The Interaction of Deworming, Improved Sanitation, and Household Flooring with Soil-Transmitted Helminth Infection in Rural Bangladesh
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{"title"=>"The Interaction of Deworming, Improved Sanitation, and Household Flooring with Soil-Transmitted Helminth Infection in Rural Bangladesh", "type"=>"journal", "authors"=>[{"first_name"=>"Jade", "last_name"=>"Benjamin-Chung", "scopus_author_id"=>"56148086100"}, {"first_name"=>"Arifa", "last_name"=>"Nazneen", "scopus_author_id"=>"36977398600"}, {"first_name"=>"Amal K.", "last_name"=>"Halder", "scopus_author_id"=>"23979889900"}, {"first_name"=>"Rashidul", "last_name"=>"Haque", "scopus_author_id"=>"7004987602"}, {"first_name"=>"Abdullah", "last_name"=>"Siddique", "scopus_author_id"=>"14523795600"}, {"first_name"=>"Muhammed Salah", "last_name"=>"Uddin", "scopus_author_id"=>"55263450800"}, {"first_name"=>"Kim", "last_name"=>"Koporc", "scopus_author_id"=>"6507546768"}, {"first_name"=>"Benjamin F.", "last_name"=>"Arnold", "scopus_author_id"=>"16174532400"}, {"first_name"=>"Alan E.", "last_name"=>"Hubbard", "scopus_author_id"=>"35551340400"}, {"first_name"=>"Leanne", "last_name"=>"Unicomb", "scopus_author_id"=>"7003809519"}, {"first_name"=>"Stephen P.", "last_name"=>"Luby", "scopus_author_id"=>"7007049837"}, {"first_name"=>"David G.", "last_name"=>"Addiss", "scopus_author_id"=>"7005696197"}, {"first_name"=>"John M.", "last_name"=>"Colford", "scopus_author_id"=>"7004130553"}], "year"=>2015, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"issn"=>"19352735", "pui"=>"607461942", "sgr"=>"84953325537", "doi"=>"10.1371/journal.pntd.0004256", "scopus"=>"2-s2.0-84953325537", "isbn"=>"1935-2735 (Electronic)\\r1935-2727 (Linking)", "pmid"=>"26624994"}, "id"=>"1a6b40c0-57ca-36bc-a341-aaeb68975fca", "abstract"=>"BACKGROUND: The combination of deworming and improved sanitation or hygiene may result in greater reductions in soil-transmitted helminth (STH) infection than any single intervention on its own. We measured STH prevalence in rural Bangladesh and assessed potential interactions among deworming, hygienic latrines, and household finished floors. METHODOLOGY: We conducted a cross-sectional survey (n = 1,630) in 100 villages in rural Bangladesh to measure three exposures: self-reported deworming consumption in the past 6 months, access to a hygienic latrine, and household flooring material. We collected stool samples from children 1–4 years, 5–12 years, and women 15–49 years. We performed mini-FLOTAC on preserved stool samples to detect Ascaris lumbricoides, Enterobius vermicularis, hookworm, and Trichuris trichiura ova. Approximately one-third (32%) of all individuals and 40% of school-aged children had an STH infection. Less than 2% of the sample had moderate/heavy intensity infections. Deworming was associated with lower Ascaris prevalence (adjusted prevalence ratio (PR) = 0.53; 95% CI 0.40, 0.71), but there was no significant association with hookworm (PR = 0.93, 95% CI 0.60, 1.44) or Trichuris (PR = 0.90, 95% CI 0.74, 1.08). PRs for hygienic latrine access were 0.91 (95% CI 0.67,1.24), 0.73 (95% CI 0.43,1.24), and 1.03 (95% CI 0.84,1.27) for Ascaris, hookworm, and Trichuris, respectively. Finished floors were associated with lower Ascaris prevalence (PR = 0.56, 95% CI 0.32, 0.97) but not associated with hookworm (PR = 0.48 95% CI 0.16,1.45) or Trichuris (PR = 0.98, 95% CI 0.72,1.33). Across helminths and combinations of exposures, adjusted prevalence ratios for joint exposures were consistently more protective than those for individual exposures. CONCLUSIONS: We found moderate STH prevalence in rural Bangladesh among children and women of childbearing age. This study is one of the first to examine independent and combined associations with deworming, sanitation, and hygiene. Our results suggest that coupling deworming with sanitation and flooring interventions may yield more sustained reductions in STH prevalence.", "link"=>"http://www.mendeley.com/research/interaction-deworming-improved-sanitation-household-flooring-soiltransmitted-helminth-infection-rura", "reader_count"=>47, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Researcher"=>10, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>8, "Student > Master"=>10, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Researcher"=>10, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>8, "Student > Master"=>10, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>7, "Engineering"=>3, "Environmental Science"=>9, "Nursing and Health Professions"=>3, "Medicine and Dentistry"=>11, "Agricultural and Biological Sciences"=>8, "Veterinary Science and Veterinary Medicine"=>1, "Social Sciences"=>2, "Immunology and Microbiology"=>2, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>3}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>11}, "Social