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Book: Danish population based registers for public health and health related welfare research

Thygesen, Lau Caspar / Ersbøll, Annette Kjær

a description of Danish registers and results from their application in research

(Scandinavian journal of public health : Supplement ; [N.S.] 7)

2011

Title variant	Danish population-based registers for public health and health-related welfare research
Author's details	guest ed.: Lau Caspar Thygesen and Annette Kjær Ersbøll
Series title	Scandinavian journal of public health : Supplement ; [N.S.] 7 Scandinavian journal of public health Scandinavian journal of public health ; Supplement
Collection	Scandinavian journal of public health Scandinavian journal of public health ; Supplement
Language	English
Size	209 S. : Ill., graph. Darst.
Publisher	Sage
Publishing place	London
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT016949108
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Association between travel distance and face-to-face consultations with general practitioners before an incident acute myocardial infarction: a nationwide register-based spatial epidemiological study.

Kjærulff, Thora Majlund / Bihrmann, Kristine / Søndergaard, Jens / Gislason, Gunnar / Larsen, Mogens Lytken / Ersbøll, Annette Kjær

BMJ open

2024 Volume 14, Issue 1, Page(s) e079124

Abstract: Objectives: This study examined the association between travel distance to the general practitioner's (GP) office and : Design: A prospective cohort study using multilevel spatial logistic regression analysis of nationwide register data.: Setting: ...

Abstract	Objectives: This study examined the association between travel distance to the general practitioner's (GP) office and Design: A prospective cohort study using multilevel spatial logistic regression analysis of nationwide register data. Setting: Nationwide study including contacts to GPs in Denmark prior to an incident AMI in 2005-2017. Participants: 121 232 adults (≥30 years) with incident AMI were included in the study. Primary and secondary outcomes measures: The primary outcome was odds of not having a face-to-face GP consultation within 1 year before an incident AMI. Results: In total, 13 108 (10.8%) of the 121 232 individuals with incident AMI had no face-to-face consultation with the GP within 1 year before the AMI. Population density modified the association between travel distance and Conclusions: Travel distance above approximately 1 km was significantly associated with
MeSH term(s)	Adult ; Humans ; General Practitioners ; Prospective Studies ; Travel ; Referral and Consultation ; Myocardial Infarction/epidemiology
Language	English
Publishing date	2024-01-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-079124
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Article ; Online: Utilization of a public subsidy scheme for dental care services among socially vulnerable citizens out of labor in Copenhagen, Denmark.

Skov Kristensen, Marie / Ersbøll, Annette Kjær / Andersen, Ingelise / Øzhayat, Esben Boeskov

Acta odontologica Scandinavica

2023 , Page(s) 1–8

Abstract: Objective: Addressing social inequality in oral health and access to dental care is a global concern. This study aims to describe the utilization of a public subsidy scheme targeting vulnerable individuals out of labor in Copenhagen municipality (2013- ... ...

Abstract	Objective: Addressing social inequality in oral health and access to dental care is a global concern. This study aims to describe the utilization of a public subsidy scheme targeting vulnerable individuals out of labor in Copenhagen municipality (2013-2018) and to identify key characteristics of individuals eligible to apply. Material and methods: Data from Copenhagen municipality were combined with data from population and health registers. Employing logistic regression analyses, we examined the association between demographic, socioeconomic, and health-related characteristics and (1) having applied, (2) being granted, and (3) using the subsidy. Results: The study included 65,174 individuals aged 18-65. Of these 10,369 (15.9%) applied for subsidies, submitting a total of 18,529 applications. Overall, 83% of the applications were granted and 85% were used. Significantly increased odds of applying for subsidies were observed among individuals receiving social benefits non-stop over the past year versus none (odds ratio [OR] = 15.45, 95% confidence interval [CI] = 14.24-16.76), aged 50-65 versus 18-29 years (OR = 4.41, CI = 4.15-4.69), and having combined indicators of social vulnerability versus none (OR = 2.90, CI = 2.73-3.07). Conclusions: While the utilization of the public subsidy scheme is low, individuals who apply are likely to be granted a subsidy and use it. Vulnerability was associated with greater utilization of the scheme, yet a substantial portion of those at risk of poor oral health did not take advantage of it.
Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	210362-x
ISSN	1502-3850 ; 0001-6357
ISSN (online)	1502-3850
ISSN	0001-6357
DOI	10.1080/00016357.2023.2279606
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Article ; Online: Is dispatcher-assisted cardiopulmonary resuscitation affected by a bystander's emotional stress state in out-of-hospital cardiac arrest?

