Occupational and Environmental Medicine最新文献

{"title":"Occupational exposure to respirable crystalline silica and incident idiopathic interstitial pneumonias and pulmonary sarcoidosis: a national prospective follow-up study.","authors":"Inge Brosbøl Iversen, Jesper Medom Vestergaard, Johan Ohlander, Susan Peters, Elisabeth Bendstrup, Jens Peter Ellekilde Bonde, Vivi Schlünssen, Jakob Hjort Bønløkke, Finn Rasmussen, Zara Ann Stokholm, Michael Brun Andersen, Hans Kromhout, Henrik Albert Kolstad","doi":"10.1136/oemed-2023-108964","DOIUrl":"10.1136/oemed-2023-108964","url":null,"abstract":"<p><strong>Background: </strong>Respirable crystalline silica is a well-known cause of silicosis but may also be associated with other types of interstitial lung disease. We examined the associations between occupational exposure to respirable crystalline silica and the risk of idiopathic interstitial pneumonias, pulmonary sarcoidosis and silicosis.</p><p><strong>Methods: </strong>The total Danish working population was followed 1977-2015. Annual individual exposure to respirable crystalline silica was estimated using a quantitative job exposure matrix. Cases were identified in the Danish National Patient Register. We conducted adjusted analyses of exposure-response relations between cumulative silica exposure and other exposure metrics and idiopathic interstitial pneumonias, pulmonary sarcoidosis and silicosis.</p><p><strong>Results: </strong>Mean cumulative exposure was 125 µg/m³-years among exposed workers. We observed increasing incidence rate ratios with increasing cumulative silica exposure for idiopathic interstitial pneumonias, pulmonary sarcoidosis and silicosis. For idiopathic interstitial pneumonias and pulmonary sarcoidosis, trends per 50 µg/m³-years were 1.03 (95% CI 1.02 to 1.03) and 1.06 (95% CI 1.04 to 1.07), respectively. For silicosis, we observed the well-known exposure-response relation with a trend per 50 µg/m³-years of 1.20 (95% CI 1.17 to 1.23).</p><p><strong>Conclusion: </strong>This study suggests that silica inhalation may be related to pulmonary sarcoidosis and idiopathic interstitial pneumonias, though these findings may to some extent be explained by diagnostic misclassification. The observed exposure-response relations for silicosis at lower cumulative exposure levels than previously reported need to be corroborated in analyses that address the limitations of this study.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"279-286"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432463","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":"Measuring lung diffusing capacity: an opportunity for improved medical surveillance and disability evaluation of coal miners.","authors":"Leonard H T Go, Kirsten S Almberg, Lee S Friedman, Lauren Zell-Baran, Cecile S Rose, Robert A Cohen","doi":"10.1136/oemed-2023-109380","DOIUrl":"10.1136/oemed-2023-109380","url":null,"abstract":"<p><strong>Objectives: </strong>Spirometry is the primary lung function test utilised for medical surveillance and disability examination for coal mine dust lung disease. However, spirometry likely underestimates physiologic impairment. We sought to characterise abnormalities of single-breath diffusing capacity for carbon monoxide (D_LCO) among a population of former coal miners.</p><p><strong>Methods: </strong>Data from 3115 former coal miners evaluated at a West Virginia black lung clinic between 2006 and 2015 were retrospectively analysed to study the association between diffusion impairment (abnormally low D_LCO), resting spirometry and the presence and severity of coal workers' pneumoconiosis on chest radiography. We developed ordinary least squares linear regression models to evaluate factors associated with per cent predicted D_LCO (D_LCOpp).</p><p><strong>Results: </strong>Diffusion impairment was identified in 20.2% of subjects. Ten per cent of all miners with normal spirometry had diffusion impairment including 7.4% of never smokers. The prevalence of diffusion impairment increased with worsening radiographic category of pneumoconiosis. Mean D_LCOpp decreased with increasing small opacity profusion subcategory in miners without progressive massive fibrosis. Linear regression analysis also showed significant decreases in D_LCOpp with increasing small opacity profusion and presence of large opacities.</p><p><strong>Conclusions: </strong>Diffusion impairment is common among former coal miners, including among never smokers, miners without radiographic pneumoconiosis and miners with normal spirometry. These findings demonstrate the value of including D_LCO testing in disability examinations of former coal miners and an important role for its use in medical surveillance of working miners to detect early chronic lung disease.