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Zhu K, Lin Z, Luo Q, Jiang Z, He R, Wu H, Yu J, Liu X, Sheng J, Zhu H, Huang H. Sexual behavior and cardiovascular diseases: univariable and multivariable Mendelian randomization. Front Cardiovasc Med 2023; 10:1250404. [PMID: 38116537 PMCID: PMC10728475 DOI: 10.3389/fcvm.2023.1250404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
Background To assess the relationship of genetically predicted sexual behavior (age at first sex (AFS) and the number of sexual partners (NSP)) on cardiovascular diseases (CVDs). Methods and results We performed two-sample Mendelian randomization (MR) with publicly available datasets from the UK Biobank and FinnGen Study, and analyzed genome-wide association results for sexual behaviors and twelve types of CVDs. The univariable MR method provided a total effect of AFS and NSP on CVDs, and showed evidence that early AFS rather than NSP was associated with CVDs, including angina pectoris (AP), atrial fibrillation and flutter (AFF), coronary atherosclerosis (CAS), deep vein thrombosis of the lower extremity (DVT-LE), heart failure (HF), hypertension (HTN), ischaemic stroke (IS), and myocardial infarction (MI). Given sex as a social determinant of CVD risk, we used gender-stratified SNPs to investigate gender differences in the development of CVDs. These results showed a stronger causal relationship of AFS on CVDs in females than in males. Further multivariable MR analyses indicated a direct effect after accounting for insomnia, number of days of vigorous physical activity 10 + minutes (VPA 10 + min), and time spent watching television (TV). Two-step MR demonstrated these three risk factors act as a mediator in AFS associated AP/HTN/HF. Conclusions We provide evidence that early AFS increased the risk of CVDs. These associations may be partly caused by VPA 10 + min, insomnia, and the time spent on TV. The causality of AFS on CVDs in females was stronger than in males. Conversely, genetically predicted NSP was not associated with CVDs.
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Affiliation(s)
- Kejing Zhu
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongliang Lin
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qinyu Luo
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhaoying Jiang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Renke He
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiyan Wu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaen Yu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueying Liu
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianzhong Sheng
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Hong Zhu
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Hefeng Huang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Reproduction and Development, Shanghai, China
- State Key Laboratory of Cardiology, Shanghai, China
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Negri M, de Souza E, Torloni MR, Ribeiro MC, Araujo E, Guazzelli CAF. Sexual function in Brazilian female adolescents and young adults: a cross-sectional study. Rev Assoc Med Bras (1992) 2022; 68:1210-1215. [PMID: 36228252 PMCID: PMC9575009 DOI: 10.1590/1806-9282.20220232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/23/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate and compare the sexual function of Brazilian adolescents and young women who were using popular contraceptive methods. METHODS This cross-sectional study took place in 2012-2014 in a free family planning clinic of a tertiary teaching hospital in Brazil. Participants were female adolescents (10-19 years) and young adults (20-24 years) who were using barrier (condom) or hormonal contraceptive methods. The Female Sexual Function Index questionnaire was used to assess the sexual function in the last 4 weeks. RESULTS A total of 199 women (128 adolescents and 71 young adults) were included. There were no significant differences in the mean total Female Sexual Function Index scores of adolescents and young adults (26.6±5.7 versus 27.6±6.2, respectively, p=0.264). Compared to young adults, adolescents had significantly lower mean scores for orgasm (3.9±1.5 versus 4.4±1.4, p=0.020) and dyspareunia (4.4±1.6 versus 5.2±1.5, p=0.001; lower scores indicate more dyspareunia). There were no significant differences in the proportion of adolescents versus adults classified as being at risk for sexual dysfunction (38.3 versus 42.3%, p=0.651) or at risk of low desire (18.0 versus 21.1%, p=0.579). CONCLUSION Nearly 40% of Brazilian female adolescents and young adults are at risk for sexual dysfunctional symptoms and 19% have low desire, without significant differences between the two age groups.
