What Triggers a Diagnosis of HIV Infection in the Tokyo Metropolitan Area? Implications for Preventing the Spread of HIV Infection in Japan
Japan has not succeeded in reducing the annual number of new HIV-infected patients, although the prevalence of HIV infection is low (0.02%). A single-center observational study was conducted at the largest HIV clinic in Tokyo, which treats 15% of the total patients in Japan, to determine the reasons...
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| Veröffentlicht in: | PloS one 2015-11, Vol.10 (11), p.e0143874-e0143874 |
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| creator | Nishijima, Takeshi Takano, Misao Matsumoto, Shoko Koyama, Miki Sugino, Yuko Ogane, Miwa Ikeda, Kazuko Kikuchi, Yoshimi Oka, Shinichi Gatanaga, Hiroyuki |
| description | Japan has not succeeded in reducing the annual number of new HIV-infected patients, although the prevalence of HIV infection is low (0.02%).
A single-center observational study was conducted at the largest HIV clinic in Tokyo, which treats 15% of the total patients in Japan, to determine the reasons for having diagnostic tests in newly infected individuals. HIV-infected patients who visited our clinic for the first time between 2011 and 2014 were analyzed.
The 598 study patients comprised one-third of the total reported number of new patients in Tokyo during the study period. 76% were Japanese MSM. The reasons for being tested which led to the diagnosis was voluntary testing in 32%, existing diseases in 53% (AIDS-defining diseases in 22%, sexually transmitted infections (STI) in 8%, diseases other than AIDS or STIs in 23%) and routine pre-surgery or on admission screening in 15%. 52% and 74% of the study patients and patients presented with AIDS, respectively, had never been tested. The median CD4 count in patients with history of previous testing (315/μL) was significantly higher than that of patients who had never been tested (203/μL, p |
| doi_str_mv | 10.1371/journal.pone.0143874 |
| format | Article |
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A single-center observational study was conducted at the largest HIV clinic in Tokyo, which treats 15% of the total patients in Japan, to determine the reasons for having diagnostic tests in newly infected individuals. HIV-infected patients who visited our clinic for the first time between 2011 and 2014 were analyzed.
The 598 study patients comprised one-third of the total reported number of new patients in Tokyo during the study period. 76% were Japanese MSM. The reasons for being tested which led to the diagnosis was voluntary testing in 32%, existing diseases in 53% (AIDS-defining diseases in 22%, sexually transmitted infections (STI) in 8%, diseases other than AIDS or STIs in 23%) and routine pre-surgery or on admission screening in 15%. 52% and 74% of the study patients and patients presented with AIDS, respectively, had never been tested. The median CD4 count in patients with history of previous testing (315/μL) was significantly higher than that of patients who had never been tested (203/μL, p<0.001).
Only 32% of the newly HIV diagnosed patients were diagnosed because of voluntary testing, and 53% were diagnosed due to presence of other diseases. These results remain unchanged from our previous report 10 years earlier (2000-2004) on newly diagnosed patients at the same clinic. HIV testing has not been widely used by newly diagnosed patients in the Tokyo metropolitan area.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0143874</identifier><identifier>PMID: 26606382</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adult ; AIDS ; Antiretroviral drugs ; CD4 antigen ; CD4 Lymphocyte Count ; Comorbidity ; Diagnosis ; Diagnostic systems ; Disease transmission ; Diseases ; Female ; Health aspects ; Health Knowledge, Attitudes, Practice ; HIV ; HIV infections ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - transmission ; Human immunodeficiency virus ; Humans ; Infections ; Male ; Medical diagnosis ; Metropolitan areas ; Middle Aged ; Observational studies ; Patient Acceptance of Health Care ; Patients ; Prevalence ; Prevention ; Risk Factors ; Sexually transmitted diseases ; STD ; Surgery ; Tokyo - epidemiology ; Young Adult</subject><ispartof>PloS one, 2015-11, Vol.10 (11), p.e0143874-e0143874</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Nishijima et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Nishijima et al 2015 Nishijima et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-ba498b55a8d1116fcb2d4b4e09c6466cd4ed547369d46ce16aca136686d21b343</citedby><cites>FETCH-LOGICAL-c758t-ba498b55a8d1116fcb2d4b4e09c6466cd4ed547369d46ce16aca136686d21b343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659593/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659593/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26606382$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Anglewicz, Philip</contributor><creatorcontrib>Nishijima, Takeshi</creatorcontrib><creatorcontrib>Takano, Misao</creatorcontrib><creatorcontrib>Matsumoto, Shoko</creatorcontrib><creatorcontrib>Koyama, Miki</creatorcontrib><creatorcontrib>Sugino, Yuko</creatorcontrib><creatorcontrib>Ogane, Miwa</creatorcontrib><creatorcontrib>Ikeda, Kazuko</creatorcontrib><creatorcontrib>Kikuchi, Yoshimi</creatorcontrib><creatorcontrib>Oka, Shinichi</creatorcontrib><creatorcontrib>Gatanaga, Hiroyuki</creatorcontrib><title>What Triggers a Diagnosis of HIV Infection in the Tokyo Metropolitan Area? Implications for Preventing the Spread of HIV Infection in Japan</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Japan has not succeeded in reducing the annual number of new HIV-infected patients, although the prevalence of HIV infection is low (0.02%).
