Journal of Exposure Science and Environmental Epidemiology最新文献

{"title":"Assessing exposure and health consequences of chemicals in drinking water in the 21st Century","authors":"Nicole C. Deziel, Cristina M. Villanueva","doi":"10.1038/s41370-024-00639-0","DOIUrl":"10.1038/s41370-024-00639-0","url":null,"abstract":"","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 1","pages":"1-2"},"PeriodicalIF":4.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41370-024-00639-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of Enhanced Vegetation Index for assessing access to different types of green space in epidemiological studies","authors":"Amy Mizen, Daniel A. Thompson, Alan Watkins, Ashley Akbari, Joanne K. Garrett, Rebecca Geary, Rebecca Lovell, Ronan A. Lyons, Mark Nieuwenhuijsen, Sarah C. Parker, Francis M. Rowney, Jiao Song, Gareth Stratton, Benedict W. Wheeler, James White, Mathew P. White, Sue Williams, Sarah E. Rodgers, Richard Fry","doi":"10.1038/s41370-024-00650-5","DOIUrl":"10.1038/s41370-024-00650-5","url":null,"abstract":"Exposure to green space can protect against poor health through a variety of mechanisms. However, there is heterogeneity in methodological approaches to exposure assessments which makes creating effective policy recommendations challenging. Critically evaluate the use of a satellite-derived exposure metric, the Enhanced Vegetation Index (EVI), for assessing access to different types of green space in epidemiological studies. We used Landsat 5–8 (30 m resolution) to calculate average EVI for a 300 m radius surrounding 1.4 million households in Wales, UK for 2018. We calculated two additional measures using topographic vector data to represent access to green spaces within 300 m of household locations. The two topographic vector-based measures were total green space area stratified by type and average private garden size. We used linear regression models to test whether EVI could discriminate between publicly accessible and private green space and Pearson correlation to test associations between EVI and green space types. Mean EVI for a 300 m radius surrounding households in Wales was 0.28 (IQR = 0.12). Total green space area and average private garden size were significantly positively associated with corresponding EVI measures (β = < 0.0001, 95% CI: 0.0000, 0.0000; β = 0.0001, 95% CI: 0.0001, 0.0001 respectively). In urban areas, as average garden size increases by 1 m2, EVI increases by 0.0002. Therefore, in urban areas, to see a 0.1 unit increase in EVI index score, garden size would need to increase by 500 m2. The very small β values represent no ‘measurable real-world’ associations. When stratified by type, we observed no strong associations between greenspace and EVI.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 5","pages":"753-760"},"PeriodicalIF":4.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41370-024-00650-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of nationally representative exposure factor database for children's products in Korea.","authors":"Jiyun Shin, Kiyoung Lee, Seung Yeol Park, Miyoung Lim","doi":"10.1038/s41370-024-00654-1","DOIUrl":"https://doi.org/10.1038/s41370-024-00654-1","url":null,"abstract":"<p><strong>Background: </strong>Children may be exposed to harmful chemicals from their products. Accurate exposure factors are critical for exposure assessment of children's products. Product usage pattern parameters are relatively limited compared with the chemical concentration, children's physiological and behavioral parameters.</p><p><strong>Objective: </strong>The aim of this study was to determine nationally representative Korean exposure factors for the usage patterns of children's products by sex, age, and season.</p><p><strong>Methods: </strong>Using proportional quota sampling, a survey of 10,000 households with children aged 0-12 years was conducted twice, once in summer and winter. The children's ages were divided into four groups: infant (0-2 years old), toddler (3-6), lower-grade elementary student (7-9), and higher-grade elementary student (10-12). Data on exposure factors such as use rate, use frequency, and use duration of 57 children's products were collected.</p><p><strong>Results: </strong>The 57 products were classified into five categories: baby products (13), toys (12), daily products (10), sporting goods (8), and stationery (14). The use rates of products in the daily products and stationery category were >90% in both seasons. Two of the 57 products showed significant sex differences in all three exposure factors (p < 0.001). Twenty-five of the 44 non-baby products showed significant age differences for all three exposure factors. Twenty-three of the 57 products varied significantly with season for all three exposure factors.</p><p><strong>Impact: </strong>This study generated a nationally representative exposure factor database for the usage patterns of children's products in Korea. The exposure factors for 57 children's products were investigated through twice survey with quota sampling with each 10,000 children nationwide. Sex, age, and seasonal differences for children's products were identified. These accurate exposure factors by sex, age, and season can be used as input parameters for refined exposure assessment.