Journal of Occupational Health最新文献

{"title":"Relationship between top management engagement, occupational health professional involvement in management reviews, and workplace health promotion program outcomes: a cross-sectional study.","authors":"Yuki Kumakawa, Tomohisa Nagata, Kiminori Odagami, Takahiro Mori, Koji Mori","doi":"10.1093/joccuh/uiaf043","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf043","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined whether management-level discussions on Health and Productivity Management (HPM) and the involvement of occupational health professionals in discussions are associated with workplace health promotion (WHP) program outcomes, as indicated by HPM evaluation.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using data from 2,495 corporations that submitted the 2020 HPM Survey Sheets. Corporations were categorized into three groups based on the presence or absence of HPM discussions at management-level meetings and the attendance of occupational health professionals. The overall score and the deviation score for \"assessment and improvement\" were used as indicators of program outcomes. Multiple regression analyses were performed, adjusting for industry sector, company size, and number of occupational physicians and occupational health nurses.</p><p><strong>Results: </strong>Corporations without HPM discussions at management-level meetings showed significantly lower scores on both indicators (the overall score: coefficient: -11.70, 95% CI: -12.83 to -10.53, \"assessment and improvement\": coefficient: -11.30, 95% CI: -12.50 to -9.97). In contrast, corporations with HPM discussions attended by occupational health professionals demonstrated significantly higher scores than those without such attendance (the overall score: coefficient: 5.39, 95% CI: 4.61 to 6.18, \"assessment and improvement\": coefficient: 5.15, 95% CI: 4.28 to 6.02). These associations remained significant after adjusting for covariates.</p><p><strong>Conclusions: </strong>The findings indicate that discussions on HPM at management-level meetings and the involvement of occupational health professionals are associated with WHP program outcomes. These results suggest that collaboration between top management and occupational health professionals in management reviews may contribute to the successful implementation of WHP programs.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698869","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 relationship between the dominant hand and neck/shoulder pain in the workplace: a prospective cohort study.","authors":"Yukiko Ogawa, Tomohisa Nagata, Kiminori Odagami, Takeshi Ebara, Junko Nakatani, Koji Mori, For The W S-Ohpm Ii Study","doi":"10.1093/joccuh/uiaf042","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf042","url":null,"abstract":"<p><strong>Background: </strong>To date, no studies have investigated the relationship between one's dominant hand and neck/shoulder pain. The aim of this prospective cohort study is to explore the relationship between one's dominant hand and the severity of neck/shoulder pain. We also examined the relationship between the dominant hand and the onset of neck/shoulder pain at the follow-up among workers without neck/shoulder pain at baseline.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of 9,451 workers. The dominant hand is measured by ten items from the Japanese version of the Flanders Questionnaire at the baseline survey. We assessed neck/shoulder pain using a numeric rating scale. We calculated the unstandardized coefficient (B) using multiple regression analysis and the incidence rate ratio (IRR) for neck/shoulder pain using modified Poisson regression among workers who were free of neck/shoulder pain at baseline.</p><p><strong>Results: </strong>Among the 9,451 respondents for the baseline survey, 6,156 responded to the follow-up survey (response rate: 65.1%). Mixed-handed workers report a higher degree of neck/shoulder pain than right-handed workers (B, 0.33; 95% CI, 0.09-0.58). Among 2,481 participants, mixed-handed workers also had a higher IRR for neck/shoulder pain (IRR, 1.27; 95% CI, 1.01-1.61). There was no difference in any of the left-handers compared with the right-handers.</p><p><strong>Conclusions: </strong>The study found that mixed-handed workers had higher levels of neck/shoulder pain than right-handed workers, and the incidence rate was also higher among mixed-handed workers. Employers should consider these findings when designing work environments, managing tasks, and providing occupational health training to optimise worker comfort and safety.