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Article ; Online: Longitudinal trends in enrollees' employment and student status after Medicaid expansion.

Tipirneni, Renuka / Kieffer, Edith C / Ayanian, John Z / Patel, Minal R / Kirch, Matthias A / Luster, Jamie E / Karmakar, Monita / Goold, Susan D

BMC health services research

2022 Volume 22, Issue 1, Page(s) 233

Abstract: Background: Medicaid community engagement requirements previously received federal approval in 12 states, despite limited data on their impact on enrollees' employment-related activities. Our objective was to assess longitudinal changes in enrollees' ... ...

Abstract	Background: Medicaid community engagement requirements previously received federal approval in 12 states, despite limited data on their impact on enrollees' employment-related activities. Our objective was to assess longitudinal changes in enrollees' employment and student status after implementation of Michigan's Medicaid expansion. Methods: Longitudinal telephone survey of Michigan Medicaid expansion enrollees in 2016 (response rate [RR] = 53.7%), 2017 (RR = 83.4%), and 2018 (N = 2,608, RR = 89.4%) serially assessing self-reported employment or student status. Survey responses were benchmarked against statewide changes in assessed similar low-income adults in the U.S. Census Bureau Current Population Survey. We used mixed models with individual random effects to assess changes in the proportion of enrollees who were employed or students by year. Results: Most respondents had incomes < 100% FPL (61.7% with 0-35% of the federal poverty level [FPL], 22.9% with 36-99% FPL, and 15.4% with 100-133% FPL), 89.3% had at least a high school diploma/equivalent, and they ranged in age (39.6% age 19-34, 34.5% age 35-50, 25.9% age 51-64). Employment or student status increased significantly among Michigan Medicaid expansion respondents, from 54.5% in 2016 to 61.4% in 2018 (P < 0.001), including among those with a chronic condition (47.8% to 53.8%, P < 0.001) or mental health/substance use disorder (48.5% to 56.0%, P < 0.001). In contrast, the statewide proportion of low-income non-elderly adults who were employed or students did not change significantly (from 42.7% in 2016 to 46.0% in 2018, P = 0.57). Conclusions: Medicaid expansion, absent a community engagement requirement, was associated with increased employment and related activities. The role of Medicaid in providing safety-net coverage to individuals during times of economic stress is likely to grow.
MeSH term(s)	Adult ; Employment ; Health Services Accessibility ; Humans ; Insurance Coverage ; Medicaid ; Michigan/epidemiology ; Middle Aged ; Patient Protection and Affordable Care Act ; Poverty ; Students ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2022-02-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-07599-x
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Article ; Online: Longitudinal trends in enrollees’ employment and student status after Medicaid expansion

Renuka Tipirneni / Edith C. Kieffer / John Z. Ayanian / Minal R. Patel / Matthias A. Kirch / Jamie E. Luster / Monita Karmakar / Susan D. Goold

BMC Health Services Research, Vol 22, Iss 1, Pp 1-

2022 Volume 7

Abstract: Abstract Background Medicaid community engagement requirements previously received federal approval in 12 states, despite limited data on their impact on enrollees’ employment-related activities. Our objective was to assess longitudinal changes in ... ...

Abstract	Abstract Background Medicaid community engagement requirements previously received federal approval in 12 states, despite limited data on their impact on enrollees’ employment-related activities. Our objective was to assess longitudinal changes in enrollees’ employment and student status after implementation of Michigan’s Medicaid expansion. Methods Longitudinal telephone survey of Michigan Medicaid expansion enrollees in 2016 (response rate [RR] = 53.7%), 2017 (RR = 83.4%), and 2018 (N = 2,608, RR = 89.4%) serially assessing self-reported employment or student status. Survey responses were benchmarked against statewide changes in assessed similar low-income adults in the U.S. Census Bureau Current Population Survey. We used mixed models with individual random effects to assess changes in the proportion of enrollees who were employed or students by year. Results Most respondents had incomes < 100% FPL (61.7% with 0–35% of the federal poverty level [FPL], 22.9% with 36–99% FPL, and 15.4% with 100–133% FPL), 89.3% had at least a high school diploma/equivalent, and they ranged in age (39.6% age 19–34, 34.5% age 35–50, 25.9% age 51–64). Employment or student status increased significantly among Michigan Medicaid expansion respondents, from 54.5% in 2016 to 61.4% in 2018 (P < 0.001), including among those with a chronic condition (47.8% to 53.8%, P < 0.001) or mental health/substance use disorder (48.5% to 56.0%, P < 0.001). In contrast, the statewide proportion of low-income non-elderly adults who were employed or students did not change significantly (from 42.7% in 2016 to 46.0% in 2018, P = 0.57). Conclusions Medicaid expansion, absent a community engagement requirement, was associated with increased employment and related activities. The role of Medicaid in providing safety-net coverage to individuals during times of economic stress is likely to grow.
Keywords	Medicaid ; Employment ; Health reform ; Health policy ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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Article ; Online: HIV-exposed uninfected infant morbidity and mortality within a nationally representative prospective cohort of mother-infant pairs in Zimbabwe.

