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Xu Z, Zhao B, Zhang Z, Wang X, Jiang Y, Zhang M, Li P. Prevalence and associated factors of secondary traumatic stress in emergency nurses: a systematic review and meta-analysis. Eur J Psychotraumatol 2024; 15:2321761. [PMID: 38426665 PMCID: PMC10911249 DOI: 10.1080/20008066.2024.2321761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Background: Nurses in emergency departments are at a high risk of experiencing secondary traumatic stress because of their frequent exposure to trauma patients and high-stress environments.Objective: This systematic review and meta-analysis aimed to determine the overall prevalence of secondary traumatic stress among emergency nurses and to identify the contributing factors.Method: We conducted a systematic search for cross-sectional studies in databases such as PubMed, Web of Science, Embase, CINAHL, Wanfang Database, and China National Knowledge Internet up to October 21, 2023. The Joanna Briggs Institute's appraisal checklists for prevalence and analytical cross-sectional studies were used for quality assessment. Heterogeneity among studies was assessed using Cochrane's Q test and the I2 statistic. A random effects model was applied to estimate the pooled prevalence of secondary traumatic stress, and subgroup analyses were performed to explore sources of heterogeneity. Descriptive analysis summarized the associated factors.Results: Out of 345 articles retrieved, 14 met the inclusion criteria, with 11 reporting secondary traumatic stress prevalence. The pooled prevalence of secondary traumatic stress among emergency nurses was 65% (95% CI: 58%-73%). Subgroup analyses indicated the highest prevalence in Asia (74%, 95% CI: 72%-77%), followed by North America (59%, 95% CI: 49%-72%) and Europe (53%, 95% CI: 29%-95%). Nine studies identified associated factors, including personal, work-related, and social factors. In the subgroup of divided by recruitment period, emergency department nurses in the COVID-19 outbreak period had a higher prevalence of secondary traumatic stress (70%, 95% CI: 62%-78%).Conclusions: Secondary traumatic stress prevalence is notably high among emergency department nurses, with significant regional variations and period differences. The factors affecting secondary traumatic stress also varied across studies. Future research should focus on improving research designs and sample sizes to pinpoint risk factors and develop prevention strategies.Registration: PROSPERO CRD42022301167.
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Affiliation(s)
- Zhiyong Xu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Bingnan Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Zhen Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Xuan Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Yifan Jiang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Min Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
| | - Ping Li
- Department of Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China
- Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Jinan, People’s Republic of China
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Wang H, Xia Q, Dong Z, Guo W, Deng W, Zhang L, Kuang W, Li T. Emotional distress and multimorbidity patterns in Chinese Han patients with osteoporosis: a network analysis. Front Public Health 2024; 11:1242091. [PMID: 38274525 PMCID: PMC10808410 DOI: 10.3389/fpubh.2023.1242091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
With the aging of the population, the prevalence of osteoporosis and multimorbidity is increasing. Patients with osteoporosis often experience varying levels of emotional distress, including anxiety and depression. However, few studies have explored the patterns of multiple conditions and their impact on patients' emotional distress. Here, we conducted a network analysis to explore the patterns of multimorbidities and their impact on emotional distress in 13,359 Chinese Han patients with osteoporosis. The results showed that multimorbidity was prevalent in Chinese patients with osteoporosis and increased with age, and was more frequent in males than in females, with the most common pattern of multimorbidity being osteoporosis and essential (primary) hypertension. Finally, we found that patients' emotional distress increased with the number of multimorbidities, especially in female patients, and identified eight multimorbidities with high correlation to patients' emotional distress.
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Affiliation(s)
- Huiyao Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Xia
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjun Guo
- Department of Neurobiology, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Deng
- Department of Neurobiology, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Weihong Kuang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
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Ni J, Yan Y, Du W, Tian Y, Fan L. Depressive symptoms, alone or together with physical comorbidity, are predictive of healthcare use and spending in older adults. J Psychosom Res 2023; 174:111482. [PMID: 37734253 DOI: 10.1016/j.jpsychores.2023.111482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE Depressive symptoms and physical comorbidity are common health problems in older adults and are both posing increasingly considerable challenges to global healthcare systems. This study investigated the relationships of depressive symptoms, alone or together with physical comorbidity, with healthcare utilization and spending among older adults, as well as examined sex differences. METHODS We used data of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 and enrolled 6519 participants. Depressive symptoms was operationalized following the Center for Epidemiological Studies Depression Scale and physical comorbidity was assessed according to the presence of 11 physical non-communicable diseases. The relationships of depressive symptoms and comorbidity with healthcare outcomes were examined using mixed-effects regression models. RESULTS Compared with the neither depressive symptoms nor physical comorbidity category, older adults classified as depressive symptoms-only, physical comorbidity-only or both conditions were all associated with elevated risks for healthcare use and spending (all OR/IRR > 1; all p < 0.001). Depressive symptoms and physical comorbidity in combination consistently led to higher risks for studied endpoints than either condition alone (outpatient visit: OR = 3.50, outpatient visit number: IRR = 3.39, inpatient visit: OR = 3.35, hospitalization days: IRR = 2.82, catastrophic health expenditure: OR = 1.70; all p-trend < 0.001). Stratification analyses revealed similar relationships irrespective of sex. CONCLUSION Depressive symptoms and physical comorbidity are separately and jointly associated with increased healthcare utilization and spending among Chinese older adults. These two conditions in combination lead to highest risks than either condition alone. Early screen for depressive symptoms, alone or together with physical comorbidity, may offer implications for appropriate policy interventions.