Tuffley, Rebecca Hvidt / Folke, Fredrik / Ersbøll, Annette Kjær / Blomberg, Stig Nikolaj Fasmer / Linderoth, Gitte

Scandinavian journal of trauma, resuscitation and emergency medicine

2023 Volume 31, Issue 1, Page(s) 82

Abstract: Aim: The study aimed to investigate whether a bystander's emotional stress state affects dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) in out-of-hospital cardiac arrest (OHCA). The primary outcome was initiation of chest compressions (Yes/ ... ...

Abstract	Aim: The study aimed to investigate whether a bystander's emotional stress state affects dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) in out-of-hospital cardiac arrest (OHCA). The primary outcome was initiation of chest compressions (Yes/No). Secondarily we analysed time until chest compressions were initiated and assessed how dispatchers instructed CPR. Method: The study was a retrospective, observational study of OHCA emergency calls from the Capital Region of Denmark. Recorded calls were evaluated by five observers using a pre-defined code catalogue regarding the variables wished investigated. Results: Included were 655 OHCA emergency calls, of which 211 callers were defined as emotionally stressed. When cardiac arrest was recognized, chest compressions were initiated in, respectively, 76.8% of cases with an emotionally stressed caller and 73.9% in cases with a not emotionally stressed caller (2.18 (0.80-7.64)). Cases with an emotionally stressed caller had a longer time until chest compressions were initiated compared to cases with a not emotionally stressed caller, however non-significant (164 s. vs. 146 s.; P = 0.145). The dispatchers were significantly more likely to be encouraging and motivating, and to instruct on speed and depth of chest compressions in cases with an emotionally stressed caller compared to cases with a not emotionally stressed caller (1.64 (1.07-2.56); 1.78 (1.13-2.88)). Barriers to CPR were significantly more often reported in cases with an emotionally stressed caller compared to cases with a not emotionally stressed caller (1.83 (1.32-2.56)). Conclusion: There was no significant difference in initiation of chest compressions or in time until initiation of chest compressions in the two groups. However, the dispatchers were overall more encouraging and motivating, and likely to instruct on speed and depth of chest compressions when the caller was emotionally stressed. Furthermore, barriers to CPR were more often reported in cases with an emotionally stressed caller compared to cases with a not emotionally stressed caller. Trial registration: We applied for ethical approval from The Danish National Committee on Health Research Ethics, but formal approval was waived. We received permission for storage of data and to use these for research of OHCAs in the Capital Region of Denmark by Danish Data Protection Agency (P-2021-670) and Danish Health Authorities (R-2,005,114). The study is registered at ClinicalTrials (NTC05113706).
MeSH term(s)	Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation ; Retrospective Studies ; Emotions ; Psychological Distress
Language	English
Publishing date	2023-11-17
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2455990-8
ISSN	1757-7241 ; 1757-7241
ISSN (online)	1757-7241
ISSN	1757-7241
DOI	10.1186/s13049-023-01117-6
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Article ; Online: Development of geographic inequality in dental caries and its association with socioeconomic factors over an 18-year period in Denmark.

Sengupta, Kaushik / Bihrmann, Kristine / Christensen, Lisa Bøge / Mortensen, Laust Hvas / Andersen, Ingelise / Ersbøll, Annette Kjær

BMC oral health

2023 Volume 23, Issue 1, Page(s) 662

Abstract: Background: Few studies have examined the development of geographic and socioeconomic inequalities in caries over time or have simultaneously assessed individual-level socioeconomic position (SEP) and neighborhood-level factors as a multi-layered ... ...