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"296-301"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420071","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":"Effects of interventions implemented by occupational health professionals to prevent work-related stress complaints: a systematic review.","authors":"Suzanne Orhan Pees, Sandra van Oostrom, Hanneke Lettinga, Frederieke Schaafsma, Karin Proper","doi":"10.1136/oemed-2024-109454","DOIUrl":"10.1136/oemed-2024-109454","url":null,"abstract":"<p><p>Work-related stress complaints are a growing societal problem. Occupational health professionals often play a key role in its prevention. However, studies providing an overview of preventive interventions and their effectiveness are lacking. Therefore, the aim of this systematic review was to summarise the evidence on the effectiveness of interventions delivered by occupational health professionals to prevent work-related stress complaints.A systematic search in PubMed, Embase, PsycInfo and Medline was performed in May 2023 based on PICO (population, intervention, control and outcomes) elements. Inclusion criteria were: peer-reviewed papers with a randomised controlled trial design, quasi-experimental design and pre-post evaluations with a control group; working populations not on sick leave; interventions delivered by occupational health professionals; and stress outcomes. Data were extracted using a predefined extraction form, risk of bias was assessed using the Cochrane risk of bias tool for randomised trials (RoB-2) and Risk of Bias in non-randomised Studies-of Interventions tool, and a narrative analysis was performed to summarise data.Nine studies were included in this review and encompassed a diverse range of populations, interventions and professionals involved, outcome measures, and effects observed. Five studies found either mixed effects on stress outcomes, short-term positive effects, or positive effects in a subgroup of participants demonstrating high adherence to the intervention.As the results show mixed findings, a high risk of bias, and a limited number of studies was available, more research is needed to the effectiveness of the interventions and the factors underlying this.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"321-328"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538269","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":"Relationships between asbestos exposure and pleural plaques: dose and time effects using fractional polynomials.","authors":"Morgane Menant, Ilyes Benlala, Isabelle Thaon, Pascal Andujar, Benoist Julia, Patrick Brochard, Christos Chouaid, Bénédicte Clin, Antoine Gislard, Celine Gramond, Christophe Paris, Jean-Claude Pairon, Fleur Delva","doi":"10.1136/oemed-2023-108975","DOIUrl":"10.1136/oemed-2023-108975","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to confirm the relationship between several parameters of exposure to asbestos and pleural plaques (PP) using data from a large cohort of retired workers occupationally exposed to asbestos in France.</p><p><strong>Method: </strong>A large screening programme, including high-resolution CT (HRCT) examinations at inclusion and two other HRCT campaigns, was organised from 2003 to 2016 in four regions of France for voluntary, formerly asbestos-exposed workers. Exposure to asbestos has been evaluated by industrial hygienists based on the complete work history. The time since first exposure, the time since last exposure, Cumulative Exposure Index and maximum level of exposure to asbestos, were used in logistic regression using fractional polynomials to model the relationship with PP.</p><p><strong>Results: </strong>The study included 5392 subjects with at least one HRCT available. There was a significant non-linear effect of time since first exposure, time since last exposure and Cumulative Exposure Index to asbestos on the presence of PP. The risk of PP increased with increasing Cumulative Exposure Index to asbestos adjusted for time since first exposure, age and smoking status. Models also show that PP odds rise with increasing time since first exposure adjusted for cumulative index exposure, age and smoking status. PP odds decrease when time since last exposure increases.</p><p><strong>Conclusion: </strong>The study provides new data on the link between asbestos exposure and the presence of PP using fractional polynomials with non-linear relationships for time exposure parameters and asbestos exposure parameters.