Journal of Occupational and Environmental Hygiene最新文献

{"title":"Tackling antineoplastic drugs' contamination in healthcare settings: New insights on surface cleaning approaches.","authors":"Maria Francisca Portilha-Cunha, Pedro Norton, Arminda Alves, Ana R L Ribeiro, Adrián M T Silva, Mónica S F Santos","doi":"10.1080/15459624.2025.2449945","DOIUrl":"https://doi.org/10.1080/15459624.2025.2449945","url":null,"abstract":"<p><p>Effective decontamination of hospital surfaces is crucial to protect workers from antineoplastic drugs (ADs) since dermal absorption is the main exposure route to these hazardous medicinal products. Sampling after daily cleaning in oncologic settings from a tertiary hospital was initially performed and exhibited low contamination levels; however, cyclophosphamide was still found (up to 957 pg/cm²) above the guidance value (100 pg/cm²) in four locations, evidencing the need to properly assess and update the cleaning protocols. Then, cleaning efficiencies of six solutions and different protocols were evaluated (including, for the first time, four commercial cleaning solutions/disinfectants not designed specifically for AD removal) after deliberate contamination of three model surfaces with 13 pharmaceuticals: bicalutamide, capecitabine, cyclophosphamide, cyproterone, doxorubicin, etoposide, flutamide, ifosfamide, imatinib, megestrol, mycophenolate mofetil, paclitaxel, and prednisone. Wipe sampling and liquid chromatography-tandem mass spectrometry were employed to determine surface contamination after cleaning. Results revealed that: (i) none of the solutions or procedures totally removed all target pharmaceuticals from surfaces; (ii) the removal efficiency increased with cleaning steps (average removals above 90% were attained for Vyclean and Clinell Universal Spray using two cleaning steps); and (iii) the cleaning efficiency was likely favored by the application of the solution/disinfectant directly on the surfaces. Therefore, considering the dissimilar chemical structures and properties of the numerous ADs in use, the cleaning agent and protocol should be adjusted to the reality of each healthcare unit. Still, the scientific community is encouraged to develop a cleaning solution/protocol to simultaneously eliminate/remove as many ADs as possible.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pathogenic burden potential of airborne particles in emanating from the respiratory area of COVID-19 patients (a case study).","authors":"Somayeh Soleimani-Alyar, Rasoul Yarahmadi, Maryam Borhani-Jebeli, Golnaz Yarahmadi, Farah Bokharaei-Salim, Alireza Alipour, Maryam Soleimani-Alyar, Hamid-Reza Monavari, Mohammad-Mehdi Darvishi, Sara Dalvand","doi":"10.1080/15459624.2024.2447317","DOIUrl":"https://doi.org/10.1080/15459624.2024.2447317","url":null,"abstract":"<p><p>The pathogenic potential of airborne particles carrying the SARS-CoV-2 viral genome was examined by considering the size distribution of airborne particles at given distances from the respiratory zone of an infected patient after coughing or sneezing with a focus on time, temperature, and relative humidity. The results show an association between the size distribution of airborne particles, particularly PM₁ and PM_2.5, and the presence of viral genome in different stations affected by the distance from the respiratory zone and the passage of time. The correlation with time was strong with all the dependent factors except PM₁. Also, the effect of time intervals on the median concentration of airborne PM in the range of PM₇ and PM₁₀ was significant. Accordingly, in the first 20 min after coughing, the COVID-19 patient was more likely to be exposed to PM-carrying RNA genomes of SARS-CoV-2. The other finding was that the two distances of 0.25 m to the patient's left of the respiratory zone and 1.0 m above the breathing zone showed positive results for the presence of SARS-CoV-2 in all studied time intervals. The patterns of results suggested that there was a high potential for distribution of the virus in an infected patient based on position and airflow and that the severity of infection and viral load may influence the presence of viral load in droplets when coughing. Based on the results, one can conclude that ventilation plays a key role in mitigating the risk of airborne virus transmission in indoor environments, and it has been shown that reductions in particulate concentrations occur when portable air purifiers are placed near the breathing zone. The use of personal protective equipment for the patient and healthcare personnel to minimize the distribution of virus particles in the air is recommended.