Journal of Occupational Health最新文献

{"title":"Comment on \"Predicting mental health-related sick leave using Stress Check data: Development and validation of a workplace risk model\".","authors":"Kei Muroi, Shotaro Doki","doi":"10.1093/joccuh/uiag020","DOIUrl":"https://doi.org/10.1093/joccuh/uiag020","url":null,"abstract":"","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774257","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":"Which Psychosocial Job Demands Matter Most for Parasympathetic Heart Rate Variability - A Dominance Analysis Study.","authors":"Kati Karhula, Maria Hirvonen, Hanna Jantunen, Maria Sihvola, Jarno Turunen, Piia Seppälä","doi":"10.1093/joccuh/uiag025","DOIUrl":"https://doi.org/10.1093/joccuh/uiag025","url":null,"abstract":"<p><strong>Objectives: </strong>Prolonged reduced heart rate variability (HRV) is associated with impaired health and chronic diseases. Despite this connection, it remains unclear which psychosocial job demands are the strongest predictors of reduced HRV and poorer health outcomes. This study aimed to determine the most relevant psychosocial job demands that predict reduced HRV.</p><p><strong>Methods: </strong>The study participants were 163 municipal employees (86% females, mean age 47) who responded to a survey on psychosocial job demands and measured their electrocardiography-based HRV over four consecutive nights during a normal work week. The root mean square of successive RR intervals (RMSSD) was used as an indicator of autonomic nervous system activity mediated by the vagus nerve. Hierarchical mixed model regression analysis included psychosocial job demands and the most relevant individual factors and occupational sector as a nested random effect. Dominance analysis (DA) was used to assess all the variable combinations to identify the most significant determinants of HRV across the regression models.</p><p><strong>Results: </strong>The participants' RMSSD was stable over the measurement period. The DA ranked the participants' age as the factor that most affected RMSSD. The psychosocial job demands that seem to be the most relevant for RMSSD are encountering bullying, violence at work, ethically challenging situations at work, and effort-reward imbalance. Gender was ranked as the fourth factor.</p><p><strong>Conclusions: </strong>These results need to be confirmed in further studies, but they suggest that workplace bullying and violence as well as ethically challenging situations at work might have the greatest effect on HRV among public sector employees.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774277","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":"Effects of participatory organizational interventions on mental health and work performance: A systematic review and meta-analysis.","authors":"Asuka Sakuraya, Mako Iida, Kotaro Imamura, Kazuhiro Watanabe, Hiroki Asaoka, Emiko Ando, Akiomi Inoue, Reiko Inoue, Mai Iwanaga, Hisashi Eguchi, Yasumasa Otsuka, Yuka Kobayashi, Yu Komase, Kazuto Kuribayashi, Natsu Sasaki, Kanami Tsuno, Ayako Hino, Takeshi Ebara, Akihito Shimazu, Norito Kawakami, Akizumi Tsutsumi","doi":"10.1093/joccuh/uiag024","DOIUrl":"https://doi.org/10.1093/joccuh/uiag024","url":null,"abstract":"<p><strong>Objectives: </strong>Participatory organizational interventions (POIs) may improve workers' mental health and work performance, but evidence from systematic reviews and meta-analyses of cluster-randomized controlled trials (cRCTs) remains limited: The meta-analysis has not been updated since 2015; a previous study focused on healthcare workers; and potential outcomes have not been adequately examined. This systematic review and meta-analysis aimed to investigate the effects of POIs on mental health and work performance among workers.</p><p><strong>Methods: </strong>The current study searched PubMed, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society for papers published by November 11, 2022. Eligible studies were cRCTs assessing the effects of POIs on mental health or work performance. The risks of bias were evaluated by using the Cochrane risk-of-bias tool for cRCTs and performed meta-analysis using a random effects model.</p><p><strong>Results: </strong>Fourteen cRCTs were included in the systematic review, and eight cRCTs in the meta-analysis. The meta-analysis showed non-significant beneficial effect on mental health conditions [the standardized mean differences (SMD) = -0.04, 95%CI; -0.10 to 0.03], positive mental health (SMD = -0.004, 95%CI; -0.077 to 0.068), and work performance (SMD = 0.01, 95%CI; -0.10 to 0.13).</p><p><strong>Conclusion: </strong>This study did not confirm that POIs had a statistically significant effect on mental health or work performance. However, several studies that reported favorable results tended to emphasize active and structured participation, alignment with workers' needs, and attention to organizational context. Further research is needed to identify the conditions under which the interventions are effective. Trial registration: The study protocol was registered at the UMIN registry (registration number: UMIN000049453).