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Article: P25 Fruit and Vegetable Intake, Intention, and Healthy Food Choice Self-Efficacy Among Second and Third Grade EFNEP Youth in Guam

Aflague, Tanisha F. / Taguacta, Kimberly / Badowski, Grazyna

Journal of nutrition education and behavior. 2021 July, v. 53, no. 7

2021

Abstract: To examine the effectiveness of the Health Kids Club (HKC) curriculum on fruit and vegetable (FV) intake and dietary behaviors among the Expanded Food and Nutrition Education Program (EFNEP) youth participants in Guam.Guam EFNEP implements the HKC ... ...

Abstract	To examine the effectiveness of the Health Kids Club (HKC) curriculum on fruit and vegetable (FV) intake and dietary behaviors among the Expanded Food and Nutrition Education Program (EFNEP) youth participants in Guam.Guam EFNEP implements the HKC curriculum and applies the Experiential Learning Model; therefore, the constructs of the Social Cognitive Theory is the framework to evaluate this study's objective.Study participants were Guam EFNEP youth in grades 3-5 (N = 2,569) during 2015-2019 from different community-based sites throughout Guam. Majority of youth were Asian and/or Native Hawaiian or Other Pacific Islander race and males (53%).The HKC curriculum consists of 6 interactive lessons on food safety, diet quality, portion control, and moving more and each has 2 activities. A lesson is added to gather exit data and celebrate program completion.Only data from youth who self-reported dietary behaviors using the nutrition education survey at entry and exit were analyzed (N = 1,714). Surveys consisted of 14 total questions for both periods 2015-2017 (n = 776) and 2017-2019 (n = 938). A paired t test and Wilcoxon signed rank test were performed to determine program effectiveness. Questions from each survey period were selected to examine FV intake, FV intention, and healthy food choice (HFC) self-efficacy behavior categories.Youth reported a significantly higher exit score for all behavior categories in both study periods. In 2015-2017, the mean increase in FV intake, FV intention, and HFC self-efficacy scores at exit were 0.45 (95% CI: 0.35-0.55), 0.18 (95% CI: 0.10-0.27), and 0.55 (95% CI: 0.45-0.65), respectively. In 2017-2019, the mean increase in FV intake and HFC self-efficacy scores at exit were 0.20 (95% CI: 0.05-0.35) and 0.37 (95% CI: 0.29-0.45), respectively, and a statistically significant median increase in FV intention score, z = 2.27, P = 0.023.Guam EFNEP youth curriculum is effective in improving children's FV intake, FV intention, and HFC self-efficacy.
Keywords	Expanded Food and Nutrition Education Program ; cognition ; curriculum ; food choices ; food quality ; food safety ; fruits ; healthy diet ; models ; nutrition education ; portion size ; self-efficacy ; surveys ; t-test ; vegetable consumption ; vegetables ; youth ; Guam
Language	English
Dates of publication	2021-07
Size	p. S35.
Publishing place	Elsevier Inc.
Document type	Article
ZDB-ID	2080501-9
ISSN	1708-8259 ; 1499-4046
ISSN (online)	1708-8259
ISSN	1499-4046
DOI	10.1016/j.jneb.2021.04.417
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Cervical Cancer and HPV Knowledge and Awareness: An Educational Intervention among College Students in Guam.

Somera, Lilnabeth P / Diaz, Tressa / Mummert, Angelina / Badowski, Grazyna / Choi, Jaeyong / Palaganas, Harmony / Ayson, Kristian

Asian Pacific journal of cancer prevention : APJCP

2023 Volume 24, Issue 2, Page(s) 443–449

Abstract: Background: Compared to the U.S. population, cervical cancer (CC) incidence is significantly higher among the CHamoru, Micronesian, and Caucasian populations in Guam. From 2008-2012, CC was the fifth most common cancer diagnosed on the island. Despite ... ...

