Journal of Occupational and Environmental Hygiene最新文献

{"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":"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 CO₂ 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 CO₂ and PM_2.5 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, CO₂ concentration near the head of each bed reached nearly 1,000 ppm within 60 min. When ventilation was on, CO₂ concentration was diluted to ambient levels within 3.3 min. However, when the ventilation was on, aerosols exhibited different propagation characteristics compared to CO₂. While CO₂ 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 CO₂ 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":"743-755"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","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}

{"title":"Field comparison of inhalable air samplers for the determination of occupational exposure to inhalable aerosols and soluble proteins in food production.","authors":"Christine Darbakk, Pål Graff, Raymond Olsen","doi":"10.1080/15459624.2025.2496492","DOIUrl":"10.1080/15459624.2025.2496492","url":null,"abstract":"<p><p>This study assessed the performance of the Institute of Occupational Medicine (IOM) and Gesamtstaubprobenahme (GSP) personal inhalable aerosol samplers in measuring aerosol and soluble protein (SP) concentrations across 12 food industry environments. A total of 193 sampling pairs (GSP and IOM) were analyzed for inhalable aerosols, and 185 sampling pairs for SP. Median aerosol concentrations ranged from 0.2 mg/m³ in snacks, nuts, and chips production to 5.6 mg/m³ in spreads production. The IOM sample had a median aerosol concentration of 1.8 mg/m³, while the GSP had a slightly lower median of 1.4 mg/m³, generally collecting 17% less inhalable aerosol than the IOM in most environments. The IOM also included wall deposits in its gravimetric determinations, contributing an additional 10-30% to the overall aerosol concentrations. For SP concentrations, the IOM measured higher aerosol concentrations in environments with a particle size distribution dominated by larger particles, while the GSP showed higher SP concentrations in environments dominated by smaller, respirable particles. The Tobit mixed-effect models showed that the IOM had statistically significantly higher aerosol concentrations compared to the GSP, but significantly lower SP concentrations than the GSP. However, these differences between the samplers were relatively small, suggesting that in occupational hygiene practices, both samplers can be used.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"702-712"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009473","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":"Airborne lead exposures during artisanal lead mining and gold ore processing in Zamfara, Nigeria.","authors":"Manti M Nota, Perry Gottesfeld, Stephen E Mbuligwe, Gabriel R Kassenga, Shehu Mohammed Anka","doi":"10.1080/15459624.2025.2491490","DOIUrl":"10.1080/15459624.2025.2491490","url":null,"abstract":"<p><p>Artisanal mining in Nigeria is growing along with the increase in the price of metals. However, self-employed miners, particularly in the northwest of the country, have brought extensive environmental contamination and severe lead poisoning from the lead content in the ore. This study assessed airborne lead exposures to miners during lead mining and gold ore processing in three villages in Zamfara State, Nigeria. Personal air samples were collected and analyzed for lead content. Gold processing operations were classified by task, including: manual mortar and pestle grinding, hammer crushing, and mechanical stone crushing and grinding operations with diesel-powered equipment. Separately, exposures were evaluated among underground lead miners. This study collected a total of 47 air samples, including 32 from gold ore processing sites and 15 from lead mining sites. The results indicated that underground miners were exposed to airborne lead at a mean concentration of 0.48 mg/m³, or approximately 10-fold the United States Occupational Safety and Health Administration (OSHA) Permissible Exposure Limit (PEL). Furthermore, miners at gold processing sites were exposed to airborne lead at a mean concentration of 1.59 mg/m³ for both mechanical and manual tasks, which is approximately 32-fold the PEL. Manual gold ore processing resulted in mean airborne lead exposures of 1.74 mg/m³, and those using mechanical methods had a mean concentration of 1.52 mg/m³. The results also indicated that the order of airborne lead level exposure was as follows: mortar and pestle operators > crusher operators > hammer operators > grinder operators > underground lead miners. Lead mining operations and gold ore processing consistently had elevated airborne lead at levels, posing risks of acute lead poisoning, and are likely contributing to take-home lead exposures observed in these communities. These results are consistent with the lead contamination of soil observed in housing compounds and at processing sites in this region. To address these risk factors, safer mine training and the adoption of wet methods were encouraged along with changes to personal hygiene practices and other measures to mitigate exposure and to protect miners and their communities.