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Fox A, Kim H. HIV policy legacies, pandemic preparedness and policy effort to address COVID-19. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001767. [PMID: 37363903 DOI: 10.1371/journal.pgph.0001767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/22/2023] [Indexed: 06/28/2023]
Abstract
That the world was unprepared for a major infectious disease outbreak is now readily apparent to all credible observers. However, some countries were more prepared than others and we have seen a variety of responses to COVID-19 emerge across nations. While recognizing that the sources of variation in country responses to COVID-19 are many and varied, in this study we seek to examine how policy legacies from national responses to HIV have influenced countries' responses to COVID-19. The aim of this study was to examine whether countries with a more conducive HIV policy environment were better prepared for COVID-19 and have therefore had more preemptive and rights-based responses. Using data from the Oxford Covid-19 Government Response Tracker, we develop measures of country effort to respond to COVID-19 including early containment and closure policies, prevention policies, economic policies, and health system policies. We combine this with data from the HIV Policy Lab and correlate overall and disaggregated country HIV Policy scores with COVID-19 Policy scores. We find that the COVID-19 Containment and Closure Measures Index was negatively correlated with supportive social policies related to HIV in the early stages of the pandemic, but the association did not persist as time went on. The COVID-19 Economic Support Measures had prolonged positive associations with supportive social policies related to HIV and negative association with clinical and treatment policies. Countries with stronger structural responses to HIV have been less inclined towards involuntary measures and more prepared for the social and economic elements of COVID-19 pandemic response.
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Affiliation(s)
- Ashley Fox
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, NY, United States of America
| | - Heeun Kim
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, NY, United States of America
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The Impact of Educational Intervention on Willingness to Enroll in a Clinical Trial of a Gonorrhea Vaccine. Vaccines (Basel) 2023; 11:vaccines11030648. [PMID: 36992233 DOI: 10.3390/vaccines11030648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Globally, >80 million new gonorrhea infections occur annually. Here, we assessed barriers to and influences on participation in a gonorrhea clinical trial and the impact of educational intervention. The survey was fielded in the US in March 2022. Higher enrollment of Black/African Americans and younger individuals than represented in the US demographic distribution reflected the higher incidence of gonorrhea in these groups. Behavioral characteristics and baseline attitudes toward vaccination were collected. Participants were probed on their knowledge of and likelihood to enroll in general and gonorrhea vaccine trials. Participants hesitant to enroll in a gonorrhea vaccine trial were given nine bullets of basic facts about the disease and asked again to rank their likelihood to enroll. Overall, 450 individuals completed the survey. Fewer participants were willing (quite/very likely) to join a gonorrhea versus a general vaccine trial (38.2% [172/450] vs. 57.8% [260/450]). The likelihood to enroll in any vaccine trial or a gonorrhea vaccine trial was greater with higher self-declared knowledge (Spearman’s ρ = 0.277 [p < 0.001] and 0.316 [p < 0.001], respectively) and baseline openness towards vaccination (p < 0.001 for both). Self-declared awareness of gonorrhea was associated with age (p = 0.001), education (p = 0.031), and ethnicity/race (p = 0.002), with older, more educated, and Black/African Americans having higher awareness. Males (p = 0.001) and those with more sexual partners (p < 0.001) were more likely to enroll in a gonorrhea vaccine trial. Educational intervention had a significant (p < 0.001) impact on hesitancy. Improvement in willingness to enroll in a gonorrhea vaccine trial was greatest in those initially marginally hesitant and lowest in those initially strongly hesitant. Basic educational intervention has the potential to improve recruitment into gonorrhea vaccine trials.
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Auerbach JD, Forsyth AD, Davey C, Hargreaves JR. Living with COVID-19 and preparing for future pandemics: revisiting lessons from the HIV pandemic. Lancet HIV 2023; 10:e62-e68. [PMID: 36370713 PMCID: PMC9764384 DOI: 10.1016/s2352-3018(22)00301-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/22/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022]
Abstract
In April, 2020, just months into the COVID-19 pandemic, an international group of public health researchers published three lessons learned from the HIV pandemic for the response to COVID-19, which were to: anticipate health inequalities, create an enabling environment to support behavioural change, and engage a multidisciplinary effort. We revisit these lessons in light of more than 2 years' experience with the COVID-19 pandemic. With specific examples, we detail how inequalities have played out within and between countries, highlight factors that support or impede the creation of enabling environments, and note ongoing issues with the scarcity of integrated science and health system approaches. We argue that to better apply lessons learned as the COVID-19 pandemic matures and other infectious disease outbreaks emerge, it will be imperative to create dialogue among polarised perspectives, identify shared priorities, and draw on multidisciplinary evidence.
