Indian Journal of Occupational and Environmental Medicine最新文献

{"title":"Musculoskeletal Disorders among Resident Doctors: An Occupational Hazard in Tertiary Care Hospitals, Gujarat, India: A Cross-Sectional Study.","authors":"Princee Chauhan, Harsha M Solanki","doi":"10.4103/ijoem.ijoem_193_24","DOIUrl":"10.4103/ijoem.ijoem_193_24","url":null,"abstract":"<p><strong>Introduction: </strong>Resident doctors constitute about one-fourth of hospital workforce. They often face high workload and have potential to develop musculoskeletal disorders (MSDs). Hence, this study was planned to estimate prevalence, pattern, and distribution of MSDs, ergonomic-risk-factors and to document coping mechanisms.</p><p><strong>Methodology: </strong>This cross-sectional study was conducted among 150 residents from tertiary care hospitals of Gujarat. The sociodemographic and occupational details, risk factors, and various coping mechanisms were captured using semistructured questionnaire (google form). \"Standardized-Nordic-Questionnaire\" was used to assess MSDs. Data were analyzed using Epi-Info-software Version-7.2.2.6. Logistic regression was applied to identify predictors of MSDs.</p><p><strong>Result: </strong>MSD prevalence was 67.8% in the last 12 months of which 56.3% were women. Almost half of residents with MSDs were from 1^st and 2^nd year and 70% from clinical branches. Major complaint was pain (51%), stiffness (45%), and tingling/numbness (22.6%). Pain and stiffness were reported in lower back (34%) and neck (27%). On univariate analysis (residency period, working for > 48 hours/week, working for long in same position and working near/more than physical limits and bending/twisting back in awkward way) were self-reported risk factors. Modifying position/stopping and pausing activities were coping mechanisms used by most of residents. On multivariate analysis, 2^nd year residency, working in same position for long time, working near/more than physical limits and bending/twisting back in awkward way were found independent predictors for MSD.</p><p><strong>Conclusion: </strong>Residents especially from clinical branches start developing MSDs at very young age. Provision of ergonomically acceptable workplace and appropriate management MSDs at tertiary care hospitals is required.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 3","pages":"199-205"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Police Ergonomic Parameters as a Method to Evaluate the Training at Cadiz Public Security School on the Use of Police Force of Candidates to Become Local Police Officers in Andalucía.","authors":"Jose C V Jimenez, Domingo V Carro, Lucas Gonzalez-Herrera, Andres P Fernandez, Jose C Vera-Jurado, José Á Á Saura, Jesus Ayuso","doi":"10.4103/ijoem.ijoem_288_23","DOIUrl":"10.4103/ijoem.ijoem_288_23","url":null,"abstract":"<p><strong>Background: </strong>Because of the numerous debates about the training on the use of force provided to police officers, this study intends to evaluate several parameters (police ergonomic parameters, PEP) in connection with such training.</p><p><strong>Research method: </strong>A smartsuit equipped with a set of 19 wireless sensors, including triaxial accelerometers, inertial measurement units, gyroscopes, and geomagnetic sensors, was used. Biomechanics of Body software application was used to evaluate the risks associated with the basic technique number 1 of the operational-tactical procedures (OTP) with regard to the established parameters (PEP). The OTP basic technique number 1 was performed by four novice police officers.</p><p><strong>Results: </strong>According to the evaluation of a number of specific parameters such as rapid entire body assessment, asymmetry over the sagittal plane, compression force at the L5-S1 junction, and shear force at the L5-S1 junction, it was observed that the measured values clearly varied depending on each individual's performance, although they remained consistent with the values established by PEP and were significantly different from the values measured when a police officer used a traditional physical intervention procedure, in which case, the values measured were indicative of higher risks.</p><p><strong>Conclusions: </strong>To achieve lower and more uniform values in terms of risk, we believe that it is necessary to employ a greater number of hours for the training of police officers on the use of force and also the convenience of conducting further studies on a larger and more representative sample of officers.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 3","pages":"188-192"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Risk Predicted Matrix of MSDs Risk Assessment in Electronic Industrial Workers of Winding Process.","authors":"Pornpailin Tidaoon, Sunisa Chaiklieng","doi":"10.4103/ijoem.ijoem_22_24","DOIUrl":"10.4103/ijoem.ijoem_22_24","url":null,"abstract":"<p><strong>Background: </strong>The electronics assembly industry is continuously expanding, and the toroidal winding process exacerbates musculoskeletal disorders (MSDs) due to exposure to ergonomic risk factors.