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690493","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":"Effectiveness of recommendations in promoting the use of Mobile health applications in health guidance: a randomized controlled trial.","authors":"Takeshi Onoue, Kazuki Nishida, Yoshio Nakata, Fumi Hayashi, Miki Marutani, Naoki Sakane, Jiro Moriguchi, Shigeki Muto, Kiminori Kato, Izuru Masuda, Tomonori Okamura, Keiichi Matsuzaki, Takashi Kawamura, Kazuyo Tsushita","doi":"10.1093/joccuh/uiaf036","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf036","url":null,"abstract":"<p><strong>Objectives: </strong>Use of commercially available mobile health (mHealth) applications in supporting lifestyle improvements has become popular in recent years. However, the effectiveness of advice promoting the use of such applications based on individual behavioral goals in a health guidance setting remains unclear. This study explored how guiding participants of the Specific Health Guidance (SHG) program, a Japanese public health initiative to prevent cardiovascular disease, to use commercially available mHealth applications impacted their application usage, lifestyle habits, and cardiovascular risk factors.</p><p><strong>Methods: </strong>In this multicenter, randomized, open-label, parallel-group comparison study, 156 individuals with a history of SHG participation and were engaged in the Motivational Health Guidance program (a type of SHG) in 2021 were assigned to intervention (n = 76) or control (n = 80) groups. While both groups received standard guidance, the intervention group also received recommendations for mHealth applications based on their individual behavioral goals. The participants' application usage, behavioral changes, and body weight were assessed after 3 months, with health checkup data evaluated after 1 year.</p><p><strong>Results: </strong>The proportion of mHealth application users after 3 months was significantly higher in the intervention group (68.4%) than in the control group (40.0%). The intervention group also reported a significantly greater weekly frequency of mHealth application usage. Moreover, the intervention group reported a significantly decreased change in triglyceride levels after 1 year compared with the control group.</p><p><strong>Conclusions: </strong>Recommending commercially available mHealth applications in a health guidance setting significantly increased the number of mHealth application users and their frequency of use.</p><p><strong>Trial registration: </strong>Japanese University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR: UMIN000042986).</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649714","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":"Forest bathing improves inflammatory markers, SpO2 and subjective symptoms related to COPD (chronic obstructive pulmonary disease) in male subjects at risk of developing COPD.","authors":"Qing Li, Norimasa Takayama, Yukako Kimura, Hiroshi Takayama, Shigeyoshi Kumeda, Takashi Miura, Tsunemi Kitagawa, Yoichiro Aoyagi, Michiko Imai","doi":"10.1093/joccuh/uiaf041","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf041","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide, causing 3.5 million deaths in 2021. Effective preventive measures are needed. Forest bathing has been reported to have positive effects on the immune system. In addition, the clean air, mild climate, phytoncides, high oxygen concentration, and other elements of forests are expected to have benefits on respiratory diseases such as COPD. Based on the above background, this study used a randomized crossover design to examine the improving effects of forest bathing on inflammatory markers and subjective symptoms related to COPD.</p><p><strong>Methods: </strong>Thirty male subjects aged 63.1 ± 7.5 years were recruited after obtaining informed consent. These subjects participated in day trips to a Japanese cypress forest park and to a city area of Nagano Prefecture as a control in June 2024. Blood samples were taken in the afternoon of each day before and after the walks. Concentrations of α1-antitrypsin (α1-AT), C-reactive protein (CRP), fibrinogen, and interleukin 6 (IL-6) in blood were measured. Percutaneous oxygen saturation (SpO2), the profile of mood states (POMS), and questionnaires for subjective fatigue and respiratory symptoms and sleep quality were carried out before and after each trip.</p><p><strong>Results: </strong>Forest bathing significantly decreased the concentrations of blood CRP, α1-AT, IL-6 and fibrinogen, significantly increased SpO2 and reduced subjective fatigue and respiratory symptoms, improved sleep and the scores of positive feelings and reduced the scores for negative emotions in POMS.</p><p><strong>Conclusions: </strong>Forest bathing may improve inflammatory markers, SpO2 and subjective symptoms related to COPD.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649715","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":"Uneven Impact of Andropause Symptoms on Daily Life Domains in Employed Men: A Cross-Sectional Study.","authors":"Fumiya Tanji, Maiko Kawajiri, Hirohito Nanbu, Daisaku Nishimoto","doi":"10.1093/joccuh/uiaf040","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf040","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the extent to which the severity of andropause symptoms affects daily functioning, specifically in work, housework, outings, social relationships, and leisure activities, among employed Japanese men.