Are Patent Medicine Vendors Effective Agents in Malaria Control? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa, Nigeria
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{"title"=>"Are Patent Medicine Vendors Effective Agents in Malaria Control? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa, Nigeria", "type"=>"journal", "authors"=>[{"first_name"=>"Sima", "last_name"=>"Berendes", "scopus_author_id"=>"37094826200"}, {"first_name"=>"Olusegun", "last_name"=>"Adeyemi", "scopus_author_id"=>"56568787500"}, {"first_name"=>"Edward Adekola", "last_name"=>"Oladele", "scopus_author_id"=>"33768028400"}, {"first_name"=>"Olusola Bukola", "last_name"=>"Oresanya", "scopus_author_id"=>"24833469500"}, {"first_name"=>"Festus", "last_name"=>"Okoh", "scopus_author_id"=>"26221898400"}, {"first_name"=>"Joseph J.", "last_name"=>"Valadez", "scopus_author_id"=>"6701414757"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"365652661", "sgr"=>"84866330692", "pmid"=>"22984555", "scopus"=>"2-s2.0-84866330692", "isbn"=>"10.1371/journal.pone.0044775", "doi"=>"10.1371/journal.pone.0044775", "issn"=>"19326203"}, "id"=>"75ebdd42-0f81-3d4a-8fd9-c26ccd8cb945", "abstract"=>"BACKGROUND: Patent medicine vendors (PMV) provide antimalarial treatment and care throughout Sub-Saharan Africa, and can play an important role in the fight against malaria. Their close-to-client infrastructure could enable lifesaving artemisinin-based combination therapy (ACT) to reach patients in time. However, systematic assessments of drug sellers' performance quality are crucial if their role is to be managed within the health system. Lot quality assurance sampling (LQAS) could be an efficient method to monitor and evaluate PMV practice, but has so far never been used for this purpose.\\n\\nMETHODS: In support of the Nigeria Malaria Booster Program we assessed PMV practices in three Senatorial Districts (SDs) of Jigawa, Nigeria. A two-stage LQAS assessed whether at least 80% of PMV stores in SDs used national treatment guidelines. Acceptable sampling errors were set in consultation with government officials (alpha and beta <0.10). The hypergeometric formula determined sample sizes and cut-off values for SDs. A structured assessment tool identified high and low performing SDs for quality of care indicators.\\n\\nFINDINGS: Drug vendors performed poorly in all SDs of Jigawa for all indicators. For example, all SDs failed for stocking and selling first-line antimalarials. PMV sold no longer recommended antimalarials, such as Chloroquine, Sulfadoxine-Pyrimethamine and oral Artesunate monotherapy. Most PMV were ignorant of and lacked training about new treatment guidelines that had endorsed ACTs as first-line treatment for uncomplicated malaria.\\n\\nCONCLUSION: There is urgent need to regularly monitor and improve the availability and quality of malaria treatment provided by medicine sellers in Nigeria; the irrational use of antimalarials in the ACT era revealed in this study bears a high risk of economic loss, death and development of drug resistance. LQAS has been shown to be a suitable method for monitoring malaria-related indicators among PMV, and should be applied in Nigeria and elsewhere to improve service delivery.", "link"=>"http://www.mendeley.com/research/patent-medicine-vendors-effective-agents-malaria-control-using-lot-quality-assurance-sampling-assess", "reader_count"=>60, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Librarian"=>2, "Researcher"=>15, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>7, "Student > Master"=>14, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Librarian"=>2, "Researcher"=>15, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>7, "Student > Master"=>14, "Other"=>2, "Student > Bachelor"=>4, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Agricultural and Biological Sciences"=>4, "Business, Management and Accounting"=>2, "Veterinary Science and Veterinary Medicine"=>1, "Chemistry"=>1, "Computer Science"=>1, "Decision Sciences"=>1, "Economics, Econometrics and Finance"=>2, "Engineering"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>31, "Design"=>1, "Psychology"=>1, "Social Sciences"=>8, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>31}, "Social Sciences"=>{"Social Sciences"=>8}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Psychology"=>{"Psychology"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Design"=>{"Design"=>1}, "Engineering"=>{"Engineering"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>4}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"Rwanda"=>1, "Brazil"=>1, "United Kingdom"=>2, "Nigeria"=>1}, "group_count"=>5}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/578397"], "description"=>"<p>Operating Characteristic Curve for health facility assessments with sample size n = 7 and a decision rule of d = 5 for the upper cut-off P<sub>U</sub> = 80% and the lower cut-off P<sub>L</sub> = 50% for Senatorial Districts with a total of N = 9 and 10 health facilities. The area in between the upper and lower cut-off is the “grey area”. Changing d would shift the curve to the left or right; increasing the sample size would result in a sharper gradient of the curve and a smaller grey area. However, no matter how large the sample size there will always be a grey area and a certain level of misclassification error. We selected n and d to reduce the two forms of misclassification errors; it was ensured that the alpha error or the probability of mistakenly failing to accept an SD with acceptable performance (≥80%) did not exceed a value of 0.10, and that similarly the beta error or the probability of mistakenly accepting an SD with unacceptable performance (≤50%) did not exceed 0.10.