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"313-319"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458385","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":"Exploring the role of silica exposure in the aetiology of interstitial lung disorders.","authors":"David Fishwick, Geoffrey Calvert, Deborah Yates","doi":"10.1136/oemed-2024-109599","DOIUrl":"10.1136/oemed-2024-109599","url":null,"abstract":"","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"277-278"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432462","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":"Thin seams and small mines are associated with higher exposures to respirable crystalline silica in US underground coal mines.","authors":"Yuan Shao, Kirsten S Almberg, Lee S Friedman, Robert A Cohen, Leonard H T Go","doi":"10.1136/oemed-2023-109347","DOIUrl":"10.1136/oemed-2023-109347","url":null,"abstract":"<p><strong>Objectives: </strong>Previous radiologic and histopathologic studies suggest respirable crystalline silica (RCS) overexposure has been driving the resurgence of pneumoconiosis among contemporary US coal miners, with a higher prevalence of severe disease in Central Appalachia. We sought to better understand RCS exposure among US underground coal miners.</p><p><strong>Methods: </strong>We analysed RCS levels, as measured by respirable quartz, from coal mine dust compliance data from 1982 to 2021.</p><p><strong>Results: </strong>We analysed 322 919 respirable quartz samples from 5064 US underground coal mines. Mean mine-level respirable quartz percentage and mass concentrations were consistently higher for Central Appalachian mines than the rest of the USA. Mean mine-level respirable quartz mass concentrations decreased significantly over time, from 0.116 mg/m³ in 1982 to as low as 0.017 mg/m³ for Central Appalachian mines, and from 0.089 mg/m³ in 1983 to 0.015 mg/m³ in 2020 for the rest of the USA. Smaller mine size, location in Central Appalachia, lack of mine safety committee and thinner coal seams were predictive of higher respirable quartz mass concentrations.</p><p><strong>Conclusions: </strong>These data substantially support the association between RCS overexposure and the resurgence of coal workers' pneumoconiosis in the USA, particularly in smaller mines in Central Appalachia.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"308-312"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469794","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":"Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal.","authors":"Chelsea Gaviola, Laura Nicolaou, Arun K Sharma, Ram Chandyo, David Parker, Laxman Shrestha, Santa K Das, Gurumurthy Ramachandran, Steven M Thygerson, Laura Beres, William Checkley","doi":"10.1136/oemed-2024-109516","DOIUrl":"10.1136/oemed-2024-109516","url":null,"abstract":"<p><strong>Objectives: </strong>Brick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE and identify factors associated with respiratory PPE use.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use.</p><p><strong>Results: </strong>We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users.</p><p><strong>Conclusions: </strong>Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"287-295"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492855","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":"Lack of association of impaired upper airway sensation with the presence or absence of obstructive sleep apnoea or chronic rhinosinusitis in World Trade Center responders.","authors":"Jag Sunderram, Alicia Legard, Adriana De Resende, Kathleen Black, Iris G Udasin, Shou-En Lu, Horacio Romero Castillo, Sri Saranya Ravi, Anna E Mullins, Rafael E de la Hoz, David M Rapoport, Indu Ayappa","doi":"10.1136/oemed-2023-109262","DOIUrl":"10.1136/oemed-2023-109262","url":null,"abstract":"<p><strong>Objective: </strong>Examine sensory function of the upper airway in four groups of subjects recruited from the World Trade Centre General Responder Cohort (WTCGRC), with/without obstructive sleep apnoea (OSA), and with/without chronic rhinosinusitis (CRS).</p><p><strong>Methods: </strong>Upper airway sensory function was determined using 2-point discrimination (2-PD) and vibration threshold (VT) in 163 WTCGRC subjects with both OSA and CRS (cases), OSA or CRS alone and without OSA or CRS (controls). Presence of OSA was determined from clinical sleep studies or home sleep testing. Presence of CRS was determined by nasal symptom questionnaire. The relationship between the presence of OSA and CRS and upper airway sensory impairment was assessed using linear regression analysis with each of 2PD and VT sensory threshold values as the dependent variable; OSA, CRS and their interaction were the independent variables. Age, gender and body mass index were covariates in the statistical model. The primary analysis was comparison of OSA+CRS versus controls (no OSA and no CRS) evaluated by linear contrasts.</p><p><strong>Results: </strong>There were no differences in 2-PD or VT in those with OSA+CRS, OSA and CRS alone or controls. However, both 2-PD and VT were significantly higher in the WTCGRC controls compared with values seen in historical controls using the same methodology (median 2-PD 13.0; CI (11.0 to 13.5) vs 10.5; CI (8 to 11); VT: mean±SEM (9.3±0.6 vs 2.2±0.1)).