Occupational and Environmental Medicine最新文献

{"title":"Drug utilisation across occupations among pregnant women working in the healthcare and social assistance sector in France: a nationwide population-based study.","authors":"Mélanie Araujo, Justine Bénévent, Christine Damase-Michel, Yolande Esquirol, Anna-Belle Beau","doi":"10.1136/oemed-2026-110920","DOIUrl":"https://doi.org/10.1136/oemed-2026-110920","url":null,"abstract":"<p><strong>Objectives: </strong>Medication use during pregnancy is common, but patterns may differ across occupational subgroups, particularly in healthcare and social assistance where working conditions, education and health literacy vary. We aimed to compare medications dispensed to pregnant women across occupations within this sector.</p><p><strong>Methods: </strong>We conducted a nationwide population-based study using the French EDP-Santé database, linking occupational and socioeconomic data with healthcare reimbursement records. Pregnancies from 2009 to 2015 among women aged 15-55 years were identified. Medication dispensing during the year before and during pregnancy was described by occupational groups using the Anatomical Therapeutic Chemical classification. Comparisons were performed within healthcare occupations.</p><p><strong>Results: </strong>Among 321 569 pregnancies, 38 860 (12%) involved women in healthcare and social assistance. Before pregnancy, 91%-95% received at least one medication (mean: 8-12). Psychotropic medication (including antidepressants and benzodiazepines) dispensing was higher among hospital service workers (18% (95% CI 17% to 19%)), healthcare assistants (16% (95% CI 15% to 16%)) and social workers (14% (95% CI 13% to 15%)) than among physicians (11% (95% CI 10% to 13%)), rehabilitation professionals (10% (95% CI 8% to 12%)) and nurses (10% (95% CI 9% to 10%)). Similar patterns were observed for analgesic and musculoskeletal medications. During pregnancy, differences were less pronounced. Folic acid, recommended before and early in pregnancy, was lower among hospital service workers (30% (95% CI 29% to 32%)) than other healthcare workers (39% to 53%).</p><p><strong>Conclusion: </strong>Medication dispensing is common among pregnant healthcare workers, with marked variation across occupations. These differences may reflect disparities in working conditions or socioeconomic status, underlining the need for tailored maternal health support in specific occupational groups.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional associations between occupational exposure profiles in daycares, evaluated from chemical composition of disinfectants and cleaning products, and asthma symptoms.","authors":"Emilie Pacheco Da Silva, Emmanuel Chevallier, Laurent Orsi, Etienne Sevin, Corinne Mandin, Valérie Siroux, Felix Forster, Orianne Dumas, Nicole Le Moual","doi":"10.1136/oemed-2025-110626","DOIUrl":"10.1136/oemed-2025-110626","url":null,"abstract":"<p><strong>Objective: </strong>While adverse respiratory health effects of exposure to disinfectants and cleaning products (DCPs) are well-documented in cleaners/healthcare workers, no study has investigated their impact on daycare workers. We evaluated cross-sectional associations between occupational exposures to DCPs, considering them as a mixture of chemical compounds and asthma in CRESPI daycare workers.</p><p><strong>Methods: </strong>Use of DCPs in daycares was assessed using a smartphone application. We retrieved their chemical compounds, classifying them as irritants, sensitisers, quaternary ammonium compounds and biocides. Latent class analysis (LCA) was conducted to identify exposure profiles for the weekly used DCPs/compounds. We assessed associations of the identified exposure profiles with the asthma symptom score (0-5) using negative binomial regressions, adjusted for age, smoking status and body mass index and accounted for daycare centre.</p><p><strong>Results: </strong>Analyses included 311 women (43 years, people who smoke: 11%). The LCA identified three exposure profiles: no weekly use of DCPs (LC1 prevalence: 24%), weekly use of a moderate number of irritants (LC2: 37%), weekly use of a high number of irritants, respiratory sensitisers and biocides (LC3: 39%). Women in LC2 and LC3 had a higher risk for asthma symptoms compared with those in LC1. The association was borderline statistically significant for LC3 (mean score ratio (MSR)=1.56; 95% CI 0.99 to 2.46) and weaker for LC2 (MSR=1.34 95% CI 0.85 to 2.13).</p><p><strong>Conclusion: </strong>Our results show positive associations between weekly occupational use of numerous DCPs and those with multiple types of chemical compounds in daycares and asthma symptoms in daycare workers.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"268-275"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic chronic beryllium disease: beyond lung disease.","authors":"Louis Jouanjan, Gernot Zissel, Prerana Agarwal, Daiana Stolz, Björn Christian Frye","doi":"10.1136/oemed-2025-110668","DOIUrl":"10.1136/oemed-2025-110668","url":null,"abstract":"<p><strong>Objective: </strong>Systemic involvement in chronic beryllium disease (CBD) has been reported only anecdotally.