Scandinavian journal of work, environment & health最新文献

{"title":"Occupational exposure to carcinogenic substances in night versus day shift jobs.","authors":"Jaclyn Parks, Umaimah Zanif, Parveen Bhatti","doi":"10.5271/sjweh.4307","DOIUrl":"https://doi.org/10.5271/sjweh.4307","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine whether night shift work was associated with exposure to carcinogenic hazards, independent of occupation and industry.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 16 250 job records reported by 7023 participants. Participants provided lifetime job histories, including shift schedules and exposures to hazardous agents. Carcinogenic agents included established carcinogens classified by the International Agency for Research on Cancer, as well as broader exposure categories that may potentially contain carcinogenic constituents. Jobs involving ≥1 and ≥7 night shifts/month were compared with day-shift jobs. Occupations and industries were coded using National Occupational Classification (2016) and North American Industry Classification System (2017) codes. Generalized linear mixed models with random intercepts for participant, occupation code (2-digit level), and industry code (2-digit level) were used to estimate odds ratios (OR) for exposures associated with night- versus day-shift work, adjusting for biological sex and job start year.</p><p><strong>Results: </strong>Night shifts were associated with greater odds of any hazardous exposure [≥1 night shift/month: OR 3.1, 95% confidence interval (CI) 2.6-3.8; ≥7 night shifts/month: OR 3.1, 95% CI 2.5-3.8]. Significant associations were observed for multiple agents, including asbestos, degreasing agents, diesel engine exhaust, gasoline engine exhaust, ionizing radiation, mineral/cutting/lubricating oil, paints/stains/varnish, welding fume, and wood dust.</p><p><strong>Conclusions: </strong>Night-shift work was associated with an increased likelihood of self-reported exposure to multiple potentially carcinogenic agents, independent of broad occupational and industry groupings. Future research with more granular task-level information and quantitative exposure assessment will be important for clarifying the mechanisms underlying these differences.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842286","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":"Labor market participation among patients referred to occupational medicine with low-back pain: a Danish nationwide register-based cohort study.","authors":"Mathias Moselund Rønnow, Jesper Medom Vestergaard, Dorte Rytter, Morten Fenger-Grøn, Morten Vejs Willert, Johan Hviid Andersen, Marianne Kyndi","doi":"10.5271/sjweh.4305","DOIUrl":"https://doi.org/10.5271/sjweh.4305","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to characterize long-term labor market participation from five years before to five years after assessment at departments of occupational medicine among patients referred with low-back pain (LBP) and to compare these patterns with those in a matched general working population. Secondary objectives were to assess subgroup differences and time to return to work.</p><p><strong>Methods: </strong>In this nationwide register-based cohort study, we included Danish residents aged 18-60 years referred for assessment (N=8256) and matched comparators (1:5 on sex, age, and calendar year; N=41 280). Using weekly register data, we calculated the prevalence of different labor market states before and after assessment as well as propensity score-weighted prevalence differences and ratios, and we performed stratified analyses. We estimated the five-year cumulative incidence of return to work among individuals on temporary public benefits using the Aalen-Johansen estimator.</p><p><strong>Results: </strong>At assessment, 37% of patients were working versus 83% of comparators. Five years post-assessment, 40% of patients were working and 32% received permanent health-related public benefits. We observed substantial heterogeneity, with larger deficits in work participation in several subgroups. Among patients on temporary public benefits at assessment, the five-year cumulative incidence of return to work was 42%, with no increase in overall work prevalence.</p><p><strong>Conclusions: </strong>LBP patients had persistently poorer labor market participation than matched comparators, with declines already evident one year before assessment. Prognosis was particularly poor among older patients, those with weaker labor market participation at assessment, and those with comorbidities. These findings highlight the need for early identification and timely intervention and referral.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842328","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":"Work-related psychosocial factors and working life expectancy among Finnish public sector employees aged 50 years or older.","authors":"Eija Haukka, Katriina Heikkilä, Jaana Pentti, Jussi Vahtera, Holendro Singh Chungkham, Paola Zaninotto, Mika Kivimäki, Jenni Ervasti, Sari Stenholm","doi":"10.5271/sjweh.4298","DOIUrl":"10.5271/sjweh.4298","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the associations between work-related psychosocial factors and working life expectancy (WLE) across occupational groups among Finnish public sector employees aged ≥50 years.