Patel, Monita R / Mushavi, Angela / Balachandra, Shirish / Shambira, Gerald / Nyakura, Justice / Mugurungi, Owen / Kilmarx, Peter H / Rivadeneira, Emilia / Dinh, Thu-Ha

AIDS (London, England)

2020 Volume 34, Issue 9, Page(s) 1339–1346

Abstract: Objective: To examine morbidity and mortality risk among HIV-exposed uninfected (HEU) infants.: Design: Secondary data analysis of HEU infants in a prospective cohort study of mother-infant pairs.: Methods: Infants were recruited from immunization ...

Abstract	Objective: To examine morbidity and mortality risk among HIV-exposed uninfected (HEU) infants. Design: Secondary data analysis of HEU infants in a prospective cohort study of mother-infant pairs. Methods: Infants were recruited from immunization clinics (n = 151) in Zimbabwe from February to August 2013, enrolled at 4-12 weeks age, and followed every 3 months until incident HIV-infection, death, or 18-month follow-up. We estimated cumulative mortality probability and hazard ratios with 95% confidence intervals (CIs) using Kaplan-Meier curves and Cox regression, respectively. We also described reported reasons for infant hospitalization and symptoms preceding death. Median weight-for-age z-scores (WAZ) and median age were calculated and analyzed across study visits. Results: Of 1188 HIV-exposed infants, 73 (6.1%) contracted HIV; we analyzed the remaining 1115 HEU infants. In total, 54 (4.8%) infants died, with median time to death of 5.5 months since birth (interquartile range: 3.6-9.8 months). Diarrhea, difficulty breathing, not eating, fever, and cough were commonly reported (range: 7.4-22.2%) as symptoms preceding infant death. Low birth weight was associated with higher mortality (adjusted hazard ratio 2.66, CI: 1.35-5.25), whereas maternal antiretroviral therapy predelivery (adjusted hazard ratio 0.34, CI: 0.18-0.64) and exclusive breastfeeding (adjusted hazard ratio 0.50, CI: 0.28-0.91) were associated with lower mortality. Overall, 9.6% of infants were hospitalized. Infant median WAZ declined after 3 months of age, reaching a minimum at 14.5 months of age, at which 50% of infants were underweight (WAZ below -2.0). Conclusion: Clinical interventions including maternal antiretroviral therapy; breastfeeding and infant feeding counseling and support; and early prevention, identification, and management of childhood illness; are needed to reduce HEU infant morbidity and mortality.
MeSH term(s)	Child ; Cohort Studies ; Female ; HIV Infections/epidemiology ; HIV Infections/transmission ; HIV Infections/virology ; Humans ; Infant ; Infant Mortality ; Infectious Disease Transmission, Vertical/statistics & numerical data ; Morbidity ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/virology ; Prospective Studies ; Zimbabwe/epidemiology
Language	English
Publishing date	2020-06-10
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000002567
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Article ; Online: Performance of Oropharyngeal Swab Testing Compared With Nasopharyngeal Swab Testing for Diagnosis of Coronavirus Disease 2019-United States, January 2020-February 2020.

Patel, Monita R / Carroll, Darin / Ussery, Emily / Whitham, Hilary / Elkins, Christopher A / Noble-Wang, Judith / Rasheed, James Kamile / Lu, Xiaoyan / Lindstrom, Stephen / Bowen, Virginia / Waller, Jessica / Armstrong, Gregory / Gerber, Susan / Brooks, John T

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2021 Volume 72, Issue 3, Page(s) 482–485

Abstract: Among 146 nasopharyngeal (NP) and oropharyngeal (OP) swab pairs collected ≤7 days after illness onset, Real-Time Reverse Transcriptase Polymerase Chain Reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 RT-PCR) diagnostic ... ...