</p>","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal exposure to ultrafine particles in multiple microenvironments among adolescents","authors":"Ashley Turner,&nbsp;Chris Wolfe,&nbsp;Patrick H. Ryan","doi":"10.1038/s41370-023-00638-7","DOIUrl":"10.1038/s41370-023-00638-7","url":null,"abstract":"Experimental studies suggest ultrafine particles (UFPs), the smallest size fraction of particulate matter, may be more toxic than larger particles, however personal sampling studies in children are lacking. The objective of this analysis was to examine individual, housing, and neighborhood characteristics associated with personal UFP concentrations as well as the differences in exposures that occur within varying microenvironments. We measured weekly personal UFP concentrations and GPS coordinates in 117 adolescents ages 13–17 to describe exposures across multiple microenvironments. Individual, home, and neighborhood characteristics were collected by caregiver completed questionnaires. Participants regularly exposed to secondhand tobacco smoke had significantly higher indoor concentrations of UFPs compared to participants who were not. We observed that the ‘home’ microenvironment dominated the relative contribution of overall UFP concentrations and sampling time, however, relative proportion of integrated UFP exposure were higher in ‘other’ environments. In this study, we employed a novel panel study design, involving real-time measurement of UFP exposure within the multiple microenvironments of adolescents. We found a combination of personal sampling and detailed activity patterns should be used in future studies to accurately describe exposure-behavior relationships.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 5","pages":"878-885"},"PeriodicalIF":4.1,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of personal exposure to black carbon levels with fixed-site monitoring data and with dispersion modelling and the influence of activity patterns and environment","authors":"Olena Gruzieva,&nbsp;Antonios Georgelis,&nbsp;Niklas Andersson,&nbsp;Christer Johansson,&nbsp;Tom Bellander,&nbsp;Anne-Sophie Merritt","doi":"10.1038/s41370-024-00653-2","DOIUrl":"10.1038/s41370-024-00653-2","url":null,"abstract":"Short-term studies of health effects from ambient air pollution usually rely on fixed site monitoring data or spatio-temporal models for exposure characterization, but the relation to personal exposure is often not known. We aimed to explore this relation for black carbon (BC) in central Stockholm. Families (n = 46) with an infant, one parent working and one parent on parental leave, carried battery-operated BC instruments for 7 days. Routine BC monitoring data were obtained from rural background (RB) and urban background (UB) sites. Outdoor levels of BC at home and work were estimated in 24 h periods by dispersion modelling based on hourly real-time meteorological data, and statistical meteorological data representing annual mean conditions. Global radiation, air pressure, precipitation, temperature, and wind speed data were obtained from the UB station. All families lived in the city centre, within 4 km of the UB station. The average level of 24 h personal BC was 425 (s.d. 181) ng/m3 for parents on leave, and 394 (s.d. 143) ng/m3 for working parents. The corresponding fixed-site monitoring observations were 148 (s.d. 139) at RB and 317 (s.d. 149) ng/m3 at UB. Modelled BC levels at home and at work were 493 (s.d. 228) and 331 (s.d. 173) ng/m3, respectively. UB, RB and air pressure explained only 21% of personal 24 h BC variability for parents on leave and 25% for working parents. Modelled home BC and observed air pressure explained 23% of personal BC, and adding modelled BC at work increased the explanation to 34% for the working parents. Short-term studies of health effects from ambient air pollution usually rely on fixed site monitoring data or spatio-temporal models for exposure characterization, but the relation to actual personal exposure is often not known. In this study we showed that both routine monitoring and modelled data explained less than 35% of variability in personal black carbon exposure. Hence, short-term health effects studies based on fixed site monitoring or spatio-temporal modelling are likely to be underpowered and subject to bias.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 3","pages":"538-545"},"PeriodicalIF":4.1,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41370-024-00653-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PM2.5 threshold exceedances during the prenatal period and risk of intellectual disability","authors":"Sara E. Grineski,&nbsp;Roger A. Renteria,&nbsp;Timothy W. Collins,&nbsp;Amanda V. Bakian,&nbsp;Deborah Bilder,&nbsp;James A. VanDerslice,&nbsp;Alison Fraser,&nbsp;Jaqueline Gomez,&nbsp;Kevin D. Ramos","doi":"10.1038/s41370-024-00647-0","DOIUrl":"10.1038/s41370-024-00647-0","url":null,"abstract":"Research demonstrates that chronic exposure to fine particulates (PM2.5) increases risks of neurodevelopmental conditions, such as intellectual disability (ID). Few studies have examined neurodevelopmental health impacts of pollution spikes exceeding 24-h (24-h) PM2.5 guidelines, despite relevance to the regulatory