</p><p><strong>Methods: </strong>In this cohort study, 70 662 Finnish public sector employees completed surveys on work-related psychosocial factors in 2000-2002, 2004, 2008, 2011-2012, 2013-2014, and 2015-2016, with each participant responding at least once at age ≥50 years (response rates 66-71%; 80% female). Survey data were linked to pensionable earnings records to verify work participation until 31 December 2018. WLE WLE between ages 50 and 68 was estimated using a multi-state life tables approach. Analyses were conducted among three occupational groups: managers and specialized professionals, non-manual professionals, and service and manual workers.</p><p><strong>Results: </strong>The overall WLE at age 50 was 13.1 years [95% confidence interval (CI) 13.1-13.2]. Work-related psychosocial factors were associated with shorter WLE across all occupational groups, with WLE shortening from the highest to the lowest occupational group. High effort-reward imbalance (ERI) was associated with the shortest WLE, approximately five months shorter than among employees with low ERI. Compared with managers and specialized professionals with low psychosocial risks, high ERI, high job strain, high relational or procedural injustice were each associated with an approximately 1-year shorter WLE among service and manual workers. Occupational group showed a stronger association with WLE than the accumulation of psychosocial risk factors. No sex differences in WLE were observed.</p><p><strong>Conclusion: </strong>These findings suggest that promoting favorable psychosocial working conditions may extend working careers and reduce inequalities in working life participation, particularly among service and manual workers.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"272-281"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699692","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":"Clinical and screening utility of the Burnout Assessment Tool: A comparative evaluation of BAT23, BAT12 and BAT4 in Sweden.","authors":"Emina Hadžibajramović E, Isabelle Dahlqvist, Ingibjörg H Jonsdottir, Hans De Witte","doi":"10.5271/sjweh.4286","DOIUrl":"10.5271/sjweh.4286","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical burnout may have serious personal and societal impacts, such as reduced productivity, prolonged sick leave and long rehabilitation. Regular screening using clinically relevant cut-offs to identify individuals at risk is essential for effective prevention. This study aimed to: (i) establish Swedish clinical cut-off scores for the Burnout Assessment Tool (BAT) versions (ie., BAT23, BAT12, BAT4); (ii) assess the BAT4's ability to classify burnout severity; and (iii) calculate burnout complaints in the Swedish workforce.</p><p><strong>Methods: </strong>A national representative sample of the Swedish working population (N=1603) and a burned-out group (N=159) diagnosed with exhaustion disorder (ED) were surveyed using BAT23, BAT12, and BAT4. Receiver operating characteristic (ROC) analyses determined diagnostic accuracy and cut-offs for mild (orange) and severe (red) burnout complaints. A sensitivity analysis using clinician-confirmed ED patients (N=25) validated findings.</p><p><strong>Results: </strong>BAT23 showed the highest accuracy in differentiating between mild and severe complaints. Among the subscales, exhaustion performed best. BAT12 showed good accuracy at the orange and slightly reduced sensitivity at the red cut-off. BAT4, while showing excellent sensitivity (0.93) at the orange cut-off, had poor sensitivity (0.47) at the red cut-off, limiting its clinical utility. Prevalence estimates using Swedish cut-offs showed approximately 13% of the workforce had severe burnout complaints (BAT23 and BAT12).</p><p><strong>Conclusions: </strong>BAT23 is recommended for comprehensive assessments; BAT12 is useful for workplace screening where a shorter questionnaire is required and BAT4 for broad organizational screening using only the orange cut-off. Findings support the structured application of BAT across varying settings and a deeper understanding of the BAT4.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"263-271"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469174","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":"Development of a European job exposure matrix (EuroJEM) for psychosocial exposures and their association with diagnosed depression in register-based cohorts.","authors":"Laura Salonen, Daniel Falkstedt, Kuan-Yu Pan, Maria Albin, Ingrid S Mehlum, Karina Undem, Taina Leinonen, Svetlana Solovieva","doi":"10.5271/sjweh.4279","DOIUrl":"10.5271/sjweh.4279","url":null,"abstract":"<p><strong>Objective: </strong>This study developed a European job exposure matrix (EuroJEM) for psychosocial work factors in order to examine their prospective associations with diagnosed depression in three register-based Nordic cohorts.</p><p><strong>Methods: </strong>National, gender-specific psychosocial JEM from Finland, Norway, and Sweden were evaluated for similarities in exposures, exposure definitions, and occupational coding. The EuroJEM harmonized two exposures: quantitative job demands and decision authority. Disagreements on exposure categories across the national JEM were addressed among experts. Associations between exposures and diagnosed depression were examined across three register-based cohorts.</p><p><strong>Results: </strong>The EuroJEM provides gender-specific exposure categories, based on the proportion of workers exposed, for 371 ISCO-88 (COM - European version of the International Standard Classification of Occupations) occupational codes. All associations were similar across the three cohorts, except for medium-high / high likelihood of exposure to high job demands among women. The pooled hazard ratios (pHR) for depression among workers with a medium-high / high likelihood of exposure to low decision authority had pHR of 1.50 [95% confidence interval (CI) 1.33-1.68] among men and 1.28 (95% CI 1.22-1.35) among women. High strain jobs had pHR of 1.19 (95% CI 1.15-1.24) and 1.07 (95% CI 1.01-1.14) and active jobs 0.79 (95% CI 0.72-0.87) and 0.86 (95% CI 0.79-0.94) among men and women, respectively. The associations between job demands and depression were less clear, especially among women.