Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis
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{"title"=>"Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Markus", "last_name"=>"Haacker", "scopus_author_id"=>"24779284000"}, {"first_name"=>"Nicole", "last_name"=>"Fraser-Hurt", "scopus_author_id"=>"57032632200"}, {"first_name"=>"Marelize", "last_name"=>"Gorgens", "scopus_author_id"=>"55246340300"}], "year"=>2016, "source"=>"PLoS Medicine", "identifiers"=>{"pmid"=>"27138961", "doi"=>"10.1371/journal.pmed.1002012", "sgr"=>"84971595245", "isbn"=>"1549-1676", "scopus"=>"2-s2.0-84971595245", "issn"=>"15491676", "pui"=>"610627082"}, "id"=>"f4789f2e-088e-3300-8459-b6a055b446ea", "abstract"=>"BACKGROUND: Empirical studies and population-level policy simulations show the importance of voluntary medical male circumcision (VMMC) in generalized epidemics. This paper complements available scenario-based studies (projecting costs and outcomes over some policy period, typically spanning decades) by adopting an incremental approach-analyzing the expected consequences of circumcising one male individual with specific characteristics in a specific year. This approach yields more precise estimates of VMMC's cost-effectiveness and identifies the outcomes of current investments in VMMC (e.g., within a fiscal budget period) rather than of investments spread over the entire policy period. METHODS/FINDINGS: The model has three components. We adapted the ASSA2008 model, a demographic and epidemiological model of the HIV epidemic in South Africa, to analyze the impact of one VMMC on HIV incidence over time and across the population. A costing module tracked the costs of VMMC and the resulting financial savings owing to reduced HIV incidence over time. Then, we used several financial indicators to assess the cost-effectiveness of and financial return on investments in VMMC. One circumcision of a young man up to age 20 prevents on average over 0.2 HIV infections, but this effect declines steeply with age, e.g., to 0.08 by age 30. Net financial savings from one VMMC at age 20 are estimated at US$617 at a discount rate of 5% and are lower for circumcisions both at younger ages (because the savings occur later and are discounted more) and at older ages (because male circumcision becomes less effective). Investments in male circumcision carry a financial rate of return of up to 14.5% (for circumcisions at age 20). The cost of a male circumcision is refinanced fastest, after 13 y, for circumcisions at ages 20 to 25. Principal limitations of the analysis arise from the long time (decades) over which the effects of VMMC unfold-the results are therefore sensitive to the discount rate applied, and more generally to the future course of the epidemic and of HIV/AIDS-related policies pursued by the government. CONCLUSIONS: VMMC in South Africa is highly effective in reducing both HIV incidence and the financial costs of the HIV response. The return on investment is highest if males are circumcised between ages 20 and 25, but this return on investment declines steeply with age.", "link"=>"http://www.mendeley.com/research/effectiveness-financial-returns-voluntary-medical-male-circumcision-hiv-prevention-south-africa-incr-3", "reader_count"=>19, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>2, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>6, "Student > Bachelor"=>2, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>2, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>6, "Student > Bachelor"=>2, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Biochemistry, Genetics and Molecular Biology"=>1, "Agricultural and Biological Sciences"=>3, "Medicine and Dentistry"=>4, "Sports and Recreations"=>1, "Business, Management and Accounting"=>1, "Social Sciences"=>4, "Economics, Econometrics and Finance"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>4}, "Social Sciences"=>{"Social Sciences"=>4}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>2}}, "group_count"=>2}