Abstract	Background: Compared to the U.S. population, cervical cancer (CC) incidence is significantly higher among the CHamoru, Micronesian, and Caucasian populations in Guam. From 2008-2012, CC was the fifth most common cancer diagnosed on the island. Despite the prevalence of CC and low HPV vaccine uptake, there is a concerning lack of awareness and preventative behavior among young adults. This study was aimed at influencing college students' knowledge and awareness of CC, CC screening, HPV, and the HPV vaccination. Methods: We delivered a 30-minute educational intervention to a sample of 108 university students in a classroom setting. The effect of the educational intervention was measured through a pre-and post-test on CC and HPV health behaviors, knowledge, and awareness. Results were analyzed using SPSS and an exact McNemar's test was used to examine the difference in the proportion of correct answers to the tests. Two-way mixed ANOVA was used to examine between (gender, ethnicity, and class level) and within subjects (pre-and post-test) program effects. Results: Of the 108 participants, only 39 (36.1%) reported being vaccinated for HPV, 23 (21.3%) had not been vaccinated, and 46 (42.6%) did not know if they had been vaccinated for HPV. Only forty-one (60.3%) female participants had had a Pap smear. When comparing the pre-to-posttest responses, most questions had an increase in correct responses. Time also influenced CCA and HPV knowledge and awareness scores as there was a significant increase in scores from the pre- to post-test. Conclusion: The educational intervention was an effective tool for increasing knowledge and awareness of CC, HPV, and HPV vaccination among college students. While study results demonstrate the educational intervention's success as a baseline measure of knowledge, the inclusion of behavioral outcome measures, such as intent to get vaccinated or screened, could result in more robust future studies.
MeSH term(s)	Young Adult ; Female ; Humans ; Male ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/prevention & control ; Guam ; Papillomavirus Infections/prevention & control ; Students ; Educational Status
Language	English
Publishing date	2023-02-01
Publishing country	Thailand
Document type	Journal Article
ZDB-ID	2218955-5
ISSN	2476-762X ; 1513-7368
ISSN (online)	2476-762X
ISSN	1513-7368
DOI	10.31557/APJCP.2023.24.2.443
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Article ; Online: Knowledge, Attitudes, Beliefs, Practices Regarding Human Papillomavirus (HPV), and Barriers to Vaccination Against HPV Infection: A Cross-Sectional Survey of Guam Residents.

Mendez, Ana Joy / Somera, Lilnabeth / Badowski, Grazyna / Mummert, Angelina / Castro, Lucy Joo / Antolin, Agrenilda / Dulana, Louis Jane / Sablan, Dwight

Hawai'i journal of health & social welfare

2023 Volume 83, Issue 2, Page(s) 54–60

Abstract: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is linked to several cancers. In Guam, the HPV vaccination rate falls short of the National Healthy People 2030 goal. Only half of eligible Guam teens ... ...

Abstract	Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is linked to several cancers. In Guam, the HPV vaccination rate falls short of the National Healthy People 2030 goal. Only half of eligible Guam teens have received the HPV vaccination series. Additionally, research on Guam HPV vaccination is limited. A cross-sectional survey was conducted, and a representative sample of Guam residents (n=775) was surveyed to examine their knowledge, attitudes, beliefs, practices regarding HPV, and barriers to HPV vaccination. Aggregated scores were calculated for these scale items: attitude, knowledge, subjective norms, and perceived behavioral control regarding HPV. One-way Analysis of Variance (ANOVA) was used to compare the means of the scores and check for significant differences. Binary logistic regression helped to identify significant predictors of HPV vaccination among respondents with children. Significant differences were found for sex, education, income, and ethnicity. Women and those with higher education and income demonstrated higher positive attitudes and knowledge about HPV vaccination. Also, those with health insurance and those who were advised by their physician were more likely to get their children vaccinated. These results will guide the implementation of effective strategies for developing targeted behavioral and other appropriate interventions to increase HPV vaccination in Guam.
MeSH term(s)	Adolescent ; Child ; Humans ; Female ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Human Papillomavirus Viruses ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Guam ; Vaccination ; Papillomavirus Vaccines/therapeutic use
Chemical Substances	Papillomavirus Vaccines
Language	English
Publishing date	2023-12-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2983566-5
ISSN	2641-5224 ; 2641-5216
ISSN (online)	2641-5224
ISSN	2641-5216
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Article ; Online: Disparities in Colorectal Cancer Incidence among Asian and Pacific Islander Populations in Guam, Hawai'i, and the United States.

