Harm Reduction Journal最新文献

{"title":"U.S. substance use harm reduction efforts: a review of the current state of policy, policy barriers, and recommendations.","authors":"Bailey E Pridgen, Andrew P Bontemps, Audrey R Lloyd, William P Wagner, Emma S Kay, Ellen F Eaton, Karen L Cropsey","doi":"10.1186/s12954-025-01238-4","DOIUrl":"10.1186/s12954-025-01238-4","url":null,"abstract":"<p><p>A wealth of research demonstrates that harm reduction interventions for substance use (SU) save lives and reduce risk for serious infectious diseases such as HIV, hepatitis C, and other SU-related health conditions. The U.S. has adopted several harm reduction interventions at federal and state levels to combat SU-related harm. While several policy changes on the federal and state levels decriminalized interventions and further support their use, other policies limit the reach of these interventions by delaying or restricting care, leaving access to life-saving interventions inconsistent across the U.S. Federal and state policies in the U.S. that restrict access to medications for opioid use disorder (MOUD), criminalize possession of drug paraphernalia, prevent syringe service programs and overdose prevention centers from operating, and limit prescribing of pre-exposure prophylaxis (PrEP) pose significant barriers to harm reduction access and implementation. This paper aims to bridge publications and reports on current state and federal harm reduction intervention policies and discuss policy recommendations. Federally, the DEA and SAMHSA should expand certification for methadone dispensing to settings beyond dedicated opioid treatment programs and non-OTP prescribers. Congress can decriminalize items currently categorized as paraphernalia, permit purchasing of syringes and all drug checking equipment using federal funds, amend the Controlled Substances Act to allow for expansion of overdose prevention centers, protect Medicaid coverage of PrEP, and expand Medicaid to cover residential SU treatment. At the state level, states can reduce regulations for prescribing MOUD and PrEP, decriminalize drug paraphernalia, codify Good Samaritan laws, and remove restrictions for syringe service program and overdose prevention center implementation. Lastly, states should expand Medicaid to allow broader access to treatment for SU and oppose Medicaid lock-outs based on current SU. These changes are needed as overdose deaths and serious infectious disease rates from SU continue to climb and impact American lives.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"101"},"PeriodicalIF":4.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based drug checking at syringe service programs in New York City observe an increasing prevalence of xylazine from 2021 through 2024.","authors":"Leonardo A Dominguez Gomez, Yarelix Estrada, Jeffery Sauer, Izza Zaidi, Andrew J Trinidad, Hannah Helmy, Alex Harocopos","doi":"10.1186/s12954-025-01237-5","DOIUrl":"10.1186/s12954-025-01237-5","url":null,"abstract":"<p><strong>Background: </strong>Xylazine has emerged as a major component of the unregulated opioid supply in several jurisdictions across the United States. However, the extent of xylazine in local drug supplies is unknown. Drug checking is a harm reduction strategy that provides information to people who use drugs and allows for insight into the composition of local drug supplies.</p><p><strong>Methods: </strong>The New York City Department of Health and Mental Hygiene (DOHMH) worked with syringe service program (SSP) partners to operate a drug checking pilot study that continued as a public health program. Drug samples were submitted by SSP participants for drug checking by trained DOHMH staff and further testing by secondary laboratory partners. The secondary laboratory used both GC/MS and LC-QTOF-MS to identify compounds present in a drug sample.</p><p><strong>Results: </strong>Drug samples collected from November 2021 through December 2024 were analyzed. There were N = 1027 secondary laboratory testing results that contained opioids. Of these, n = 449 (43.7%) also contained xylazine. The prevalence of opioids containing xylazine increased from 10.7% in 2021 to 53.7% through 2024. Visualization of the monthly xylazine prevalence, as well as an accompanying chi-square test for trend in proportions (χ² = 45.229, degrees of freedom = 1, p-value = < 0.001), provided further evidence that the prevalence of xylazine increased over time.</p><p><strong>Conclusion: </strong>The prevalence of xylazine in samples containing opioids has increased in New York City from November 2021 through December 2024. Drug checking can monitor changes in the local drug supply and inform existing harm reduction efforts.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"99"},"PeriodicalIF":4.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics, crack use, housing situation and psychosocial problems of people in the open drug scene in cologne, Germany - results of a cross-sectional survey.","authors":"Daniel Deimel, Lucie Feldmann, Norbert Scherbaum, Christine Firk, Simon Fleißner","doi":"10.1186/s12954-025-01256-2","DOIUrl":"10.1186/s12954-025-01256-2","url":null,"abstract":"<p><strong>Background: </strong>Open drug scenes are characterized by public gatherings of people who use drugs (PWUD) for the purpose of drug consumption and trade, often related to poor health conditions as risk of overdose, a higher prevalence of infectious disease and social exclusion. This cross-sectional survey investigated the characteristics, substance use patterns, and support needs of PWUD within the open drug scene at Neumarkt in Cologne (ODSC) in Germany.