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interlaboratory comparison of particle filtration efficiency testing equipment.","authors":"Timothy A Sipkens, Rym Mehri, Ruth Perez Calderon, Richard G Green, Andrew Oldershaw, Gregory J Smallwood","doi":"10.1080/15459624.2024.2447321","DOIUrl":"https://doi.org/10.1080/15459624.2024.2447321","url":null,"abstract":"<p><p>Particle filtration efficiency (PFE) is a critical property of face masks, with the most common test methods using sodium chloride as a challenge aerosol. In the absence of bottom-up uncertainty budgets for PFE, interlaboratory comparisons provide an alternative route to robustly quantify the precision and bias of the method. This work presents the results of several interlaboratory comparisons of particle filtration efficiency performed across a network of laboratories. Using log-penetration as a surrogate for PFE, it is shown that expanded reproducibility intervals were consistent across most samples, at around 26% of the nominal value of log-penetration. Between-laboratory contributions to this reproducibility were significant, nearly doubling the lab-reported uncertainties in most instances and emphasizing the need for ongoing interlaboratory studies to be performed for particle filtration. More work is required to identify the causes of these between-laboratory differences, requiring dedicated testing. Alongside uncertainty quantification, testing materials across a range of variables (such as the number of layers, amount of charge on the material, and basis weight) affirm that constant quality is a good approximation when layering or changing the basis weight on an otherwise identical material.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-15"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional improbity: How Hermann J. Muller's ethics affected his science.","authors":"Edward J Calabrese, James Giordano, Dima Yazji Shamoun","doi":"10.1080/15459624.2025.2449937","DOIUrl":"https://doi.org/10.1080/15459624.2025.2449937","url":null,"abstract":"<p><p>The present paper provides an assessment of how the scientific and national policy achievements/goals of Hermann J. Muller were impacted by his ethics and provides several documented episodes in which Muller acted unethically to promote his personal gain-at the expense of others-within the scientific community. Muller manipulated the scientific community in self-serving ways to suppress perspectives that challenged his own views on radiation-induced gene mutation, and hereditary and cancer risk assessment in ways that influenced his significant awards (e.g., Nobel Prize in Medicine or Physiology), continued grant funding, and manifest effect on public health policy. Muller acted irresponsibly toward students and directed them to violate University of Texas policies that incurred severe student disciplinary actions (e.g., University suspension). Muller avoided responsibility by resigning from the University of Texas, avoiding a trial that could have led to his dismissal, and impacted his career achievements during the period of his nomination for the Nobel Prize. Muller was also a member of a US National Academy of Sciences Committee that committed scientific misconduct by misrepresenting the research record in ways that enhanced his continued funding support and fortified his influence on US health policy. The case of Muller is presented as a morality and object lesson worthy of consideration for current and future ethical conduct of scientific research.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regression tools for chemical release modeling: An additive manufacturing case study.","authors":"David E Meyer, Raymond L Smith, Elizabeth Lanphear, Sudhakar Takkellapati, John D Chea, Gerardo J Ruiz-Mercado, Michael A Gonzalez, William M Barrett","doi":"10.1080/15459624.2024.2447320","DOIUrl":"https://doi.org/10.1080/15459624.2024.2447320","url":null,"abstract":"<p><p>Chemical release data are essential for performing chemical risk assessments to understand the potential exposures arising from industrial processes. Often, these data are unknown or unavailable and must be estimated. A case study of volatile organic compound releases during extrusion-based additive manufacturing is used here to explore the viability of various regression methods for predicting chemical releases to inform chemical assessments. The methods assessed in this work include linear Least Squares, Least Absolute Shrinkage and Selection Operator (LASSO) and Ridge regression, classification and regression tree, random forest model, and neural network analysis. Secondary data describing polymeric extrusion in multiple applications are curated and assembled in a dataset to support regression modeling using default parameters for the various approaches. The potential to add noise to the dataset and improve regression is evaluated using synthetic data generation. Evaluation of model performance for a common test set found all methods were able to achieve predictions within 10%-error for up to 98% of the test sample population. The degree to which this level of performance was maintained when varying the number and type of features for regression was dependent on the model type. Linear methods and neural network analysis predicted the most test samples within 10%-error for smaller numbers of features while tree-based approaches could accommodate a larger number of features. The number and type of features can be important if the desire is to make chemical-specific release predictions. The inclusion of release data from related processes generally improved test set predictions across all models while the use of synthetic data as implemented here resulted in smaller increases in test sample predictions within 10%-error. Future work should focus on improving access to primary data and optimizing models to achieve maximum predictive performance of environmental releases to support chemical risk assessment.