Choi, JaeYong / Badowski, Grazyna / Shvetsov, Yurii B / Dulana, Louis / Teria, Rodney / Jin, Su Bin / Aguon, Cabrini / Bordallo, Renata / Leon Guerrero, Rachael T

International journal of environmental research and public health

2024 Volume 21, Issue 2

Abstract: Colorectal cancer (CRC) ranks among the three most common cancers in Guam (GU), Hawai'i (HI), and the mainland United States (US). CRC prevalence in these areas is high among Filipinos, and indigenous CHamorus and Native Hawaiians; however, data on these ...

Abstract	Colorectal cancer (CRC) ranks among the three most common cancers in Guam (GU), Hawai'i (HI), and the mainland United States (US). CRC prevalence in these areas is high among Filipinos, and indigenous CHamorus and Native Hawaiians; however, data on these populations are frequently aggregated in epidemiological studies, which can mask true CRC disparities. We examined CRC cumulative incidence rates (CIRs) among CHamorus in GU, Filipinos in GU, HI, and the US, and Native Hawaiians in HI and the US. CRC CIRs were calculated for two age groups (20-49 years; early onset, and 50-79 years; senior) and four time periods (2000-2004, 2005-2009, 2010-2014, and 2015-2019), stratified by ethnicity, sex, and location. Data analyzed included all invasive CRC cases reported to the Surveillance, Epidemiology, and End Results 9-Registry (
MeSH term(s)	Adult ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Colorectal Neoplasms/epidemiology ; Guam/epidemiology ; Hawaii/epidemiology ; Incidence ; Native Hawaiian or Other Pacific Islander ; United States/epidemiology ; Aged
Language	English
Publishing date	2024-02-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph21020170
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Article: Improving Willingness to Try Fruits and Vegetables and Gross Motor Skills in Preschool Children in Guam

Aflague, Tanisha F. / Badowski, Grazyna / Sanchez, Hyett / Sablan, Dwight / Schroeder, Catherine M. / Sanchez, Eloise / Leon Guerrero, Rachael T.

Nutrients. 2021 Dec. 27, v. 14, no. 1

2021

Abstract: Early childhood interventions have the potential to promote long-term healthy eating and physical activity habits to prevent obesity. However, research studies including indigenous young children are lacking. This study examined the effectiveness of the ... ...

Abstract	Early childhood interventions have the potential to promote long-term healthy eating and physical activity habits to prevent obesity. However, research studies including indigenous young children are lacking. This study examined the effectiveness of the Food Friends®: Fun with New Foods™ and Get Movin’ with Mighty Moves™ (FFMM) curricula on willingness to try fruits and vegetables (FV) and gross motor (GM) skills among preschoolers in Guam. A pre-post community-based study included preschoolers from Head Start (HS), gifted and talented education (Pre-GATE), and Pre-Kindergarten programs during school years (SY) 2017–2018 and 2018–2019. In SY2017–2018, the intervention group had a significant increase in imported FV when compared with the other three groups. No significant differences between groups were found on the other FV scales. Regarding gross motor skills, no significant differences between groups were found. In SY2018–2019, the intervention group had a significant increase in all FV scales except imported FV when compared with the enhanced intervention group. With gross motor skills, no significant differences were found between groups on its progress. These results warrant FFMM adaptations for the prevention of obesity among Guam preschoolers.
Keywords	childhood ; obesity ; physical activity ; Guam
Language	English
Dates of publication	2021-1227
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14010093
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Prediction of breast cancer risk among women of the Mariana Islands: the BRISK retrospective case-control study.