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between April and June 2023 among PWUD frequenting the ODSC. A structured questionnaire, comprising sociodemographic information, substance use patterns, overdose history, and psychosocial support needs was used.</p><p><strong>Results: </strong>A total of 119 participants were surveyed, with a majority identifying as male (79%) and an average age of 42 years. Heroin was the most frequently consumed substance (64.7%), followed by alcohol (56.3%) and crack/cocaine (21%). People who use crack (PWUC) were younger (mean age 36.6) and more likely to be homeless (56%) than respondents who are not using crack. The most mentioned support needs included housing (69.5%), bureaucratic assistance (60.2%), and health related support (51.7%).</p><p><strong>Conclusion: </strong>The ODSC presents a complex risk environment where homelessness, limited access to healthcare due to lack of health insurance, and frequent substance use exacerbate health and social challenges. Expanding harm reduction services, including housing first initiatives, and low-threshold opioid substitution treatment access for individuals without health insurance, is crucial to address these issues.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"96"},"PeriodicalIF":4.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We've lost a lot of lives:\" the impact of the closure of North America's busiest supervised consumption site on people who use substances and the organizations that work with them.","authors":"Morgan Magnuson, Shannon Vandenberg, Tracy Oosterbroek, Kevin Dey","doi":"10.1186/s12954-025-01251-7","DOIUrl":"10.1186/s12954-025-01251-7","url":null,"abstract":"<p><strong>Background: </strong>Supervised Consumption Sites (SCS) are an evidence-based harm reduction intervention that reduces the risk of fatal drug poisonings. However, these approaches have faced political opposition in Canada, resulting in the closures of SCS in some provinces. Our study examines the aftermath of the closure of what was once North America's busiest SCS, located in Lethbridge, Alberta, Canada, offering a contextualized exploration of regressive drug policies.</p><p><strong>Methods: </strong>Our study adopts a descriptive qualitative design to explore the Lethbridge SCS closure and the city's current state of harm reduction service provision. We conducted 37 interviews to understand the perspectives of people who use substances (PWUS) and staff members of organizations that provide harm-reduction services in Lethbridge. We chose to use reflexive thematic analysis, which allows for a critical realist and contextual approach to data analysis.</p><p><strong>Results: </strong>We developed three themes based on our analysis. Our first theme speaks to the harms of SCS closures on PWUS and organizations that provide harm reduction services. Next, our second theme highlights participants' perspectives on the political motivations behind the SCS closure. Our last theme explores how PWUS and organizations navigate the political opposition to harm reduction approaches while responding to the worsening unregulated drug poisoning crisis.</p><p><strong>Conclusions: </strong>Our findings speak to the dangers of political decisions that restrict access to harm reduction services within the context of the current unregulated drug poisoning crisis.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"98"},"PeriodicalIF":4.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Broad-scale overdose education and naloxone distribution- 5-year follow-up of a regional program in Skåne County, Sweden.","authors":"Katja Troberg, Pernilla Isendahl, Disa Dahlman, Anders Håkansson","doi":"10.1186/s12954-025-01255-3","DOIUrl":"10.1186/s12954-025-01255-3","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder is a chronic disorder with a high risk of overdose-related morbidity and mortality where a large proportion of these can be averted by timely administration of the antidote naloxone. For naloxone to be present when and where overdoses occur, broad-scale overdose education and naloxone distribution (OEND) must be established. A regional naloxone program was implemented in 2018, in Skåne County, Sweden. This five-year follow-up aims to describe all naloxone-related lay-person events, whether recommendations previously described in the literature were met, and to further investigate events conducted by individuals reporting overdose reversals with naloxone on three or more occasions ('Supersavers').</p><p><strong>Methods: </strong>Between June 2018 and June 2023, data was collected in six-month intervals from 52 participating units, containing information on trained individuals, gender, year of birth and distributed naloxone kits. Upon naloxone replenishment, patients were asked whether previous naloxone had been used for overdose reversals on someone else, or themselves, had been lost, stolen, or given to someone else. Targets for naloxone distribution and program enrolment were set to a minimum of 20 kits per annual opioid overdose death, and 100 individuals at-risk per 100,000 inhabitants, respectively.