Current Environmental Health Reports最新文献

{"title":"Occupational Heat Exposure & Mental Health Outcomes: A Review and Framework Incorporating Social Determinants of Health to Guide Future Research.","authors":"Stefani Florez-Acevedo, Maria T Blancas, June T Spector","doi":"10.1007/s40572-025-00479-6","DOIUrl":"https://doi.org/10.1007/s40572-025-00479-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Environmental heat exposure is associated with adverse mental health outcomes in the general population; however, the mental health effects of heat exposure in occupational populations have not been fully characterized. We sought to: (1) review primary research studies on the relationship of occupational heat exposure with mental health outcomes; and (2) synthesize the literature with a proposed framework to identify gaps and opportunities for future research, using an equity lens.</p><p><strong>Recent findings: </strong>Ten peer-reviewed studies between 1997 and 2024 that met our selection criteria included five cross-sectional, one longitudinal, one mixed-methods, one qualitative, and two experimental/quasi-experimental studies of varying quality. Studies were conducted across five continents covering agriculture, forestry, fishing, hunting; public administration and healthcare; utilities; mining, oil and gas extraction; and glass manufacturing industries. Occupational heat exposure was associated with mental health outcomes including stress, anxiety, mental disorders and burnout in seven of ten studies. The literature on occupational heat exposure and mental health outcomes among workers is emerging. Future research should address research gaps through high-quality etiologic and solutions-oriented intervention research and should be informed by a framework that considers both upstream and downstream factors, including work psychosocial factors and social determinants of health. Research with worker populations with high current and projected occupational heat exposure and/or a high prevalence of factors associated with an increased risk of adverse mental health outcomes should be prioritized. Work equity should be addressed through partner-engaged methods and co-development of culturally appropriate products, incorporating the contexts and needs of populations at disproportionate risk of adverse mental health outcomes.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"15"},"PeriodicalIF":7.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Heat Vulnerability and Heat Risk for Neighborhood Health Risk Management in Urban Environment? Challenges and Opportunities.","authors":"Hung Chak Ho, Shilu Tong, Yi Zhou, Kejia Hu, Xuchao Yang, Yuanjian Yang","doi":"10.1007/s40572-025-00478-7","DOIUrl":"https://doi.org/10.1007/s40572-025-00478-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Heat vulnerability mapping (or heat risk mapping) is commonly used as a cost-effective tool to assess neighborhood health burdens for policy development and implementations. Some local governments have adopted this strategy to develop community action plans to cope with an increasing threat from heat exposure. However, various data/methods for mapping have yielded inconsistent results. For a compact city with high population density, issues from generic mapping techniques would become more apparent due to its complexity of social/environmental structures.</p><p><strong>Recent findings: </strong>We explored the similarities/differences in existing heat vulnerability mapping approaches. Previous models (1) failed to characterize extreme heat variations (e.g. days with different temperature extremes, difference between single hot days and prolonged heat events); (2) generally lacked a validation of associations between mapping results and various health outcomes (e.g. only relying on mortality data for validation but no validation of morbidities or clinical visits); (3) had a low ability to incorporate spatiotemporal variability of demographic patterns (e.g. difference in daytime/nighttime population patterns due to daily mobility); (4) were unable to adopt perceived heat exposure (e.g. Universal Thermal Climate Index); and (5) did not measure heat vulnerability at street-/building-levels even though 3-dimensional urban forms exist across major cities. Additionally, most applications (including those from local governments) were developed from a top-down perspective without a participatory design. A location-specific, evidence-based framework based on various exposure patterns and health outcomes with bottom-up strategies for implementations is needed for minimizing bias from \"one-size-fits-all\" strategies for action plans across high-density cities.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"14"},"PeriodicalIF":7.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposome Burden Scores to Summarize Environmental Chemical Mixtures: Creating a Fair and Common Scale for Cross-study Harmonization, Report-back and Precision Environmental Health.","authors":"Shelley H Liu, Katherine E Manz, Jessie P Buckley, Leah Feuerstahler","doi":"10.1007/s40572-024-00467-2","DOIUrl":"https://doi.org/10.1007/s40572-024-00467-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Environmental health researchers are increasingly concerned about characterizing exposure to environmental chemical mixtures (co-exposure to multiple chemicals simultaneously). We discuss approaches for quantifying an overall summary score or index that reflects an individual's total exposure burden to components of the mixture. We focus on unsupervised methods, in which the summary score is not computed in relation to a pre-specified health outcome.