</p><p><strong>Aim: </strong>The objectives of this study were to assess the ergonomic risk and health risks of MSDs among workers in the toroidal winding electronics assembly industry.</p><p><strong>Materials and methods: </strong>The cross-sectional descriptive study included 46 workers in one electronics winding assembly industry in Northeast Thailand who met the inclusion criteria of having work experience of at least 6 months and working at least 8 hours a day The data were collected using a self-assessment MSDs Severity and Frequency Questionnaire (MSFQ), ergonomic risk assessment for standing posture via applied Rapid Entire Body Assessment (REBA) and for sitting posture via applied Rapid Upper Limb Assessment (RULA), as well as a health risk matrix for MSDs risk assessment.</p><p><strong>Results: </strong>In the winding process without using the machine, workers predominantly experienced body discomfort in the shoulders and upper back, while in the winding process with the machine, this discomfort shifted to the shoulders and lower back. The ergonomic risk for the standing posture was at the highest level of risk, level 4, while the sitting posture was at level 3. The analysis of the MSDs risk matrix showed that workers winding without the machine were at a very high health risk level (65.22%), whereas workers winding with the machine were also at a very high health risk level (60.87%).</p><p><strong>Conclusion: </strong>The health risk matrix for the prediction of MSDs is very useful in MSD surveillance programs among workers in the toroidal winding industry.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"124-129"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal Pain and Analysis of Postural Risk in Harmonium Players in India: A Cross-Sectional Study.","authors":"Prachita P Walankar, Anushka S Joglekar, Priyadarshani S Katalkar","doi":"10.4103/ijoem.ijoem_153_24","DOIUrl":"10.4103/ijoem.ijoem_153_24","url":null,"abstract":"<p><p>Harmonium, a commonly played instrument, requires repetitive movements, awkward playing postures, and intense practice routines which may place the musician at risk for injury. This study aimed to determine the prevalence of musculoskeletal pain and analyze the postural risk in harmonium players. A cross-sectional study was conducted on 80 harmonium players who received at least 7 consecutive years of formal training. A self-designed questionnaire comprising demographic profiles, playing characteristics, presence of musculoskeletal pain, and specific areas of pain was administered. Postural risk was evaluated using a rapid upper limb assessment tool. Among 80 harmonium players, 34 (42.5%) and 52 (65%) reported musculoskeletal pain for 12-month and 7-day prevalence, respectively. The most common site of pain was the lower back, followed by the knee, shoulder, wrist, and hand. Also, there was no significant difference between the harmonium players with pain and without pain for body mass index, duration of playing harmonium, and harmonium exposure. It was observed that 62 (77.5%) players were in the category of low risk for injury and 18 (22.5%) were in the medium-risk category for developing musculoskeletal disorders. A high prevalence of musculoskeletal pain was observed in harmonium players. The posture adopted by players predisposed them to the development of musculoskeletal disorders as per the risk assessment.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"172-176"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Multifaceted Intervention on Ocular Health and Ophthalmic Safety Among Metal Workers of Moradabad, Uttar Pradesh.","authors":"Pinaki Adak, Rituparna Ghoshal, Navneet Kumar","doi":"10.4103/ijoem.ijoem_291_24","DOIUrl":"10.4103/ijoem.ijoem_291_24","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate ocular health status and ophthalmic safety practices among industrial metal workers of Moradabad, pre- and post-intervention.</p><p><strong>Methods: </strong>A longitudinal study was conducted from November 2022 to December 2023. Metal workers, recruited from an industrial zone of Moradabad, underwent eye examination and were administered a pre-validated questionnaire on ocular health and safety, translated in Hindi. A multifaceted intervention included detailed ophthalmic evaluation, correction of refractive error, and presbyopia followed by provision of personal protective equipment (PPE). Thereafter, an awareness program was conducted using leaflets, followed by monthly monitoring group meetings. All workers were followed up for one year.