</p><p><strong>Results: </strong>Training and initial kits were provided to 2685 individuals at risk of own opioid overdose. Upon refill (n = 2,364), naloxone had been used for overdose reversal in 39% (n = 926) situations. In total, 5900 naloxone kits were distributed. Distribution target in relation to opioid overdose mortality was met annually, while the enrolment target was first met during the second year. The core group of Supersavers represent 9% (n = 50) of participants returning for refill while reporting 54.5% (n = 292) of all overdose reversals.</p><p><strong>Conclusions: </strong>Broad-scale naloxone training and distribution reaches a large proportion of individuals at risk of opioid overdose. A continuous focus and priority in supporting units with a high prevalence of individuals witnessing overdose events is of great importance as these individuals report a large proportion of overdose reversals. Likewise, it is of great importance to provide these individuals, i.e. Supersavers, with needed and sufficient support for their continued essential work intervening in overdose situations.</p><p><strong>Trial registration: </strong>Naloxone Treatment in Skåne County- Effect on Drug-related Mortality and Overdose-related Complications, NCT03570099, registered 26 June 2018.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"97"},"PeriodicalIF":4.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in distribution of harm-reduction equipment for persons who use drugs in Norway, 2016-2022. Archival analysis based on nationwide data collections.","authors":"Jens Christoffer Skogen, Katharina Natalie Gottschlich, Martin Blindheim, Janne Årstad","doi":"10.1186/s12954-025-01245-5","DOIUrl":"10.1186/s12954-025-01245-5","url":null,"abstract":"<p><p>Harm-reduction strategies are interventions designed to mitigate the adverse effects of substance use, without requiring abstinence. Evidence supports the effectiveness and efficacy of harm reduction as a broad framework for addressing illicit drug use. To ensure the implementation of these measures, Center for Alcohol and Drug Research (KORFOR) was mandated by the Norwegian Directorate of Health in 2016 to annually assess municipalities' adherence to harm-reduction guidelines. This study aims to present national trends in the distribution of harm-reduction equipment for the prevention of infectious diseases, specifically needles and syringes and smoking foil. We investigated the proportion of distributing municipalities, additional equipment distributed (naloxone, condoms and lubricants, disposable toothbrushes, and cookers, filters, disinfection swabs, sterile water, and ascorbic acid), and the population coverage. Our findings indicate an increased coverage in the distribution of harm-reduction equipment in Norway between 2016 and 2022. This positive trend demonstrates progress in addressing the negative consequences of drug use and aligns with Norwegian national strategies to mitigate drug-related harms. Future research should evaluate the effectiveness of these harm-reduction strategies and identify areas for improvement within the Norwegian context, especially related to use of opioid analgesics.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"93"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"50 years of harm reduction in Europe: high time for transformation.","authors":"Iga Jeziorska, Thomas F Martinelli, John-Peter Kools","doi":"10.1186/s12954-025-01200-4","DOIUrl":"10.1186/s12954-025-01200-4","url":null,"abstract":"<p><p>Europe has been the first home for the harm reduction movement, acknowledging its values and principles relatively early, although not without challenges. Built on successful experiences starting in the early 1980s, some pioneering European countries committed, invested in and implemented a broad spectrum of harm reduction services over the years. The HIV/AIDS epidemic helped to establish a broader recognition of the effectiveness of harm reduction policies in other countries as well by the mid-1990s. However, we argue that the adoption of harm reduction is lagging behind in important ways, leading to uneven and poor implementation of services. In this perspective-paper, we highlight some reasons that may have contributed to this, and we explore how multiple societal trends and the current conceptualisation of harm reduction have hindered further acceptance and implementation. We do this by revealing assumptions underlying the concept of harm reduction. Finally, we explore how we may move harm reduction forward as a field.