</p>", "links"=>[], "tags"=>["assessments"], "article_id"=>248885, "categories"=>["Biotechnology", "Medicine", "Infectious Diseases"], "users"=>["Sima Berendes", "Olusegun Adeyemi", "Edward Adekola Oladele", "Olusola Bukola Oresanya", "Festus Okoh", "Joseph J. Valadez"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0044775.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Operating_Characteristic_Curve_for_health_facility_assessments_in_Jigawa_Nigeria_/248885", "title"=>"Operating Characteristic Curve for health facility assessments in Jigawa, Nigeria.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-19 23:29:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/578482"], "description"=>"*<p>Multiple responses were allowed; no LQAS judgments made, because list includes adequate and inadequate behavior, i.e. stocking and selling of brands that are MOH approved and non-approved for treatment of uncomplicated malaria in Nigeria.</p>†<p>Number of PMVs in the sample of 7 PMVs per Sub-District (SD) who had brands in stock as observed on survey day.</p>‡<p>95% confidence intervals for state estimates of coverage with finite population correction.</p><p>MOH = Ministry of Health, AL = Arthemether-lumefantrine, AA = Artesunate-amodiaquine.</p>", "links"=>[], "tags"=>["brands", "observed", "pmv", "stores"], "article_id"=>248967, "categories"=>["Biotechnology", "Medicine", "Infectious Diseases"], "users"=>["Sima Berendes", "Olusegun Adeyemi", "Edward Adekola Oladele", "Olusola Bukola Oresanya", "Festus Okoh", "Joseph J. Valadez"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0044775.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Available_ACT_brands_observed_on_the_survey_day_in_PMV_stores_in_Jigawa_Nigeria_/248967", "title"=>"Available ACT brands observed on the survey day in PMV stores in Jigawa, Nigeria<sup>*</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-19 23:30:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/578519"], "description"=>"<p>Jigawa State with three Senatorial Districts by total number of Health Facilities (HFs), PMVs, sample sizes, and alpha and beta errors for an LQAS decision rule of “d” = 5.</p>", "links"=>[], "tags"=>["senatorial", "districts", "facilities", "alpha", "beta", "errors", "lqas"], "article_id"=>249004, "categories"=>["Biotechnology", "Medicine", "Infectious Diseases"], "users"=>["Sima Berendes", "Olusegun Adeyemi", "Edward Adekola Oladele", "Olusola Bukola Oresanya", "Festus Okoh", "Joseph J. Valadez"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0044775.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Jigawa_State_with_three_Senatorial_Districts_by_total_number_of_Health_Facilities_HFs_PMVs_sample_sizes_and_alpha_and_beta_errors_for_an_LQAS_decision_rule_of_8220_d_8221_8202_8202_5_/249004", "title"=>"Jigawa State with three Senatorial Districts by total number of Health Facilities (HFs), PMVs, sample sizes, and alpha and beta errors for an LQAS decision rule of “d” = 5.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-19 23:30:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/578555"], "description"=>"*<p>Multiple responses were allowed; no LQAS judgements made because the data are stratified by response options as well as by stocking and selling of drugs that are recommended and non-recommended for treatment of uncomplicated malaria in Nigeria.</p>†<p>As observed on survey day.</p>‡<p>Purchased by clients with fever/malaria on day before survey as reported by PMV.</p>§<p>Number of PMVs in the sample of 7 PMVs per Senatorial District (SD).</p>**<p>95% confidence intervals for state estimates of coverage with finite population correction.</p>", "links"=>[], "tags"=>["sold", "pmv", "stores"], "article_id"=>249045, "categories"=>["Biotechnology", "Medicine", "Infectious Diseases"], "users"=>["Sima Berendes", "Olusegun Adeyemi", "Edward Adekola Oladele", "Olusola Bukola Oresanya", "Festus Okoh", "Joseph J. Valadez"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0044775.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Antimalarials_in_stock_on_survey_day_and_sold_on_the_day_before_the_survey_at_PMV_stores_in_Jigawa_Nigeria_2009_/249045", "title"=>"Antimalarials in stock on survey day and sold on the day before the survey at PMV stores in Jigawa, Nigeria, 2009<sup>*</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-19 23:30:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/578598"], "description"=>"*<p>Number of adequately performing PMVs in the sample of n = 7 PMVs per SD and classification of SD as high or low performance based on the decision rule (d = 5).</p>†<p>95% confidence intervals for state estimates of coverage with finite population correction.</p>‡<p>as observed on the day of the survey.</p>§<p>PMV reported having had malaria-related training on at least three of the following components: treatment with ACTs, promotion of ITNs, referral for danger signs, disuse of chloroquine and SP for treatment.</p>††<p>PMV mentioned at least four of the following components of government recommendations: Treatment with ACTs, disuse of chloroquine and SP for treatment, disuse of oral artemisinin-based monotherapy for treatment, antimalarials to be given in single treatment packs, SP to be provided at least twice during pregnancy, treatment sought for febrile cases within 24 hrs of onset of symptoms.