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Affiliation(s)
- Judith D Auerbach
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Calum Davey
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - James R Hargreaves
- Department of Epidemiology and Evaluation, London School of Hygiene & Tropical Medicine, London, UK
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Martin SK, Finn KM, Kisielewski M, Simmons R, Zaas AK. Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1683-1690. [PMID: 35797520 PMCID: PMC9592146 DOI: 10.1097/acm.0000000000004800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To quantify the extent to which internal medicine (IM) residents provided care for patients with COVID-19 and examine characteristics of residency programs with or without plans (at some point) to exclude residents from COVID-19 care during the first 6 months of the pandemic. METHOD The authors used data from a nationally representative, annually recurring survey of U.S. IM program directors (PDs) to quantify early (March-August 2020) resident participation in COVID-19 care. The survey was fielded from August to December 2020. PDs reported whether they had planned to exclude residents from COVID-19 care (i.e., PTE status). PTE status was tested for association with program and COVID-19 temporal characteristics, resident schedule accommodations, and resident COVID-19 cases. RESULTS The response rate was 61.5% (264/429). Nearly half of PDs (45.4%, 118/260) reported their program had planned at some point to exclude residents from COVID-19 care. Northeastern U.S. programs represented a smaller percentage of PTE than non-PTE programs (26.3% vs 36.6%; P = .050). PTE programs represented a higher percentage of programs with later surges than non-PTE programs (33.0% vs 13.6%, P = .048). Median percentage of residents involved in COVID-19 care was 75.0 (interquartile range [IQR]: 22.5-100.0) for PTE programs, compared with 95.0 (IQR: 60.0-100.0) for non-PTE programs ( P < .001). Residents participated most in intensive care units (87.6%, 227/259) and inpatient wards (80.8%, 210/260). Accommodations did not differ by PTE status. PTE programs reported fewer resident COVID-19 cases than non-PTE programs (median percentage = 2.7 [IQR: 0.0-8.6] vs 5.1 [IQR: 1.6-10.7]; P = .011). CONCLUSIONS IM programs varied widely in their reported plans to exclude residents from COVID-19 care during the early pandemic. A high percentage of residents provided COVID-19 care, even in PTE programs. Thus, the pandemic highlighted the tension as to whether residents are learners or employees.
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Affiliation(s)
- Shannon K. Martin
- S.K. Martin is associate professor, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-7431-4956
| | - Kathleen M. Finn
- K.M. Finn is assistant professor, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Michael Kisielewski
- M. Kisielewski is assistant director of surveys and research, Alliance for Academic Internal Medicine, Alexandria, Virginia; ORCID: https://orcid.org/0000-0001-7006-581X
| | - Rachel Simmons
- R. Simmons is assistant professor, Department of Medicine, Boston University, Boston, Massachusetts
| | - Aimee K. Zaas
- A.K. Zaas is professor, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; ORCID: https://orcid.org/0000-0003-2718-915X
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Cuen AJ, Kante A, Tsemo S, Djoudalbaye B. Fighting COVID-19 and HIV through community mobilisation: lessons from an integrated approach to the Africa CDC Partnership to Accelerate COVID-19 Testing (PACT) initiative in seven countries. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:132-142. [PMID: 35901297 DOI: 10.2989/16085906.2022.2103005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Recent literature has shown how the HIV architecture, including community systems, has been critical for fighting COVID-19 in many countries, while sustaining the HIV response. Innovative initiatives suggest that fostering the integration of health services would help address the colliding pandemics. However, there are few documented real-life examples of community mobilisation strategies responding to COVID-19 and HIV. The African Union and Africa Centres for Disease Control and Prevention (Africa CDC) launched the Partnership to Accelerate COVID-19 Testing (PACT) in June 2020 with the goal of training and deploying one million community health workers across the continent. UNAIDS partnered with Africa CDC to implement the PACT initiative in seven countries, i.e. Algeria, Côte d'Ivoire, Gabon, Ghana, Madagascar, Malawi and Namibia. The initiative engaged networks of people living with HIV and community-led organisations to support two of its pillars, test and trace, and the sensitisation to protective measures against COVID-19 for the most vulnerable populations. It later expanded to improve access to COVID-19 vaccines. Based on the assessment of country projects, this article explains how PACT activities implemented by communities contributed to mitigating COVID-19 and HIV among vulnerable and marginalised groups. This article contributes to a better understanding of the impact of a community-based approach in responding effectively to emerging health threats and provides lessons from integrated COVID-19 and HIV community-led responses.