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"94"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Tranq': perceptions of xylazine and harm reduction practices among people receiving treatment for substance use disorders.","authors":"Aaron Salwan, KariLynn Dowling-McClay, Daniel Greer, Ali AlAli, Bill Brooks","doi":"10.1186/s12954-025-01249-1","DOIUrl":"10.1186/s12954-025-01249-1","url":null,"abstract":"<p><strong>Background: </strong>Xylazine, commonly known as 'Tranq,' is a veterinary tranquilizer that is increasingly found in the recreational opioid supply, complicating the user experience. Xylazine-adulterated fentanyl is associated with a withdrawal syndrome that may not respond to usual treatment, and the opioid overdose reversal agent naloxone does not reverse the effect of xylazine.1 While it remains unclear whether xylazine directly increases overdose deaths, its presence in the drug supply likely elevates overall harm and morbidity. Moreover, due to unintended contact, xylazine poses an often unaccounted for danger to people who use drugs, and there is limited understanding of risk perception among people subject to xylazine exposure. The existing research indicates variations in the extent that individuals desire to use or avoid substances that contain xylazine.2, 3 This study aimed to evaluate how people who use drugs perceive their susceptibility to and severity of exposure to xylazine, and to assess how these perceptions impact their engagement in harm reduction behaviors.</p><p><strong>Methods: </strong>We recruited people receiving treatment for substance use disorders at a community hospital. We used Spearman correlations to evaluate the associations between patient characteristics and perceptions of xylazine exposure are associated with harm reduction behaviors. The survey instrument was informed by the Health Belief Model.</p><p><strong>Results: </strong>Over half of participants (26/49), estimated that at least some of the drugs that they use contain xylazine, and 73.5% believed that exposure to xylazine increased their risk of overdose. Approximately 65% of respondents reported never trying to obtain xylazine, and only 12.2% agreed or strongly agreed that they were more likely to use a batch of drugs if they knew it contained xylazine. Overall, engagement in harm reduction behaviors was limited, with 57.1%, reporting that they rarely or never carried naloxone when using drugs and 77.6% reported rarely or never testing their drugs before use. There was a positive association between the belief that xylazine increases the risk of overdose and engagement in harm reduction behaviors (Spearman Rho = 0.290, p = 0.043). Participants who identified xylazine in their drugs and modified their behavior as a result are significantly more likely to regularly practice overdose prevention behaviors.</p><p><strong>Conclusion: </strong>Xylazine is increasingly present in the drug supply, yet susceptibility to exposure does not appear to influence engagement in harm reduction behaviors. Limited use and knowledge of test strips, as well as other overdose prevention behaviors, highlights the need for targeted harm reduction education. Healthcare providers in all practice settings should be aware of the potential risks posed by xylazine exposure and prioritize evidence-based care, including harm reduction.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"95"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural community-based participatory research with families of people who use drugs: key considerations from a multi-provincial research partnership.","authors":"Holly Mathias, Elsie Duff, Petra Schulz, Sarah Auger, Antoinette Gravel-Ouellette, Teresa Lockhart, Willi McCorriston, Jenn McCrindle, Nyal Mirza, Em Pijl, Tyla Savard, Elaine Hyshka","doi":"10.1186/s12954-025-01247-3","DOIUrl":"10.1186/s12954-025-01247-3","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"92"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm reduction in substance use: perspectives and experiences of community volunteers and student interns in Durban, South Africa.","authors":"Nkeka Peter Tseole, Julian David Pillay","doi":"10.1186/s12954-025-01253-5","DOIUrl":"10.1186/s12954-025-01253-5","url":null,"abstract":"<p><strong>Background: </strong>Substance abuse is a significant public health concern globally, exposing individuals to substantial health risks and mortality. Despite the effectiveness of harm reduction interventions, they remain limited and inadequately accessible in South Africa, where substance use prevalence is increasing. This study explores the perspectives of community volunteers and student interns on harm reduction and its interventions using Bellhaven Harm Reduction Centre as a case study.</p><p><strong>Methods: </strong>This qualitative study employed a cross-sectional design, utilising thematic analysis to examine the views of 15 participants on harm reduction programs and their experiences within the harm reduction centre context.</p><p><strong>Results: </strong>The findings indicate that harm reduction interventions have a positive impact on all stakeholders, fostering transformative attitudes toward substance use and promoting empathy and understanding. Our findings highlight four major themes: the client-focused nature of harm reduction interventions, their ability to reduce stigma and discrimination against marginalised populations, their capacity-building nature, and ability to reduce substance abuse-related harm.</p><p><strong>Conclusion: </strong>This study highlights the value of harm reduction programs in addressing substance use challenges, emphasizing client-centered care, capacity building, and stigma reduction. The findings provide a valuable model for resource-constrained environments, informing policy and practice to improve health outcomes among vulnerable populations.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"91"},"PeriodicalIF":4.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}