</p><p><strong>Methods: </strong>We describe a case series of six patients with CBD demonstrating systemic involvement across diverse occupational settings.</p><p><strong>Results: </strong>All patients had documented occupational beryllium exposure. CBD diagnosis was confirmed by positive histology and lymphocyte proliferation test in all cases. All patients presented with signs of extrapulmonary organ involvement, including hepatic, gastric, neurologic, splenic, ocular, cutaneous, as well as possible cardiac and renal involvement.</p><p><strong>Conclusions: </strong>This series underscores the importance of including CBD in the differential diagnosis of sarcoidosis in workers with possible beryllium exposure, even in the presence of extrapulmonary manifestations. Clinicians should maintain awareness of extrapulmonary involvement in patients with CBD.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"283-286"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing respirable silica exposure among brick kiln workers in Nepal: a human-centred design and implementation science framework to develop and pilot a personal protective equipment intervention.","authors":"Chelsea Gaviola, Arun K Sharma, Kopila Lama, Avigya Karki, Ram Chandyo, Laxman Shrestha, David Parker, Nathan M Thielman, Gurumurthy Ramachandran, Steven M Thygerson, Laura Beres, Laura Nicolaou, William Checkley","doi":"10.1136/oemed-2025-110582","DOIUrl":"10.1136/oemed-2025-110582","url":null,"abstract":"<p><strong>Objectives: </strong>Brick kiln workers in Nepal face high exposure to respirable silica but are not required to use personal protective equipment (PPE). We sought to understand factors influencing PPE use, design and pilot a PPE training and distribution intervention and assess its feasibility.</p><p><strong>Methods: </strong>We used a human-centred design approach guided by the Discover, Design, Build, Test framework and conducted four pre-intervention workshops (36 participants), a 21-day randomised controlled trial (RCT) and three post-intervention workshops (19 participants) at a kiln in Bhaktapur, Nepal. Workers and leadership aged ≥18 years were purposively sampled for workshops and randomly selected for the RCT (20 intervention, 20 control). Intervention participants received PPE training, weekly reminders and free N95 respirators and eyewear. Control participants received counselling and information on where to purchase PPE.</p><p><strong>Results: </strong>Pre-intervention workshops revealed barriers to PPE use, including cost, discomfort and work efficiency concerns. Workers preferred expert-led, hands-on PPE training. We identified high feasibility (mean Feasibility of Intervention Measure, 4.6±0.5 points) among workers; leadership rated feasibility lower due to cost concerns. Observed N95 use was higher in the intervention group (78.9%, 71/90 visits) compared with none in the control group (0%, 0/93 visits; p<0.001). Post-intervention feedback showed workers felt N95s reduced dust exposure and respiratory symptoms without impacting efficiency, but eyewear needed adaptation for sustained use.</p><p><strong>Conclusions: </strong>With worker-centred training, N95 respirators are feasible to reduce silica exposure in this setting. However, broader adoption may depend on improving the affordability and accessibility of PPE through advocacy and policy changes.</p><p><strong>Trial registration number: </strong>NCT06090370.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"243-250"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in physical workload and the risk of work disability due to musculoskeletal disorders: a register-based study of 1 703 935 workers in Sweden.","authors":"Daniel Falkstedt, Tomas Hemmingsson, Laura Punnett, Katarina Kjellberg, Alicia Kurowski, Kuan-Yu Pan, Melody Almroth","doi":"10.1136/oemed-2026-111034","DOIUrl":"10.1136/oemed-2026-111034","url":null,"abstract":"<p><strong>Objective: </strong>This register-based study examined whether changes over 14 years in occupational physical workload (PWL) affected the risk of registered work disability due to a musculoskeletal disorder (MSD).</p><p><strong>Methods: </strong>This study included 1 703 935 workers in Sweden in 2005. PWL exposure was measured using job-exposure matrices linked to registered occupations in 1990 and 2005; change in PWL was defined between categories (low, medium, high) in either direction. The outcome was cumulative incidence of 'work disability' (either long-term sickness of at least 2 years or disability pension) due to MSD from 2006 to 2019. Crude and multivariate Cox proportional hazards regression models estimated sex-specific HRs with 95% CIs. Models were adjusted for sociodemographic factors and health and employment history.