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Affiliation(s)
| | - Agnes Kante
- UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Sihaka Tsemo
- UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Benjamin Djoudalbaye
- Health Diplomacy and Communication, Africa Centres for Disease Control, Addis Ababa, Ethiopia
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Gumede N, Durden E, Govender E. Presidential communication approaches and the impact on public health: a comparative analysis of three South African presidents' communication on AIDS and COVID-19. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:143-151. [PMID: 35901300 DOI: 10.2989/16085906.2022.2091463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/01/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
The HIV response in the African continent over past decades demonstrates the potency that the words and actions of political leaders have in either expediting or impeding the implementation and adoption of preventive measures at the individual and community levels. The article explores the health communication approaches employed by two South African past presidents (Thabo Mbeki and Jacob Zuma) in responding to the HIV epidemic, and contrasts these with the communicative approach of President Cyril Ramaphosa during the COVID-19 pandemic. Approached from this understanding, this article provides a comparative analysis of the communication approaches of these three presidencies across the two pandemics, and considers the variously trusted sources of top-down, government-driven and bottom-up, community-informed approaches to health communication. Critical lessons that emerged in South Africa during the HIV epidemic regarding the need to include communities in communicating about risks and behaviour change have not been adopted into the COVID-19 response. Political leaders are not best placed to communicate about these issues, and, in the context of pandemics, there is a clear need to reconsider top-down communication approaches that are designed without the participation of communities and ignore the interconnected nature of health and other social determinants of health.
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Affiliation(s)
- Nompumelelo Gumede
- Centre for Communication, Media & Society, College of Humanities, University of KwaZulu-Natal, Durban, South Africa
| | - Emma Durden
- Centre for Communication, Media & Society, College of Humanities, University of KwaZulu-Natal, Durban, South Africa
| | - Eliza Govender
- Centre for Communication, Media & Society, College of Humanities, University of KwaZulu-Natal, Durban, South Africa
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Stover J, Kelly SL, Mudimu E, Green D, Smith T, Taramusi I, Bansi-Matharu L, Martin-Hughes R, Phillips AN, Bershteyn A. The risks and benefits of providing HIV services during the COVID-19 pandemic. PLoS One 2021; 16:e0260820. [PMID: 34941876 PMCID: PMC8699979 DOI: 10.1371/journal.pone.0260820] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has caused widespread disruptions including to health services. In the early response to the pandemic many countries restricted population movements and some health services were suspended or limited. In late 2020 and early 2021 some countries re-imposed restrictions. Health authorities need to balance the potential harms of additional SARS-CoV-2 transmission due to contacts associated with health services against the benefits of those services, including fewer new HIV infections and deaths. This paper examines these trade-offs for select HIV services. METHODS We used four HIV simulation models (Goals, HIV Synthesis, Optima HIV and EMOD) to estimate the benefits of continuing HIV services in terms of fewer new HIV infections and deaths. We used three COVID-19 transmission models (Covasim, Cooper/Smith and a simple contact model) to estimate the additional deaths due to SARS-CoV-2 transmission among health workers and clients. We examined four HIV services: voluntary medical male circumcision, HIV diagnostic testing, viral load testing and programs to prevent mother-to-child transmission. We compared COVID-19 deaths in 2020 and 2021 with HIV deaths occurring now and over the next 50 years discounted to present value. The models were applied to countries with a range of HIV and COVID-19 epidemics. RESULTS Maintaining these HIV services could lead to additional COVID-19 deaths of 0.002 to 0.15 per 10,000 clients. HIV-related deaths averted are estimated to be much larger, 19-146 discounted deaths per 10,000 clients. DISCUSSION While there is some additional short-term risk of SARS-CoV-2 transmission associated with providing HIV services, the risk of additional COVID-19 deaths is at least 100 times less than the HIV deaths averted by those services. Ministries of Health need to take into account many factors in deciding when and how to offer essential health services during the COVID-19 pandemic. This work shows that the benefits of continuing key HIV services are far larger than the risks of additional SARS-CoV-2 transmission.