</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729024","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":"Rural Hospital General Ward Nurses Experiences of Workplace Violence by Patients and Visitors - A Scoping Review.","authors":"Christine Trotman, Joanne E Porter, Michael Olasoji M, Anita Raymond, Bindu Joseph","doi":"10.1093/joccuh/uiag022","DOIUrl":"10.1093/joccuh/uiag022","url":null,"abstract":"<p><strong>Objective: </strong>Workplace violence (WPV) is increasing globally, and nurses are disproportionately affected. While WPV has been studied in high-risk units such as Emergency Departments and Mental Health Units, less is known about violence in general medical and surgical hospital wards, where most nurses work. WPV exacerbates nursing workforce shortages, especially in rural hospitals, already facing staffing challenges. In rural areas, previous research indicates that nurses' familiarity with patients and visitors makes patient-initiated violence more complex and limited resources may mean a lack of on-site security and reduced local police presence. This study aimed to describe generalist nurses' experiences of WPV by patients and visitors in acute hospital wards, with particular attention to rural settings where reported.</p><p><strong>Methods: </strong>A scoping review using PRISMA-ScR guidelines identified relevant peer-reviewed studies via CINAHL, Cochrane Library, Medline, Google Scholar, and Scopus.</p><p><strong>Results: </strong>Out of 165 records, 12 met the inclusion criteria. No included studies directly reported rural hospital generalist nurses' experiences of workplace violence, and evidence for this cohort could not be isolated. Four themes emerged: high prevalence of violence, under-reporting, contributing factors, and negative impacts. Most generalist nurses reported experiencing WPV, with increased risk when inpatients were awaiting care-facility beds. These negative outcomes both result from, and contribute to, workforce shortages.</p><p><strong>Conclusions: </strong>Despite recognition of the issue, there is little evidence on patient/visitor-initiated violence in rural hospital general wards. Further research is needed to understand how such violence affects nurses' safety, patient care quality, and workforce sustainability in rural areas, to inform policies.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722851","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":"Competencies Required for Occupational Health Nurses: A Scoping Review.","authors":"Etsuko Yoshikawa, Satoru Kanamori, Yoshiko Kubo, Yumi Takamizawa, Junko Nakatani","doi":"10.1093/joccuh/uiag023","DOIUrl":"https://doi.org/10.1093/joccuh/uiag023","url":null,"abstract":"<p><strong>Objectives: </strong>The competencies required of occupational health nurses (OHNs) to effectively address increasingly complex occupational health needs require systematic clarification. This scoping review aimed to comprehensively examine occupational health nursing competencies by mapping their scope, definitions, and practical applications.</p><p><strong>Methods: </strong>This study adopted a scoping review methodology to systematically summarize key concepts and knowledge. Literature searches were conducted using the Ichushi Web and PubMed databases, covering studies published between 2015 and 2025. Keywords included \"occupational health nursing\" and \"competencies.\" Peer-reviewed studies published in English or Japanese were included. Two researchers independently conducted primary and secondary screenings, resulting in the selection of 31 studies based on predefined eligibility criteria.</p><p><strong>Results: </strong>Thirty-one studies were included in the review. Occupational health nursing competencies were described as both basic competencies, essential for all OHNs, and advanced competencies, which are demonstrated by proficient nurses and associated with high performance. The competencies were categorized into four domains: \"foundations of occupational health nursing\" including professionalism and communication, \"coordination\" including relationship building, \"management\" including PDCA-based management, and \"occupational health activities\" including health promotion and consultation.</p><p><strong>Conclusions: </strong>Occupational health nursing competencies span basic to advanced levels and integrating knowledge, skills, and professional attitudes required for effective occupational health practice. These competencies highlight the importance of foundational expertise, collaborative coordination, systematic management, and practical occupational health activities. The findings provide a framework that may support the development of structured education and training programs to strengthen occupational health nursing practice in increasingly complex work environments.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698528","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 Ergonomic Risk Factors and Neuropathic Pain Among Korean Workers: A Cross-Sectional Analysis.","authors":"Jeong Woo Park, Mo-Yeol Kang, Seong-Sik Cho, Seong-Soo Choi","doi":"10.1093/joccuh/uiag021","DOIUrl":"https://doi.org/10.1093/joccuh/uiag021","url":null,"abstract":"<p><strong>Objectives: </strong>Research on the impact of ergonomic risk factors on neuropathic pain is limited. Accordingly, this study investigated the relationship between ergonomic risk exposure and neuropathic pain in a population of Korean workers.