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"726-732"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002836","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":"Evaluation of a smoke extraction system for veterinarian exposures to surgical smoke-A pilot study.","authors":"Kimberly R Anderson, Shiori Arai","doi":"10.1080/15459624.2025.2496493","DOIUrl":"10.1080/15459624.2025.2496493","url":null,"abstract":"<p><p>Electrosurgery generates surgical smoke, which contains hazardous compounds. The concentration, composition, and size distribution of surgical smoke vary significantly with surgery type, duration, and number of times electrocautery is used. Exposure assessments have focused on characterizing occupational exposure to surgical smoke during human surgeries, but occupational exposure to surgical smoke during veterinary surgeries is largely unknown. Given the hazardous exposure concentrations identified in human surgical procedures, similar occupational exposures are expected in small animal surgeries. Thus, there is a critical need to evaluate occupational exposures among veterinarians conducting small animal surgeries and to evaluate potential exposure reduction systems. The objectives of the study are to quantify the particle number concentration and size distribution during canine limb amputation (CLA) surgery and to quantify the exposure reductions associated with a smoke evacuation system (SES). Exposure to ultrafine particles (UFP) during CLA was measured using a TSI NanoScan Scanning Mobility Particle Sizer (SMPS) Nanoparticle Sizer 3910 during surgeries with and without the SES. Particle number concentrations were 11 times higher compared to background concentrations during CLA surgeries. The particle number concentration was significantly reduced when using SES during surgery compared to surgeries without SES. The average total particle number concentration near the veterinarian's breathing zone was 25,141 particles/cm³ for surgeries without SES and 7,643 particles/cm³ when the SES was used during surgeries, which represents about a 70% reduction in exposure. CLA was associated with particle exposures similar to those seen in human surgeries. The use of SES effectively reduced the concentration of particles near the surgeon's breathing zone.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"691-701"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174053","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":"Occupational noise exposure of ushers during National Hockey League games in an indoor arena.","authors":"Samantha Curtis, Avian White, Lok Pokhrel, Jo Anne G Balanay","doi":"10.1080/15459624.2025.2540824","DOIUrl":"https://doi.org/10.1080/15459624.2025.2540824","url":null,"abstract":"<p><p>Workers employed in recreational settings, such as sporting events, may be potentially exposed to hazardous noise levels, increasing the risk of temporary and permanent hearing loss. The purpose of this study was to assess the occupational noise exposures of ushers employed in an indoor arena during 12 National Hockey League games in eastern North Carolina. Participants were monitored for personal noise exposure during games using noise dosimeters. Area noise monitoring was conducted at arena level 1 using a sound level meter and in a production office using a noise dosimeter. Ten of 12 games (83.3%) had at least one 8-hr TWA noise exposure measurement that exceeded the ACGIH^® TLV^® of 85 dBA, while one (8.3%) exceeded the OSHA PEL of 90 dBA. The differences in L_avg and 8-hr TWA noise levels by game were statistically significant (<i>p</i> < 0.01) for both ACGIH and OSHA noise metrics. All of the 8 arena sections (100%) had at least one 8-hr TWA noise exposure measurement that exceeded the ACGIH TLV, while one (12.5%) exceeded the OSHA PEL. The differences in L_avg, 8-hr dose and 8-hr TWA by arena seating level were not statistically significant (<i>p</i> = 0.11 to 0.36) for both OSHA and ACGIH metrics. Although the overall 8-hr TWA noise exposure levels (76.5 ± 4.6 dBA using OSHA metric; 83.7 ± 3.7 dBA using ACGIH metric) did not exceed the OSHA PEL or ACGIH TLV, respectively, employees during professional hockey games may be exposed to hazardous noise as demonstrated by the percentages of 8-hr TWA noise measurements exceeding the OSHA PEL (1.1%) and ACGIH TLV (24.2%). Study findings may be beneficial for identifying practical and feasible control measures to reduce noise exposures of workers at the arena during professional hockey games and may be used to estimate attendee noise exposures and to improve arena design for noise reduction.