The importance of physical and mental health in explaining health-related academic role impairment among college students.
Identifieur interne : 000080 ( Main/Exploration ); précédent : 000079; suivant : 000081The importance of physical and mental health in explaining health-related academic role impairment among college students.
Auteurs : Chelsey R. Wilks [États-Unis] ; Randy P. Auerbach [États-Unis] ; Jordi Alonso [Espagne] ; Corina Benjet [Mexique] ; Ronny Bruffaerts [Belgique] ; Pim Cuijpers [Pays-Bas] ; David D. Ebert [Allemagne] ; Jennifer G. Green [États-Unis] ; Claude A. Mellins [États-Unis] ; Philippe Mortier [Espagne] ; Ekaterina Sadikova [États-Unis] ; Nancy A. Sampson [États-Unis] ; Ronald C. Kessler [États-Unis]Source :
- Journal of psychiatric research [ 1879-1379 ] ; 2020.
Abstract
Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.
DOI: 10.1016/j.jpsychires.2020.01.009
PubMed: 32036074
PubMed Central: PMC7047531
Affiliations:
- Allemagne, Belgique, Espagne, Mexique, Pays-Bas, États-Unis
- Bavière, Communauté de Madrid, District de Moyenne-Franconie, Hollande-Septentrionale, Massachusetts, État de New York
- Amsterdam, Boston, Erlangen, Madrid, New York
- Université Columbia, Université Harvard
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Wilks</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychology, Harvard University, Boston, USA; Department of Health Care Policy, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychology, Harvard University, Boston, USA; Department of Health Care Policy, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName><orgName type="university">Université Harvard</orgName></affiliation></author><author><name sortKey="Auerbach, Randy P" sort="Auerbach, Randy P" uniqKey="Auerbach R" first="Randy P" last="Auerbach">Randy P. 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Electronic address: kessler@hcp.med.harvard.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32036074</idno><idno type="pmid">32036074</idno><idno type="doi">10.1016/j.jpsychires.2020.01.009</idno><idno type="pmc">PMC7047531</idno><idno type="wicri:Area/Main/Corpus">000239</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000239</idno><idno type="wicri:Area/Main/Curation">000239</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000239</idno><idno type="wicri:Area/Main/Exploration">000239</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The importance of physical and mental health in explaining health-related academic role impairment among college students.</title><author><name sortKey="Wilks, Chelsey R" sort="Wilks, Chelsey R" uniqKey="Wilks C" first="Chelsey R" last="Wilks">Chelsey R. Wilks</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychology, Harvard University, Boston, USA; Department of Health Care Policy, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychology, Harvard University, Boston, USA; Department of Health Care Policy, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName><orgName type="university">Université Harvard</orgName></affiliation></author><author><name sortKey="Auerbach, Randy P" sort="Auerbach, Randy P" uniqKey="Auerbach R" first="Randy P" last="Auerbach">Randy P. Auerbach</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Columbia University, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Columbia University, New York</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Alonso, Jordi" sort="Alonso, Jordi" uniqKey="Alonso J" first="Jordi" last="Alonso">Jordi Alonso</name><affiliation wicri:level="3"><nlm:affiliation>Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Benjet, Corina" sort="Benjet, Corina" uniqKey="Benjet C" first="Corina" last="Benjet">Corina Benjet</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City</wicri:regionArea><wicri:noRegion>Mexico City</wicri:noRegion></affiliation></author><author><name sortKey="Bruffaerts, Ronny" sort="Bruffaerts, Ronny" uniqKey="Bruffaerts R" first="Ronny" last="Bruffaerts">Ronny Bruffaerts</name><affiliation wicri:level="1"><nlm:affiliation>Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Cuijpers, Pim" sort="Cuijpers, Pim" uniqKey="Cuijpers P" first="Pim" last="Cuijpers">Pim Cuijpers</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Ebert, David D" sort="Ebert, David D" uniqKey="Ebert D" first="David D" last="Ebert">David D. Ebert</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen</wicri:regionArea><placeName><settlement type="city">Erlangen</settlement><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Moyenne-Franconie</region></placeName></affiliation></author><author><name sortKey="Green, Jennifer G" sort="Green, Jennifer G" uniqKey="Green J" first="Jennifer G" last="Green">Jennifer G. Green</name><affiliation wicri:level="3"><nlm:affiliation>Wheelock College of Education and Human Development, Boston University, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Wheelock College of Education and Human Development, Boston University, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Mellins, Claude A" sort="Mellins, Claude A" uniqKey="Mellins C" first="Claude A" last="Mellins">Claude A. Mellins</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Columbia University, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Columbia University, New York</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Mortier, Philippe" sort="Mortier, Philippe" uniqKey="Mortier P" first="Philippe" last="Mortier">Philippe Mortier</name><affiliation wicri:level="3"><nlm:affiliation>Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Sadikova, Ekaterina" sort="Sadikova, Ekaterina" uniqKey="Sadikova E" first="Ekaterina" last="Sadikova">Ekaterina Sadikova</name><affiliation wicri:level="3"><nlm:affiliation>Department of Health Care Policy, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sampson, Nancy A" sort="Sampson, Nancy A" uniqKey="Sampson N" first="Nancy A" last="Sampson">Nancy A. Sampson</name><affiliation wicri:level="3"><nlm:affiliation>Department of Health Care Policy, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C" last="Kessler">Ronald C. Kessler</name><affiliation wicri:level="3"><nlm:affiliation>Department of Health Care Policy, Harvard Medical School, Boston, USA. Electronic address: kessler@hcp.med.harvard.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">Journal of psychiatric research</title><idno type="eISSN">1879-1379</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">32036074</PMID><DateRevised><Year>2020</Year><Month>08</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1379</ISSN><JournalIssue CitedMedium="Internet"><Volume>123</Volume><PubDate><Year>2020</Year><Month>04</Month></PubDate></JournalIssue><Title>Journal of psychiatric research</Title><ISOAbbreviation>J Psychiatr Res</ISOAbbreviation></Journal><ArticleTitle>The importance of physical and mental health in explaining health-related academic role impairment among college students.