landscape. The current potential for regulatory changes to 24-h PM2.5 standards in the United States makes research on exceedances relevant. To examine associations between 24-h PM2.5 exceedances and the risk of ID. We conducted a retrospective case-control study of a sample of children in Utah, USA. We used generalized estimating equations to predict odds of ID based on the number of 24-h PM2.5 exceedance days during the preconception period and three trimesters of pregnancy. Exceedance days are defined as per current World Health Organization (WHO) [≥15 μg/m3] and current US Environmental Protection Agency (EPA) [≥35 μg/m3] 24-h guidelines. PM2.5 exceedances are associated with ID risk during the preconception and first trimester periods and not the second and third trimesters. During the preconception period, each day exceeding 15 μg/m3 or 35 μg/m3 was associated with a 1.023 (CI: 1.011–1.040) or 1.042 (CI: 1.026–1.059, p &lt; 0.001) increase in odds of ID, respectively. During the first trimester, each day exceeding 15 μg/m3 or 35 μg/m3 was associated with a 1.032 (CI: 1.017–1.047) or 1.059 (CI: 1.030–1.088) increase in odds of ID, respectively.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 5","pages":"861-867"},"PeriodicalIF":4.1,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the difference in contamination of retail meat with multidrug-resistant bacteria using for-consumer package label claims that indicate on-farm antibiotic use practices- United States, 2016-2019.","authors":"G Sean Stapleton, Gabriel K Innes, Keeve E Nachman, Joan A Casey, Andrew N Patton, Lance B Price, Sara Y Tartof, Meghan F Davis","doi":"10.1038/s41370-024-00649-y","DOIUrl":"https://doi.org/10.1038/s41370-024-00649-y","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic use in food-producing animals can select for antibiotic resistance in bacteria that can be transmitted to people through contamination of food products during meat processing. Contamination resulting in foodborne illness contributes to adverse health outcomes. Some livestock producers have implemented antibiotic use reduction strategies marketed to consumers on regulated retail meat packaging labels (\"label claims\").</p><p><strong>Objective: </strong>We investigated whether retail meat label claims were associated with isolation of multidrug-resistant organisms (MDROs, resistant to ≥3 classes of antibiotics) from U.S. meat samples.</p><p><strong>Methods: </strong>We utilized retail meat data from the U.S. Food and Drug Administration National Antimicrobial Resistance Monitoring System (NARMS) collected during 2016-2019 for bacterial contamination of chicken breast, ground turkey, ground beef, and pork chops. We used modified Poisson regression models to compare the prevalence of MDRO contamination among meat samples with any antibiotic restriction label claims versus those without such claims (i.e., conventionally produced).</p><p><strong>Results: </strong>In NARMS, 62,338 meat samples were evaluated for bacterial growth from 2016-2019. Of these, 24,446 (39%) samples had label claims that indicated antibiotic use was restricted during animal production. MDROs were isolated from 2252 (4%) meat samples, of which 71% (n = 1591) were conventionally produced, and 29% (n = 661) had antibiotic restriction label claims. Compared with conventional samples, meat with antibiotic restriction label claims had a statistically lower prevalence of MDROs (adjusted prevalence ratio: 0.66; 95% CI: 0.61, 0.73). This relationship was consistent for the outcome of any bacterial growth.</p><p><strong>Impact: </strong>This repeated cross-sectional analysis of a nationally representative retail meat surveillance database in the United States supports that retail meats labeled with antibiotic restriction claims were less likely to be contaminated with MDROs compared with retail meat without such claims during 2016-2019. These findings indicate the potential for the public to become exposed to bacterial pathogens via retail meat and emphasizes a possibility that consumers could reduce their exposure to environmental reservoirs of foodborne pathogens that are resistant to antibiotics.</p>","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A state-by-state comparison of policies that protect private well users","authors":"Katlyn Schmitt,&nbsp;Darya Minovi,&nbsp;Sophie Loeb,&nbsp;Mary H. Ward","doi":"10.1038/s41370-024-00645-2","DOIUrl":"10.1038/s41370-024-00645-2","url":null,"abstract":"While the Safe Drinking Water Act allows states and localities to adopt stronger protections for drinking water, state and local requirements concerning private drinking water wells vary dramatically and often do not provide necessary protections for residents who rely on well water. This paper inventories ten types of policies including laws, regulations, programs, and activities that states have adopted or partaken in to encourage safe drinking water for residential well owners. To identify categories of private well protections, we conducted a preliminary internet search with key search terms to create an initial list of 10 categories of laws, regulations, programs, and activities (collectively referred to as “policies”) that states have taken to protect residential well water