</p><p><strong>Methods: </strong>A cross-sectional internet-based survey was conducted in September 2024. Participants (N = 1,054), aged 20-69 years, completed the Aging Males' Symptoms scale to evaluate symptom severity. Impacts on daily life were assessed using a four-point scale. Multivariate logistic regression analyses estimated odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>After adjusting for relevant covariates, moderate and severe symptoms were significantly associated with greater difficulties in daily life. Compared to individuals with very mild symptoms, those with moderate symptoms had higher ORs for severe difficulties in work (OR = 7.2, 95% CI: 2.9-18.0), social relationships (OR = 17.7, 95% CI: 4.0-78.4), and housework (OR = 3.2, 95% CI: 1.2-9.0). Associations were stronger for severe symptoms: work (OR = 21.1, 95% CI: 8.0-55.5), social relationships (OR = 37.2, 95% CI: 7.9-174.3), and housework (OR = 8.5, 95% CI: 2.9-24.4). Severe symptoms were also linked to significant difficulties in outings (OR = 4.7, 95% CI: 1.8-12.4) and leisure (OR = 8.2, 95% CI: 3.0-22.5).</p><p><strong>Conclusions: </strong>Andropause symptoms significantly affect multiple areas of daily life, particularly work, social engagement, and household tasks. These findings underscore the importance of early recognition and intervention.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608618","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":"Comparative evaluation of FIB-3 and FIB-4 indices for liver fibrosis screening in workplace-based health check-ups.","authors":"Kota Fukai, Shoko Nakazawa, Kosuke Sakai, Yuko Furuya, Yuya Watanabe, Toru Honda, Takeshi Hayashi, Toru Nakagawa, Masaaki Korenaga, Masayuki Tatemichi","doi":"10.1093/joccuh/uiaf038","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf038","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the utility of the FIB-3 index as a secondary screening tool for liver fibrosis in workplace-based health check-ups, by comparing its concordance and negative predictive values (NPVs) with those of the FIB-4 index.</p><p><strong>Methods: </strong>This cross-sectional study included 12,622 workers from the Hitachi Cohort Study who underwent workplace-based health check-ups between April 2021 and March 2022. FIB-4 was calculated using age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count, whereas FIB-3 used the same components except age. To evaluate the utility of FIB-3 in excluding liver fibrosis, NPVs were calculated using FIB-4 thresholds (1.30, 2.01, and 2.67) as references. Concordance between FIB-3 and FIB-4 was examined across different age groups. In addition, multivariate logistic regression analysis was conducted to identify factors associated with false-positive FIB-3 results.</p><p><strong>Results: </strong>The FIB-3 index demonstrated high NPVs for excluding liver fibrosis, with values of 99.9% at FIB-4 ≥1.30 and 98.2% at FIB-4 ≥2.67. Strong concordance between FIB-3 and FIB-4 was observed consistently across different age groups. Among participants with elevated ALT (>30 IU/L), FIB-3 consistently ruled out fibrosis, whereas FIB-4 positivity increased with advancing age. Multivariate analysis indicated that higher AST levels and increased alcohol intake were significantly associated with false-positive FIB-3 results.</p><p><strong>Conclusions: </strong>The FIB-3 index demonstrated stable performance across age groups while maintaining high concordance and NPV relative to FIB-4. These findings suggest that FIB-3 may serve as a practical screening tool in routine workplace-based health check-ups, particularly in mitigating age-related overestimation observed with the FIB-4 index.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591488","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":"School Refusal: A Hidden Challenge for Working Parents.","authors":"Natsu Sasaki","doi":"10.1093/joccuh/uiaf039","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf039","url":null,"abstract":"<p><p>School refusal is rising globally and has reached an all-time high in Japan. It imposes critical work-family conflict on employed parents, with preliminary surveys linking it to job loss, depression, and anxiety. Despite its public-health importance, work-family conflict due to school refusal has scarcely been studied in occupational health. This Opinion reviewed existing research on parents of school-refusing children, discuss how occupational health professionals can support this underserved population, and outline priorities for future research to mitigate the impacts on working-age parents' health and employment.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591489","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":"Relatively lower-intensity physical activity during leisure time and presenteeism among Japanese workers.","authors":"Koki Nagata, Shohei Yamamoto, Yosuke Inoue, Haruka Miyake, Hiroko Okazaki, Toshiaki Miyamoto, Takeshi Kochi, Isamu Kabe, Aki Tomizawa, Maki Konishi, Seitaro Dohi, Tetsuya Mizoue","doi":"10.1093/joccuh/uiaf037","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf037","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the cross-sectional association between relatively lower-intensity physical activity (LIPA) during leisure time and presenteeism, accounting for relatively higher-intensity physical activity (HIPA) during leisure time.