</p><p><strong>Methods: </strong>Data were obtained from the third and fourth rounds of the Korean Working, Sleep, and Health Study. Neuropathic pain was identified using the Douleur Neuropathique 4 (DN4) screening tool. The association between ergonomic risk factors and neuropathic pain was analyzed using multiple logistic regression analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated after adjusting for relevant confounding factors.</p><p><strong>Results: </strong>Two-wheeled vehicle operation (OR = 3.66, 95% CI = 1.26-10.58), manual material handling (OR = 2.81, 95% CI = 1.63-4.85), kneeling or squatting (OR = 2.47, 95% CI = 1.35-4.53), repetitive hand or finger motions (OR = 2.10, 95% CI = 1.38-3.19), trunk flexion or twisting (OR = 2.13, 95% CI = 1.25-3.63), and wrist twisting or pushing or pulling with upper limbs (OR = 1.90, 95% CI = 1.08-3.34) were significantly associated with neuropathic pain in the fully-adjusted model.</p><p><strong>Conclusion: </strong>This study supports a link between ergonomic risk factors and the occurrence of neuropathic pain among Korean workers.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690820","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":"Health and Occupational Environment of Japanese Expatriates in the United States: Medical Interview Analysis Using Text Mining.","authors":"Yuchi Maeda, Masaaki Matsunaga, Yuito Hosaka, Koji Ishikawa, Atsuhiko Ota","doi":"10.1093/joccuh/uiag017","DOIUrl":"https://doi.org/10.1093/joccuh/uiag017","url":null,"abstract":"<p><strong>Objectives: </strong>While the health issues of expatriates have predominantly been investigated in the context of assignments to developing countries, there is a paucity of research addressing Japanese expatriates stationed in the United States, which is a developed country.</p><p><strong>Methods: </strong>This study employed quantitative content analysis, using the text mining software \"KH Coder 3,\" on records obtained from 17 Japanese expatriates who participated in interviews with an occupational physician during a United States medical tour in May 2025.</p><p><strong>Results: </strong>The interview records comprised 7856 words and 440 sentences. Co-occurrence network analysis extracted six factors: The following subjects were examined: \"Family Life and Daily Challenges,\" \"Extended Working Hours and Meetings Between Japan and the United States,\" \"Comprehensive Health Checkups (Ningen Dock) and Patterns of Health Care Utilization,\" \"Health Checkups and Test Results,\" \"Workload and Stress,\" and \" Physical Inactivity and Weight Gain.\" Among these, the factor with the highest frequency of constituent terms was \"Extended Working Hours and Meetings Between Japan and the United States.\"</p><p><strong>Conclusions: </strong>Japanese expatriates encounter considerable health challenges, including difficulties in daily life, limited access to medical care, insufficient physical activity, and the substantial burden of work and meetings that extend late into the night owing to time differences. Global companies should ensure appropriate management of health- and work-related issues, even in assignments to developed countries, with particular attention to support systems, such as adjusting meeting schedules and providing family support.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674347","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":"Development of a Workplace Health Initiatives Checklist for Women and its Cross-Sectional Associations with Burnout, Productivity, and Satisfaction.","authors":"Haruna Ushigome, Songee Jung, Masahiro Iwakura, Mayumi Tsuji, Miho Iida, Yuko Mitsuhashi, Michiko Nohara, Kanae Karita, Megumi Kawashima, Youhwi Song, Kyoko Adachi, Yoshihisa Horiuchi, Satori Nagai, Yoko Araki, Kaori Koga, Akizumi Tsutsumi, Kyoko Nomura","doi":"10.1093/joccuh/uiag018","DOIUrl":"https://doi.org/10.1093/joccuh/uiag018","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a Workplace Health Initiatives Checklist for Women (WHIC‑W), we assessed content validity (expert) and provided initial evidence for construct validity by examining hypothesized cross-sectional associations with burnout, productivity, and job satisfaction.</p><p><strong>Methods: </strong>A multi-disciplinary expert panel comprising gynecologists, occupational physicians, nurses, industrial hygienists, and psychosomatic specialists created 26 items for the WHIC‑W. A survey was conducted in October 2023 with 3,343 working women aged 20-69 years. The checklist includes two domains: Domain 1 (15 items on work environment) and Domain 2 (11 items on pregnancy, child/elderly care, and support for balancing illness and work). The outcome included the Copenhagen Burnout Inventory, work productivity using presenteeism (WHO Health and Work Performance Questionnaire) and absenteeism (health-related days off in the past 28 days), satisfaction rated on a Visual Analog Scale (0-10), and intention to resign over the past year.