</p><p><strong>Recent findings: </strong>Sum-scores and principal components analysis (PCA) are common approaches for quantifying a total exposure burden metric but have several limitations: 1) they require imputation when using exposure biomarkers with high frequency of non-detection, 2) they do not account for exposure heterogeneity, 3) sum-scores assume the same measurement error for all people, while there is no error term inherent to the PCA model as its primary purpose is dimension reduction, and 4) in pooled analyses, both approaches are limited to analyzing the set of exposure variables that are in common across all studies, potentially discarding valuable information. Meanwhile, item response theory (IRT) is a novel and promising alternative to calculate an exposure burden score that addresses the above limitations. It allows for the inclusion of exposure analytes with high frequency of non-detects without the need for imputation. It can account for exposure heterogeneity to calculate fair metrics for all people, through assessment of differential item functioning and mixture IRT. IRT also quantifies measurement errors of the exposure burden score that are individual-specific, such that it appropriately assigns a larger standard error to an individual who has missing data on one or more exposure variables. Lastly, IRT enhances cross-study harmonization by enabling the creation of exposure burden calculators to set a common scale across studies, and allows for the inclusion of all exposure variables within a chemical class, even if they were only measured in a subset of participants. Summarizing total exposure burden, through the creation of fair and informative index scores, is a promising tool for environmental health research as environmental exposures are increasingly used for biomonitoring and clinical recommendations.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"13"},"PeriodicalIF":7.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Carcinogenic Mechanisms of Hexavalent Chromium: from DNA Breaks to Chromosome Instability and Neoplastic Transformation.","authors":"Idoia Meaza, Aggie R Williams, Sandra S Wise, Haiyan Lu, John Pierce Wise","doi":"10.1007/s40572-025-00480-z","DOIUrl":"https://doi.org/10.1007/s40572-025-00480-z","url":null,"abstract":"","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"12"},"PeriodicalIF":7.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposed and Vulnerable: Sources and Health Implications of Chemical Exposures in Neonatal, Pediatric, and Cardiac Intensive Care Units.","authors":"Jordan R Kuiper, Melania Bembea, J William Gaynor, David Graham, Eric M Graham, Kurunthachalam Kannan, Nikki G Posnack, Allen D Everett, Jessie P Buckley","doi":"10.1007/s40572-025-00477-8","DOIUrl":"https://doi.org/10.1007/s40572-025-00477-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Exposures to endocrine disrupting chemicals (EDCs) in early life have demonstrable adverse implications on child health and development. Yet, there is a dearth of studies evaluating the potential exposures to EDCs, such as bisphenols, parabens, phthalates, and volatile organic compounds (VOCs), in hospital-based settings among children who are critically ill and/or particularly vulnerable. This narrative review seeks to provide up-to-date evidence on the sources and magnitude of exposure to EDCs in neonatal-, pediatric-, and cardiac intensive care units (NICUs/PICUs/CICUs) as well as resulting health impacts.</p><p><strong>Recent findings: </strong>Thirty-three studies were included in this review. The most frequently studied and characterized EDCs in NICUs/PICUs/CICUs were phthalates followed by terephthalates and alternative plasticizers. Evaluations of health outcomes resulting from such exposures were scarce, and few studies assessed health outcomes after hospital discharge. EDCs are pervasive in NICU/PICU/CICU settings and pediatric exposure levels are much higher than in other environments. However, the existing evidence has multiple limitations that should be addressed in future work. Specifically, studies evaluating a more expansive array of chemicals, including contemporary and emerging replacements for legacy compounds, are needed, as are studies that consider chemical mixtures. Additionally, few studies evaluated the health impacts of chemical exposures, and their mixtures, in NICU/PICU/CICU settings, especially long-term health outcomes observed after hospital discharge. Such studies could be invaluable in supporting policy as well as development of medical products without toxic chemicals.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"11"},"PeriodicalIF":7.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hurricanes and Health Equity: A Review of Structural Determinants of Vulnerability for Climate and Health Research.","authors":"Shifali Mathews, Genee Smith, Jaime Madrigano","doi":"10.1007/s40572-025-00475-w","DOIUrl":"10.1007/s40572-025-00475-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Understanding hurricane vulnerability is crucial for targeting and identifying climate adaptation measures. However, vulnerability assessments often focus on proximal factors, which may obscure underlying drivers of health inequities. We sought to describe the literature characterizing hurricane vulnerability in the U.S., from 2000 to 2022. We abstracted the approaches and factors in each hurricane vulnerability assessment study, and developed a conceptual framework to guide data collection on structural determinants of climate vulnerability.