马帝国时期),并已成为大多数国家的参考,对健康和预期寿命有无可争议的好处。传统医学(TMs)有上千年的历史,提供经验实践,包括自然元素的药物治疗,并关注整体健康。尽管在WM和TM方法中缓解的目的是相似的,但哲学和方法不同。TM强调将患者的身心作为一个整体来进行诊断、预防和治疗;西医注重对身体特定部位的症状抑制。由于缺乏突破性的科学证据证明传统医学的益处和效率,加上对其内在医学基础的无知,科学界对传统医学的接受受到限制。我们回顾了来自南亚和东亚的传统医学的起源和概念,并将其与西医相比较,并相信它可以帮助创建一种基于现代系统生物学的健康和治疗方法,在预测、预防、个性化和参与性(P4)医学的意义上。
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引用次数: 40
A Scoping Review of Health Outcomes Examined in Randomized Controlled Trials Using Guided Imagery. 使用引导式想象对随机对照试验中的健康结果进行范围审查。
Pub Date : 2017-12-01 DOI: 10.1097/pp9.0000000000000010
Peter R Giacobbi, Jonathan Stewart, Keeley Chaffee, Anna-Marie Jaeschke, Meagan Stabler, George A Kelley

Introduction: Guided imagery involves the controlled visualization of detailed mental images. This integrative health technique is used for healing, health maintenance, or the treatment of specific conditions. Guided imagery is an integral part of mindfulness meditation, hypnosis, and various relaxation exercises. However, evidence to support the widespread use and dissemination of guided imagery interventions has been lacking. The purposes of this scoping review were to document the scope of health outcomes and disease processes examined by guided imagery researchers and the journal outlets where this work has been published. Secondary purposes were to review the efficacy of guided imagery, risk of bias from studies published in selected integrative health journals, and gain feedback from clinicians in a practiced-based research network (PBRN) about potential barriers for use in clinical settings.

Methods: Ten bibliographic databases were searched for randomized controlled trials (RCTs) published between 1960 and 2013 that included adult participants. Descriptive and analytic methods were employed to document the journal outlets, diseases, and health outcomes investigated.

Results: 320 RCTs that included more than 17,979 adult participants were reviewed. The published studies appeared in 216 peer-reviewed journals from diverse disciplines largely representing psychology, the sport sciences, rehabilitation, nursing, and medicine. Major outcomes observed were coping with pain, stroke recovery, anxiety, coping with stress, and sport skills. Practitioner feedback from the PBRN revealed some interest but skepticism and time constraints were discussed as barriers.

Conclusions: Ongoing research and creative dissemination techniques are warranted.

