Scandinavian journal of work, environment & health最新文献

{"title":"Effects of the Labor Inspection Authority's regulatory tools on physician-certified sick leave and employee health in Norwegian home-care services - a cluster randomized controlled trial.","authors":"Bjørnar Finnanger Garshol, Stein Knardahl, Jan Shahid Emberland, Øivind Skare, Håkon A Johannessen","doi":"10.5271/sjweh.4126","DOIUrl":"10.5271/sjweh.4126","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the effects of the Labor Inspection Authority's regulatory tools on physician-certified sick leave and self-reported health outcomes among employees in municipal home-care services in Norway.</p><p><strong>Methods: </strong>We conducted a cluster-randomized controlled trial in the home-care service sector, and 96 eligible municipalities were randomly assigned to one of three groups: (i) labor inspection visits, based on the Labor Inspection Authority's standard inspections; (ii) guidance-through-workshops, where participants from home-care services met with labor inspectors to receive information and discuss relevant topics; and (iii) the control group. Data on employee self-reported health (N=1669) were collected at baseline and 6 and 12 months after the interventions. Additionally, registry data (N=1202) on diagnosis specific physician-certified sick leave were collected for 18 months after the interventions.</p><p><strong>Results: </strong>We found no statistically significant effects of either intervention on self-reported health outcomes. There was, for both interventions, a pattern of decrease in days and periods of physician-certified sick leave due to musculoskeletal diagnoses and increase in days and periods of physician-certified sick leave due to psychological diagnoses, but these were not statistically significant.</p><p><strong>Conclusion: </strong>Labor inspections and guidance-through-workshops had no statistically significant effect on self-reported health and physician-certified sick leave. The results should be interpreted with caution given the low response rate and subsequent attrition, and in the context of the COVID-19 pandemic. Future studies, in various industries, should further elucidate whether regulatory tools influence employee health and sick leave due to musculoskeletal and mental disorders.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"28-38"},"PeriodicalIF":6.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10924761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413831","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":"Parkinson's disease and occupational exposure to organic solvents in Finland: a nationwide case-control study.","authors":"Markku Sallmén, Igor Burstyn, Sanni Uuksulainen, Aki Koskinen, Christer Hublin, Markku Sainio","doi":"10.5271/sjweh.4125","DOIUrl":"10.5271/sjweh.4125","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between Parkinson's disease (PD) and occupational exposure to organic solvents generally and chlorinated hydrocarbons (CHC) in particular.</p><p><strong>Methods: </strong>We assembled a Finland-wide case-control study for birth years 1930-1950 by identifying incident PD cases from the register of Reimbursement of Medical Costs and drawing two controls per case using incidence density sampling from the Population Information System, matched on sex, birth year, and residency in Finland in 1980-2014. Occupation and socioeconomic status (SES) were identified from national censuses. We assessed cumulative occupational exposures via FINJEM job-exposure matrix. Smoking was based on occupation-specific prevalence by sex from national surveys. We estimated confounder-adjusted PD incidence rate ratios (IRR) via logistic regression and evaluated their sensitivity to errors in FINJEM through probabilistic bias analysis (PBA).</p><p><strong>Results: </strong>Among ever-employed, we identified 17 187 cases (16.0% potentially exposed to CHC) and 35 738 matched controls. Cases were more likely to not smoke and belong to higher SES. Cumulative exposure (CE) to CHC (per 100 ppm-years, 5-year lag) was associated with adjusted IRR 1.235 (95% confidence interval 0.986-1.547), with stronger associations among women and among persons who had more census records. Sensitivity analyses did not reveal notable associations, but stronger effects were seen in the younger birth cohort (1940-1950). PBA produced notably weaker associations, yielding a median IRR 1.097 (95% simulation interval 0.920-1.291) for CHC.</p><p><strong>Conclusion: </strong>Our findings imply that PD is unlikely to be related to typical occupational solvent exposure in Finland, but excess risk cannot be ruled out in some highly exposed occupations.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"39-48"},"PeriodicalIF":6.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10924827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692268","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":"The impact of employment on mental healthcare use among people with disability: distinguishing between part- and full-time employment.","authors":"Karinna Saxby, Helen Dickinson, Dennis Petrie, Anne Kavanagh, Zoe Aitken","doi":"10.5271/sjweh.4123","DOIUrl":"10.5271/sjweh.4123","url":null,"abstract":"<p><strong>Objective: </strong>Employment can improve mental health among people with disability (PWD), however, little is known about how different levels of workforce participation influence mental healthcare use. The aim of this study was to estimate the extent to which different levels of working hours are associated with changes in mental healthcare use among PWD.