</p><p><strong>Recent findings: </strong>The review included a total of 121 studies. The majority pre-specified vulnerable populations, while 40% empirically derived vulnerability. Downstream factors pertaining to demographics, spatial analysis, and health status were most commonly used to assess vulnerability to hurricanes. Only five studies reported structural vulnerabilities, including racism, governance, institutions, and infrastructure deficiencies, which form the basis of our conceptual framework. Most hurricane vulnerability studies do not consider upstream factors of health inequities. We developed a conceptual framework and provided example data measures for structural determinants to incorporate into climate and health research, facilitating the development of more effective interventions to address root causes.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"10"},"PeriodicalIF":7.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Early-life PFAS Exposure on Child Neurodevelopment: A Review of the Evidence and Research gaps.","authors":"Jennifer L Ames, Vanshika Sharma, Kristen Lyall","doi":"10.1007/s40572-024-00464-5","DOIUrl":"10.1007/s40572-024-00464-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Per- and polyfluoroalkyl substances (PFAS) are persistent chemicals with many modern applications, leading to widespread contamination and universal human exposure. PFAS exposure during early life is of particular concern, given susceptibility of the developing fetal and infant brain to toxic exposures. This review aims to synthesize current evidence, discuss methodological challenges, and highlight research gaps to guide future studies on the impact of PFAS on neurodevelopment.</p><p><strong>Recent findings: </strong>Sixty-one studies in total were published from 2008 to March 2024, with 35 in the last five years. Findings primarily link early life PFAS exposure to reduced cognitive, motor, and language development in infancy and increased behavioral issues like hyperactivity in childhood. Large studies have shown mixed results concerning child cognition, executive function, autism, and ADHD, with some indicating no association or unexpected protective findings. Sex-specific associations have been observed, but not consistently. Most research has addressed low-level exposure, suggesting subtle but potentially significant population-wide neurodevelopmental effects. Recent research also highlights concerns about newer, alternative PFAS, suggesting they too might affect neurodevelopment.  The effects of early-life PFAS exposure on neurodevelopment merit further study, particularly the cumulative effects of prenatal and postnatal exposures. Research has not fully explored sensitive subgroups or potential mitigating factors such as breastfeeding and nutrient intake, which will require larger, more diverse samples. Future directions include deeper study of PFAS mixtures, interactions with other neurotoxic environmental chemicals, and effects of newer PFAS types. There is also a need to focus on neuropsychological functioning in later childhood, using direct assessments for more reliable evaluations.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"9"},"PeriodicalIF":7.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-Analysis Assessing the Impact of Improved Cookstove Technology Trials (ICTs) on Household Air Pollution and Human Health in Sub-Saharan Africa.","authors":"David Dillon, Samara Reigh, Kristen M Rappazzo, Thomas J Luben, Anne M Weaver","doi":"10.1007/s40572-025-00476-9","DOIUrl":"10.1007/s40572-025-00476-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>A major contributor to household air pollution (HAP) in sub-Saharan Africa (SSA) is unclean cooking fuel. Improved cookstove technology (ICT) interventions have been promoted as a solution, but their impacts on health are unclear. Our aim is to conduct a systematic review to explore the impacts of ICT interventions on health outcomes in SSA. We conducted a systematic review, following PRISMA guidelines, on ICT interventions in SSA from 2000-present. We performed this search in MEDLINE, PubMed, Web of Science, Web of Science CABI, and EMBASE via ProQuest. Two reviewers assessed each study using predefined inclusion/exclusion criteria and extracted data. We evaluated each study on participant selection, exposure assessment, control comparability, outcomes, analyses, and biases.</p><p><strong>Recent findings: </strong>From 4,461 articles, k = 23 (n = 31,261 individuals) articles described results of ICT interventions on health outcomes. Pooled mean exposure estimates for fine particulate matter (PM_2.5) in control and intervention groups were 102.88 µg/m³ (95% confidence interval [CI]I: 52.63, 153.14; I² 96.9%) and 101.76 µg/m³ (95%CI: 57.47, 146.06; I² 98.2%), respectively. Estimates for pooled mean carbon monoxide (CO) were 2.40 ppm (95% CI: 0, 8.33; I² 99.0%) and 1.66 ppm (0, 4.91; I² 98.5%) respectively. Of health outcomes, 19.4% were reported as significantly different between control and intervention groups. There is mixed evidence that ICT interventions influence health outcomes due to heterogeneity in study designs, sample size, stove stacking, etc. ICT interventions may decrease HAP, but other sources of air pollutant exposure are not addressed by improved cookstoves.