Abstract	Among 146 nasopharyngeal (NP) and oropharyngeal (OP) swab pairs collected ≤7 days after illness onset, Real-Time Reverse Transcriptase Polymerase Chain Reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 RT-PCR) diagnostic results were 95.2% concordant. However, NP swab cycle threshold values were lower (indicating more virus) in 66.7% of concordant-positive pairs, suggesting NP swabs may more accurately detect the amount of SARS-CoV-2.
MeSH term(s)	COVID-19 ; Clinical Laboratory Techniques ; Diagnostic Tests, Routine ; Humans ; Nasopharynx ; Real-Time Polymerase Chain Reaction ; SARS-CoV-2 ; United States
Language	English
Publishing date	2021-01-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa759
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Article ; Online: Prevalence of Gonorrhea and Chlamydia Testing by Anatomical Site Among Men Who Have Sex With Men in HIV Medical Care, United States, 2013-2014.

Patel, Monita R / Brooks, John T / Tie, Yunfeng / Garg, Shikha / Bradley, Heather

Sexually transmitted diseases

2017 Volume 45, Issue 1, Page(s) 25–27

Abstract: Fewer than one-third of men who have sex with men were tested for Neisseria gonorrhoeae or Chlamydia trachomatis as part of HIV medical care in the United States in 2013 to 2014, and only 11.6% were tested for either sexually transmitted disease at an ... ...

Abstract	Fewer than one-third of men who have sex with men were tested for Neisseria gonorrhoeae or Chlamydia trachomatis as part of HIV medical care in the United States in 2013 to 2014, and only 11.6% were tested for either sexually transmitted disease at an extragenital site.
MeSH term(s)	Adult ; Chlamydia Infections/epidemiology ; Chlamydia Infections/microbiology ; Ethnic Groups ; Gonorrhea/epidemiology ; Gonorrhea/microbiology ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Middle Aged ; Pharyngeal Diseases/epidemiology ; Pharyngeal Diseases/microbiology ; Pharynx/microbiology ; Population Surveillance ; Prevalence ; Rectal Diseases/epidemiology ; Rectal Diseases/microbiology ; Rectum/microbiology ; Reproductive Health ; Sexual Behavior ; United States
Language	English
Publishing date	2017-09-06
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000000691
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Article ; Online: The Impact of the Affordable Care Act Medicaid Expansion on Racial/Ethnic and Sex Disparities in HIV Testing: National Findings from the Behavioral Risk Factor Surveillance System.

Menon, Anitha / Patel, Payal K / Karmakar, Monita / Tipirneni, Renuka

Journal of general internal medicine

2021 Volume 36, Issue 6, Page(s) 1605–1612

Abstract: Introduction: Over half of Americans have not been tested for HIV in their lifetime, and over a third of all HIV diagnoses are made less than a year before progression to AIDS. The Affordable Care Act (ACA) Medicaid expansion of 2014 had potential to ... ...

Abstract	Introduction: Over half of Americans have not been tested for HIV in their lifetime, and over a third of all HIV diagnoses are made less than a year before progression to AIDS. The Affordable Care Act (ACA) Medicaid expansion of 2014 had potential to improve HIV and other health screenings. We assessed the differential impacts of Medicaid expansion on racial/ethnic and racial/ethnic-sex disparities in HIV testing. Methods: Using Behavioral Risk Factor Surveillance System data from all 50 states and D.C., we sampled low-income (≤ 138% of the federal poverty level) adults ages 19-64 who were non-pregnant and non-disabled. Using a difference-in-differences (DD) and triple difference-in-differences (DDD) study design, we assessed differential impacts by race/ethnicity (White, Black, Hispanic, and other) and race/ethnicity-sex between 2011 and 2013 and 2014-2018. Outcomes were (1) ever having received an HIV test and (2) having received an HIV test in the last year. Results: Overall, Medicaid expansion was associated with a significant increase in HIV testing (p = 0.003). White females and Black males appeared most likely to benefit from this increase (DD 4.5 and 4.8 percentage points; p = 0.001 and 0.130 respectively). However, despite having baseline higher rates of HIV diagnosis, Black and Hispanic females did not have increased rates of ever having HIV testing following Medicaid expansion (DD - 1.9 and 0.9 percentage points; p = 0.391 and 0.703, respectively), including when compared to a White male reference subgroup and across other race/ethnicity-sex subgroups. Conclusions: Medicaid expansion was associated with an increased overall probability of HIV testing among low-income, nonelderly adults, but certain groups including Black females were not more likely to benefit from this increase, despite being disproportionately affected by HIV at baseline. Targeted and culturally informed interventions to increase Medicaid enrollment and access to primary care may be needed to expand HIV testing in vulnerable groups.
MeSH term(s)	Adult ; Behavioral Risk Factor Surveillance System ; Ethnicity ; Female ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Health Services Accessibility ; Healthcare Disparities ; Hispanic or Latino ; Humans ; Insurance Coverage ; Male ; Medicaid ; Middle Aged ; Patient Protection and Affordable Care Act ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2021-01-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-021-06590-2
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Article ; Online: The effect of tuberculosis treatment at combination antiretroviral therapy initiation on subsequent mortality: a systematic review and meta-analysis.