</p><p><strong>Methods: </strong>Data on working hours and healthcare use among working age PWD who were receiving government benefits (N=260 825) was obtained from Australian Census-linked administrative records between 2011 and 2019. Individual fixed effects panel models were used to estimate the impact of increased working hours on mental healthcare (services and prescriptions). Heterogeneity analyses by job security and key sociodemographic characteristics were conducted.</p><p><strong>Results: </strong>Compared to not working, we found that working 1-14, 15-29, and ≥30 hours per week was respectively associated with a 3.3%, 18.0%, and 9.9% reduction in the use of mental healthcare prescriptions as well as a 6.8%, 18.4%, and 22.3% reduction in the use of mental healthcare services by PWD. The effects were larger for PWD in more secure work and those living in rural and disadvantaged areas.</p><p><strong>Conclusions: </strong>Working more hours was associated with reduced mental healthcare use among PWD. Policy interventions should consider the broader benefits of enabling part-time and secure work placements for PWD, particularly for those living in rural and disadvantaged regions.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"598-609"},"PeriodicalIF":4.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41183537","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":"Development and evaluation of the gender-specific CONSTANCES job exposure matrix for physical risk factors in France.","authors":"Francesca Wuytack, Bradley A Evanoff, Ann Marie Dale, Fabien Gilbert, Marc Fadel, Annette Leclerc, Alexis Descatha","doi":"10.5271/sjweh.4118","DOIUrl":"10.5271/sjweh.4118","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to construct and evaluate a gender-specific job exposure matrix (JEM) for 27 physical work exposures, based on self-report.</p><p><strong>Methods: </strong>We constructed a JEM using questionnaire data on current physical exposures from 29 381 male and 35 900 female asymptomatic workers aged 18-69 years in the French CONSTANCES cohort study. We excluded workers with musculoskeletal pain to reduce potential reporting bias. We grouped 27 self-reported physical exposures using the French national job codes and stratified by gender. We compared individual and group-based exposures using the performance indicators Cohen's kappa (κ), sensitivity, specificity, and area under the receiver operating curve (AUC).</p><p><strong>Results: </strong>JEM validation showed fair-to-moderate agreement (κ 0.21-0.60) for most physical exposures for both genders except for 'reach behind' (poor), 'bend neck' (poor), 'finger pinch' (poor), standing' (good), 'use computer screen' (good), and 'use keyboard or scanner' (good). We found the highest AUC for 'standing' (men 0.85/ women 0.87), 'kneel/squat' (men 0.80/women 0.81), 'use computer screen' (men/women 0.81), and 'use keyboard or scanner' (men 0.82/ women 0.84). The AUC was <0.60 for only three exposures: 'bend neck' (men 0.58/women 0.57), 'finger pinch' (men 0.56/ women 0.55), and 'reach behind' (men 0.54/ women 0.51).</p><p><strong>Conclusion: </strong>The constructed JEM validation measures were comparable for men and women for all exposures. Further research will examine the predictive ability of this gender-specific JEM for musculoskeletal disorders and the relevance of gender-stratification in this process, knowing accuracy of each exposure.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"549-557"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10515650","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":"Predicting long-term sickness absence with employee questionnaires and administrative records: a prospective cohort study of hospital employees.","authors":"Solja T Nyberg, Marko Elovainio, Jaana Pentti, Philipp Frank, Jenni Ervasti, Mikko Härmä, Aki Koskinen, Laura Peutere, Annina Ropponen, Jussi Vahtera, Marianna Virtanen, Jaakko Airaksinen, G David Batty, Mika Kivimäki","doi":"10.5271/sjweh.4124","DOIUrl":"10.5271/sjweh.4124","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the utility of risk estimation derived from questionnaires and administrative records in predicting long-term sickness absence among shift workers.</p><p><strong>Methods: </strong>This prospective cohort study comprised 3197 shift-working hospital employees (mean age 44.5 years, 88.0% women) who responded to a brief 8-item questionnaire on work disability risk factors and were linked to 28 variables on their working hour and workplace characteristics obtained from administrative registries at study baseline. The primary outcome was the first sickness absence lasting ≥90 days during a 4-year follow-up.