Sciences"=>{"Social Sciences"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Unspecified"=>{"Unspecified"=>7}, "Environmental Science"=>{"Environmental Science"=>9}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"Bhutan"=>1, "United Kingdom"=>2}, "group_count"=>5}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2595621", "https://ndownloader.figshare.com/files/2595622", "https://ndownloader.figshare.com/files/2595623", "https://ndownloader.figshare.com/files/2595624", "https://ndownloader.figshare.com/files/2595625", "https://ndownloader.figshare.com/files/2595626", "https://ndownloader.figshare.com/files/2595627"], "description"=>"<div><p>Background</p><p>The combination of deworming and improved sanitation or hygiene may result in greater reductions in soil-transmitted helminth (STH) infection than any single intervention on its own. We measured STH prevalence in rural Bangladesh and assessed potential interactions among deworming, hygienic latrines, and household finished floors.</p><p>Methodology</p><p>We conducted a cross-sectional survey (n = 1,630) in 100 villages in rural Bangladesh to measure three exposures: self-reported deworming consumption in the past 6 months, access to a hygienic latrine, and household flooring material. We collected stool samples from children 1–4 years, 5–12 years, and women 15–49 years. We performed mini-FLOTAC on preserved stool samples to detect <i>Ascaris lumbricoides</i>, <i>Enterobius vermicularis</i>, hookworm, and <i>Trichuris trichiura</i> ova. Approximately one-third (32%) of all individuals and 40% of school-aged children had an STH infection. Less than 2% of the sample had moderate/heavy intensity infections. Deworming was associated with lower <i>Ascaris</i> prevalence (adjusted prevalence ratio (PR) = 0.53; 95% CI 0.40, 0.71), but there was no significant association with hookworm (PR = 0.93, 95% CI 0.60, 1.44) or <i>Trichuris</i> (PR = 0.90, 95% CI 0.74, 1.08). PRs for hygienic latrine access were 0.91 (95% CI 0.67,1.24), 0.73 (95% CI 0.43,1.24), and 1.03 (95% CI 0.84,1.27) for <i>Ascaris</i>, hookworm, and <i>Trichuris</i>, respectively. Finished floors were associated with lower <i>Ascaris</i> prevalence (PR = 0.56, 95% CI 0.32, 0.97) but not associated with hookworm (PR = 0.48 95% CI 0.16,1.45) or <i>Trichuris</i> (PR = 0.98, 95% CI 0.72,1.33). Across helminths and combinations of exposures, adjusted prevalence ratios for joint exposures were consistently more protective than those for individual exposures.</p><p>Conclusions</p><p>We found moderate STH prevalence in rural Bangladesh among children and women of childbearing age. This study is one of the first to examine independent and combined associations with deworming, sanitation, and hygiene. Our results suggest that coupling deworming with sanitation and flooring interventions may yield more sustained reductions in STH prevalence.</p></div>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615169, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>["https://dx.doi.org/10.1371/journal.pntd.0004256.s001", "https://dx.doi.org/10.1371/journal.pntd.0004256.s002", "https://dx.doi.org/10.1371/journal.pntd.0004256.s003", "https://dx.doi.org/10.1371/journal.pntd.0004256.s004", "https://dx.doi.org/10.1371/journal.pntd.0004256.s005", "https://dx.doi.org/10.1371/journal.pntd.0004256.s006", "https://dx.doi.org/10.1371/journal.pntd.0004256.s007"], "stats"=>{"downloads"=>5, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Interaction_of_Deworming_Improved_Sanitation_and_Household_Flooring_with_Soil_Transmitted_Helminth_Infection_in_Rural_Bangladesh_/1615169", "title"=>"The Interaction of Deworming, Improved Sanitation, and Household Flooring with Soil-Transmitted Helminth Infection in Rural Bangladesh", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595597"], "description"=>"<p>This figure shows the number of surveys returned, samples analyzed, and final sample size for this analysis.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615148, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.g001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Data_collected_/1615148", "title"=>"Data collected.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595604"], "description"=>"<p>We mapped STH prevalence in each study cluster for which valid GPS coordinates were available (n = 99). Panel A shows the cluster-level prevalence of any STH infection, Panel B shows the prevalence of <i>Ascaris lumbricoides</i>, Panel C shows the prevalence of hookworm, and Panel D shows the prevalence of <i>Trichuris trichiura</i>.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615155, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.g002", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Map_of_soil_transmitted_helminth_prevalence_in_Bangladesh_/1615155", "title"=>"Map of soil-transmitted helminth prevalence in Bangladesh.