Shvetsov, Yurii B / Wilkens, Lynne R / White, Kami K / Chong, Marie / Buyum, Arielle / Badowski, Grazyna / Leon Guerrero, Rachael T / Novotny, Rachel

BMJ open

2022 Volume 12, Issue 12, Page(s) e061205

Abstract: Objectives: To develop a breast cancer risk prediction model for Chamorro and Filipino women of the Mariana Islands and compare its performance to that of the Breast Cancer Risk Assessment Tool (BCRAT).: Design: Case-control study.: Setting: ... ...

Abstract	Objectives: To develop a breast cancer risk prediction model for Chamorro and Filipino women of the Mariana Islands and compare its performance to that of the Breast Cancer Risk Assessment Tool (BCRAT). Design: Case-control study. Setting: Clinics/facilities and other community-based settings on Guam and Saipan (Northern Mariana Islands). Participants: 245 women (87 breast cancer cases and 158 controls) of Chamorro or Filipino ethnicity, age 25-80 years, with no prior history of cancer (other than skin cancer), residing on Guam or Saipan for at least 5 years. Primary and secondary outcome measures: Breast cancer risk models were constructed using combinations of exposures previously identified to affect breast cancer risk in this population, population breast cancer incidence rates and all-cause mortality rates for Guam. Results: Models using ethnic-specific relative risks performed better than those with relative risks estimated from all women. The model with the best performance among both ethnicities (the Breast Cancer Risk Model (BRISK) model; area under the receiver operating characteristic curve (AUC): 0.64 and 0.67 among Chamorros and Filipinos, respectively) included age at menarche, age at first live birth, number of relatives with breast cancer and waist circumference. The 10-year breast cancer risk predicted by the BRISK model was 1.28% for Chamorros and 0.89% for Filipinos. Performance of the BCRAT was modest among both Chamorros (AUC: 0.60) and Filipinos (AUC: 0.55), possibly due to incomplete information on BCRAT risk factors. Conclusions: The ability to develop breast cancer risk models for Mariana Islands women is constrained by the small population size and limited availability of health services and data. Nonetheless, we have demonstrated that breast cancer risk prediction models with adequate discriminatory performance can be built for small populations such as in the Mariana Islands. Anthropometry, in particular waist circumference, was important for estimating breast cancer risk in this population.
MeSH term(s)	Female ; Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Risk ; Breast Neoplasms/epidemiology ; Case-Control Studies ; Retrospective Studies ; Micronesia/epidemiology ; Risk Factors ; Risk Assessment
Language	English
Publishing date	2022-12-09
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-061205
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Article ; Online: Salivary Areca and tobacco alkaloids for bioverification in the Betel Nut Intervention Trial.

Franke, Adrian A / Li, Xingnan / Herzog, Thaddeus A / Paulino, Yvette C / Badowski, Grazyna / Wilkens, Lynne R / Lai, Jennifer F

Drug testing and analysis

2022 Volume 15, Issue 1, Page(s) 58–65

Abstract: Background: The Betel Nut Intervention Trial (BENIT) is the first known randomized controlled intervention trial designed to help minority Pacific Islanders in Guam and Saipan quit chewing the carcinogenic Areca catechu nut (AN). We report the BENIT's ... ...