</p><p><strong>Results: </strong>The C-index of 0.73 [95% confidence interval (CI) 0.70-0.77] for a questionnaire-only based prediction model, 0.71 (95% CI 0.67-0.75) for an administrative records-only model, and 0.79 (95% CI 0.76-0.82) for a model combining variables from both data sources indicated good discriminatory ability. For a 5%-estimated risk as a threshold for positive test results, the detection rates were 76%, 74%, and 75% and the false positive rates were 40%, 45% and 34% for the three models. For a 20%-risk threshold, the corresponding detection rates were 14%, 8%, and 27% and the false positive rates were 2%, 2%, and 4%. To detect one true positive case with these models, the number of false positive cases accompanied varied between 7 and 10 using the 5%-estimated risk, and between 2 and 3 using the 20%-estimated risk cut-off. The pattern of results was similar using 30-day sickness absence as the outcome.</p><p><strong>Conclusions: </strong>The best predictive performance was reached with a model including both questionnaire responses and administrative records. Prediction was almost as accurate with models using only variables from one of these data sources. Further research is needed to examine the generalizability of these findings.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"610-620"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41183536","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":"Development and validation of a work-related risk score for upper-extremity musculoskeletal disorders in a French working population.","authors":"Clémence Rapicault, Yves Roquelaure, Julie Bodin, Natacha Fouquet, Sandrine Bertrais","doi":"10.5271/sjweh.4119","DOIUrl":"10.5271/sjweh.4119","url":null,"abstract":"<p><strong>Objectives: </strong>The aim was to develop an easy-to-use risk score based on occupational factors and to validate its performance to identify workers either having (diagnostic setting) or developing (prognostic setting) upper-extremity musculoskeletal disorders (UEMSD).</p><p><strong>Methods: </strong>This study relied on data from the Cosali prospective cohort conducted in a French working population. Diagnostic status for six UEMSD at inclusion and at follow-up was assessed by a standardized clinical examination. Data on occupational factors were collected through a self-administered questionnaire completed before the clinical examination at inclusion. The risk score was derived from a prediction model developed on data of 2,468 workers included in 2002-2003, and the validation sample is composed of 1,051 workers included later in 2004-2005. The prognostic performance of the risk score was assessed in workers without UEMSD at baseline.</p><p><strong>Results: </strong>A total of 13% and 12% of workers had a UEMSD at inclusion in the development and validation sample. The developed risk score includes physical, organizational and psychosocial factors at work. In the validation sample, this score had acceptable performance for identifying workers having or not UEMSD at baseline (AUC: 0.60 [95% CI 0.57 to 0.63]), in particular the negative predictive value was high (89%-90%). The baseline risk score showed similar performance for predicting incident UEMSD at follow-up examination.</p><p><strong>Conclusion: </strong>This score can be useful as a first-line risk assessment tool, especially for excluding the low-risk work situations from further intervention by an ergonomist. Further validation studies are needed to determine its performance among various working populations.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"558-568"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365901","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":"The impact of leisure-time physical activity and occupational physical activity on sickness absence. A prospective study among people with physically demanding jobs.","authors":"Margo Ketels, Thomas Belligh, Dirk De Bacquer, Els Clays","doi":"10.5271/sjweh.4120","DOIUrl":"10.5271/sjweh.4120","url":null,"abstract":"<p><strong>Objectives: </strong>This prospective study aimed to investigate the relation between occupational physical activity (OPA), leisure-time physical activity (LTPA) and sickness absence (SA). A second aim was to explore the possible interaction effects between OPA and LTPA in determining SA.</p><p><strong>Methods: </strong>The study is based on data from 304 workers in the service and manufacturing sector. Moderate-to-vigorous physical activity (MVPA) was measured by two Axivity AX3 accelerometers for 2-4 consecutive working days. Participants reported on the level of their physically demanding tasks by using a 5-item scale from the Job Content Questionnaire. Data on SA was provided by the administration departments of the participating companies during a 1 year follow-up period. We used negative binomial regression models for our statistical analysis.</p><p><strong>Results: </strong>After adjusting for potential confounders, physically demanding tasks were significantly associated with a higher number of SA episodes and days. Accelerometer-assessed MVPA during leisure time but not during work was correlated with lower SA. Our results show a significant interaction effect between MVPA during work and leisure time in the sense that more MVPA during work increased the risk for SA days only among workers with low LTPA, but not among workers with moderate-to-high LTPA.</p><p><strong>Conclusions: </strong>Our results indicate that LTPA and OPA are related to opposite SA outcomes. MVPA during leisure time and work interact in their effect on SA, whereas we found no interaction effect between LTPA and self-reported physically demanding tasks in determining SA.