Abstract	Background: Few studies have examined the development of geographic and socioeconomic inequalities in caries over time or have simultaneously assessed individual-level socioeconomic position (SEP) and neighborhood-level factors as a multi-layered phenomenon influencing caries inequalities. This study examined (i) the trends in geographic inequalities in caries among adolescents in Denmark and (ii) how the association between SEP and caries has progressed over time, when accounting for individual and neighborhood-level confounding factors. Methods: This nationwide repeated cross-sectional study included 15-year-olds in Denmark from 1995, 2003, and 2013 (n = 149,808). The outcome was caries experience (measured by the decayed, missing, and filled tooth surfaces [DMFS] index). The exposure of interest was SEP, indicated by the previous year's parental education, occupational social class, and (equivalized) disposable household income. Covariates included individual-level factors (immigration status, country of origin, number of children and persons in the family, and household type) and neighborhood (residence municipality)-level factors (Gini index; proportion of unemployed, low-educated, and unmarried/non-cohabiting individuals; proportion of single-parent households and households with overcrowding). Data sources included the Danish national dental and administrative social registers and Statistics Denmark's statistics database (StatBank). Data were analyzed using spatial and spatiotemporal modelling utilizing zero-inflated negative binomial regressions and integrated nested Laplace approximations for Bayesian parametric inference. Observed caries experience geo-maps of the Danish municipalities for 1995, 2003, and 2013 were created. Results: Between 1995 and 2013, caries prevalence in the 15-year-olds declined sharply (1995, 71%; 2013, 45%). Caries experience declined in nearly all socioeconomic subgroups and municipalities. However, geographic inequalities persisted with higher caries levels largely concentrated in the relatively deprived areas of Denmark. Increasing relative socioeconomic inequalities in caries over time were observed with significant graded associations between SEP and caries despite adjustment for the various individual and neighborhood-level covariates and the effect of assessment year (e.g., 15-year-olds with parents having basic education had 1.91-fold [95% CI: 1.86-1.95] higher caries experience than those having parents with high education). Conclusions: Reducing these enduring inequalities will likely require additional resources and targeted supportive and preventive measures for adolescents from lower SEP backgrounds and those residing in municipalities with higher caries prevalence.
MeSH term(s)	Adolescent ; Child ; Humans ; Bayes Theorem ; Cross-Sectional Studies ; Dental Caries/epidemiology ; Socioeconomic Factors ; Denmark/epidemiology
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/s12903-023-03373-5
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Article ; Online: Joint mapping of cardiovascular diseases: comparing the geographic patterns in incident acute myocardial infarction, stroke and atrial fibrillation, a Danish register-based cohort study 2014-15.

Bihrmann, Kristine / Gislason, Gunnar / Larsen, Mogens Lytken / Ersbøll, Annette Kjær

International journal of health geographics

2021 Volume 20, Issue 1, Page(s) 41

Abstract: Background: Disease mapping aims at identifying geographic patterns in disease. This may provide a better understanding of disease aetiology and risk factors as well as enable targeted prevention and allocation of resources. Joint mapping of multiple ... ...

Abstract	Background: Disease mapping aims at identifying geographic patterns in disease. This may provide a better understanding of disease aetiology and risk factors as well as enable targeted prevention and allocation of resources. Joint mapping of multiple diseases may lead to improved insights since e.g. similarities and differences between geographic patterns may reflect shared and disease-specific determinants of disease. The objective of this study was to compare the geographic patterns in incident acute myocardial infarction (AMI), stroke and atrial fibrillation (AF) using the unique, population-based Danish register data. Methods: Incident AMI, stroke and AF was modelled by a multivariate Poisson model including a disease-specific random effect of municipality modelled by a multivariate conditionally autoregressive (MCAR) structure. Analyses were adjusted for age, sex and income. Results: The study included 3.5 million adults contributing 6.8 million person-years. In total, 18,349 incident cases of AMI, 28,006 incident cases of stroke, and 39,040 incident cases of AF occurred. Estimated municipality-specific standardized incidence rates ranged from 0.76 to 1.35 for AMI, from 0.79 to 1.38 for stroke, and from 0.85 to 1.24 for AF. In all diseases, geographic variation with clusters of high or low risk of disease after adjustment was seen. The geographic patterns displayed overall similarities between the diseases, with stroke and AF having the strongest resemblances. The most notable difference was observed in Copenhagen (high risk of stroke and AF, low risk of AMI). AF showed the least geographic variation. Conclusion: Using multiple-disease mapping, this study adds to the results of previous studies by enabling joint evaluation and comparison of the geographic patterns in AMI, stroke and AF. The simultaneous mapping of diseases displayed similarities and differences in occurrence that are non-assessable in traditional single-disease mapping studies. In addition to reflecting the fact that AF is a strong risk factor for stroke, the results suggested that AMI, stroke and AF share some, but not all environmental risk factors after accounting for age, sex and income (indicator of lifestyle and health behaviour).
MeSH term(s)	Adult ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Cardiovascular Diseases ; Cohort Studies ; Denmark/epidemiology ; Humans ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Stroke/diagnosis ; Stroke/epidemiology
Language	English
Publishing date	2021-08-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1476-072X
ISSN (online)	1476-072X
DOI	10.1186/s12942-021-00294-w
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Article ; Online: Patient safety culture and associated factors in secondary health care of the Capital Region of Denmark: influence of specialty, healthcare profession and gender.

Østergaard, Doris / Madsen, Marlene Dyrløv / Ersbøll, Annette Kjær / Frappart, Helle Søgaard / Kure, Josefine Haahr / Kristensen, Solvejg

BMJ open quality

2022 Volume 11, Issue 4

Abstract: Background: We aimed to explore (1) the influence of healthcare professionals' (HCPs') specialty, profession, gender and length of employment on their perception of six dimensions of patient safety culture (PSC) and (2) the relation between these ... ...