Soeters, Heidi M / Poole, Charles / Patel, Monita R / Van Rie, Annelies

PloS one

2013 Volume 8, Issue 10, Page(s) e78073

Abstract: Objective: We aimed to perform a systematic review and meta-analysis examining the impact of TB treatment at the time of combination antiretroviral therapy (cART) initiation on subsequent mortality.: Methods: We searched PubMed, EMBASE, and selected ... ...

Abstract	Objective: We aimed to perform a systematic review and meta-analysis examining the impact of TB treatment at the time of combination antiretroviral therapy (cART) initiation on subsequent mortality. Methods: We searched PubMed, EMBASE, and selected conference proceedings for studies that report adult mortality on cART, stratified by TB treatment status at cART initiation. Stratified random-effects and meta-regression analyses were used to examine the influence of study and population characteristics. Results: 22 eligible cohort studies reported data on 98,350 (range 74-15,225) adults, of whom 14,779 (15%) were receiving TB treatment at cART initiation. Studies of those receiving vs. not receiving TB treatment had an average mortality relative risk of 1.10 (95% confidence interval 0.87-1.40) at 1-3 months (based upon 8 estimates), 1.15 (0.94-1.41) at 6-12 months (11 estimates), and 1.33 (1.02-1.75) at 18-98 months (10 estimates) following cART initiation. However, there was a wide range of estimates and those at later time points were markedly heterogeneous. Meta-regression identified factors associated with elevated average risk estimates: lower median baseline CD4 counts and adjustment for baseline hemoglobin at 1-3 months; longer length of follow-up and women-only studies at 6-12 months; and not adjusting for BMI/weight at 18-98 months. Conclusions: Patients receiving TB treatment at cART initiation did not have a statistically significant estimated increase in short-term risk of all-cause mortality as compared to those not receiving TB treatment. TB treatment was significantly associated with increased mortality after about a year of cART, suggesting that patients with concurrent TB treatment at cART initiation may benefit from continued support after TB treatment completion.
MeSH term(s)	Anti-Retroviral Agents/therapeutic use ; Drug Combinations ; Humans ; Risk ; Tuberculosis/drug therapy ; Tuberculosis/mortality
Chemical Substances	Anti-Retroviral Agents ; Drug Combinations
Language	English
Publishing date	2013-10-15
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Review ; Systematic Review
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0078073
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Article ; Online: SARS-CoV-2 Infections and Serologic Responses from a Sample of U.S. Navy Service Members - USS Theodore Roosevelt, April 2020.

Payne, Daniel C / Smith-Jeffcoat, Sarah E / Nowak, Gosia / Chukwuma, Uzo / Geibe, Jesse R / Hawkins, Robert J / Johnson, Jeffrey A / Thornburg, Natalie J / Schiffer, Jarad / Weiner, Zachary / Bankamp, Bettina / Bowen, Michael D / MacNeil, Adam / Patel, Monita R / Deussing, Eric / Gillingham, Bruce L

MMWR. Morbidity and mortality weekly report

2020 Volume 69, Issue 23, Page(s) 714–721

Abstract: Compared with the volume of data on coronavirus disease 2019 (COVID-19) outbreaks among older adults, relatively few data are available concerning COVID-19 in younger, healthy persons in the United States (1,2). In late March 2020, the aircraft carrier ... ...