</p><p><strong>Conclusion: </strong>While no differences were found in upper airway sensation between cases of OSA and CRS versus controls in the WTGRC population, there was evidence of impaired upper airway sensation in the WTGRC overall.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"302-307"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317929","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":"Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study.","authors":"Stephanie Mathieson, Alex Collie, Christopher G Maher, Christina Abdel Shaheed, Ting Xia, Stephen Gilbert, Giovanni E Ferreira, Michael F Di Donato","doi":"10.1136/oemed-2023-109369","DOIUrl":"10.1136/oemed-2023-109369","url":null,"abstract":"<p><strong>Objectives: </strong>The increase in gabapentinoid prescribing is paralleling the increase in serious harms. To describe the low back pain workers compensation population whose management included a gabapentinoid between 2010 and 2017, and determine secular trends in, and factors associated with gabapentinoid use.</p><p><strong>Methods: </strong>We analysed claim-level and service-level data from the Victorian workers' compensation programme between 1 January 2010 and 31 December 2017 for workers with an accepted claim for a low back pain injury and who had programme-funded gabapentinoid dispensing. Secular trends were calculated as a proportion of gabapentinoid dispensings per year. Poisson, negative binomial and Cox hazards models were used to examine changes over time in incidence and time to first dispensing.</p><p><strong>Results: </strong>Of the 17 689 low back pain claimants, one in seven (14.7%) were dispensed at least one gabapentinoid during the first 2 years (n=2608). The proportion of workers who were dispensed a gabapentinoid significantly increased over time (7.9% in 2010 to 18.7% in 2017), despite a reduction in the number of claimants dispensed pain-related medicines. Gabapentinoid dispensing was significantly associated with an opioid analgesic or anti-depressant dispensing claim, but not claimant-level characteristics. The time to first gabapentinoid dispensing significantly decreased over time from 311.9 days (SD 200.7) in 2010 to 148.2 days (SD 183.1) in 2017.</p><p><strong>Conclusions: </strong>The proportion of claimants dispensed a gabapentinoid more than doubled in the period 2010-2017; and the time to first dispensing halved during this period.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"245-251"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088242","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 particle exposure and chronic kidney disease: a cohort study in Swedish construction workers.","authors":"Karl Kilbo Edlund, Eva M Andersson, Martin Andersson, Lars Barregard, Anders Christensson, Sandra Johannesson, Florencia Harari, Nicola Murgia, Kjell Torén, Leo Stockfelt","doi":"10.1136/oemed-2023-109371","DOIUrl":"10.1136/oemed-2023-109371","url":null,"abstract":"<p><strong>Objectives: </strong>Increasing epidemiological and experimental evidence suggests that particle exposure is an environmental risk factor for chronic kidney disease (CKD). However, only a few case-control studies have investigated this association in an occupational setting. Hence, our objective was to investigate associations between particle exposure and CKD in a large cohort of Swedish construction workers.</p><p><strong>Methods: </strong>We performed a retrospective cohort study in the Swedish Construction Workers' Cohort, recruited 1971-1993 (n=286 089). A job-exposure matrix was used to identify workers exposed to nine different particulate exposures, which were combined into three main categories (inorganic dust and fumes, wood dust and fibres). Incident CKD and start of renal replacement therapy (RRT) were obtained from validated national registries until 2021 and analysed using adjusted Cox proportional hazards models.</p><p><strong>Results: </strong>Exposure to inorganic dust and fumes was associated with an increased risk of CKD and RRT during working age (adjusted HR for CKD at age <65 years 1.15, 95% CI 1.05 to 1.26). The elevated risk did not persist after retirement age. Exposure to cement dust, concrete dust and diesel exhaust was associated with CKD. Elevated HRs were also found for quartz dust and welding fumes.</p><p><strong>Conclusions: </strong>Workers exposed to inorganic particles seem to be at elevated risk of CKD and RRT. Our results are in line with previous evidence of renal effects of ambient air pollution and warrant further efforts to reduce occupational and ambient particle exposure.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"238-243"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175757","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}