Abstract	Background: The Betel Nut Intervention Trial (BENIT) is the first known randomized controlled intervention trial designed to help minority Pacific Islanders in Guam and Saipan quit chewing the carcinogenic Areca catechu nut (AN). We report the BENIT's saliva bioverification results against the self-reported chewing status ("quitter" or "chewer") at day 22 follow-up. Material and methods: AN-specific (arecoline, arecaidine, guvacoline, and guvacine) and tobacco-specific (nicotine, cotinine, and hydroxycotinine) alkaloids were analyzed in saliva from 176 BENIT participants by an established and sensitive liquid chromatography mass spectrometry-based assay. Results: The combined four AN alkaloid levels decreased from baseline in quitters (n = 50) and chewers (n = 108) by 32% and 9%, respectively. In quitters, decreases were significant for arecoline (p = 0.044)-the most prominent AN alkaloid, along with arecaidine (p = 0.042) and nicotine (p = 0.011). In chewers, decreases were significant only for hydroxycotinine (p = 0.004). Similar results were obtained when quitters and chewers were stratified by treatment arm. Discussion: Salivary AN alkaloid levels generally agreed with self-reported chewing status, which suggests the former can be used to verify the latter. Conclusion: Our results can help to objectively evaluate compliance and program effectiveness in AN cessation programs.
MeSH term(s)	Humans ; Alkaloids/analysis ; Areca/chemistry ; Arecoline/analysis ; Arecoline/chemistry ; Nicotine ; Nicotiana
Chemical Substances	Alkaloids ; Arecoline (4ALN5933BH) ; Nicotine (6M3C89ZY6R)
Language	English
Publishing date	2022-10-02
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2462336-2
ISSN	1942-7611 ; 1942-7603
ISSN (online)	1942-7611
ISSN	1942-7603
DOI	10.1002/dta.3364
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Pacific Islands Cohort on Cardiometabolic Health Study: rationale and design.

Guerrero, Rachael T Leon / Hattori-Uchima, Margaret P / Badowski, Grazyna / Aflague, Tanisha F / Wood, Kathryn / Hammond, Kristi / Perez, Remedios

BMC public health

2022 Volume 22, Issue 1, Page(s) 1428

Abstract: Background: Pacific Islanders, including those residing in the US Affiliated Pacific Islands (USAPI), experience some of the highest mortality rates resulting from non-communicable diseases (NCDs) worldwide. The Pacific Island Health Officers' ... ...

Abstract	Background: Pacific Islanders, including those residing in the US Affiliated Pacific Islands (USAPI), experience some of the highest mortality rates resulting from non-communicable diseases (NCDs) worldwide. The Pacific Island Health Officers' Association declared a Regional State of Health Emergency in 2010 due to the epidemic of NCDs in the USAPI. Obesity, a known risk factor for NCDs, has become an epidemic among both children and adults in Micronesia and other parts of the USAPI. There is some recent information about overweight and obesity (OWOB) among young children in the USAPI, but there is no data looking at the relationship between children and their biological parents. The Pacific Islands Cohort on Cardiometabolic Health (PICCAH) Study aims to collect data on NCD lifestyle factors from two generations of families (n = 600 child-parent dyads or 1,200 participants) living in Guam, Pohnpei, and Palau. Methods: The PICCAH Study is an epidemiological study using community-based convenience sampling to recruit participants in USAPI of Guam, Palau, and Pohnpei. The goal is to recruit participant dyads consisting of 1 child plus their biological parent in Guam (500 dyads or 1,000 participants), Pohnpei (50 dyads or 100 participants), and Palau (50 dyads or 100 participants). All participants are having the following information collected: demographic, health, and lifestyle information; anthropometry; diet; physical activity; sleep; acanthosis nigricans; blood pressure; and serum levels of fasting plasma glucose, fasting insulin, glycated hemoglobin, total cholesterol, triglycerides, LDL, and HDL. Discussion: The PICCAH Study is designed to establish the baseline of a generational epidemiologic cohort with an emphasis on cardiometabolic risk, and to better understand the extent of DM and CVD conditions and related risk factors of those living in the USAPI jurisdictions of Guam, Pohnpei, and Palau. This study also serves to further build research capacity in the underserved USAPI Region.
MeSH term(s)	Adult ; Cardiovascular Diseases/epidemiology ; Child, Preschool ; Humans ; Life Style ; Obesity/epidemiology ; Overweight ; Pacific Islands/epidemiology
Language	English
Publishing date	2022-07-27
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-022-13783-9
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Article ; Online: The Betel Nut Intervention Trial (BENIT)-A Randomized Clinical Trial for Areca Nut and Betel Quid Cessation: Primary Outcomes.