简介引导想象包括有控制地想象出详细的心理图像。这种综合保健技术可用于治疗、维护健康或治疗特定病症。引导想象是正念冥想、催眠和各种放松练习中不可或缺的一部分。然而,引导式意象干预的广泛使用和传播一直缺乏证据支持。本次范围界定综述的目的是记录引导式意象疗法研究人员所研究的健康结果和疾病过程的范围,以及发表这些研究成果的期刊。次要目的是回顾引导式意象疗法的疗效、在选定的综合健康期刊上发表的研究的偏倚风险,并从基于实践的研究网络(PBRN)中的临床医生那里获得有关在临床环境中使用引导式意象疗法的潜在障碍的反馈意见:方法: 在 10 个文献数据库中搜索了 1960 年至 2013 年间发表的包含成人参与者的随机对照试验 (RCT)。采用了描述性和分析性方法来记录所调查的期刊刊物、疾病和健康结果:结果:共审查了 320 项 RCT,其中包括超过 17,979 名成年参与者。发表在 216 份同行评审期刊上的研究报告涉及多个学科,主要包括心理学、运动科学、康复学、护理学和医学。观察到的主要结果包括疼痛应对、中风恢复、焦虑、压力应对和运动技能。来自 PBRN 的从业人员反馈显示了一些兴趣,但怀疑和时间限制被认为是障碍:结论:有必要继续开展研究并采用创新的传播技术。
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引用次数: 0
Leisure Time Physical Activity and Sleep Predict Mortality in Men Irrespective of Background in Competitive Sports 闲暇时间、体力活动和睡眠预测男性死亡率,与竞技体育背景无关
Pub Date : 2017-11-01 DOI: 10.1097/pp9.0000000000000009
H. Wennman, E. Kronholm, O. Heinonen, U. Kujala, J. Kaprio, T. Partonen, H. Bäckmand, S. Sarna, K. Borodulin
Introduction: Physical activity and sleep are closely related behaviors with suggested synergistic influence on cardiovascular health. Physical activity potentially modifies associations between sleep and mortality. Our aim was to study the interrelationships between sleep, leisure-time physical activity (LTPA), a history of sports, and mortality. Methods: A prospective cohort of former elite male athletes (n = 1,028), and age- and region-matched nonathlete men (n = 610) completed a health questionnaire in 1985. Their mortality was followed up until December 31, 2011. Analyses included Cox proportional hazards models with sleep duration and sleep quality as main predictors of all-cause and cardiovascular disease (CVD) mortality. Results: Sleep duration or sleep quality were not independently associated with mortality after controlling for socioeconomic and lifestyle factors. The interaction between sleep duration and LTPA was significant, with higher risk of all-cause and CVD mortality if sleeping 6 hours or less and not achieving 450 metabolic equivalent minutes LTPA weekly, as compared with sleeping 6.5–8.5 hours and achieving 450 metabolic equivalent minutes of LTPA. Also, the relative excess risk due to interaction between short sleep and low LTPA was significant for CVD mortality. Discussion: Significant interactions between sleep duration and LTPA with regard to mortality were observed. In particular, short sleep and low LTPA jointly predicted all-cause and CVD mortality irrespective of a history of sports. Findings suggest important synergistic associations of short sleep and low LTPA with CVD mortality risk.
引言:体育活动和睡眠是密切相关的行为,对心血管健康有协同影响。体育活动可能会改变睡眠和死亡率之间的关系。我们的目的是研究睡眠、休闲时间体育活动(LTPA)、运动史和死亡率之间的相互关系。方法:一个由前优秀男运动员(n=1028)和年龄和地区匹配的非运动员(n=610)组成的前瞻性队列于1985年完成了一份健康问卷。他们的死亡率一直随访到2011年12月31日。分析包括Cox比例风险模型,睡眠时间和睡眠质量是全因和心血管疾病(CVD)死亡率的主要预测因素。结果:在控制了社会经济和生活方式因素后,睡眠时间或睡眠质量与死亡率没有独立相关性。睡眠时间和LTPA之间的相互作用是显著的,与睡眠6.5-8.5小时和达到450代谢当量分钟的LTPA相比,如果睡眠6小时或更短且每周LTPA未达到450代谢等效分钟,则全因和CVD死亡率的风险更高。此外,由于睡眠时间短和LTPA低之间的相互作用,相对过度的风险对CVD死亡率具有显著意义。讨论:在死亡率方面,观察到睡眠时间和LTPA之间存在显著的相互作用。特别是,无论运动史如何,睡眠时间短和LTPA低共同预测了全因和CVD死亡率。研究结果表明,短睡眠和低LTPA与CVD死亡率之间存在重要的协同关系。
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引用次数: 10
Acquired Left Ventricular Hypertrabeculation/Noncompaction in Sarcoidosis—A Rare but Possible Preventable Cause of Myocardial Infarction 结节病患者获得性左心室肥厚/不充盈——一种罕见但可能预防的心肌梗死原因
Pub Date : 2017-08-01 DOI: 10.1097/pp9.0000000000000008
F. Javed, Shahzeb A. Khan, A. Sheikh, S. Mahmood, Nimra Zia, G. Nadkarni, A. Benjo, Sayf Altabaqchali, C. Lavie
Left ventricular hypertrabeculation/noncompaction (LVHT/NC) is a rare if not unique disorder of endomyocardial morphogenesis. Left ventricle in this condition consists of trabeculations that are both increased in prominence and excessive in number, was hypothesized to be caused by intrauterine arrest of compaction of the myocardial fibers and meshwork. LVHT/NC has been observed to have high prevalence in children as opposed to adults with genetic linkage. Acquired LVHT/NC has been recently reported to be associated with other autoimmune diseases like mitochondriopathy, myotonic dystrophy type 1, essential thrombocythemia, Duchenne muscular dystrophy, and various neuromuscular disorders. We report here an interesting case displaying LVHT/NC in a patient with coexistent neuro-sarcoidosis at an age of 49 years with concomitant non-ST-Elevation Myocardial Infarction. Following diagnosis of LVHT/NC by means of transthoracic echocardiography, our patient was treated with a course of intravenous steroids with resultant improvement in his symptoms. This case is a unique presentation of the association of neuro-sarcoidosis with LVHT/NC with a presumptive complication in the form of non-ST-Elevation Myocardial Infarction due to synergistic interplay of pathophysiological mechanisms of these 2 individual conditions.
摘要左室超纤/非压实(LVHT/NC)是一种罕见的心内膜心肌形态发生疾病。这种情况下的左心室由小梁组成,小梁突出且数量过多,假设是由子宫内心肌纤维和心肌网压实的停止引起的。LVHT/NC在儿童中的患病率高于具有遗传连锁的成人。最近有报道称,获得性LVHT/NC与其他自身免疫性疾病相关,如线粒体病、1型肌强直性营养不良、原发性血小板增多症、杜氏肌营养不良和各种神经肌肉疾病。我们在此报告一个有趣的病例,显示LVHT/NC患者共存神经结节病,49岁,并伴有非st段抬高型心肌梗死。经胸超声心动图诊断为LVHT/NC后,患者接受了一个疗程的静脉类固醇治疗,症状得到改善。该病例是神经结节病与LVHT/NC的独特关联,由于这两种个体疾病的病理生理机制的协同相互作用,可能出现非st段抬高型心肌梗死的并发症。
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引用次数: 2
The Objective Monitoring of Physical Activity 体育活动的客观监控
Pub Date : 2017-07-01 DOI: 10.1097/pp9.0000000000000007
R. Shephard
Epidemiologists have long recognized the significant limitations of physical activity questionnaires. Advances in the development of objective monitoring devices such as accelerometers have spurred hopes of defining more accurately the relationships between habitual physical activity and chronic disease. As yet, realization of these objectives has been curbed by the failure of accelerometers to record important sources of energy expenditure and the limitation of sample size by labor-intensive checking of output data for artifacts. But in the near future, more complex devices that link the measurement of body accelerations to other phenomena such as posture and GPS location, together with computer-assisted checking of records and processing of data may earn objective monitoring a key place in large-scale epidemiological investigations.
流行病学家早就认识到体育活动问卷的显著局限性。加速度计等客观监测设备的发展激发了人们更准确地定义习惯性体育活动与慢性疾病之间关系的希望。到目前为止,由于加速度计无法记录重要的能源消耗源,以及通过劳动密集型的伪影输出数据检查来限制样本量,这些目标的实现受到了限制。但在不久的将来,将身体加速度测量与姿势和GPS定位等其他现象联系起来的更复杂的设备,加上计算机辅助的记录检查和数据处理,可能会在大规模流行病学调查中获得客观监测的关键地位。
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引用次数: 14
期刊
Progress in preventive medicine (New York, N.Y.)
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