</ArticleTitle><Pagination><MedlinePgn>54-61</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0022-3956(19)31125-2</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jpsychires.2020.01.009</ELocationID><Abstract><AbstractText>Research consistently documents high rates of mental health problems among college students and strong associations of these problems with academic role impairment. Less is known, though, about prevalence and effects of physical health problems in relation to mental health problems. The current report investigates this by examining associations of summary physical and mental health scores from the widely-used Short-Form 12 (SF-12) Health Survey with self-reported academic role functioning in a self-report survey of 3,855 first-year students from five universities in the northeastern United States (US; mean age 18.5; 53.0% female). The mean SF-12 physical component summary (PCS) score (55.1) was half a standard deviation above the benchmark US adult population mean. The mean SF-12 mental component summary (MCS) score (38.2) was more than a full standard deviation below the US adult population mean. Two-thirds of students (67.1%) reported at least mild and 10.5% severe health-related academic role impairment on a modified version of the Sheehan Disability Scale. Both PCS and MCS scores were significantly and inversely related to these impairment scores, but with nonlinearities and interactions and much stronger associations involving MCS than PCS. Simulation suggests that an intervention that improved the mental health of all students with scores below the MCS median to be at the median would result in a 61.3% reduction in the proportion of students who experienced severe health-related academic role impairment. Although low-cost scalable interventions exist to address student mental health problems, pragmatic trials are needed to evaluate the effectiveness of these interventions in reducing academic role impairment.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wilks</LastName><ForeName>Chelsey R</ForeName><Initials>CR</Initials><AffiliationInfo><Affiliation>Department of Psychology, Harvard University, Boston, USA; Department of Health Care Policy, Harvard Medical School, Boston, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Auerbach</LastName><ForeName>Randy P</ForeName><Initials>RP</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Columbia University, New York, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alonso</LastName><ForeName>Jordi</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Benjet</LastName><ForeName>Corina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bruffaerts</LastName><ForeName>Ronny</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cuijpers</LastName><ForeName>Pim</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ebert</LastName><ForeName>David D</ForeName><Initials>DD</Initials><AffiliationInfo><Affiliation>Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Green</LastName><ForeName>Jennifer G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Wheelock College of Education and Human Development, Boston University, Boston, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mellins</LastName><ForeName>Claude A</ForeName><Initials>CA</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Columbia University, New York, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mortier</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sadikova</LastName><ForeName>Ekaterina</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Health Care Policy, Harvard Medical School, Boston, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sampson</LastName><ForeName>Nancy A</ForeName><Initials>NA</Initials><AffiliationInfo><Affiliation>Department of Health Care Policy, Harvard Medical School, Boston, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kessler</LastName><ForeName>Ronald C</ForeName><Initials>RC</Initials><AffiliationInfo><Affiliation>Department of Health Care Policy, Harvard Medical School, Boston, USA. Electronic address: kessler@hcp.med.harvard.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R01 DA016558</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R56 MH109566</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R03 TW006481</GrantID><Acronym>TW</Acronym><Agency>FIC NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 MH069864</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 MH070884</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R13 MH066849</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>01</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Psychiatr Res</MedlineTA><NlmUniqueID>0376331</NlmUniqueID><ISSNLinking>0022-3956</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">College students</Keyword><Keyword MajorTopicYN="Y">Health-related academic role impairment</Keyword><Keyword MajorTopicYN="Y">Mental health</Keyword><Keyword MajorTopicYN="Y">Physical health</Keyword></KeywordList><CoiStatement>Declaration of competing interest Dr. Ebert reports to have received consultancy fees/served on the scientific advisory board for Sanofi, Novartis, Minddistrict, Lantern, Schoen Kliniken, and two German health insurance companies (BARMER, Techniker Krankenkasse). He is also a stakeholder in the Institute for health training online (GET.ON), which aims to implement scientific findings related to digital health interventions into routine care. In the past 3 years, Dr. Kessler received support for his epidemiological studies from Sanofi Aventis; was a consultant for Datastat, Inc., Johnson & Johnson Wellness and Prevention, Sage Pharmaceuticals, Shire, Takeda; and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. The remaining authors have no conflicts to declare.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>10</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>01</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>01</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="pmc-release"><Year>2021</Year><Month>04</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>2</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>2</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>2</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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