Abstract	Background: We aimed to explore (1) the influence of healthcare professionals' (HCPs') specialty, profession, gender and length of employment on their perception of six dimensions of patient safety culture (PSC) and (2) the relation between these characteristics and the two dimensions of safety climate and perception of management. Methods: In a cross-sectional study, a Danish version of the Safety Attitudes Questionnaire was sent to all HCPs at a large regional hospital organisation. This included hospitals, the Emergency Services, the Regional Pharmacy and the Centre for Diabetes corporations. A total of 30 230 HCPs received the survey. Differences between specialties, professions, gender and years of employment were tested for each dimension of PSC. Differences in mean attitude scores were tested using analysis of variance and differences in having a positive attitude were tested using logistic regression. Results: In total, 15 119 (50%) HCPs returned the survey. Significant differences are seen across hospitals and corporations for all dimensions of PSC. The proportion of HCPs with a positive attitude was largest regarding job satisfaction (74.8%) and lowest regarding perception of management (43.9%). Significant differences are seen in physicians' and nurses' perception of PSC in the different specialties within all dimensions of PSC except for the dimension of recognition of stress. Significant differences in positive perception of teamwork climate are seen between anaesthesiologists' (69.4%) and surgeons' (41.7%). No significant gender differences were found between physicians' and nurses' perception of safety climate and of management. In addition, we found an influence of years of employment on PSC. Discussion: Significant differences were found in HCPs' perception of PSC between corporations, specialties and professions. The lowest proportion of HCPs with a positive perception of PSC was found within the dimensions of safety climate and perception of management. These differences may have implications for teamwork and patient safety.
MeSH term(s)	Humans ; Patient Safety ; Cross-Sectional Studies ; Safety Management ; Attitude of Health Personnel ; Denmark
Language	English
Publishing date	2022-10-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2022-001908
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Article ; Online: Long-Term Cardiovascular Health After Pregnancy in Danish Women With Congenital Heart Disease. A Register-Based Cohort Study Between 1993 and 2016.

Kloster, Stine / Tolstrup, Janne S / Nielsen, Dorte Guldbrand / Søndergaard, Lars / Johnsen, Søren Paaske / Ersbøll, Annette Kjær

Journal of the American Heart Association

2022 Volume 11, Issue 5, Page(s) e023588

Abstract: Background Little is known about the impact of pregnancy on long-term cardiovascular health in individuals with congenital heart disease (CHD). We aimed to determine if giving birth in patients with CHD is associated with higher risk of long-term ... ...

Abstract	Background Little is known about the impact of pregnancy on long-term cardiovascular health in individuals with congenital heart disease (CHD). We aimed to determine if giving birth in patients with CHD is associated with higher risk of long-term cardiovascular morbidity. Methods and Results We studied a cohort of 1262 individuals with CHD giving birth (live or still) from 1993 to 2015 using Danish nationwide registers. We randomly sampled a comparison cohort matched on age of women with CHD who had not given birth at the time. We balanced the 2 cohorts on baseline demographic (eg, education) and clinical variables (eg, CHD severity) using inverse probability of treatment weighting. Individuals were followed for critical (eg, heart failure), other cardiovascular morbidity (eg, arrhythmia), and cardiac surgery/interventions after pregnancy. Individuals were followed for median 6.0 years (interquartile range 3.2-9.2). Among individuals giving birth the incidence rate per 1000 person-years was 1.6, 10.0, and 6.0 for critical and other cardiovascular morbidity and cardiac surgery, respectively. There was no overall difference in risk of neither critical and other cardiovascular morbidity nor cardiac surgery among individuals who gave birth and individuals who did not; adjusted hazard ratios (aHR) were 0.74 (95% CI, 0.37-1.48), 0.88 (95% CI, 0.65-1.19), and 0.78 (95% C,I 0.54-1.12), respectively. However, individuals with obstetric complications had a higher long-term risk of other cardiovascular morbidity (aHR, 1.85; 95% CI, 1.07-3.20). Conclusions Giving birth seemed not to be associated with a higher risk of long-term cardiovascular morbidity among women with CHD. However, individuals having obstetric complications had a higher risk of other cardiovascular morbidity in the long term.
MeSH term(s)	Cohort Studies ; Denmark/epidemiology ; Female ; Heart Defects, Congenital/epidemiology ; Heart Defects, Congenital/surgery ; Humans ; Parturition ; Pregnancy ; Pregnancy Complications, Cardiovascular/epidemiology ; Proportional Hazards Models ; Risk Factors
Language	English
Publishing date	2022-02-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.121.023588
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Article ; Online: Association of Real-Time Feedback and Cardiopulmonary-Resuscitation Quality Delivered by Ambulance Personnel for Out-of-Hospital Cardiac Arrest.