</p><p><strong>Results: </strong>The checklist was scored on a 26-point scale, with a median score of 3 (IQR: 1-9), indicating limited workplace support for women. Higher checklist total scores were associated with lower Personal burnout (β -0.32, 95% CI: -0.435, -0.196), Work-related burnout (β -0.30, 95% CI: -0.395, -0.207), and Client-related burnout (β -0.17, 95% CI: -0.276, -0.065), higher absolute presenteeism (β 0.43, 95% CI: 0.336, 0.516), absenteeism (OR 1.01, 95% CI: 1.001, 1.021), and satisfaction (OR 1.07, 95% CI: 1.055, 1.079).</p><p><strong>Conclusions: </strong>This study provides preliminary construct validity evidence supporting WHIC-W as a formative checklist, with higher scores showing hypothesized cross-sectional associations with lower burnout, better productivity, and job satisfaction.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674308","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":"Association between handedness and occupational accidents: A prospective cohort study.","authors":"Aki Tomizawa, Tomohisa Nagata, Kiminori Odagami, Takahiro Mori, Koji Mori","doi":"10.1093/joccuh/uiag019","DOIUrl":"https://doi.org/10.1093/joccuh/uiag019","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the association between handedness and the incidence of occupational accidents among Japanese workers.</p><p><strong>Methods: </strong>A prospective cohort study was conducted from March to December 2023. Among 9451 workers at the baseline, 6156 responded to the follow-up. Participants who reported working fewer than 20 days per month and those with weekly working hours of less than 30 hours were excluded from the analysis, leaving 4016 participants for final analysis. We assessed handedness using the FLANDERS Handedness Questionnaire at baseline and occupational accident experiences at follow-up. We used adjusted Poisson regression analysis to calculate the incidence rate ratio (IRR) of occupational accidents among participants. The multivariate-adjusted model was adjusted for covariates: age, sex, education, industry, working hours, work style (day, shift, night, others), and sleeping time. The IRR and 95% confidence interval (CI) were subsequently calculated.</p><p><strong>Results: </strong>Of the participants, 3646 were right-handed, 193 mixed-handed, and 177 left-handed. Occupational accidents were reported by 181(5.0%) of right-handed, 19 (9.8.%) of mixed-handed, and 11 (6.2%) of left-handed participants. Compared to right-handed participants, the IRR for occupational accident was significantly elevated in mixed-handed participants (IRR = 1.84, 95% CI: 1.17-2.88). However, no significant difference was observed in left-handed participants (IRR = 1.13, 95% CI: 0.63-2.04).</p><p><strong>Conclusions: </strong>Mixed-handedness is associated with a higher incidence of occupational accidents. In contrast, left-handedness does not confer additional risk.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674331","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":"Chronic inhalation exposure to 0.5 ppm of 2-ethyl-1-hexanol induces histopathological changes in olfactory, respiratory, and skin tissue of mice.","authors":"Takanari Wakayama, Mio Miyake, Yuki Ito, Naoko Oya, Hirotaka Sato, Masato Sawada, Kazunobu Sawamoto, Michihiro Kamijima","doi":"10.1093/joccuh/uiag016","DOIUrl":"https://doi.org/10.1093/joccuh/uiag016","url":null,"abstract":"<p><strong>Objectives: </strong>2-Ethyl-1-hexanol (2EH) is a volatile organic compound that can cause sick building syndrome and can be released from flooring materials for more than 10 years through the hydrolysis of compounds with 2-ethylhexyl moieties. Previous studies using mice have raised concerns about tissue-damaging effects on the olfactory epithelium (OE), olfactory bulb (OB), brain, lungs, and skin. A subchronic mouse study observed degeneration of OE at concentrations as low as 20 ppm. However, the effects of long-term exposure to 2EH remain unclear. This study aimed to elucidate the histopathological effects of chronic exposure to 2EH relative to its airborne concentration.</p><p><strong>Methods: </strong>Ten-week-old male ICR mice were exposed to 0, 0.5, 10, or 100 ppm 2EH by inhalation for 8 h/d, 5 d/wk, for 6 months. Subsequently, histopathological analysis was conducted.</p><p><strong>Results: </strong>At 0.5 ppm, acute and chronic inflammation were observed in the OE and alveoli, with tissue repair in the OE, and thickening of the epithelium and smooth muscle in the bronchi. Metaplasia of OE in the respiratory epithelium was induced at 10 and 100 ppm. At all concentrations, the number of mature neurons in the OE and immature neurons in the OB decreased, suggesting that olfactory nerve activity was suppressed. Fibroblasts increased in the dorsal skin. Microglia in the hippocampus and amygdala increased in number.</p><p><strong>Conclusions: </strong>Chronic inhalation exposure at as low as 0.5 ppm caused inflammation in the OE, OB, segmental bronchi, and alveoli, and affected the target area of OB neurons.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499334","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}