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Affiliation(s)
- Jinmeng Ni
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Yuhan Yan
- Department of Geriatrics, General Hospital of Eastern Theater Command, Nanjing 210000, China
| | - Wei Du
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Yong Tian
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Lijun Fan
- School of Public Health, Southeast University, Nanjing 210009, China.
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Nishida Y, Anzai T, Takahashi K, Kozuma T, Kanda E, Yamauchi K, Katsukawa F. Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association. PLoS One 2023; 18:e0291554. [PMID: 37768909 PMCID: PMC10538783 DOI: 10.1371/journal.pone.0291554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023] Open
Abstract
Although the economic burden of multimorbidity is a growing global challenge, the contribution of multimorbidity in patients with high medical expenses remains unclear. We aimed to clarify multimorbidity patterns that have a large impact on medical costs in the Japanese population. We conducted a cross-sectional study using health insurance claims data provided by the Japan Health Insurance Association. Latent class analysis (LCA) was used to identify multimorbidity patterns in 1,698,902 patients who had the top 10% of total medical costs in 2015. The present parameters of the LCA model included 68 disease labels that were frequent among this population. Moreover, subgroup analysis was performed using a generalized linear model (GLM) to assess the factors influencing annual medical cost and 5-year mortality. As a result of obtaining 30 latent classes, the kidney disease class required the most expensive cost per capita, while the highest portion (28.6%) of the total medical cost was spent on metabolic syndrome (MetS) classes, which were characterized by hypertension, dyslipidemia, and type 2 diabetes. GLM applied to patients with MetS classes showed that cardiovascular diseases or complex conditions, including malignancies, were powerful determinants of medical cost and mortality. MetS was classified into 7 classes based on real-world data and accounts for a large portion of the total medical costs. MetS classes with cardiovascular diseases or complex conditions, including malignancies, have a significant impact on medical costs and mortality.
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Affiliation(s)
- Yuki Nishida
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
- Graduate School of Health Management, Keio University, Yokohama, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Yokohama, Kanagawa, Japan
| | - Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahide Kozuma
- Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Eiichiro Kanda
- Medical Science, Kawasaki Medical School, Okayama, Japan
| | - Keita Yamauchi
- Graduate School of Health Management, Keio University, Yokohama, Kanagawa, Japan
| | - Fuminori Katsukawa
- Sports Medicine Research Center, Keio University, Yokohama, Kanagawa, Japan
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Liu X, Zhang J, Zhang S, Peng S, Pei M, Dai C, Wang T, Zhang P. Quality of life and associated factors among community-dwelling adults with multimorbidity in Shanghai, China: A cross-sectional study. Nurs Open 2023. [PMID: 37243492 DOI: 10.1002/nop2.1770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/23/2023] [Accepted: 04/16/2023] [Indexed: 05/28/2023] Open
Abstract
AIM To compare the quality of life of patients with and without multimorbidity and investigate potential factors related to the quality of life in patients with multimorbidity. DESIGN A descriptive cross-sectional study. METHODS This study included 1778 residents with chronic diseases, including single disease (1255 people, average age: 60.78 ± 9.42) and multimorbidity (523 people, average age: 64.03 ± 8.91) groups, who were recruited from urban residents of Shanghai through a multistage, stratified, probability proportional to size sampling method. The quality of life was measured using the World Health Organization Quality of Life Questionnaire. The socio-demographic data and psychological states were measured using a self-made structured questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale. Differences in demographic characteristics were estimated using Pearson's chi-squared test, and independent t-test or one-way ANOVA followed by S-N-K test was used to compare the mean quality of life. Multiple linear regression analysis was conducted to identify risk factors for multimorbidity. RESULTS There were differences in age, education, income, and BMI between single-disease and multimorbidity groups, but no differences in gender, marriage, and occupation. Multimorbidity had lower quality of life, reflected in all four domains. Multiple linear regression analyses showed that low level of education, low income, number of diseases, depression, and anxiety were negatively related to quality of life in all domains.