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging emerging technologies in industrial hygiene to improve occupational safety.","authors":"Putri Anis Syahira Mohamad Jamil, Nur Athirah Diyana Mohammad Yusof, Intan Suraya Noor Arzahan","doi":"10.1080/15459624.2024.2439805","DOIUrl":"https://doi.org/10.1080/15459624.2024.2439805","url":null,"abstract":"","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between WBGT app prototype and WBGT monitor to assess heat stress risk in an eastern North Carolina outdoor setting.","authors":"Bridget Angol, Sinan Sousan, Jo Anne G Balanay","doi":"10.1080/15459624.2024.2444415","DOIUrl":"https://doi.org/10.1080/15459624.2024.2444415","url":null,"abstract":"<p><p>The wet bulb globe temperature (WBGT) index is the preferred environmental heat metric for occupational heat-related illness prevention but may not always be readily accessible in the workplace. Thus, there is a need for well-designed WBGT-based tools that are reliable, accessible, and inexpensive. A novel WBGT app prototype was developed to calculate the current and forecasted outdoor WBGT. The purpose of this study was to assess the reliability of the WBGT app prototype in providing accurate heat stress risk information for outdoor workplace settings in eastern North Carolina by comparing the WBGT indices and risk levels from the app (WBGT_app) with those derived from a heat stress monitor (WBGT_ins). Outdoor WBGT measurements were data logged at a university campus site using a heat stress monitor from March to August 2023 for 81 days and were assigned to risk levels by workload based on the ACGIH Threshold Limit Values. Hourly WBGT_app values and their corresponding risk levels were obtained using the app prototype. Data analysis was conducted using a t-test, Pearson correlation test, and cross-tabulation. Results showed that the hourly mean WBGT_app was significantly higher (<i>p</i> < 0.01) than the WBGT_ins, but there was no significant difference between the overall average of the daily mean (<i>p</i> = 0.15) and daily maximum (<i>p</i> = 0.69) WBGT_app and WBGT_ins. There was a strong, positive correlation between the hourly mean (<i>r</i> = 0.94, <i>p</i> < 0.01), daily mean (<i>r</i> = 0.97, <i>p</i> < 0.01), and daily maximum (<i>r</i> = 0.94, <i>p</i> < 0.01) WBGT_app and WBGT_ins. The app correctly identified 73-88% of minimal-risk conditions, depending on workload type, and was most reliable in correctly identifying extreme-risk conditions at 97%, 95%, and 93% for light, moderate, and heavy workloads, respectively. This demonstrates the app's capability of being protective of the workers, particularly in more severe heat stress risk conditions. Recommendations to improve the app's accuracy involved using accurate solar irradiance data and applying linear calibration. The WBGT app prototype shows good potential as an alternative risk assessment tool for heat stress risk among outdoor workers.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer mortality among aircraft manufacturing workers with long-term, low-level, hexavalent chromium exposure.","authors":"Loren Lipworth, Julie M Panko, Bruce C Allen, Michael T Mumma, Xiaohui Jiang, Melissa J Vincent, Jennifer L Bare, Todor Antonijevic, Stephanie N Vivanco, Donald E Marano, Mina Suh, Sarah Cohen, Liz Mittal, Deborah M Proctor","doi":"10.1080/15459624.2024.2439817","DOIUrl":"https://doi.org/10.1080/15459624.2024.2439817","url":null,"abstract":"<p><p>Hexavalent chromium (CrVI) is known to cause lung cancer among workers exposed to high concentrations in certain historical industries. It is also a toxic air contaminant considered to pose a potentially significant cancer risk at comparatively low concentrations in urban air. However, very limited data currently exist to quantify risk at low-concentration occupational or environmental exposures. This study reconstructs individual-level exposures using a job-exposure matrix (JEM) and examines mortality among 3,723 CrVI-exposed aircraft manufacturing workers, including 440 women with long-term low-level CrVI exposures and long-term follow-up. The JEM used Bayesian methods with industrial hygiene data to calculate cumulative worker exposures from 1960 to 1998. A retrospective cohort mortality study was also conducted to calculate standardized mortality ratios (SMRs) by population demographics and to conduct an internally referenced dose-response analysis. CrVI-exposed painters, electroplaters, and aircraft assembly workers, with 1 to 37 years of exposure (median: 8 years) had mean and median cumulative exposures of 16 µg/m³-yrs and 2.9 µg/m³-yrs, respectively. Based on 1,758 observed deaths, mortality from cancer overall (SMR 1.24; 95% CI 