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958055","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":"Quantitative headform fit evaluation and predictive modeling to assist with selecting N95 filtering facepiece respirators to mitigate respiratory hazards.","authors":"Brooke Vollmer, Michael S Bergman, Harold Boyles, Jordan Meyers, Nora Y Payne, Jonisha Pollard, Ziqing Zhuang","doi":"10.1080/15459624.2025.2540829","DOIUrl":"https://doi.org/10.1080/15459624.2025.2540829","url":null,"abstract":"<p><p>Ensuring that respiratory protection is effective for all can be difficult if limited resources are available to assist with selecting a well-fitting respirator model and user guidance. To better understand how various N95^® filtering facepiece respirator models fit on a variety of face sizes, a quantitative fit evaluation was performed on 12 different N95 respirators distributed by the Strategic National Stockpile using five manikin headform sizes representative of most of the U.S. worker population (540 total tests). Manikin fit factor results varied depending on the respirator model and headform combination. Four respirator models achieved passing fit results across all headform sizes. Predictive modeling was then initiated, where the headform most closely aligned to an individual's facial dimensions is determined and then used to identify N95 respirators that may provide an acceptable fit. A multinomial logistic regression model was trained and tested using NIOSH's 2003 Anthropometric U.S. Survey and was found to have an accuracy of 85%. To address potential risks associated with predicting only a single headform size, a modified model allowing for multiple headform size predictions was also assessed and found to have an improved accuracy rate of 98%. With further human subject validation and field testing, this modeling approach could be used as a tool to aid in making the fit testing process more efficient, less burdensome, and better enable individuals to use respirators that fit more effectively, thereby adequately protecting them from hazards.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958043","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":"Healthcare workers' exposure to aerosolized medications while crushing oral tablets.","authors":"Erin Tavares, Benjamin Loosley, Ahlia Shaik","doi":"10.1080/15459624.2025.2544747","DOIUrl":"https://doi.org/10.1080/15459624.2025.2544747","url":null,"abstract":"<p><p>Crushing oral tablets can potentially aerosolize active ingredients in the medication and expose healthcare workers to drug particulates. Few studies have quantified aerosolized particulate matter generated during tablet crushing. Inhalation of patient medications can result in negative health effects to the healthcare worker, especially if hazardous medications are being crushed. This study evaluated four different pill crusher and pill container combinations to assess particulate exposure risks and examine whether particulate levels varied depending on the pill crusher, container type, and crushing method. The pill crushers included MAXCRUSH, Silent Knight, and SafeCrush. The MAXCRUSH pill crusher was used with paper pill cups and unit-dose packaging. Factors influencing aerosolized particle generation included the method and intensity of crushing, and the type of pill crusher and container used. An optical particle counter was used to record particle counts in the breathing zone. The highest number of particles was produced when tablets in unit dose packaging were crushed with the MAXCRUSH pill crusher. An aggressive and vigorous procedure significantly increased the number of aerosolized particles generated across devices (<i>p</i> < 0.001) except MAXCRUSH with paper pill cups (<i>p</i> = 0.14). Most of the aerosolized particulate matter was produced when the crushed tablet was poured from its container into a cup of water. To minimize exposure, recommended control measures include substituting tablet medications with liquid forms, having pills crushed by the pharmacy, using a pill crushing syringe, limiting vigorous pouring of crushed medications from pill containers, and wearing a fit-tested N95 respirator.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957910","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":"Evaluating United States Air Force hearing conservation educational materials for compliance, readability, understandability, and actionability.","authors":"Thomas Dominguez, Lucas Pettit, Clayton Garner, Dirk P Yamamoto, James A VanDerslice, Rodney G Handy, Lisa H Gren, Darrah K Sleeth","doi":"10.1080/15459624.2025.2529983","DOIUrl":"https://doi.org/10.1080/15459624.2025.2529983","url":null,"abstract":"<p><p>Noise-induced hearing loss and tinnitus are two of the most prevalent service-connected disabilities of United States military veterans. Educational materials meant for hearing conservation program-eligible Airmen were evaluated from active-duty, continental United States (CONUS) Air Force bases for compliance with US Air Force (USAF), Department of Defense (DoD), and Occupational Safety and Health Administration (OSHA) regulations. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), while readability was assessed with Flesch-Kincaid Grade Level (FKGL). Educational materials were received from 44 of 61 (72%) active-duty, CONUS bases, with 27 bases sending one item and 17 bases sending multiple items, for a total of 67 educational materials, which were evaluated by three evaluators. Educational materials were categorized into one of four types: (A) supervisor's guide to hearing conservation (<i>n</i> = 21); (B) new worker hearing conservation training (<i>n</i> = 20); (C) two-page hearing conservation program training pamphlet (<i>n</i> = 14); and (D) other (<i>n</i> = 12). Overall mean compliance was 84% (CI: 63,100) (USAF), 83% (CI: 62,100) (DoD), and 88% (CI: 67,100) (OSHA), respectively. Overall mean understandability was 75% (CI: 63,87) and actionability was 89% (67,100). There was good agreement between the three evaluators for each of the criteria (87-90%). Overall mean readability was grade level 10.68 ± 1.68 on the FKGL scale. For educational materials, 65 of the 67 (97%) were above the recommended 6th-grade reading level, and 62 of the 67 (93%) educational materials were above the average American 8th-grade reading level. This study established compliance, understandability, actionability, and readability scores for educational materials that military service members receive upon entry into the hearing conservation program, gathered from active-duty, CONUS Air Force bases. Using the determined scores, recommendations, such as providing active feedback and condensing information, were given to improve future hearing conservation educational materials.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957917","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":"Use of undergloves to assess pathways leading to contamination on firefighters' hands.","authors":"Andrea F Wilkinson, M Christina Kander, Alexander C Mayer, I-Chen Chen, Richard M Kesler, Farzaneh Masoud, Denise L Smith, Gavin P Horn, Kenneth W Fent","doi":"10.1080/15459624.2025.2530070","DOIUrl":"10.1080/15459624.2025.2530070","url":null,"abstract":"<p><p>Firefighters (FFs) are occupationally exposed to many carcinogens, including polycyclic aromatic hydrocarbons (PAHs). Previous studies have evaluated PAH contamination on FFs' personal protective equipment (PPE), including fire gloves; however, there is a need to better understand PAH contamination that may break through fire gloves during active firefighting, donning, and doffing of PPE. Researchers in this study aimed to understand the potential contamination of FFs' hands during firefighting activities. A pilot study was conducted with 23 FFs, asking them to wear up to 3 separate sets of newly opened cotton undergloves during (1) donning, (2) simulated firefighting activities conducted in a smoky environment, and (3) doffing activities (donning and firefighting were combined for some samples). Samples were taken from the palm, index finger, and thumb areas of the cotton gloves and analyzed for PAHs. Overall, it was found that fire gloves were relatively effective at minimizing PAH exposure on the hands (undergloves) during active firefighting operations, though some PAH contamination was still present. PAH contamination was highest during the doffing of PPE and was significantly higher on the thumb and finger relative to the palm (<i>p</i> values < 0.05). PAH contamination was found in the cotton gloves during donning, even though FFs' self-contained breathing apparatuses were cleaned and the turnout gear was previously laundered, using commercial extractors. Future research could explore the potential for contaminated, decontaminated, and/or laundered gear to present contamination risks to fire personnel and investigate the use of undergloves as additional protection for FFs' skin.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the future of occupational safety research: A strategic foresight approach.","authors":"Jessica M K Streit, Sarah A Felknor, Nicole T Edwards, John J Howard","doi":"10.1080/15459624.2025.2537397","DOIUrl":"https://doi.org/10.1080/15459624.2025.2537397","url":null,"abstract":"<p><p>A team from the U.S. National Institute for Occupational Safety and Health conducted a strategic foresight project to explore the future of occupational safety research (OSR). Data collected via systematic horizon scanning and key informant interviews were synthesized into six drivers of OSR change: (1) technological advancement, (2) partnerships and public trust, (3) prioritizing research investments, (4) safety and health integration, (5) data and science quality, and (6) worker protections. These drivers served as the basis for envisioning four potential OSR futures. Analysis of the resulting scenarios identified opportunities to enhance and advance OSR methods and approaches, innovation, systems thinking, interpersonal networks and connections, and the ethical application of scientific findings as we move into the future of work.</p>","PeriodicalId":16599,"journal":{"name":"Journal of Occupational and Environmental Hygiene","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855534","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}