{"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":"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 PM<sub>1</sub> and PM<sub>2.5</sub>, 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 PM<sub>1</sub>. Also, the effect of time intervals on the median concentration of airborne PM in the range of PM<sub>7</sub> and PM<sub>10</sub> 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":"362-374"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","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}
Emily J Tetzlaff, Nathalie V Kirby, Leonidas G Ioannou, Robert D Meade, Fergus K O'Connor, Andreas Flouris, Glen P Kenny
{"title":"An exploratory survey assessing the determinants of heat stress and heat strain in the Canadian mining industry from the worker's perspective.","authors":"Emily J Tetzlaff, Nathalie V Kirby, Leonidas G Ioannou, Robert D Meade, Fergus K O'Connor, Andreas Flouris, Glen P Kenny","doi":"10.1080/15459624.2025.2449947","DOIUrl":"10.1080/15459624.2025.2449947","url":null,"abstract":"<p><p>With mines extending deeper and rising surface temperatures, workers are exposed to hotter environments. This study aimed to characterize heat stress and strain in the Canadian mining industry and evaluate the utility of the Heat Strain Score Index (HSSI), combined with additional self-reported adverse health outcomes. An exploratory web-based survey was conducted among workers (<i>n</i> = 119) in the Canadian mining industry. The survey included 74 questions on workers' risk perception, strategies for heat stress management, and the HSSI-a validated tool to classify workplace heat stress based on various workplace factors and indicators of heat strain. Most workers reported that heat stress is an occupational hazard associated with their duties and tasks (89%). Based on the HSSI, 22% of respondents were classified as high risk, 42% at moderate risk, and 36% at low risk for heat stress and heat strain. Those with higher HSSI scores self-reported more heat-related adverse signs and symptoms with a higher prevalence of self-reported heat-related illness (<i>p</i> < 0.01). Despite workers reporting various self-initiated practices (e.g., drinking water) and management-enforced heat mitigation practices (e.g., rest breaks), many workers reported still having experienced signs or symptoms of heat stress (86%) and heat-related illnesses (37%). The study found elevated heat stress and strain levels among a sample of workers in the Canadian mining industry despite workers employing various heat-mitigating strategies. Heat stress management programs considering mining-specific factors and challenges are needed to safeguard worker health and safety.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"400-424"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059362","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 Action Level<sup>®</sup>\".","authors":"J Thomas Pierce","doi":"10.1080/15459624.2025.2493032","DOIUrl":"https://doi.org/10.1080/15459624.2025.2493032","url":null,"abstract":"","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":"22 5","pages":"D15-D16"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000168","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}
Edward J Calabrese, James Giordano, Dima Yazji Shamoun
{"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":"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":"337-349"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","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}
AnnMarie L Walton, Melissa A Powell, Leila Ledbetter, Margaret A Bush
{"title":"A scoping review of surface wipe sampling for antineoplastic drug contamination in patient care areas.","authors":"AnnMarie L Walton, Melissa A Powell, Leila Ledbetter, Margaret A Bush","doi":"10.1080/15459624.2025.2471397","DOIUrl":"https://doi.org/10.1080/15459624.2025.2471397","url":null,"abstract":"<p><p>Antineoplastic drug (AD) exposure can cause adverse health effects for healthcare workers. AD contamination on surfaces persists despite interventions to reduce it. The United States Pharmacopeial Convention recommends surface sampling as a measure of exposure control but does not offer guidance regarding specific ADs, surfaces in patient care areas, or size of surface area to sample. This scoping review of literature published since January 1, 2004 aimed to identify specific surfaces in patient care areas which were tested and found to be contaminated with ADs. The authors describe (a) which ADs were assessed, (b) the percent of surfaces contaminated; and sizes of sampling areas for surface testing, and (c) whether personal protective equipment (PPE) or closed system transfer devices (CSTDs) were utilized to reduce healthcare worker exposure and AD surface contamination. The majority of studies were conducted in North America or Europe. The most common location for testing was hospitals. Most studies sampled for one to three marker drugs of interest, with cyclophosphamide being the most common. Most studies utilized a standardized surface area with 100 to 900 cm<sup>2</sup> being the most common. Time of day varied, but most sampling was conducted at the end of the workday before cleaning. Gas chromatography-tandem mass spectrometry (GC-MSMS) and liquid chromatography-tandem mass spectrometry (LC-MSMS) were the most frequent analytical methods used. Contamination was found most often on floors, nursing counters, armchairs, intravenous (IV) poles/pumps, patient tables, hazardous drug (HD) waste containers, doorknobs/handles, storage shelves, bathroom surfaces, HD vials/bags, and telephones. PPE and CSTD use were not consistently reported. Based on this review, the authors make several recommendations for the standardization of data collection and reporting of findings. Key among these is the need to measure and report data on the use of PPE and CSTDs to modify environmental contamination and, critically, healthcare worker exposure to ADs.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-20"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030387","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}