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Affiliation(s)
- Xingyue Liu
- Graduate School, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Juhua Zhang
- Department of integrated traditional Chinese and Western Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shixiang Zhang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Shuzhi Peng
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengyun Pei
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunying Dai
- Department of medicine, Kashgar Vocational and Technical College, Kashgar, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Peng Zhang
- School of Management, Hainan Medical University, Haikou, China
- School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Fu G, Yu Y, Ye J, Zheng Y, Li W, Cui N, Wang Q. A method for diagnosing depression: Facial expression mimicry is evaluated by facial expression recognition. J Affect Disord 2023; 323:809-818. [PMID: 36535548 DOI: 10.1016/j.jad.2022.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/20/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Considerable evidence has shown that facial expression mimicry is impaired in patients with depression. We aimed to evaluate voluntary expression mimicry by facial expression recognition for diagnosing depression. METHODS A total of 168 participants performed voluntary expression mimicry task, posing anger, disgust, fear, happiness, neutrality, sadness, and surprise. 9 healthy raters performed facial expression recognition task through the observer scoring method, and evaluated seven expressions imitated by participants. Emotional scores were calculated to measure any differences between two groups of participants and provided a basis for clinical diagnosis of depression. RESULTS Compared with the control group, the depression group had lower accuracy in imitating happiness. Compared with the control group, the depression group imitated a higher neutrality bias for sadness, surprise, happiness and disgust, while sadness and surprise had a lower happiness bias; for imitating happiness, the depression group showed higher anger, disgust, fear, neutrality, and surprise bias; for imitating neutrality, the depression group showed higher sadness bias, and lower happiness bias. Compared with the control group, the raters had a higher reaction time to recognize the happiness imitated by depression group, and it was positively correlated with severity of depression. The severity of depression was also negatively correlated with accuracy in imitating happiness, and positively correlated with neutrality bias of imitating surprise. LIMITATIONS The ecological effectiveness of static stimulus materials is lower than that of dynamic stimuli. Without synchronized functional imaging, there is no way to link brain activation patterns. CONCLUSION The ability of patients with depression to voluntarily imitate facial expressions declines, which is mainly reflected in accuracy, bias and recognizability. Our experiment has discovered deficits in these aspects of patients with depression, which will be used as a method for diagnosising depression.
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Affiliation(s)
- Gang Fu
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Yanhong Yu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Jiayu Ye
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Yunshao Zheng
- Shandong Provincial Mental Health Center, Jinan 250014, China
| | - Wentao Li
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China
| | - Ning Cui
- College of Health, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Qingxiang Wang
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan 250353, China.
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Ji Y, Feng Y, Wu S, Wu Y, Wang J, Zhao X, Liu Y. Longitudinal trajectories of depressive symptoms: the role of multimorbidity, mobility and subjective memory. BMC Geriatr 2023; 23:22. [PMID: 36635652 PMCID: PMC9837987 DOI: 10.1186/s12877-023-03733-4] [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: 04/07/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The high prevalence of depression among older people in China places a heavy burden on the health system. Multimorbidity, mobility limitation and subjective memory impairment are found to be risk indicators for depression. However, most studies on this topic focused on depression at a single point in time, ignoring the dynamic changes in depressive symptoms and the relationship between the trajectories and these three conditions. Therefore, we aimed to identify distinct trajectories of depressive symptoms in older people and investigate their associations with multimorbidity, mobility limitation and subjective memory impairment. METHODS Data was drawn from China Health and Retirement Longitudinal Study conducted during 2011-2018. A total of 5196 participants who completed 4 visits, conducted every 2-3 years were included in this study. Group-based trajectory modeling was conducted to identify distinct trajectories of depressive symptoms z-scores. Multinomial logistic regression was used to investigate the relationships. RESULTS Four distinct trajectories of depressive symptoms z-scores were identified, labeled as persistently low symptoms (68.69%, n = 3569), increasing symptoms (12.14%, n = 631), decreasing symptoms (14.05%, n = 730) and persistently high symptoms (5.12%, n = 266). Participants with multimorbidity had unfavorable trajectories of depressive symptoms compared with those without multimorbidity, with adjusted odds ratios (95% CIs) of 1.40 (1.15, 1.70), 1.59 (1.33, 1.90) and 2.19 (1.65, 2.90) for the increasing symptoms, decreasing symptoms and persistently high symptoms, respectively. We also observed a similar trend among participants with mobility limitations. Compared with participants who had poor subjective memory, participants with excellent/very good/good subjective memory had a lower risk of developing unfavorable trajectories of depressive symptoms. The adjusted odds ratios (95% CIs) of the increasing symptoms, decreasing symptoms and persistently high symptoms were 0.54 (0.40, 0.72), 0.50 (0.38, 0.65) and 0.48 (0.31, 0.73), respectively. CONCLUSIONS Multimorbidity, mobility limitation and subjective memory impairment were found to be potential risk factors for unfavorable depression trajectories.
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Affiliation(s)
- Yiman Ji
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Yiping Feng
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Sijia Wu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Yutong Wu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Jiongjiong Wang
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Xiangjuan Zhao
- Department of gynecology, Maternal and Child Health Care Hospital of Shandong Province, Jinan, 250014 Shandong China
| | - Yunxia Liu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
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