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595611"], "description"=>"<p>Panel A shows the prevalence of each helminth among those who did not receive deworming (D-), those who did receive deworming (D+), those who did not have access to a hygienic latrine (L-), and those who did have access to a hygienic latrine (L+). Panel B shows the prevalence of each helminth among those who did not receive deworming (D-), those who did receive deworming (D+), those whose household did not have a finished floor (F-), and those whose household did have a finished floor (F+).</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615159, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.g003", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_STH_prevalence_by_exposure_to_deworming_hygienic_latrines_and_finished_floors_/1615159", "title"=>"STH prevalence by exposure to deworming, hygienic latrines, and finished floors.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595612"], "description"=>"<p>Panel A shows the cluster-level prevalence of <i>Ascaris</i>, Panel B shows the prevalence of hookworm, and Panel C shows the prevalence of <i>Trichuris</i> by the proportion of respondents with hygienic latrines in each cluster.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615160, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.g004", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cluster_level_STH_prevalence_by_cluster_level_hygienic_latrine_coverage_/1615160", "title"=>"Cluster-level STH prevalence by cluster-level hygienic latrine coverage.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595613"], "description"=>"<p>aIncludes <i>Enterobius</i> infections</p><p>Helminth infection prevalence by age, helminth, and infection intensity.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615161, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.t001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Helminth_infection_prevalence_by_age_helminth_and_infection_intensity_/1615161", "title"=>"Helminth infection prevalence by age, helminth, and infection intensity.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595614"], "description"=>"<p><sup>a</sup>The number of observations was slightly lower for adjusted prevalence ratios because some observations of potential confounders had missing values.</p><p><sup>b</sup>PRs estimated using modified Poisson regression and adjusted for age, sex, sub-district, household wealth, cluster-level wealth, and mother’s education level.</p><p>Prevalence ratios for deworming, hygienic latrine access, and finished floors.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615162, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.t002", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_ratios_for_deworming_hygienic_latrine_access_and_finished_floors_/1615162", "title"=>"Prevalence ratios for deworming, hygienic latrine access, and finished floors.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595615"], "description"=>"<p><sup>a</sup>PRs adjusted for age, sex, household floor type, geographic district, household wealth, cluster-level wealth, and mother’s education level.</p><p><sup>b</sup>Relative excess risk due to interaction (RERI). A RERI = 0 indicates no interaction on the additive scale, RERI>0 indicates synergistic interaction on the additive scale for monotonic aPRs, RERI>1 indicating synergistic interaction on the additive scale for non-monotonic aPRs, and RERI<0 indicates antagonistic interaction on the additive scale.</p><p>PRs adjusted for age, sex, hygienic latrine access, geographic district, household wealth, cluster-level wealth, and mother’s education level</p><p>95% Confidence intervals were not estimated because there were strata with fewer than 5 observations for this measure.</p><p>Adjusted prevalence ratios for single and combined deworming and hygienic latrine access and relative excess risk due to interaction.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615163, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.t003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_prevalence_ratios_for_single_and_combined_deworming_and_hygienic_latrine_access_and_relative_excess_risk_due_to_interaction_/1615163", "title"=>"Adjusted prevalence ratios for single and combined deworming and hygienic latrine access and relative excess risk due to interaction.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-12-01 14:49:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/2595616"], "description"=>"<p><sup>a</sup>PRs adjusted for age, sex, household floor type, geographic district, household wealth, cluster-level wealth, and mother’s education level.