1.13-1.36), smoking-related cancers (SMR 1.31; 95% CI 1.15-1.49), and lung cancer (SMR 1.39; 95% CI 1.17-1.63) were significantly elevated and more highly elevated among women (lung cancer SMR 2.61; 95% CI:1.66-3.92). Internal analyses revealed no dose-response relationship between cumulative exposure and lung cancer mortality. Data available for 12% of CrVI-exposed workers showed smoking prevalence higher than general population norms, especially for women. The absence of a dose-response relationship with cumulative exposure suggests that elevated cancer risks are primarily smoking-related in this cohort, and possibly as a consequence, any increased risk associated with CrVI exposure is not observable. Although an association between lung cancer risk and CrVI exposure was not found, this study provides significant new observations in the low exposure range, and among women, which may be useful for quantitative risk assessment.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polychlorinated biphenyls (PCBs) from common cooking fuels in Nigeria.","authors":"Jamiu Adetayo Adeniran, Basheerah Folake Jimoh, Ayodele Sarat Atanda, Tunmise Latifat Adewoye, Muhammad-Najeeb O Yusuf, Khadijat Abdulkareem Abdulraheem, Emmanuel Toluwalope Odediran","doi":"10.1080/15459624.2024.2443196","DOIUrl":"https://doi.org/10.1080/15459624.2024.2443196","url":null,"abstract":"<p><p>Cooking fuels are sources of polychlorinated biphenyls (PCBs), which are persistent in the environment and have detrimental effects on human health. Fifteen PCBs congeners from the smoke of eight (8) commonly used cooking fuels in Nigeria were investigated in this study. Glass fiber filters were used to collect air emissions during the combustion of cooking fuels in a controlled chamber. PCB congeners in the smoke of studied cooking fuels were analyzed using Gas Chromatography-Mass Spectrometry (GC-MS) and their associated health risks were evaluated. The health risks of PCBs (both carcinogenic and non-carcinogenic) from inhalation exposure were evaluated for both children and adults. The daily inhalation rate ranged from 4.44 × 10⁵ to 6.16 × 10⁵ fgTEQkg^-1 for adults and 9.94 × 10⁵ to 1.38 × 10⁶ fgTEQkg^-1 for children. Hazard quotient (HQ) values obtained for both adults and children were higher than the acceptable limit of 1. The Incremental Lifetime Cancer Risk (ILCR) varied between 2.40 × 10^-3 and 3.33 × 10^-3 for adults and <math><mn>6.211</mn><mo>×</mo><msup><mrow><mn>10</mn></mrow><mrow><mo>-</mo><mn>4</mn></mrow></msup></math> and <math><mn>8.62</mn><mo>×</mo><msup><mrow><mn>10</mn></mrow><mrow><mo>-</mo><mn>4</mn></mrow></msup></math> for children. This study recommends promoting clean cooking technologies through policy interventions, public awareness campaigns, and investment in research and development, to reduce risks associated with harmful cooking emissions.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory analysis of gait mechanics in farmers.","authors":"Mariana V Jacobs, Kate N Jochimsen, Jody L Clasey, Michael A Samaan","doi":"10.1080/15459624.2024.2421004","DOIUrl":"https://doi.org/10.1080/15459624.2024.2421004","url":null,"abstract":"<p><p>Farmers may be at a higher risk of developing hip osteoarthritis (OA) due to the high demands of their occupation. To the authors' knowledge, the gait patterns of farmers that may be associated with hip joint degeneration have yet to be analyzed. Therefore, this study compares gait mechanics between farmers and non-farmers (controls). It is hypothesized that farmers would exhibit altered lower extremity joint mechanics during walking when compared to matched controls. This exploratory study included five farmers and five sex-, age-, and body mass index (BMI)-matched controls. A 3D gait analysis was performed while study participants walked at a self-selected speed on an instrumented treadmill. Sagittal plane hip, knee, and ankle kinetics and kinematics were assessed. Effect sizes and between-group differences in demographics and gait mechanics were assessed. There were no group differences in walking speed, total stance time as well as hip and knee joint kinematics (<i>p</i> > 0.05). Farmers exhibited statistical trends (<i>p</i> = 0.07-0.08) of lower peak ankle plantarflexion angles, higher plantarflexor moments, higher knee flexion moment impulse, and higher peak vertical ground reaction force during the first and second halves of stance. Additionally, farmers ambulated with a significantly higher knee extensor moment (<i>p</i> = 0.04) and moment impulse (<i>p</i> = 0.05) during the first half of stance and a higher ankle plantarflexion moment impulse (<i>p</i> = 0.04). The results demonstrate a multi-joint gait alteration in farmers compared to non-farmers and may suggest a compensatory gait pattern to optimize hip joint mechanics and mitigate hip joint degeneration. These results provide a preliminary understanding of the impact that agricultural occupations have on joint mechanics that may be associated with the increased prevalence of hip OA in the farming population.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}