</p><p><strong>Methods: </strong>Data were derived from 11,438 workers from six worksites of large companies in Japan, which participated in a questionnaire survey conducted between fiscal years 2018-2020. Frequency and duration per occasion were assessed for leisure-time physical activities at three intensities as determined by shortness of breath. LIPA was defined as activity not causing shortness of breath. The participants were divided into three groups according to LIPA volume (none, < 60 minutes/week, or ≥ 60 minutes/week) and into two groups according to HIPA volume (none or engaged). A single question assessed the participants' presenteeism through self-ratings of their work performance. A multivariable Poisson regression model with a robust variance estimator estimated prevalence ratios (PRs) of presenteeism and their 95% confidence intervals (CIs) across the categories for both LIPA and HIPA.</p><p><strong>Results: </strong>The prevalence of presenteeism tended to decrease with increasing amounts of LIPA and HIPA (P for trend < 0.001). Among those who did not engage in HIPA, a significantly lower prevalence of presenteeism was observed among individuals who engaged in LIPA for ≥ 60 minutes/week compared with those who did not (adjusted PR = 0.74, 95% CI = 0.68-0.81).</p><p><strong>Conclusions: </strong>This study supports the protective role of LIPA during leisure time that does not cause shortness of breath against presenteeism among workers who do not engage in HIPA during leisure time.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560442","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":"Physical activity interventions delivered through digital health technology for improving workers' mental health symptoms: a systematic review and meta-analysis.","authors":"Satoru Kanamori, Kotaro Imamura, Yuta Inagawa, Takenori Yamauchi, Hiroki Ikeda, Takuro Okuyama, Go Muto, Rika Kato, Mako Iida, Hiroki Asaoka, Akiomi Inoue, Kazuhiro Watanabe, Kanami Tsuno, Natsu Sasaki, Yuka Kobayashi, Asuka Sakuraya, Yu Komase, Yasumasa Otsuka, Mai Iwanaga, Reiko Inoue, Kazuto Kuribayashi, Ayako Hino, Akihito Shimazu, Akizumi Tsutsumi, Norito Kawakami, Naomichi Tani, Hisashi Eguchi, Noriko Kojimahara, Takeshi Ebara","doi":"10.1093/joccuh/uiaf035","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf035","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to clarify the primary preventive effects of physical activity interventions delivered through digital health technology (DHT) on workers' mental health symptoms, and examine the conditions of attrition and adherence in these interventions.</p><p><strong>Methods: </strong>We examined randomized controlled trials (RCTs) that analyzed the effects of physical activity interventions delivered through DHT on workers' health outcomes. We included RCTs published in English or Japanese since 2010 and excluded studies that targeted specific diseases or secondary and tertiary prevention. We conducted the search on July 25, 2023, using Cochrane CENTRAL, EMBASE, PsycINFO, PubMed, and Ichushi-Web, and citation searches. We assessed risk of bias using the Cochrane Risk of Bias Tool version 2, and data were integrated using a random-effects model. Attrition rates were averaged, and adherence was qualitatively reviewed.</p><p><strong>Results: </strong>Eight studies were included in the systematic review, and five in the meta-analysis. Pooled effect sizes immediately after intervention were as follows: Cohen's d = -0.51 (95% CI: -0.75, -0.27) for depression and negative affect, and -0.36 (-0.60, -0.05) for perceived stress. The attrition rate was 16.8% and 12.4% for the control and intervention groups, with only two studies providing details on adherence.</p><p><strong>Conclusions: </strong>Physical activity interventions delivered through DHT may moderately improve depression and negative affect, and slightly reduce perceived stress among workers. However, these findings should be interpreted with caution due to the limited number of studies and low evidence certainty. Future studies should explore long-term effects, additional mental health outcomes, and factors affecting adherence.</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528346","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":"Correction to: Importance of early detection and treatment of occupational hypersensitivity pneumonitis.","authors":"","doi":"10.1093/joccuh/uiaf033","DOIUrl":"https://doi.org/10.1093/joccuh/uiaf033","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/joccuh/uiaf026.].</p>","PeriodicalId":16632,"journal":{"name":"Journal of Occupational Health","volume":"67 1","pages":"uiaf033"},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528347","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}