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/5048722"], "description"=>"<p>Net savings from one male circumcision, by discount rate (USD, adjusted for inflation).</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216739, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g007", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Net_savings_from_one_male_circumcision_by_discount_rate_USD_adjusted_for_inflation_/3216739", "title"=>"Net savings from one male circumcision, by discount rate (USD, adjusted for inflation).", "pos_in_sequence"=>8, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048671"], "description"=>"<p>Note: Lines are stacked, so that the distance between the lines gives the effect for each group, and the highest line shows the total effect.</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216706, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g004", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Accumulated_effect_of_one_male_circumcision_on_HIV_incidence_by_age_of_individual_circumcised_HIV_infections_prevented_in_units_/3216706", "title"=>"Accumulated effect of one male circumcision on HIV incidence, by age of individual circumcised (HIV infections prevented, in units).", "pos_in_sequence"=>5, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048695"], "description"=>"<p>Projected costs caused by one new HIV infection, 2013.</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216721, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g005", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Projected_costs_caused_by_one_new_HIV_infection_2013_/3216721", "title"=>"Projected costs caused by one new HIV infection, 2013.", "pos_in_sequence"=>6, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048608"], "description"=>"<p>Projected annual infection risk for male individual, by age.</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216658, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g001", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Projected_annual_infection_risk_for_male_individual_by_age_/3216658", "title"=>"Projected annual infection risk for male individual, by age.", "pos_in_sequence"=>2, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048644"], "description"=>"<p>Note: \"Male (direct effect)\" shows the expected effect on the individual circumcised, \"Females\" shows the population-level effects among female partners, \"Other males\" represent population-level effects among males other than the individual circumcised, and \"MTCT\" stands for HIV infections averted through mother-to-child transmission.</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216694, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g003", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Direct_and_indirect_effects_of_one_male_circumcision_on_HIV_incidence_/3216694", "title"=>"Direct and indirect effects of one male circumcision on HIV incidence.", "pos_in_sequence"=>4, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048758"], "description"=>"<p>Summary of results (based on one male circumcision performed in South Africa in 2013).</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216763, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.t001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Summary_of_results_based_on_one_male_circumcision_performed_in_South_Africa_in_2013_/3216763", "title"=>"Summary of results (based on one male circumcision performed in South Africa in 2013).", "pos_in_sequence"=>9, "defined_type"=>3, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048716"], "description"=>"<p>Projected financial savings following one male circumcision (USD, adjusted for inflation).</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216733, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g006", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Projected_financial_savings_following_one_male_circumcision_USD_adjusted_for_inflation_/3216733", "title"=>"Projected financial savings following one male circumcision (USD, adjusted for inflation).", "pos_in_sequence"=>7, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/5048617"], "description"=>"<p>Reduction in lifetime risk of contracting HIV for individual circumcised, by age at circumcision (units).</p>", "links"=>[], "tags"=>["return", "VMMC", "discount rate", "investment", "policy period", "ages 20", "25. Principal limitations", "age 20", "ASSA 2008 model", "circumcision", "0.2 HIV infections", "HIV incidence"], "article_id"=>3216670, "categories"=>["Biotechnology", "Evolutionary Biology", "Biological Sciences not elsewhere classified", "Science Policy", "Infectious Diseases", "Virology", "Computational Biology"], "users"=>["Markus Haacker", "Nicole Fraser-Hurt", "Marelize Gorgens"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1002012.g002", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Reduction_in_lifetime_risk_of_contracting_HIV_for_individual_circumcised_by_age_at_circumcision_units_/3216670", "title"=>"Reduction in lifetime risk of contracting HIV for individual circumcised, by age at circumcision (units).", "pos_in_sequence"=>3, "defined_type"=>1, "published_date"=>"2016-05-03 08:56:10"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"20", "full-text"=>"17", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"13", "full-text"=>"13", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"6", "full-text"=>"7", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"14", "full-text"=>"10", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"20", "full-text"=>"19", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"12", "full-text"=>"11", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"9", "full-text"=>"12", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"22", "full-text"=>"21", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"4", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"13", "full-text"=>"14", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"4", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"15", "full-text"=>"18", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"12", "full-text"=>"17", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"10", "full-text"=>"10", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"13", "full-text"=>"14", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"17", "full-text"=>"21", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"17", "full-text"=>"16", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"13", "full-text"=>"15", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"13", "full-text"=>"14", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"20", "full-text"=>"16", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"20", "full-text"=>"14", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"10", "full-text"=>"9", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"12", "full-text"=>"10", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"12", "full-text"=>"14", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"13", "full-text"=>"7", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"4", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"7", "full-text"=>"6", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"3", "full-text"=>"2", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"9", "full-text"=>"10", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"9", "supp-data"=>"4", "cited-by"=>"1", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}

Relative Metric

{"start_date"=>"2016-01-01T00:00:00Z", "end_date"=>"2016-12-31T00:00:00Z", "subject_areas"=>[]}
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