</p><p><sup>b</sup>Relative excess risk due to interaction (RERI). A RERI = 0 indicates no interaction on the additive scale, RERI>0 indicates synergistic interaction on the additive scale for monotonic aPRs, RERI>1 indicating synergistic interaction on the additive scale for non-monotonic aPRs, and RERI<0 indicates antagonistic interaction on the additive scale.</p><p><sup>c</sup>PRs adjusted for age, sex, hygienic latrine access, geographic district, household wealth, cluster-level wealth, and mother’s education level</p><p><sup>d</sup>95% Confidence intervals were not estimated because there were strata with fewer than 5 observations for this measure.</p><p>Adjusted prevalence ratios for single and combined deworming and household finished floor and relative excess risk due to interaction.</p>", "links"=>[], "tags"=>["stool samples", "pr", "Rural Bangladesh BackgroundThe combination", "ci", "household flooring material", "Ascaris prevalence", "hookworm", "STH prevalence", "Trichuris trichiura ova", "deworming"], "article_id"=>1615164, "categories"=>["Biological Sciences"], "users"=>["Jade Benjamin-Chung", "Arifa Nazneen", "Amal K. Halder", "Rashidul Haque", "Abdullah Siddique", "Muhammed Salah Uddin", "Kim Koporc", "Benjamin F. Arnold", "Alan E. Hubbard", "Leanne Unicomb", "Stephen P. Luby", "David G. Addiss", "John M. Colford Jr."], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0004256.t004", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_prevalence_ratios_for_single_and_combined_deworming_and_household_finished_floor_and_relative_excess_risk_due_to_interaction_/1615164", "title"=>"Adjusted prevalence ratios for single and combined deworming and household finished floor and relative excess risk due to interaction.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-12-01 14:49:43"}

PMC Usage Stats | Further Information

  • {"unique-ip"=>"25", "full-text"=>"26", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"35", "full-text"=>"27", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"50", "full-text"=>"44", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"18", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"31", "full-text"=>"31", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"8", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"29", "full-text"=>"30", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"34", "full-text"=>"37", "pdf"=>"19", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"21", "full-text"=>"33", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"18", "full-text"=>"21", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"12", "full-text"=>"15", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"19", "full-text"=>"20", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"19", "full-text"=>"17", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"17", "full-text"=>"18", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"22", "full-text"=>"20", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"6", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"13", "full-text"=>"16", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"14", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"13", "full-text"=>"11", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"13", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"12", "full-text"=>"13", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"8", "full-text"=>"10", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"6", "full-text"=>"9", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"11", "full-text"=>"16", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"17", "full-text"=>"20", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"15", "full-text"=>"17", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"7", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"11", "full-text"=>"15", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"16", "full-text"=>"21", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"21", "full-text"=>"13", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"10", "full-text"=>"12", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"14", "full-text"=>"20", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"19", "full-text"=>"22", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"5", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"11", "full-text"=>"13", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"12", "full-text"=>"12", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"14", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"11", "full-text"=>"10", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}

Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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