</p><p><strong>Conclusion: </strong>We found consistent associations between diagnosed depression and EuroJEM-based psychosocial exposures. Especially decision authority and job strain indicate a good performance of this JEM. The performance for job demands may be suboptimal.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"252-262"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378387","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":"Goodbye work-related musculoskeletal disorders, welcome musculoskeletal health! A call for action.","authors":"P Paul F M Kuijer, Pieter Coenen","doi":"10.5271/sjweh.4304","DOIUrl":"10.5271/sjweh.4304","url":null,"abstract":"","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"191-194"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676444","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":"Association between job insecurity and cardiovascular diseases in workers with type 2 diabetes mellitus.","authors":"Heejoo Park, Jian Lee, Youngsun Park, Juho Sim, Jin-Ha Yoon, Byungyoon Yun","doi":"10.5271/sjweh.4272","DOIUrl":"10.5271/sjweh.4272","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzes the association between job insecurity, measured by cumulative unemployment, and the risk of cardiovascular disease (CVD) among middle-aged workers with type 2 diabetes mellitus.</p><p><strong>Methods: </strong>We utilized data from the National Health Insurance Service of Korea, focusing on patients with type 2 diabetes, aged 40-50 who were continuously employed in 2009-2010. Job insecurity was defined by cumulative unemployment in 2012-2016 and categorized as stable, partially stable, or unstable. Participants were followed until December 2023, with incident CVD as the primary outcome. Cox regression models estimated sex-stratified hazard ratios (HR) with 95% confidence intervals (CI), with additional subgroup and sensitivity analyses.</p><p><strong>Results: </strong>Among 128 704 participants (107 071 males and 21 633 females; median age 51 years), CVD occurred among 6.1% of males and 3.9% of females. Job insecurity was associated with an increased risk of CVD [males: HR 1.12 (95% CI 1.05-1.19) for partially stable, HR 1.25 (95% CI 1.16-1.34) for unstable; females: HR 1.00 (95% CI 0.85-1.19) for partially stable, HR 1.33 (95% CI 1.13-1.57) for unstable]. Subgroup analyses showed particularly elevated risks among low-income males and high-income females. By age, males aged 40-49 in the partially stable and unstable groups had increased CVD risks, while those aged 50-59 had the highest risk in the unstable group. Among females, significant associations appeared only in the 40-49 age group.</p><p><strong>Conclusions: </strong>Among middle-aged workers with type 2 diabetes, prolonged job insecurity was significantly associated with an increased risk of CVD.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"292-301"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106838","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 healthy working life expectancy and its difference by workload group among aged over 50 years: a longitudinal perspective.","authors":"Jingxuan Ma, Yuzhen Pingcuo, XiaoKe Jin, Juan Wang, Hongjian Wang, Yajia Lan","doi":"10.5271/sjweh.4281","DOIUrl":"10.5271/sjweh.4281","url":null,"abstract":"<p><strong>Objectives: </strong>While extending working life is a key policy objective, its impact on population health is not fully understood. This study investigated the long-term effects of physical and psychological workloads as well as initial health-work status on healthy working life expectancy (HWLE), working life expectancy (WLE), and total life expectancy (TLE) at age 50.</p><p><strong>Methods: </strong>Data were drawn from the Health and Retirement Study covering 1992-2022. The study population consisted of US adults aged ≥50 years. We implemented a multi-state life table approach based on continuous-time Markov models. Transition intensities between health and employment states were modeled to derive HWLE. Analyses were stratified by physical and psychological workload levels across three temporal cohorts.</p><p><strong>Results: </strong>Over the study period, WLE increased significantly for both sexes, while TLE slightly declined. Conversely, HWLE decreased substantially across all groups and health states. Individuals in high physical workload groups experienced shorter WLE and HWLE compared to low workload groups. High psychological load was associated with a lower proportion of healthy working years, particularly among those with initial health limitations.</p><p><strong>Conclusions: </strong>The extension of working lives is occurring at the cost of healthy years. Physical and psychological workloads exert distinct but equally detrimental effects on the sustainability of a healthy working life. These findings underscore the urgent need for targeted workplace interventions to protect worker health, particularly for vulnerable groups in high-stress or physically demanding jobs.