</p><p><strong>Results: </strong>Four hundred metal workers aged between 14 and 65 years, predominantly from unorganized sector (70%), were evaluated. While a notable percentage of the metal workers (18.50%) reported ocular injuries in last 5 years, only 11.25% wore PPE and 4.3% of the participants attended prior ophthalmic safety training at baseline evaluation. Majority of the participants reported uncorrected presbyopia and/or refractive error. All participants completed 3 stages of intervention. A total of 297 spectacles were provided. After the intervention and 1 year of monitoring, safety attitudes of the workers improved significantly (<i>P</i> < 0.05). There were no cases of eye injuries reported during 1 year.</p><p><strong>Conclusions: </strong>Present research revealed eye injuries to be a significant public health concern among metal workers of Moradabad, further highlighting the minimal use of PPE. However, continuous education, increased supervision, and mandatory safety measures improved worker attitudes and reduced work-related eye injuries in this occupational group.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"102-109"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey on the Prevalence of Low Back Pain and the Disability in Accredited Social Health Activists (ASHA) in Panvel Division of Maharashtra.","authors":"Trupti S Rothe, Tejashree A Dabholkar","doi":"10.4103/ijoem.ijoem_108_24","DOIUrl":"10.4103/ijoem.ijoem_108_24","url":null,"abstract":"<p><strong>Background: </strong>People with low back pain (LBP) frequently experience diminished productivity. Long-term, poor physical health, mental health issues, repetitive lifting of heavy objects, and prolonged movement repetition are all thought to be contributing factors to low back pain. An Accredited Social Health Activist (ASHA) is a woman who serves as a vital liaison between public health and the local community. ASHA provides health, birth planning, safe childbirth, and breastfeeding counseling to rural women and conducts civil registration. The study seeks to determine the substantial occurrence of low back pain and its disability in ASHA, given their susceptibility to work-related musculoskeletal low back pain.</p><p><strong>Methodology: </strong>This cross-sectional study was carried out in Maharashtra's Urban Public Health Centers (UPHCs). Interviews were conducted with 113 ASHA who had a normal Body Mass Index (BMI), at least a year of work experience, and no history of significant neurological or musculoskeletal disorders or injuries. We collected demographic information. To screen for LBP, the Nordic Musculoskeletal Questionnaire (NMQ) was used. The Oswestry Disability Index (ODI) was then used to assess disability. In addition, a self-structured questionnaire was administered. Descriptive analysis was done using Microsoft Excel.</p><p><strong>Results: </strong>Out of 113 participants, 88.5% had LBP. Mild disability was seen in 57% of participants and 42% had moderate disability, with 1% of no disability.</p><p><strong>Conclusion: </strong>The responsibilities of the job put ASHA at higher risk of lower back pain. Mild disability is the most common type of disability, followed by moderate disability.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"151-153"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitude and Perceptions of Technology Enabled Mental Health Care for Supporting Occupational Mental Health and Well Being Among Doctors in India.","authors":"Nidhi Bhatnagar, Vibha Swaroop, Irena Mandal, Mongjam Meghachandra Singh","doi":"10.4103/ijoem.ijoem_144_24","DOIUrl":"10.4103/ijoem.ijoem_144_24","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, the mental healthcare system faces significant challenges, including delays in service delivery, limited access, and fragmented services with an unmatched supply and need. The importance of mental health support for doctors is often overlooked, impacting patient care and leading to burnout. Mental health apps and smartphone mindfulness applications show promise in treating depression and reducing stress. Doctors are ideal candidates for studying the acceptance of digital mental health tools.</p><p><strong>Methodology: </strong>A qualitative study involving in-depth interviews with 20 doctors from the Department of Community Medicine, Maulana Azad Medical College, New Delhi, India. The selection was purposive, based on their willingness to participate and their varying types of experience (academics and program implementation) in public health.</p><p><strong>Results: </strong>Four themes emerged: Attitudes toward mental health and well-being, attitudes toward nonmental health technology, personal and professional life, and coping and support mechanisms.</p><p><strong>Conclusion: </strong>Participants emphasized the importance of mental health and well-being but noted unmet needs and inadequate support. Limited personalized care with technology was a challenge, despite the benefits of digital healthcare. Communication and ease of connection were advantages, but privacy and confidentiality were concerns.