A single-center observational study was conducted at the largest HIV clinic in Tokyo, which treats 15% of the total patients in Japan, to determine the reasons for having diagnostic tests in newly infected individuals. HIV-infected patients who visited our clinic for the first time between 2011 and 2014 were analyzed.
The 598 study patients comprised one-third of the total reported number of new patients in Tokyo during the study period. 76% were Japanese MSM. The reasons for being tested which led to the diagnosis was voluntary testing in 32%, existing diseases in 53% (AIDS-defining diseases in 22%, sexually transmitted infections (STI) in 8%, diseases other than AIDS or STIs in 23%) and routine pre-surgery or on admission screening in 15%. 52% and 74% of the study patients and patients presented with AIDS, respectively, had never been tested. The median CD4 count in patients with history of previous testing (315/μL) was significantly higher than that of patients who had never been tested (203/μL, p<0.001).
Only 32% of the newly HIV diagnosed patients were diagnosed because of voluntary testing, and 53% were diagnosed due to presence of other diseases. These results remain unchanged from our previous report 10 years earlier (2000-2004) on newly diagnosed patients at the same clinic. HIV testing has not been widely used by newly diagnosed patients in the Tokyo metropolitan area.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>Antiretroviral drugs</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count</subject><subject>Comorbidity</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Disease transmission</subject><subject>Diseases</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>HIV</subject><subject>HIV infections</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - transmission</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Metropolitan areas</subject><subject>Middle Aged</subject><subject>Observational studies</subject><subject>Patient Acceptance of Health Care</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Prevention</subject><subject>Risk Factors</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Surgery</subject><subject>Tokyo - epidemiology</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99u0zAUxiMEYmPwBggsISG4aIljx3FuQNX4s6KhIVbGpXViO6lLagc7ndgz8NK4bTa1qBfIF7bs3_ed42OfJHmK0zEmBX6zcCtvoR13zupxiinhBb2XHOOSZCOWpeT-zvooeRTCIk1zwhl7mBxljKWM8Ow4-fNjDj2aedM02gcE6L2BxrpgAnI1OpteoamtteyNs8hY1M81mrmfNw590b13nWtNDxZNvIZ3aLrsWiNhzQZUO4--en2tbW9ssxFedhFTB30_Qwf2cfKghjboJ8N8knz_-GF2ejY6v_g0PZ2cj2SR835UAS15lefAFcaY1bLKFK2oTkvJKGNSUa1yWhBWKsqkxgwkYMIYZyrDFaHkJHm-9e1aF8RQxyBwlNCUpxRHYrollIOF6LxZgr8RDozYbDjfCPC9ka0WdcarKmdFTINTkIqXUFEKPAWsJFV19Ho7RFtVS61kLIiHds90_8SauWjctaAsL_OSRINXg4F3v1Y69GJpgtRtC1a71SZvTjmmeJ33i3_Qw7cbqAbiBYytXYwr16ZiQknOUlzwIlLjA1QcSi-NjJ-uNnF_T_B6TxCZXv_uG1iFIKaX3_6fvbjaZ1_usHMNbT8Prl1t_tk-SLeg9C4Er-u7IuNUrHvmthpi3TNi6Jkoe7b7QHei2yYhfwHz2RH5</recordid><startdate>20151125</startdate><enddate>20151125</enddate><creator>Nishijima, Takeshi</creator><creator>Takano, Misao</creator><creator>Matsumoto, Shoko</creator><creator>Koyama, Miki</creator><creator>Sugino, Yuko</creator><creator>Ogane, Miwa</creator><creator>Ikeda, Kazuko</creator><creator>Kikuchi, Yoshimi</creator><creator>Oka, Shinichi</creator><creator>Gatanaga, Hiroyuki</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151125</creationdate><title>What Triggers a Diagnosis of HIV Infection in the Tokyo Metropolitan Area? Implications for Preventing the Spread of HIV Infection in Japan</title><author>Nishijima, Takeshi ; Takano, Misao ; Matsumoto, Shoko ; Koyama, Miki ; Sugino, Yuko ; Ogane, Miwa ; Ikeda, Kazuko ; Kikuchi, Yoshimi ; Oka, Shinichi ; Gatanaga, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-ba498b55a8d1116fcb2d4b4e09c6466cd4ed547369d46ce16aca136686d21b343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>AIDS</topic><topic>Antiretroviral drugs</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count</topic><topic>Comorbidity</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Disease transmission</topic><topic>Diseases</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>HIV</topic><topic>HIV infections</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - transmission</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infections</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Metropolitan areas</topic><topic>Middle Aged</topic><topic>Observational studies</topic><topic>Patient Acceptance of Health Care</topic><topic>Patients</topic><topic>Prevalence</topic><topic>Prevention</topic><topic>Risk