Abstract	Compared with the volume of data on coronavirus disease 2019 (COVID-19) outbreaks among older adults, relatively few data are available concerning COVID-19 in younger, healthy persons in the United States (1,2). In late March 2020, the aircraft carrier USS Theodore Roosevelt arrived at port in Guam after numerous U.S. service members onboard developed COVID-19. In April, the U.S. Navy and CDC investigated this outbreak, and the demographic, epidemiologic, and laboratory findings among a convenience sample of 382 service members serving aboard the aircraft carrier are reported in this study. The outbreak was characterized by widespread transmission with relatively mild symptoms and asymptomatic infection among this sample of mostly young, healthy adults with close, congregate exposures. Service members who reported taking preventive measures had a lower infection rate than did those who did not report taking these measures (e.g., wearing a face covering, 55.8% versus 80.8%; avoiding common areas, 53.8% versus 67.5%; and observing social distancing, 54.7% versus 70.0%, respectively). The presence of neutralizing antibodies, which represent antibodies that inhibit SARS-CoV-2, among the majority (59.2%) of those with antibody responses is a promising indicator of at least short-term immunity. This report improves the understanding of COVID-19 in the U.S. military and among young adults in congregate settings and reinforces the importance of preventive measures to lower risk for infection in similar environments.
MeSH term(s)	Aircraft ; Antibodies, Neutralizing/blood ; Antibodies, Viral/blood ; Betacoronavirus/immunology ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/immunology ; Disease Outbreaks ; Female ; Humans ; Male ; Military Personnel/statistics & numerical data ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/immunology ; SARS-CoV-2 ; United States/epidemiology ; Young Adult
Chemical Substances	Antibodies, Neutralizing ; Antibodies, Viral
Keywords	covid19
Language	English
Publishing date	2020-06-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm6923e4
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Article: Performance of oropharyngeal swab testing compared to nasopharyngeal swab testing for diagnosis of COVID-19 -United States, January-February 2020

Patel, Monita R / Carroll, Darin / Ussery, Emily / Whitham, Hilary / Elkins, Christopher A / Noble-Wang, Judith / Rasheed, James Kamile / Lu, Xioayan / Lindstrom, Stephen / Bowen, Virginia / Waller, Jessica / Armstrong, Gregory / Gerber, Susan / Brooks, John T

Clin. infect. dis

Abstract: Among 146 nasopharyngeal (NP) and oropharyngeal (OP) swab pairs collected ≤7 days since illness onset, CDC real-time RT-PCR SARS-CoV-2 assay diagnostic results were 95.2% concordant. However, NP swab Ct values were lower (indicating more virus) in 66.7% ... ...

Abstract	Among 146 nasopharyngeal (NP) and oropharyngeal (OP) swab pairs collected ≤7 days since illness onset, CDC real-time RT-PCR SARS-CoV-2 assay diagnostic results were 95.2% concordant. However, NP swab Ct values were lower (indicating more virus) in 66.7% of concordant-positive pairs, suggesting NP swabs may more accurately detect amount of SARS-CoV-2.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #599634
Database	COVID19

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Article ; Online: The effect of tuberculosis treatment at combination antiretroviral therapy initiation on subsequent mortality

Heidi M Soeters / Charles Poole / Monita R Patel / Annelies Van Rie

PLoS ONE, Vol 8, Iss 10, p e

a systematic review and meta-analysis.

2013 Volume 78073

Abstract: OBJECTIVE:We aimed to perform a systematic review and meta-analysis examining the impact of TB treatment at the time of combination antiretroviral therapy (cART) initiation on subsequent mortality. METHODS:We searched PubMed, EMBASE, and selected ... ...

Abstract	OBJECTIVE:We aimed to perform a systematic review and meta-analysis examining the impact of TB treatment at the time of combination antiretroviral therapy (cART) initiation on subsequent mortality. METHODS:We searched PubMed, EMBASE, and selected conference proceedings for studies that report adult mortality on cART, stratified by TB treatment status at cART initiation. Stratified random-effects and meta-regression analyses were used to examine the influence of study and population characteristics. RESULTS:22 eligible cohort studies reported data on 98,350 (range 74-15,225) adults, of whom 14,779 (15%) were receiving TB treatment at cART initiation. Studies of those receiving vs. not receiving TB treatment had an average mortality relative risk of 1.10 (95% confidence interval 0.87-1.40) at 1-3 months (based upon 8 estimates), 1.15 (0.94-1.41) at 6-12 months (11 estimates), and 1.33 (1.02-1.75) at 18-98 months (10 estimates) following cART initiation. However, there was a wide range of estimates and those at later time points were markedly heterogeneous. Meta-regression identified factors associated with elevated average risk estimates: lower median baseline CD4 counts and adjustment for baseline hemoglobin at 1-3 months; longer length of follow-up and women-only studies at 6-12 months; and not adjusting for BMI/weight at 18-98 months. CONCLUSIONS:Patients receiving TB treatment at cART initiation did not have a statistically significant estimated increase in short-term risk of all-cause mortality as compared to those not receiving TB treatment. TB treatment was significantly associated with increased mortality after about a year of cART, suggesting that patients with concurrent TB treatment at cART initiation may benefit from continued support after TB treatment completion.
Keywords	Medicine ; R ; Science ; Q
Subject code	310
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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