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Affiliation(s)
- Mariana Negri
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | - Eduardo de Souza
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | - Maria Regina Torloni
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Internal Medicine – São Paulo (SP), Brazil
| | - Meireluci Costa Ribeiro
- Centro Universitário Salesiano de São Paulo, Postgraduate Program in Sex Therapy – São Paulo (SP), Brazil
| | - Edward Araujo
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
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Sprecher S, O'Sullivan LF, Drouin M, Verette-Lindenbaum J, Willetts MC. Perhaps It Was Too Soon: College Students' Reflections on the Timing of Their Sexual Debut. JOURNAL OF SEX RESEARCH 2022; 59:39-52. [PMID: 33646063 DOI: 10.1080/00224499.2021.1885599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Early sexual debut has been a focus of social scientific research due to its association with adverse circumstances and negative outcomes. However, there has been a recent shift to considering not only chronological age, but also the degree to which the event is viewed to be optimally timed (i.e., the perception that it occurred at the "right time" versus too soon). The purpose of this study was to assess how individual/family background variables and contextual aspects of the experience (including partner and relationship aspects) are associated with both the actual age at sexual debut and the perceived acceptability of the timing of the event. Using data collected from students at a U.S. university between 1990 and 2019 (N = 6,430), several factors (in addition to chronological age) were associated with the perceived acceptability of the timing of sexual debut. Strong gender differences were found - women perceived their timing to be less acceptable, even though they did not differ from men in actual age at sexual debut. Other robust predictors of perceived acceptability included (lower) religious involvement and recalling desire (for the experience), pleasure, and lower guilt at the time. Only slight changes occurred over the 30-year period in age at sexual debut and perceived acceptability of the timing. Suggestions for future research are provided and implications for sex education/sexual health interventions are discussed.
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Affiliation(s)
- Susan Sprecher
- Department of Sociology & Anthropology, Illinois State University
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Yeo JH, Kim EY, Kim MT. Association Between Timing of Sexual Initiation and Suicidal Ideation Among Adolescents in South Korea: A Cross-Sectional Study. J Nurs Res 2021; 30:e190. [PMID: 34750339 DOI: 10.1097/jnr.0000000000000466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The age of adolescents' sexual initiation is decreasing worldwide. Early sexual initiation has been reported to affect social, physical, and mental health, but little is known about the relationship between the timing of sexual initiation and suicidal ideation. PURPOSE This study was designed to identify the association between the timing of sexual initiation and suicidal ideation by gender. METHODS This cross-sectional study used data from South Korea's Youth Health Behavior Online Survey for 2016. Data on first- to 12th-grade students (N = 10,810) were analyzed using descriptive statistics, χ2 tests, and hierarchical logistic regression. RESULTS The results revealed a significant relationship between early sexual initiation and suicidal ideation among both boys and girls. This relationship remained significant after controlling for confounding variables that are known to affect suicidal ideation, including perceived stress, hopelessness, school grades, and sociodemographic characteristics. The risk of suicidal ideation was higher among students who first experienced sex in earlier grades (before the ninth grade) and was also higher in girls than in boys. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Health providers should be aware of the potentially higher risk of suicidal behavior among adolescents after early sexual initiation. Given the extreme sensitivity and vulnerability of this target population, a multidisciplinary school- or community-based intervention program to promote the mental health of affected individuals and the general student population is warranted.