</p><p><strong>Results: </strong>A total of 33 369 individuals (1.96%) became work disability cases during follow-up. Compared with workers with consistently high PWL, any reduction in PWL was associated with a decreased risk of work disability due to MSD (women: HR 0.57, 95% CI 0.52 to 0.63, men: HR 0.59, 95% CI 0.52 to 0.66 for change from high to low exposure). Compared with workers with consistently low PWL, any increase was associated with a higher risk of work disability due to MSD (women: HR 1.68, 95% CI 1.53 to 1.86, men: HR 2.19, 95% CI 1.89 to 2.52 for change from low to high).</p><p><strong>Conclusion: </strong>In both sexes, decreases in PWL exposure were associated with a lower risk of MSD disability and increases in exposure with a higher risk.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"261-267"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148605767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational exposure to pesticides increases the risk of amyotrophic lateral sclerosis: a systematic review and meta-analysis.","authors":"France Labrèche, Pamela Prud'homme, Maryse Gagnon, Nicolas Dupré, Sabrina Gravel","doi":"10.1136/oemed-2025-110662","DOIUrl":"10.1136/oemed-2025-110662","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the evidence on the association between occupational exposure to pesticides and the risk of amyotrophic lateral sclerosis (ALS).</p><p><strong>Methods: </strong>A systematic search, conducted in eight bibliographic databases for publications between 1990 and 2025, identified observational studies estimating the risk of ALS after occupational pesticide exposure. Study quality was assessed using the WHO Risk of Bias (RoB) assessment instrument for systematic reviews, with the ROBINS-E (RoB in non-randomised studies of exposure) tool domains of bias. Pooled risk estimates were produced using random-effects models with restricted maximum likelihood, heterogeneity was assessed with I² statistics, and meta-regressions and publication bias explored with funnel plots and Egger's test.</p><p><strong>Results: </strong>Eight case-control studies (1734 cases) were retained for meta-analysis from 767 initially screened articles. 'Ever' occupational exposure to pesticides was associated with an increased risk of ALS (n=6 studies, pooled OR (pOR)=1.6; 95% CI 1.1, 2.2; I²=57%), for combined sexes. The risk for exposure to herbicides was slightly greater (pOR=1.7, I²=0.0%) than for exposure to insecticides or fungicides (pORs=1.6, I²=0.0%). Based on three studies, ever exposure to high levels of pesticides was associated with a higher risk (pOR=2.7; 95% CI=1.4, 5.0) than exposure to low levels (pOR=1.9; 95% CI=1.0, 3.7). Self-reported exposure assessment methods and older publication dates (<2015) were statistically significant predictors of the effect size.</p><p><strong>Conclusion: </strong>Despite the small number of studies and some heterogeneity, our results add to the evidence suggesting that occupational exposure to pesticides may increase the risk of ALS.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"291-300"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjusting for the diagnostic accuracy of CXR in the dose-response relationship between cumulative silica exposure and silicosis in miners.","authors":"Patrick Howlett, Ashwin Durairaj, Jeffrey Gan, Maia Lesosky, Johanna Feary","doi":"10.1136/oemed-2025-110368","DOIUrl":"10.1136/oemed-2025-110368","url":null,"abstract":"<p><strong>Introduction: </strong>A recent meta-analysis confirmed that chest X-ray (CXR) has low sensitivity for diagnosing silicosis. We re-estimated previously published dose-response relationships between cumulative respirable crystalline silica (RCS) exposure and silicosis risk, under the assumptions that sensitivity was either fixed or relative to the population proportion of severe silicosis.</p><p><strong>Methods: </strong>We combined unpublished logistic regression models from Scottish coal miners with meta-analysis results to model how CXR sensitivity changed according to cumulative RCS exposure. We assumed specificity was 0.95. Among mining cohorts, we calculated the difference in the cumulative risk of silicosis between the unadjusted and fixed and relative scenarios. Finally, we re-estimated a published dose-response meta-analysis and associated absolute risk reductions (ARR).</p><p><strong>Results: </strong>The cumulative risk of silicosis was substantially higher in both the fixed and relative sensitivity scenarios compared with the unadjusted estimate in all mining cohorts. This was most pronounced in the relative scenario and when cumulative RCS exposures were below approximately 6 mg/m³-years. A reduction in cumulative RCS exposure from 4 to 2mg/m³-years corresponded to larger ARRs in the fixed and relative scenarios than the unadjusted scenario; 382 (95% CI 361 to 399) and 529 (95% CI 353 to 592) cases per 1000 miners compared with 313 (95% CI 288 to 333) cases per 1000 miners, respectively.</p><p><strong>Discussion: </strong>We relied on a single estimate of the proportion of severe disease to link sensitivity and cumulative RCS exposure. Nevertheless, adjusting for the reduced diagnostic accuracy of CXR for silicosis suggests the burden of silicosis is underestimated in published mining cohorts.