Herzog, Thaddeus A / Wilkens, Lynne R / Badowski, Grazyna / Mendez, Ana Joy Pacilan / Franke, Adrian A / Pokhrel, Pallav / Chennaux, Jade S N / Tenorio, Lynnette F / Sotto, Patrick P / Kawamoto, Crissy T / Paulino, Yvette C

International journal of environmental research and public health

2023 Volume 20, Issue 16

Abstract: Background: Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials-NCT02942745) is the first known randomized trial designed for ANBQ chewers.: Methods: We compared the intensive behavioral treatment ... ...

Abstract	Background: Areca nut and betel quid (ANBQ) chewing is a widespread carcinogenic habit. The BENIT (ClinicalTrials-NCT02942745) is the first known randomized trial designed for ANBQ chewers. Methods: We compared the intensive behavioral treatment intervention condition (IC) with the control condition (CC) in the BENIT and included a 5-stage early stopping rule. We report the primary analysis at stage 3. English-literate adults in Guam and Saipan who self-identified as ANBQ chewers with tobacco were enrolled between August 2016 and August 2020. IC participants ( Results: Cessation rates were 38.6% (IC) and 9.1% (CC). Proportional hazards regression revealed a Conclusions: Robust self-reported intervention effects at day 22 suggest that intensive cessation programs such as BENIT should be further developed and implemented on a larger scale.
MeSH term(s)	Adult ; Humans ; Areca ; Nuts ; Research Design ; Behavior Therapy ; Carcinogenesis
Language	English
Publishing date	2023-08-21
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20166622
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Article ; Online: Cultural Considerations for Conducting the Health Information National Trends Survey with Micronesian Communities: Lessons from a Qualitative Study.

Cassel, Kevin / Lee, Hye-Ryeon / Somera, Lilnabeth P / Badowski, Grazyna / Hagiwara, Megan Kiyomi Inada

Hawai'i journal of health & social welfare

2020 Volume 79, Issue 6 Suppl 2, Page(s) 64–69

Abstract: A critical barrier to addressing health disparities among minorities is the lack of data, particularly on Pacific Islanders. Typically, national health surveillance systems do not have the resources to ensure proper representation of these small ... ...

Abstract	A critical barrier to addressing health disparities among minorities is the lack of data, particularly on Pacific Islanders. Typically, national health surveillance systems do not have the resources to ensure proper representation of these small population groups. This study reports factors that guided the cultural adaptation and administration of the National Cancer Institute's Health Information Trends National Survey (HINTS) for a United States-dwelling Pacific Islander population in Hawai'i. To adapt the survey, four focus groups were conducted with 32 purposively-selected Micronesian migrants. Themes on health, healthcare barriers, cancer and methods to implement the survey were extracted from the analyses of the focus group narratives. Key cultural factors were identified that impact health practices, including religious and cancer fatalism, racism, health locus of control and other barriers. Using information from the focus group participants, the HINTS questionnaire was modified and the survey was implemented. The survey data provided will inform the future delivery of health promotion strategies for this unique medically underserved population.
MeSH term(s)	Adult ; Culturally Competent Care/methods ; Culturally Competent Care/standards ; Female ; Focus Groups/methods ; Health Information Systems/standards ; Health Information Systems/trends ; Health Services Accessibility/standards ; Health Services Accessibility/statistics & numerical data ; Humans ; Male ; Micronesia/ethnology ; Minority Groups/psychology ; Minority Groups/statistics & numerical data ; Qualitative Research ; Surveys and Questionnaires
Language	English
Publishing date	2020-06-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2983566-5
ISSN	2641-5224 ; 2641-5216
ISSN (online)	2641-5224
ISSN	2641-5216
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