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"154-159"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Work-Related Musculoskeletal Disorders in the Banking Sector: A Cross-Sectional Study in Western Vidarbha Region, India.","authors":"Amar P Mankar, Umesh G Kawalkar, Anshu Singh, Nilesh Jadhao, Jahur Sayyed, Shounak Joshi","doi":"10.4103/ijoem.ijoem_357_24","DOIUrl":"10.4103/ijoem.ijoem_357_24","url":null,"abstract":"<p><strong>Background: </strong>Work-related musculoskeletal disorders (WMSDs) are a leading cause of occupational morbidity, particularly among desk-based professionals. Banking employees face increased risk due to prolonged screen time and poor ergonomics. Limited regional data exists on WMSDs in emerging cities like Akola, Maharashtra.</p><p><strong>Objectives: </strong>This study aimed to estimate the prevalence of work-related musculoskeletal disorders (WMSDs) among banking employees in Akola, Western Vidarbha, and identify the key demographic, occupational, ergonomic, and lifestyle factors contributing to it.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 390 banking employees in Akola. Data were collected using a validated semistructured proforma, incorporating the Nordic Musculoskeletal Questionnaire (NMQ).</p><p><strong>Results: </strong>The prevalence of WMSDs was found to be 37%. Female employees reported significantly higher WMSD prevalence compared with men (49.2% vs. 29.1%). Prolonged sitting (>8 h/day) increased the odds of WMSDs (OR: 2.82; 95% CI: 1.36-5.86), repetitive motion tasks (OR: 19.5; 95% CI: 4.67-81.38), and extended computer usage (>8 h/day) (OR: 3.65; 95% CI: 1.37-9.73). Higher body mass index (BMI) and abnormal waist-to-hip ratios were also associated with increased odds of WMSDs.</p><p><strong>Conclusions: </strong>The high prevalence of WMSDs among banking employees highlights the urgent need for ergonomic interventions, lifestyle modifications, and organizational support systems. Addressing these factors through targeted workplace modifications and health promotion strategies can reduce the burden of WMSDs, enhance employee well-being, and improve workplace productivity. Future research should focus on longitudinal studies to evaluate the long-term impact of these interventions.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"130-135"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Postural Training and Core Strengthing Exercise Anlong with Interferential Therapy on Low Back Pain in Household Workers.","authors":"V Saravanan, A Karunya, G Thirulogachandar, V Rajalaxmi, D Monesh, B Arun","doi":"10.4103/ijoem.ijoem_164_24","DOIUrl":"10.4103/ijoem.ijoem_164_24","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to know the effectiveness of postural training and core strengthening exercises along with interferential therapy on low back pain for household workers.</p><p><strong>Background of the study: </strong>Pain in the lower back area that can be related to problems with the lumbar spine. This may be due to changing work environment, including the nature of long sitting work hours. Postural training helps develop strength, flexibility, and balance in the body, while core strengthening exercises improve balance, stability, and core muscle function. Interferential therapy, widely used for pain relief, muscle stimulation, increasing local blood flow, and reducing edema, has been extensively studied and proven effective in relieving pain associated with musculoskeletal conditions.</p><p><strong>Methods and materials: </strong>This quasi-experimental study with a pre-and post-comparative design was conducted in the Faculty Physiotherapy Outpatient Department with 60 randomly selected women aged 35-50 years, clinically diagnosed with low back pain. The intervention lasted 12 weeks and excluded males below 35, recent low back fractures, hernia, and VAS scores below 4. Pre-tests using the VAS and QBPDS scales were conducted, followed by 4 days of interferential therapy (IFT) and 30 minutes/day of postural and core strengthening exercises with IFT for 12 weeks. Post-tests using the same scales were performed, and statistical analysis was conducted on the collected data to assess the intervention's effectiveness.</p><p><strong>Result: </strong>On comparing Pre test and Post test within Group A and Group B on Visual Analogue Scale (VAS) Score and QBPDS score shows significant difference in the mean values at <i>P</i> ≤ 0.05.</p><p><strong>Conclusion: </strong>The present study concluded that postural training exercise is more effective than conventional exercise. As the subject feels that postural training exercise improves functional activities and reduces low back pain. Which given good relief to the subject.</p>","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"145-150"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rise of the 'Gig Economy' and it's Health Toll on Workers.","authors":"Bobby Joseph, Merlyn Joseph","doi":"10.4103/ijoem.ijoem_217_25","DOIUrl":"10.4103/ijoem.ijoem_217_25","url":null,"abstract":"","PeriodicalId":43585,"journal":{"name":"Indian Journal of Occupational and Environmental Medicine","volume":"29 2","pages":"85-86"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}