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Affiliation(s)
- John Stover
- Avenir Health, Glastonbury, CT, United States of America
- * E-mail:
| | | | - Edinah Mudimu
- Department of Decision Sciences, University of South Africa, Pretoria, South Africa
| | - Dylan Green
- Cooper/Smith, Washington, DC, United States of America
| | - Tyler Smith
- Cooper/Smith, Washington, DC, United States of America
| | | | | | | | - Andrew N. Phillips
- Institute for Global Health, University College London, London, United Kingdom
| | - Anna Bershteyn
- New York University School of Medicine, New York, NY, United States of America
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Eagen-Torkko M, Altman MR, Kantrowitz-Gordon I, Gavin A, Mohammed S. Moral Distress, Trauma, and Uncertainty for Midwives Practicing During a Pandemic. J Midwifery Womens Health 2021; 66:304-307. [PMID: 34086389 PMCID: PMC8242461 DOI: 10.1111/jmwh.13260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 02/01/2023]
Affiliation(s)
- Meghan Eagen-Torkko
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington
| | - Molly R Altman
- School of Nursing, University of Washington Seattle, Seattle, Washington
| | | | - Amelia Gavin
- School of Social Work, University of Washington Seattle, Seattle, Washington
| | - Selina Mohammed
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington
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Bakovic A, Risner K, Bhalla N, Alem F, Chang TL, Weston WK, Harness JA, Narayanan A. Brilacidin Demonstrates Inhibition of SARS-CoV-2 in Cell Culture. Viruses 2021; 13:271. [PMID: 33572467 PMCID: PMC7916214 DOI: 10.3390/v13020271] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the newly emergent causative agent of coronavirus disease-19 (COVID-19), has resulted in more than two million deaths worldwide since it was first detected in 2019. There is a critical global need for therapeutic intervention strategies that can be deployed to safely treat COVID-19 disease and reduce associated morbidity and mortality. Increasing evidence shows that both natural and synthetic antimicrobial peptides (AMPs), also referred to as Host Defense Proteins/Peptides (HDPs), can inhibit SARS-CoV-2, paving the way for the potential clinical use of these molecules as therapeutic options. In this manuscript, we describe the potent antiviral activity exerted by brilacidin-a de novo designed synthetic small molecule that captures the biological properties of HDPs-on SARS-CoV-2 in a human lung cell line (Calu-3) and a monkey cell line (Vero). These data suggest that SARS-CoV-2 inhibition in these cell culture models is likely to be a result of the impact of brilacidin on viral entry and its disruption of viral integrity. Brilacidin demonstrated synergistic antiviral activity when combined with remdesivir. Collectively, our data demonstrate that brilacidin exerts potent inhibition of SARS-CoV-2 against different strains of the virus in cell culture.
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Affiliation(s)
- Allison Bakovic
- National Center for Biodefense and Infectious Diseases, George Mason University, Manassas, VA 20110, USA; (A.B.); (K.R.); (N.B.); (F.A.)
| | - Kenneth Risner
- National Center for Biodefense and Infectious Diseases, George Mason University, Manassas, VA 20110, USA; (A.B.); (K.R.); (N.B.); (F.A.)
| | - Nishank Bhalla
- National Center for Biodefense and Infectious Diseases, George Mason University, Manassas, VA 20110, USA; (A.B.); (K.R.); (N.B.); (F.A.)
| | - Farhang Alem
- National Center for Biodefense and Infectious Diseases, George Mason University, Manassas, VA 20110, USA; (A.B.); (K.R.); (N.B.); (F.A.)
| | - Theresa L. Chang
- Public Health Research Institute, Rutgers, New Jersey Medical School, The State University of New Jersey, Newark, NJ 07103, USA;
| | - Warren K. Weston
- Innovation Pharmaceuticals Inc., Wakefield, MA 01880, USA; (W.K.W.); (J.A.H.)
| | - Jane A. Harness
- Innovation Pharmaceuticals Inc., Wakefield, MA 01880, USA; (W.K.W.); (J.A.H.)
| | - Aarthi Narayanan
- National Center for Biodefense and Infectious Diseases, George Mason University, Manassas, VA 20110, USA; (A.B.); (K.R.); (N.B.); (F.A.)
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Silva RRD, Guilhermino GMS, Oliveira Neto BLD, Lira Neto JBD. The Interiorization of COVID-19 in the cities of Pernambuco State, Northeast of Brazil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-9304202100s100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Objectives: to analyze how the disseminationof COVID-19 occurred in the cities of Pernambuco State, Northeast in Brazil. Methods: descriptive, exploratory and quantitative study whose units of analysis were the 184 cities and Fernando de Noronha Archipelago which constitutes the state of Pernambuco. Geoprocessing techniques used QGis 3.14.16 and were presented in figures. Results: the first city to register a case of COVID-19 was Recife, in 129 days there were already confirmed cases of the disease in all the cities in the state and including Fernando de Noronha Archipelago. Only 117 cities informed the patients’ sexin public reports since the first case and only 88 cities mentioned the patients ’ age. Conclusion: there was a fast spread of COVID-19 in the state of Pernambuco, showing the inability of the Health Surveillance services to control the transmission, especially in smalltowns.
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Lee JK. Challenging Issues Caused by COVID-19 - A Window of Opportunity to Make Our Health System Healthier. Osong Public Health Res Perspect 2020; 11:267-268. [PMID: 33117630 PMCID: PMC7577387 DOI: 10.24171/j.phrp.2020.11.5.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jong-Koo Lee
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
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