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Affiliation(s)
- Jung Hee Yeo
- PhD, RN, Professor, College of Nursing, Dong-A University, Republic of Korea
| | - Eun-Young Kim
- PhD, RN, Professor, College of Nursing, Dong-A University, Republic of Korea
| | - Miyong T Kim
- PhD, RN, FAAN, Professor, School of Nursing, University of Texas at Austin, USA
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Cifríková R, Bašková M, Kolarčík P. Trends in sexual behaviour in Slovak schoolchildren between 2006-2018. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Izdebski Z, Wąż K, Kowalewska A, Mazur J. Psychosocial determinants of sexual norms and their impact on sexual debut in Polish adolescents. Int J Public Health 2020; 65:1393-1401. [PMID: 32876771 PMCID: PMC7588370 DOI: 10.1007/s00038-020-01470-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/15/2020] [Accepted: 08/25/2020] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES In an attempt to describe composite scales relating to sexual norms, we present their structure, psychosocial determinants, and the association with adolescent sexual initiation. METHODS A representative sample of Polish students was surveyed in 2015 (n = 1024, mean age 17.8 ± 0.31). Three scales of sexual norms were identified using principal component analysis. Logistic regression and path models were applied. RESULTS The scales concerning stereotype gender norms, as well as restrictive and permissive sexual norms, were developed. Restrictive norms lead to later sexual initiation and were more frequent in combination with love for the first partner. The variability of all the indices was significantly correlated with the peer environment. A number of direct and indirect paths were found among the above indices, family relationships (support, communication), and socio-emotional strengths, such as the meaning of life, coherence, and self-esteem. CONCLUSIONS The norms of sexual morality should be included in the analysis of the determinants of adolescent sexual behaviours along with an investigation of complex causal models. The results may contribute to improvement in sexual health promotion.
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Affiliation(s)
- Zbigniew Izdebski
- Department of Biomedical Foundations of Development and Sexology, Faculty of Education, University of Warsaw, Warsaw, Poland
| | - Krzysztof Wąż
- Institute of Pedagogy, University of Zielona Góra, Zielona Góra, Poland
| | - Anna Kowalewska
- Department of Biomedical Foundations of Development and Sexology, Faculty of Education, University of Warsaw, Warsaw, Poland
| | - Joanna Mazur
- Department of Humanization in Medicine and Sexology, Institute of Health Science, University of Zielona Góra, Zielona Góra, Poland
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Gender, sexual experiences and sexual behavioural differences in Turkish university students. J Biosoc Sci 2020; 53:471-480. [PMID: 32631460 DOI: 10.1017/s002193202000036x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study was conducted to determine sexual experiences and gender differences in sexual behaviour in university students. In this cross-sectional and descriptive study conducted between 1st February and 12th November 2017. A total of 491 volunteer students were selected at a state university in the Mediterranean region of Turkey using a systematic sampling method. Questionnaires were distributed to the students in sealed envelopes and collected on completion. The data were collected using a socio-demographic form and a sexual experiences and sexual health behaviours form. A total of 414 students (78 males; 336 females) were included in this study. The prevalence of sexual intercourse among these was 4.3%, and total oral and anal sex experiences were 35% and 16.7%, respectively. A significantly higher number of female students of those who reported having sexual intercourse (n = 9; 50.0%), oral sex (n = 81; 55.9%) and anal sex (n = 60; 87.0%), also reported not telling anyone about his/her partner (77.2%), not talking about sex (82.4%) and not buying contraceptive products, even when necessary (78.3%). Hidden sexuality was seen to affect female students more often and this may lead to risky sexual behaviours, sexually transmitted diseases, an unhealthy sexual life with multiple partners and even unplanned, unwanted pregnancies.