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"578-587"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10866622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592240","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":"Metabolic syndrome increases the risk for premature employment exit: A longitudinal study among 60 427 middle-aged and older workers from the Lifelines Cohort Study and Biobank.","authors":"Katharina Runge, Sander K R van Zon, Kène Henkens, Ute Bültmann","doi":"10.5271/sjweh.4113","DOIUrl":"10.5271/sjweh.4113","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine whether (i) metabolic syndrome (MetS) increases the risk for premature employment exit and (ii) a dose-response relationship exists between an increasing number of MetS components and premature employment exit among middle-aged and older workers.</p><p><strong>Methods: </strong>A sample of N=60 427 Dutch workers (40-64 years old) from the Lifelines Cohort Study and Biobank were examined using data from five measurement waves during a total median follow-up time of 4.2 years. MetS components were based on physical measures, blood markers, and medication use. Premature employment exit types (ie, unemployment, work disability, and early retirement) were determined using questionnaires. MetS and number of MetS components were examined as risk factors for premature employment exit using competing risk regression analysis.</p><p><strong>Results: </strong>MetS significantly increased the risk for work disability [adjusted sub distribution hazard ratio (SHR) 1.78, 95% confidence interval (CI) 1.54-2.05] and unemployment (adjusted SHR 1.16, 95% CI 1.06-1.26). A clear dose-response relationship was found for an increasing number of MetS components and work disability. No associations were found between MetS (components) and early retirement after adjusting for sociodemographic factors.</p><p><strong>Conclusions: </strong>MetS was identified as a modifiable early-stage cardio-metabolic risk factor especially for work disability and, to a lesser extent, for unemployment. Further, a clear dose-response relationship was found between an increasing number of MetS components and work disability. MetS interventions and prevention might help to prolong working lives. More awareness is needed among employers and occupational health professionals about the premature employment exit risk faced by middle-aged and older workers with MetS.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"569-577"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10866619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225866","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":"Long working hours and all-cause mortality in China: A 26-year follow-up study.","authors":"Yeen Huang, Yingping Xiang, Wei Zhou, Guanpeng Li, Chengzhi Zhao, Di Zhang, Shenying Fang","doi":"10.5271/sjweh.4115","DOIUrl":"10.5271/sjweh.4115","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between long working hours and the risk of mortality has been debated in various countries. This study aimed to investigate the association between long working hours and all-cause mortality in a large population-based cohort in China.</p><p><strong>Methods: </strong>This retrospective cohort study (N=10 269) used a large, nationally representative data set [the China Health and Nutrition Surveys (CHNS)] from 1989 to 2015. Long working hours (≥55 hours per week) were compared to standard working hours (35-40 hours per week). The outcome measure was all-cause mortality. Hazard ratio (HR) for all-cause mortality was calculated from Cox proportional hazards regression models, with stratified analyses to assess differences in mortality risk among subgroups.</p><p><strong>Results: </strong>Among the participants, 411 deaths (3.52 per 1000 person-years) occurred during a median follow-up of 11.0 (range 4.0-18.0) years. After adjusting for covariates, long working hours were associated with a significantly increased risk of all-cause mortality [HR 1.49, 95% confidence intervals (CI) 1.02-2.18]. Stratified analyses revealed that this association was present only among men (HR 1.78, 95% CI 1.15-2.75) and smoking participants (HR 1.57, 95% CI 1.05-2.57).</p><p><strong>Conclusion: </strong>This study provides evidence of an association between long working hours and all-cause mortality, which is specifically observed among men and smokers. Targeted interventions should be implemented to reduce excessive working hours and identify individuals at elevated risk, with support from labor organizations, policymakers, and employers.</p>","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"539-548"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169143","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":"Physical exposures in the work environment during pregnancy - a challenge for risk assessment.","authors":"Jenny Selander","doi":"10.5271/sjweh.4128","DOIUrl":"10.5271/sjweh.4128","url":null,"abstract":"","PeriodicalId":21528,"journal":{"name":"Scandinavian journal of work, environment & health","volume":" ","pages":"535-538"},"PeriodicalIF":6.3,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692269","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}