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"287-290"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chlordecone (Kepone) exposure in the French West Indies: the urgent need to address a flawed management approach.","authors":"Dabor Resiere, Jonathan Florentin, Astrid Monfort, Frédéric Lapostolle, Bruno Megarbane, Hatem Kallel, Remi Nevière","doi":"10.1136/oemed-2026-110853","DOIUrl":"10.1136/oemed-2026-110853","url":null,"abstract":"","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"241-242"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumoconiosis screening and classification using deep learning models.","authors":"Meiqi Liu, Zenas Huang, Michal Borek, Ian Loveless, Kenneth Rosenman, Adam Alessio, Ling Wang","doi":"10.1136/oemed-2026-111040","DOIUrl":"10.1136/oemed-2026-111040","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and evaluate different deep learning (DL) models for clinically relevant screening and classification of pneumoconiosis based on chest radiographs.</p><p><strong>Methods: </strong>This retrospective study used B-reader labelled pneumoconiosis lung images from US workers. After pre-processing the images, DL models were trained and evaluated for four classification tasks: (1) parenchymal abnormalities present versus absent, (2) parenchymal and/or pleural abnormalities present versus absent, (3) small parenchymal opacities grade 1 versus grade 0 and (4) progressive massive fibrosis versus simple pneumoconiosis versus no pneumoconiosis.</p><p><strong>Results: </strong>A total of 2968 lung images were divided as follows: 2294 for training, 287 for validation, 287 for independent in-distribution testing and 100 for out-of-distribution testing from a separate scanner manufacturer dataset. On the in-distribution testing data set, the DL models achieved an accuracy of 0.93 (SD=0.01), 0.92 (SD=0.02) and 0.91 (SD=0.02) for task 1, 2 and 3, respectively. DL had comparable or better performance compared with certified B-readers who had average accuracies of 0.9 (SD=0.11), 0.91 (SD=0.10) and 0.77 (SD=0.21). For task 4, the DL model achieved an accuracy of 0.83 (SD=0.02), which is similar to B-readers' performance (average accuracy of 0.86 (SD=0.12)). Performance was markedly lower on the out-of-distribution test set, with reduced accuracy and AUC.</p><p><strong>Conclusions: </strong>On independent, in-distribution test images, DL models performed comparably to certified B-readers for tasks 1-4, supporting their potential to augment pneumoconiosis screening and classification. Reduced performance on challenging out-of-distribution cases warrants further study to improve generalisation.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"276-282"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in employment inequalities for people with disability, Australia 2003 to 2023.","authors":"Lu Ye, Glenda M Bishop, Zoe Aitken","doi":"10.1136/oemed-2026-110930","DOIUrl":"10.1136/oemed-2026-110930","url":null,"abstract":"<p><strong>Objectives: </strong>People with disability are less likely to participate in the labour force and be employed compared with people without disability. However, it is not known whether these inequalities have changed over time. We therefore assessed whether disability-related inequalities in employment have changed over time among adults aged 20-64 years in Australia.</p><p><strong>Methods: </strong>We analysed 21 years of data (2003-2023) from the Household, Income and Labour Dynamics in Australia Survey. Trends were investigated to describe changes in inequalities in employment, unemployment and not in the labour force (NILF) between people with and without disability. Analyses were further disaggregated for age group, sex and disability subgroups.</p><p><strong>Results: </strong>From 2003 to 2023, people with disabilities experienced persistent and substantial inequalities in employment outcomes. Neither absolute nor relative inequalities in employment outcomes changed and relative inequalities for NILF widened over time. People with disability were 30% to 40% less likely to be employed, 1.4 to 2.7 times more likely to be unemployed and 2.0 to 2.8 times more likely to be NILF compared with people without disability. The greatest relative inequalities in employment were experienced by older working-age people with disability, people with intellectual or learning disability, brain injury or stroke and psychological disability.</p><p><strong>Conclusions: </strong>This descriptive study adds to previous findings showing employment inequalities by demonstrating that disability-related inequalities in employment have been sustained for two decades in Australia without improvement. As a key social determinant of health, the findings are a critical public health concern.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"251-260"},"PeriodicalIF":3.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}