Lyngby, Rasmus Meyer / Quinn, Tom / Oelrich, Roselil Maria / Nikoletou, Dimitra / Gregers, Mads Christian Tofte / Kjølbye, Julie Samsøe / Ersbøll, Annette Kjær / Folke, Fredrik

Journal of the American Heart Association

2023 Volume 12, Issue 20, Page(s) e029457

Abstract: Background High-quality cardiopulmonary resuscitation (CPR) is associated with improved survival from out-of-hospital cardiac arrest and includes chest compression depth, chest compression rate, and chest compression fraction within international ... ...

Abstract	Background High-quality cardiopulmonary resuscitation (CPR) is associated with improved survival from out-of-hospital cardiac arrest and includes chest compression depth, chest compression rate, and chest compression fraction within international guideline recommendations. Previous studies have demonstrated divergent results of real-time feedback on CPR performance and patient outcomes. This study investigated the association between emergency medical service CPR quality and real-time CPR feedback for out-of-hospital cardiac arrest. Methods and Results This study collected out-of-hospital cardiac arrest data within the Capital Region of Denmark and compared CPR quality delivered by ambulance personnel. Data were collected in 2 consecutive phases from October 2018 to February 2020. Median chest compression depth was 6.0 cm (no feedback) and 5.9 cm (real-time feedback) (
MeSH term(s)	Humans ; Out-of-Hospital Cardiac Arrest/diagnosis ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation/methods ; Heart Massage/methods ; Ambulances ; Feedback ; Time Factors ; Emergency Medical Services/methods
Language	English
Publishing date	2023-10-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.029457
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Article ; Online: Trends in low-density lipoprotein cholesterol goal achievement and changes in lipid-lowering therapy after incident atherosclerotic cardiovascular disease: Danish cohort study.

Ersbøll, Annette Kjær / Kristensen, Marie Skov / Nybo, Mads / Hede, Simone Møller / Mikkelsen, Kristian Handberg / Gislason, Gunnar / Lytken Larsen, Mogens / Green, Anders

PloS one

2023 Volume 18, Issue 5, Page(s) e0286376

Abstract: Background: We aimed to investigate trends in low-density lipoprotein cholesterol (LDL-C) goal achievement (LDL-C<1.8 mmol/L, equivalent to 70 mg/dL), initiation of lipid-lowering therapy (LLT) and changes in LLT intensity in individuals with ... ...

Abstract	Background: We aimed to investigate trends in low-density lipoprotein cholesterol (LDL-C) goal achievement (LDL-C<1.8 mmol/L, equivalent to 70 mg/dL), initiation of lipid-lowering therapy (LLT) and changes in LLT intensity in individuals with atherosclerotic cardiovascular disease (ASCVD) at very high risk of recurrent cardiovascular disease. Methods: A cohort study design was used including individuals with incident ASCVD and LDL-C≥1.8 mmol/L in 2010-2015. Data were obtained from national, population-based registers (patient, prescription, income, and laboratory). Results: We included 11,997 individuals. Acute myocardial infarction, ischemic stroke and stable angina pectoris accounted for 79.6% of the qualifying ASCVD events. At inclusion, 37.2% were in LLT. Mean LDL-C before or during ASCVD hospitalization was 3.1 mmol/L (120 mg/dL). LDL-C goal achievement increased within the first two years after inclusion from 40.5% to 50.6%. LLT initiation within the first 90 days increased from 48.6% to 56.0%. Initiation of intensive LLT increased from 9.6% to 32.8%. The largest change in LLT intensity was seen in the period 180 days before to 90 days after discharge with 2.2% in 2010 to 12.1% in 2015. Conclusion: LDL-C goal achievement within the first 2 years after inclusion increased from 40.5% in 2010 to 50.6% in 2015. LLT initiation within the first year after inclusion increased, especially for intensive LLT, although only one third initiated intensive LLT in 2015. Despite trends show improvements in LDL-C goal achievement, 49.4% of individuals at very high risk of a CV event did not achieve the LDL-C goal within 2 years after ASCVD hospitalization.
MeSH term(s)	Humans ; Cholesterol, LDL ; Cohort Studies ; Cardiovascular Diseases ; Goals ; Atherosclerosis/drug therapy ; Atherosclerosis/epidemiology ; Denmark/epidemiology ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
Chemical Substances	Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2023-05-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0286376
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