Factors</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>Surgery</topic><topic>Tokyo - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nishijima, Takeshi</creatorcontrib><creatorcontrib>Takano, Misao</creatorcontrib><creatorcontrib>Matsumoto, Shoko</creatorcontrib><creatorcontrib>Koyama, Miki</creatorcontrib><creatorcontrib>Sugino, Yuko</creatorcontrib><creatorcontrib>Ogane, Miwa</creatorcontrib><creatorcontrib>Ikeda, Kazuko</creatorcontrib><creatorcontrib>Kikuchi, Yoshimi</creatorcontrib><creatorcontrib>Oka, Shinichi</creatorcontrib><creatorcontrib>Gatanaga, Hiroyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nishijima, Takeshi</au><au>Takano, Misao</au><au>Matsumoto, Shoko</au><au>Koyama, Miki</au><au>Sugino, Yuko</au><au>Ogane, Miwa</au><au>Ikeda, Kazuko</au><au>Kikuchi, Yoshimi</au><au>Oka, Shinichi</au><au>Gatanaga, Hiroyuki</au><au>Anglewicz, Philip</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What Triggers a Diagnosis of HIV Infection in the Tokyo Metropolitan Area? Implications for Preventing the Spread of HIV Infection in Japan</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-11-25</date><risdate>2015</risdate><volume>10</volume><issue>11</issue><spage>e0143874</spage><epage>e0143874</epage><pages>e0143874-e0143874</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Japan has not succeeded in reducing the annual number of new HIV-infected patients, although the prevalence of HIV infection is low (0.02%).
A single-center observational study was conducted at the largest HIV clinic in Tokyo, which treats 15% of the total patients in Japan, to determine the reasons for having diagnostic tests in newly infected individuals. HIV-infected patients who visited our clinic for the first time between 2011 and 2014 were analyzed.
The 598 study patients comprised one-third of the total reported number of new patients in Tokyo during the study period. 76% were Japanese MSM. The reasons for being tested which led to the diagnosis was voluntary testing in 32%, existing diseases in 53% (AIDS-defining diseases in 22%, sexually transmitted infections (STI) in 8%, diseases other than AIDS or STIs in 23%) and routine pre-surgery or on admission screening in 15%. 52% and 74% of the study patients and patients presented with AIDS, respectively, had never been tested. The median CD4 count in patients with history of previous testing (315/μL) was significantly higher than that of patients who had never been tested (203/μL, p<0.001).
Only 32% of the newly HIV diagnosed patients were diagnosed because of voluntary testing, and 53% were diagnosed due to presence of other diseases. These results remain unchanged from our previous report 10 years earlier (2000-2004) on newly diagnosed patients at the same clinic. HIV testing has not been widely used by newly diagnosed patients in the Tokyo metropolitan area.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26606382</pmid><doi>10.1371/journal.pone.0143874</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-11, Vol.10 (11), p.e0143874-e0143874 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1736408041 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adult AIDS Antiretroviral drugs CD4 antigen CD4 Lymphocyte Count Comorbidity Diagnosis Diagnostic systems Disease transmission Diseases Female Health aspects Health Knowledge, Attitudes, Practice HIV HIV infections HIV Infections - diagnosis HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - transmission Human immunodeficiency virus Humans Infections Male Medical diagnosis Metropolitan areas Middle Aged Observational studies Patient Acceptance of Health Care Patients Prevalence Prevention Risk Factors Sexually transmitted diseases STD Surgery Tokyo - epidemiology Young Adult |
| title | What Triggers a Diagnosis of HIV Infection in the Tokyo Metropolitan Area? Implications for Preventing the Spread of HIV Infection in Japan |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T09%3A11%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=What%20Triggers%20a%20Diagnosis%20of%20HIV%20Infection%20in%20the%20Tokyo%20Metropolitan%20Area?%20Implications%20for%20Preventing%20the%20Spread%20of%20HIV%20Infection%20in%20Japan&rft.jtitle=PloS%20one&rft.au=Nishijima,%20Takeshi&rft.date=2015-11-25&rft.volume=10&rft.issue=11&rft.spage=e0143874&rft.epage=e0143874&rft.pages=e0143874-e0143874&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0143874&rft_dat=%3Cgale_plos_%3EA435601787%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1736408041&rft_id=info:pmid/26606382&rft_galeid=A435601787&rft_doaj_id=oai_doaj_org_article_f28bb567fcb84acd89ab44a80a1dc4df&rfr_iscdi=true |