</p>§§<p>Interviewers brought the most common available brand of both types of recommended ACTs, showed them to the PMV and then asked them the dosage for a 2-year-old child for each drug. PMVs were not restricted from looking up dosage information if they wanted to do so.</p>¶<p>Recognizable danger signs to be named included convulsions, coma, severe vomiting, inability to drink or breastfeed, severe sickness/inability to sit or stand, difficulty in breathing/fast breathing, persistent fever, and lack of improvement or worsening of symptoms after two days.</p>**<p>PMV reported that client looking for treatment of fever/malaria purchased a first line antimalarial (recommended ACTs) rather than a non-recommended antimalarial.</p><p>AL = Arthemether-lumefantrine, AA = Artesunate-amodiaquine, ITN = Insecticide Treated Nets, LLIN = Long Lasting Insecticide treated Nets.</p>", "links"=>[], "tags"=>["indicators", "lqas", "senatorial", "districts", "ne-north", "nw-north"], "article_id"=>249082, "categories"=>["Biotechnology", "Medicine", "Infectious Diseases"], "users"=>["Sima Berendes", "Olusegun Adeyemi", "Edward Adekola Oladele", "Olusola Bukola Oresanya", "Festus Okoh", "Joseph J. Valadez"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0044775.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_Process_and_Output_indicators_and_LQAS_judgment_for_three_Senatorial_Districts_C_Central_NE_North_East_NW_North_West_in_Jigawa_Nigeria_2009_/249082", "title"=>"Input, Process and Output indicators and LQAS judgment for three Senatorial Districts (C-Central, NE-North East, NW-North West) in Jigawa, Nigeria, 2009.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-19 23:30:40"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"24", "full-text"=>"22", "pdf"=>"15", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"10"}
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  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"1", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"1"}
  • {"unique-ip"=>"9", "full-text"=>"14", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"3"}
  • {"unique-ip"=>"11", "full-text"=>"10", "pdf"=>"2", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"2"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"4"}
  • {"unique-ip"=>"9", "full-text"=>"9", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"11"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"5"}
  • {"unique-ip"=>"8", "full-text"=>"5", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"6"}
  • {"unique-ip"=>"11", "full-text"=>"7", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"7"}
  • {"unique-ip"=>"6", "full-text"=>"5", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"8"}
  • {"unique-ip"=>"7", "full-text"=>"8", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"9"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"10"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"11"}
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  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"1"}
  • {"unique-ip"=>"7", "full-text"=>"8", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"2"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"3"}
  • {"unique-ip"=>"4", "full-text"=>"4", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"5"}
  • {"unique-ip"=>"11", "full-text"=>"19", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"6"}
  • {"unique-ip"=>"6", "full-text"=>"3", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"4"}
  • {"unique-ip"=>"10", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"11", "full-text"=>"11", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"3", "full-text"=>"9", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"19", "full-text"=>"15", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"9", "full-text"=>"9", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"8", "full-text"=>"9", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"11", "full-text"=>"26", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"11", "full-text"=>"10", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"18", "full-text"=>"39", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"15", "full-text"=>"12", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"7", "full-text"=>"8", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"7", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"12", "full-text"=>"10", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"3", "full-text"=>"9", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"7", "full-text"=>"8", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"9", "full-text"=>"4", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"7", "full-text"=>"5", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"7", "full-text"=>"6", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"7", "full-text"=>"4", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"6", "full-text"=>"4", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"13", "full-text"=>"11", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"6", "full-text"=>"3", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"11", "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"=>"1"}
  • {"unique-ip"=>"11", "full-text"=>"7", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"3", "full-text"=>"1", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
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Relative Metric

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