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Barrense-Dias Y, Akre C, Surís JC, Berchtold A, Morselli D, Jacot-Descombes C, Leeners B. Does the Primary Resource of Sex Education Matter? A Swiss National Study. JOURNAL OF SEX RESEARCH 2020; 57:166-176. [PMID: 31215800 DOI: 10.1080/00224499.2019.1626331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sex education (SE) remains a subject of debate, including controversies on resources. The purpose of this paper was to determine the main SE resource during adolescence and its associations with personal characteristics and sexual behaviors of youths. Data were obtained from a self-administrated Swiss national survey on sexuality among young adults (mean age 26.3). Participants (N = 4978) were divided into six groups according to their main SE resource during their adolescence: Friends (1939; 38.9%), Parents (1361; 27.3%), School (n = 949; 19.1%), The Internet (399; 8.0%), Nobody (172; 3.5%) and Other (157; 3.2%). Groups were compared on sociodemographic, first sexual experiences, pregnancy, risky sexual behaviors, and undesired sexual experiences data. Males and non-heterosexual participants were overrepresented in the Internet group while, females more often reported their parents as their main SE resource. Participants in the School group reported the lowest rates of sexually transmitted infections and Friends the highest. Compared to the School group, those in the Friends, Internet, Nobody, and Other groups were more likely to report undesired sexual experiences. Few differences appeared between parents and school. Even though some resources such as friends or the Internet presented negative outcomes when they were assessed individually, we cannot deny the important place that they occupy in the lives of some youths.
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Affiliation(s)
- Yara Barrense-Dias
- Research Group on Adolescent Health (GRSA), Center for Primary Care and Public Health (Unisanté), - University of Lausanne, Lausanne, Switzerland
| | - Christina Akre
- Research Group on Adolescent Health (GRSA), Center for Primary Care and Public Health (Unisanté), - University of Lausanne, Lausanne, Switzerland
| | - Joan-Carles Surís
- Research Group on Adolescent Health (GRSA), Center for Primary Care and Public Health (Unisanté), - University of Lausanne, Lausanne, Switzerland
| | - André Berchtold
- Institute of Social Sciences & Swiss Center of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
| | - Davide Morselli
- Institute of Social Sciences & Swiss Center of Competence in Research LIVES, University of Lausanne, Lausanne, Switzerland
| | | | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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Suris JC, Akre C, Jacot-Descombes C, Leeners B, Morselli D, Barrense-Dias Y. Does regretting first vaginal intercourse have an effect on young adults' sexual behaviour? Sex Health 2020; 17:247-254. [DOI: 10.1071/sh19174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/11/2020] [Indexed: 11/23/2022]
Abstract
Background
The aims of this research were to determine personal differences depending on the reason for regretting or not first vaginal intercourse and its effects on sexual behaviour later on among young adults, and to assess the association between reasons for engaging in first vaginal intercourse and regretting it. Methods: Data were drawn from the 2017 Swiss national survey on youth sexual behaviours among young adults (mean age 26 years) living in Switzerland. Out of the 7142 participants, 4793 (51% females) answered the question ‘Looking back now to the first time you had vaginal intercourse, do you think that…’ with five possible answers: (1) I should not have done it (6.7%); (2) I should have waited longer (7.7%); (3) I should have done it earlier (7.4%); (4) It was about the right time (67.9%); and (5) I don’t know (10.3%). The five groups were compared on sociodemographic and sex behaviour-related variables, analysed separately by gender. Results: One-third of participants regretted their first experience. In the multivariate analysis, compared with the ‘right time’ group, all other groups were more likely to find their first experience unpleasant and to have done it with a casual partner. Those in the ‘I should not have done it’ and ‘I should have waited longer’ groups were also more likely to have done it because of external pressure, especially among females. Conclusions: The study results underline the significance to choose the right time and the right partner for first vaginal intercourse and the importance of including partner respect and avoiding external pressure as part of sexual education.
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Romantic Attraction and Substance Use in 15-Year-Old Adolescents from Eight European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173063. [PMID: 31450730 PMCID: PMC6747452 DOI: 10.3390/ijerph16173063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/16/2022]
Abstract
Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.
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Inchley JC. Growing through adolescence: a gendered approach is needed. Int J Public Health 2019; 64:151-152. [PMID: 30740627 DOI: 10.1007/s00038-019-01213-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 01/25/2019] [Indexed: 12/25/2022] Open
Affiliation(s)
- Joanna C Inchley
- School of Medicine, University of St Andrews, St Andrews, Fife, KY16 9TF, UK.
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