Jun Wang, John Singletary, Tiina Reponen, Sergey Grinshpun, Michael Yermakov, James Bunte
{"title":"Aerosol emission, transmission, and mitigation from performing singing and wind instruments.","authors":"Jun Wang, John Singletary, Tiina Reponen, Sergey Grinshpun, Michael Yermakov, James Bunte","doi":"10.1080/15459624.2025.2491486","DOIUrl":"https://doi.org/10.1080/15459624.2025.2491486","url":null,"abstract":"<p><p>During the COVID-19 pandemic, concerns about potential airborne virus transmission and exposure during musical performances were raised. Past studies suggest that aerosols are emitted from exhaling and talking with varying magnitudes. Meanwhile, little was known about aerosol emissions from singing and playing wind instruments. The objective of this study was to examine the spatial and temporal build-up of aerosol concentration in a typical studio room where singing, talking, and playing wind instruments are involved, to represent musical practicing and teaching scenarios at the University of Cincinnati College-Conservatory of Music (CCM). Four condensation particle counters were strategically placed throughout a room at various distances from the performer. Besides singing, musical professionals played seven instruments (clarinet, flute, French horn, saxophone, trombone, trumpet, and tuba). Two types of tests were conducted for each instrument: 10 min of playing and 10 min of combined playing and talking to mimic the teaching session. The results show that singing increased aerosol concentration to 3.9 × 10<sup>3</sup> cm<sup>-3</sup> at the performing point, more than double the background (1.2 × 10<sup>3</sup> cm<sup>-3</sup>). Most wind instruments had minimal but detectable emission of aerosols over time, suggesting instruments could provide wall deposition for aerosols compared to singing. Particle concentrations decreased further from the performing point; however, they were still detectable over the background level at 10 feet away. Use of a portable high-efficiency particulate air (HEPA) filtration reduced aerosol concentrations developed during musical performances to below background level. These findings suggest that there are risks associated with aerosolized transmission of infectious agents such as SARS-CoV-2 from musical performance if the performer is infected. Distancing beyond the 6 ft distancing recommendation and proper room and local ventilation combined with disinfecting procedures are needed to minimize the risk of exposure to infectious aerosols.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023660","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":"Retrospective assessment of shift-work in epidemiological studies - Lessons learned.","authors":"Sylvia Rabstein, Beate Pesch, Lewin Eisele, Anja Marr, Susanne Moebus, Raimund Erbel, Börge Schmidt, Nico Dragano, Thomas Brüning, Thomas Behrens, Karl-Heinz Jöckel","doi":"10.1080/15459624.2025.2485089","DOIUrl":"https://doi.org/10.1080/15459624.2025.2485089","url":null,"abstract":"<p><p>The reliable assessment of characteristics of shift-work exposure remains a critical methodological issue in epidemiological studies. A working group of the International Agency for Research on Cancer developed recommendations for the assessment of shift-work. These were translated into a detailed interview for the 10-year follow-up of the Heinz Nixdorf Recall (HNR) cohort. This study investigated the agreement of shift-work characteristics between three different assessments that were administered in interviews at two time points. At the study baseline (2000-2003), 4,814 participants were enrolled, and brief shift-work information was collected for 2,121 working participants (1,244 men and 877 women aged 45-75 years). Of 2,613 cohort members in the prospective 10-year follow-up between 2011 and 2013, 2,444 (also non-working) individuals participated in detailed shift-work interviews that consisted of (a) key summary questions and (b) period-based shift-work histories. participants' shift-work exposures up to the study baseline were compared in 1,217 subjects who were interviewed during both the baseline and the follow-up. Within the follow-up, participant responses to key summary questions were compared with calculated parameters from period-based histories. Agreement was measured by simple agreement (%), Gwet's agreement coefficient 1 (Gwet's AC1), and intraclass correlation coefficients (ICC) with 95% confidence intervals (CI). Beta-regression models were applied to investigate potential associations between age and sex with the reliability of shift-work characteristics. A high level of agreement was found between ever having worked shift-work (ever shift-work) and duration that each participant worked shift-work (duration of shift-work) reported during baseline and at follow-up (ever shift-work until study baseline in men: Gwet's AC1 = 0.77 (CI 0.72-0.82)). When comparing key summary questions and detailed shift-work histories, the duration of shift-work showed a high level of reliability that marginally decreased with age (in women ICC = 0.96 (CI 0.95-0.97), linear effect of age groups on <i>µ</i>: <i>p</i> = 0.08). Participants had problems remembering more detailed shift-work information. Ever shift-work and duration of shift-work can be assessed with key summary questions but reliability slightly decreases with age.