quality. To have a private well safety category present, the law, regulation, program, or activity must fit within the scope of the ten classifications. To limit the breadth of our search, we excluded local and county protections, as well as activities by non-governmental organizations. We also excluded basic construction standards for new wells and licensing standards for well drillers, both of which are covered under a previous study. We conducted an additional internet search to complete a comprehensive review of each state and category and to validate our previous findings. In addition to this internet search, we completed phone and email outreach to the state agencies implementing the well safety categories identified in our internet search to confirm our results. The results indicate a wide range of state-based well water protections. The number of residential well water protections present in each state ranged from 8 policies in Iowa, Kentucky, and Maine to 1 policy in Oklahoma, with a median of 5 policies across the 50 states.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 1","pages":"155-160"},"PeriodicalIF":4.5,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational exposure to organic solvents and risk of bladder cancer","authors":"Shuai Xie,&nbsp;Melissa C. Friesen,&nbsp;Dalsu Baris,&nbsp;Molly Schwenn,&nbsp;Nathaniel Rothman,&nbsp;Alison Johnson,&nbsp;Margaret R. Karagas,&nbsp;Debra T. Silverman,&nbsp;Stella Koutros","doi":"10.1038/s41370-024-00651-4","DOIUrl":"10.1038/s41370-024-00651-4","url":null,"abstract":"Bladder cancer has been linked to several occupations that involve the use of solvents, including those used in the dry-cleaning industry. We evaluated exposure to solvents and risk of bladder cancer in 1182 incident cases and 1408 controls from a population-based study. Exposure to solvents was quantitatively assessed using a job-exposure matrix (CANJEM). Exposure to benzene, toluene and xylene often co-occur. Therefore, we created two additional sets of metrics for combined benzene, toluene and xylene (BTX) exposure: (1) CANJEM-based BTX metrics and (2) hybrid BTX metrics, using an approach that integrates the CANJEM-based BTX metrics together with lifetime occupational histories and exposure-oriented modules that captured within-job, respondent-specific details about tasks and chemicals. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated using logistic regression. Bladder cancer risks were increased among those ever exposed to benzene (OR = 1.63, 95% CI: 1.14–2.32), toluene (OR = 1.60, 95% CI: 1.06–2.43), and xylene (OR = 1.67, 95% CI: 1.13–2.48) individually. We further observed a statistically significant exposure-response relationship for cumulative BTX exposure, with a stronger association using the hybrid BTX metrics (ORQ1vsUnexposed = 1.26, 95% CI: 0.83–1.90; ORQ2vsUnexposed = 1.52, 95% CI: 1.00–2.31; ORQ3vsUnexposed = 1.88, 95% CI: 1.24–2.85; and ORQ4vsUnexposed = 2.23, 95% CI: 1.35–3.69) (p-trend=0.001) than using CANJEM-based metrics (p-trend=0.02). There is limited evidence about the role of exposure to specific organic solvents, alone or in combination on the risk of developing bladder cancer. In this study, workers with increasing exposure to benzene, toluene, and xylene as a group (BTX) had a statistically significant exposure-response relationship with bladder cancer. Future evaluation of the carcinogenicity of BTX and other organic solvents, particularly concurrent exposure, on bladder cancer development is needed.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 3","pages":"546-553"},"PeriodicalIF":4.1,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41370-024-00651-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of chlormequat in food and urine from adults in the United States from 2017 to 2023","authors":"Alexis M. Temkin,&nbsp;Sydney Evans,&nbsp;Demetri D. Spyropoulos,&nbsp;Olga V. Naidenko","doi":"10.1038/s41370-024-00643-4","DOIUrl":"10.1038/s41370-024-00643-4","url":null,"abstract":"Chlormequat chloride is a plant growth regulator whose use on grain crops is on the rise in North America. Toxicological studies suggest that exposure to chlormequat can reduce fertility and harm the developing fetus at doses lower than those used by regulatory agencies to set allowable daily intake levels. Here we report, the presence of chlormequat in urine samples collected from people in the U.S., with detection frequencies of 69%, 74%, and 90% for samples collected in 2017, 2018–2022, and 2023, respectively. Chlormequat was detected at low concentrations in samples from 2017 through 2022, with a significant increase in concentrations for samples from 2023. We also observed high detection frequencies of chlormequat in oat-based foods. These findings and chlormequat toxicity data raise concerns about current exposure levels, and warrant more expansive toxicity testing, food monitoring, and epidemiological studies to assess health effects of chlormequat exposures in humans.","PeriodicalId":15684,"journal":{"name":"Journal of Exposure Science and Environmental Epidemiology","volume":"34 2","pages":"317-321"},"PeriodicalIF":4.5,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41370-024-00643-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}