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"282-291"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309746","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":"Re: Park et al. \"Association between job insecurity and cardiovascular disease among workers with type 2 diabetes mellitus\".","authors":"Johana Shiomara Paiva Suarez","doi":"10.5271/sjweh.4293","DOIUrl":"10.5271/sjweh.4293","url":null,"abstract":"&lt;p&gt;&lt;p&gt;We read with great interest the recent article by Park H et al (1), entitled \"Association between job insecurity and cardiovascular disease among workers with type 2 diabetes mellitus\". The study provides important evidence on the impact of labor-related social determinants on cardiovascular health in a particularly vulnerable population: workers living with type 2 diabetes mellitus. Previous research has consistently shown that psychosocial work-related factors, including job strain and employment insecurity, are associated with an increased risk of cardiovascular disease (2, 3). In this context, the study by Park and colleagues represents a valuable contribution to the field of occupational epidemiology. The use of a large national cohort derived from the Korean National Health Insurance Service, including more than 120 000 participants and a long follow-up period, strengthens the validity of the findings. Furthermore, the possibility of exploring differences according to sex and socioeconomic status aligns with the broader framework of social determinants of health (4). Nevertheless, several aspects merit further consideration and could contribute to a more nuanced interpretation of the results. First, the operational definition of job insecurity based on cumulative unemployment duration provides an objective and measurable indicator. However, this approach may not fully capture the broader spectrum of contemporary labor precariousness. Modern labor markets increasingly involve temporary contracts, underemployment, informal employment arrangements, and unstable contractual conditions. These forms of precarious employment may exert substantial effects on workers' health but may not be adequately reflected by unemployment duration alone. Therefore, future studies may benefit from incorporating multidimensional measures of employment quality and labor instability. Second, although the authors appropriately acknowledged the possibility of residual confounding in their discussion-particularly regarding unmeasured factors such as dietary habits, genetic predisposition, and limitations in capturing smoking behavior-additional sources of residual confounding may still be relevant. Factors such as depression, access to healthcare services, adherence to antidiabetic treatment, and dietary quality could simultaneously influence both employment stability and cardiovascular outcomes. This issue is especially important among individuals with diabetes mellitus, given their increased cardiometabolic vulnerability (5). Third, the authors also recognized that the generalizability of their findings may be limited due to differences in occupational and cultural contexts across countries. In this regard, it is important to highlight that South Korea has a nearly universal health insurance system and a specific labor market structure. Consequently, extrapolating these findings to middle-income countries or settings characterized by high levels of labor inform","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"343-344"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594405","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":"Employers' utilization of and collaboration with occupational health services in preventive occupational health and safety management.","authors":"Magnus Akerstrom, Jens Wahlström, Cathrine Reineholm, Ingibjörg H Jonsdottir","doi":"10.5271/sjweh.4269","DOIUrl":"10.5271/sjweh.4269","url":null,"abstract":"<p><strong>Objectives: </strong>Occupational health services (OHS) are an important resource within employers' preventive occupational health and safety management (OHSM). The aims of this study were to investigate employers' utilization of OHS in preventive OHSM and identify decisive contextual, structural and/or processual conditions in ensuring successful collaboration with OHS in preventive OHSM.</p><p><strong>Methods: </strong>A total of 122 organizations within the Swedish welfare sector (education, social services and healthcare), of which 112 had access to OHS, responded to a quantitative survey on the organization and management of their preventive OHSM. Responses were investigated using both conventional descriptive analysis and configurational analysis.</p><p><strong>Results: </strong>Only a third of the participating organizations utilized OHS to a high or very high degree within their preventive OHSM. Factors for successful collaboration with OHS within preventive OHSM included having a contract that made it possible to use OHS and having established routines for involving OHS in the early phases of preventive measures, especially when managing external demands and complex challenges.</p><p><strong>Conclusions: </strong>The utilization of OHS within preventive OHSM is limited, and increased utilization may improve the ability of employers to successfully implement OHSM. The successful organization of OHSM practices and the OHS contract were key factors in a successful collaboration with OHS. Working together in preventive OHSM may also strengthen social capital for all stakeholders, which could further enhance collaboration.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"333-342"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901116","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}