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022781","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":"Influence of kindergarten dormitory bed layout on the proximity propagation characteristics of exhaled pollutants.","authors":"Yanhui Mao, Yongsheng Wang, Lina Zhang, Qiu Tu, Lijuan Wang, Xiangfei Kong, Jihui Yuan","doi":"10.1080/15459624.2025.2491489","DOIUrl":"https://doi.org/10.1080/15459624.2025.2491489","url":null,"abstract":"<p><p>Kindergarten dormitories are indoor napping areas where preschool children spend extended periods nearby, making them high-risk environments for the transmission of respiratory diseases. To understand the transmission characteristics of respiratory pollutants, particularly CO<sub>2</sub> and simulated cough aerosols between adjacent beds, two common bed layouts in kindergartens were investigated: three beds of staggered height (TBSH) and three beds of uniform height (TBUH). The experiments measured CO<sub>2</sub> and PM<sub>2.5</sub> concentrations (using liquid aerosols generated by an ultrasonic nebulizer as surrogates for cough particles) in the breathing zone of mannequins under different ventilation modes (on and off) and sleeping postures (lying face up and on the right side). The results showed that when ventilation was off, CO<sub>2</sub> concentration near the head of each bed reached nearly 1,000 ppm within 60 min. When ventilation was on, CO<sub>2</sub> concentration was diluted to ambient levels within 3.3 min. However, when the ventilation was on, aerosols exhibited different propagation characteristics compared to CO<sub>2</sub>. While CO<sub>2</sub> was rapidly diluted, aerosols accumulated downstream and formed high-concentration zones at adjacent downstream beds. These findings visualize the potential aerosol transmission pathways between beds in kindergarten dormitories and highlight the limitations of using CO<sub>2</sub> as an aerosol transmission tracer. The study found that increasing bed heights along the ventilation airflow direction effectively reduced downstream aerosol concentrations and compensated for the insufficient horizontal distance in kindergarten dormitories. Kindergarten design standards should consider local dilution efficiency in the breathing zone, and bed layouts should be integrated with the ventilation system to ensure air velocities exceed 0.01 m/s near the head, thereby reducing the residence time of pollutants in the breathing zone.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970576","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}
Wei Lin, Wanhong He, Ye Fu, Minghui He, Mingzhu Li, Yang Liu, Yanli Liu, Meiqin Zhu, Liting Yang, Yuefeng He, Hongcheng Ding, Jing Wang
{"title":"Socioeconomic disparities in hygiene behaviors and their association with urinary metal levels in Chinese preschoolers.","authors":"Wei Lin, Wanhong He, Ye Fu, Minghui He, Mingzhu Li, Yang Liu, Yanli Liu, Meiqin Zhu, Liting Yang, Yuefeng He, Hongcheng Ding, Jing Wang","doi":"10.1080/15459624.2025.2485088","DOIUrl":"https://doi.org/10.1080/15459624.2025.2485088","url":null,"abstract":"<p><p>The relationship between personal hygiene and the risk of communicable diseases is well established, with socioeconomic status recognized as a significant factor in this context. Given that infectious diseases, environmental pollutants, and metals share pathways of entry into the human body, this study sought to investigate the correlation between hygiene practices and urinary metal levels in preschool-aged children. A cross-sectional analysis involving 1,477 preschoolers was conducted where urinary concentrations of 23 metals were determined using inductively coupled plasma mass spectrometry. Information about hygiene practices and socioeconomic status was collected from the children's guardians. The results of regression analyses revealed a significant association between improved hygiene practices and lower urinary levels of chromium, iron, and antimony (all <i>p</i> < 0.05), as well as with high household per capita monthly income. Compared to children from low-income families, children from high-income families had better hygiene behaviors (all <i>p</i> < 0.05). In low-income families, children with good hygiene behaviors had lower urinary chromium, iron, and antimony levels (all <i>p</i> < 0.05). Mediation analysis further suggested that bathing and hygiene practices could explain about 7.56% to 28.24% of the effects of urinary chromium, iron, and antimony levels related to household per capita monthly income (all <i>p</i> < 0.05). These findings emphasized that good hygiene behaviors might be a feasible way to reduce heavy metal exposure among children.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-12"},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029596","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}
Mirle Pena, Dylan T Neu, H Amy Feng, Duane R Hammond, Kenneth R Mead, Rupak K Banerjee
{"title":"Use of portable air cleaners within an ambulance workspace.","authors":"Mirle Pena, Dylan T Neu, H Amy Feng, Duane R Hammond, Kenneth R Mead, Rupak K Banerjee","doi":"10.1080/15459624.2025.2485074","DOIUrl":"https://doi.org/10.1080/15459624.2025.2485074","url":null,"abstract":"<p><p>Emergency medical service (EMS) providers face significant exposure to infectious aerosols during outbreaks like the COVID-19 pandemic. Most ambulances lack ventilation controls to reduce EMS worker exposure to these aerosols. Ambulances are smaller than hospital rooms and handle numerous patients daily, increasing contact with potentially infectious individuals. Ventilation controls such as portable high-efficiency particulate air (HEPA) filtration can mitigate this risk. Few studies have assessed portable HEPA filters in ambulances. This study evaluated two HEPA filter models in an unoccupied, stationary research ambulance at the National Institute for Occupational Safety and Health (NIOSH) in Cincinnati. A tracer aerosol simulated patient aerosol generation, and optical particle counters (OPCs) measured aerosols. The HEPA units were tested individually, placed in the same location, and operated for 50 min. Results showed significant reductions in aerosol concentrations during the generation phase, with performance varying during the decay period. Overall, HEPA units reduced particle concentrations by around 50% during the generation phase and continued to be effective through the decay period. This demonstrates the potential of portable HEPA filters as an affordable and effective option for air cleaning in ambulance patient modules.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026086","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}