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"8"},"PeriodicalIF":7.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ways to Measure Metals: From ICP-MS to XRF.","authors":"Kolawole E Adesina, Chandler J Burgos, Thomas R Grier, Abu S M Sayam, Aaron J Specht","doi":"10.1007/s40572-025-00473-y","DOIUrl":"10.1007/s40572-025-00473-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review explores the use of Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and X-ray Fluorescence (XRF) for quantifying metals and metalloids in biological matrices such as hair, nails, blood, bone, and tissue. It provides a comprehensive overview of these methodologies, detailing their technological limitations, application scopes, and practical considerations for selection in both laboratory and field settings. By examining traditional and novel aspects of each method, this review aims to guide researchers and clinical practitioners in choosing the most suitable analytical tool based on their specific needs for sensitivity, precision, speed, and sample preparation.</p><p><strong>Recent findings: </strong>Recent studies highlight enhanced capabilities of both ICP-MS and XRF technologies, making them more adaptable to various analytical needs. ICP-MS is renowned for its unmatched sensitivity and precision in detecting ultra-trace metals and metalloids in complex biological samples, such as lead in plasma or seawater. XRF advancements include lower detection limits and reduced sample preparation time, enabling rapid, non-destructive analyses, ideal for quick field assessments. Portable XRF analyzers have revolutionized on-the-spot testing, providing robust data without traditional wet-lab constraints. Moreover, hybrid techniques combining ICP-MS and XRF features are emerging, offering rapid and precise metal analysis for environmental monitoring, clinical diagnostics, and epidemiological studies. Matching analytical methods to specific research demands is critical. ICP-MS is the gold standard for detailed quantitative analysis in laboratories, while XRF excels in non-destructive, immediate field applications. Selection should consider sample complexity, sensitivity, speed, and cost-efficiency. Integrating ICP-MS and XRF offers a versatile approach to metals analysis, transforming practices in environmental science and healthcare diagnostics. As these technologies evolve, they are promising to expand capabilities in detecting and understanding the roles of metals and metalloids in health and the environment.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"7"},"PeriodicalIF":7.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caenorhabditis Elegans as a Model for Environmental Epigenetics.","authors":"Adam Filipowicz, Patrick Allard","doi":"10.1007/s40572-025-00472-z","DOIUrl":"10.1007/s40572-025-00472-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>The burgeoning field of environmental epigenetics has revealed the malleability of the epigenome and uncovered numerous instances of its sensitivity to environmental influences; however, pinpointing specific mechanisms that tie together environmental triggers, epigenetic pathways, and organismal responses has proven difficult. This article describes how Caenorhabditis elegans can fill this gap, serving as a useful model for the discovery of molecular epigenetic mechanisms that are conserved in humans.</p><p><strong>Recent findings: </strong>Recent results show that environmental stressors such as methylmercury, arsenite, starvation, heat, bacterial infection, and mitochondrial inhibitors can all have profound effects on the epigenome, with some insults showing epigenetic and organismal effects for multiple generations. In some cases, the pathways connecting the stressor to epigenetic pathways and organismal responses have been elucidated. For example, a small RNA from the bacterial pathogen Pseudomonas aeruginosa induces transgenerational learned avoidance by activating the RNA interference PIWI-interacting RNA pathways across generations to downregulate, via Cer1 retrotransposon particles and histone methylation, maco-1, a gene that functions in sensory neurons to regulate chemotaxis. Mitochondrial inhibitors seem to have a profound effect on both the DNA methylation mark 6mA and histone methylation, and may act within mitochondrial DNA (mtDNA) to regulate mitochondrial stress response genes. Transgenerational transcriptional responses to alcohol have also been worked out at the single-nucleus resolution in C. elegans, demonstrating its utility when combined with modern sequencing technologies. These recent studies highlight how C. elegans can serve as a bridge between biochemical in vitro experiments and the more associative findings of epidemiological studies in humans to unveil possible mechanisms of environmental influence on the epigenome. The nematode is particularly well-suited to transgenerational experiments thanks to its rapid generation time and ability to self-fertilize. These studies have revealed connections between the various epigenetic mechanisms, and so studies in C. elegans that take advantage of recent advancements in sequencing technologies, including single-cell techniques, to gain unprecedented resolution of the whole epigenome across development and generations will be critical.</p>","PeriodicalId":10775,"journal":{"name":"Current Environmental Health Reports","volume":"12 1","pages":"6"},"PeriodicalIF":7.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}