Lancet Planetary Health最新文献

{"title":"Health workforce as a climate and health priority in nationally determined contributions","authors":"Jessica Clarke , Iris Martine Blom , Diarmid Campbell-Lendrum , Vanessa Kerry","doi":"10.1016/j.lanplh.2025.101288","DOIUrl":"10.1016/j.lanplh.2025.101288","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101288"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exhibition","authors":"Rebecca Heald","doi":"10.1016/j.lanplh.2025.101298","DOIUrl":"10.1016/j.lanplh.2025.101298","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101298"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ethics of climate change and health-care delivery: a national survey of US-based physicians","authors":"Andrew Hantel MD ,&nbsp;Emily Senay MD ,&nbsp;Fay J Hlubocky PhD ,&nbsp;Thomas P Walsh MPH ,&nbsp;Hannah Johnston MD ,&nbsp;Angel Cronin MS ,&nbsp;Adam S DuVall MD ,&nbsp;Anna Revette PhD ,&nbsp;Brett Nava-Coulter PhD ,&nbsp;Prof Mark Siegler MD ,&nbsp;Cristina Richie PhD ,&nbsp;Prof Gregory A Abel MD","doi":"10.1016/j.lanplh.2025.101289","DOIUrl":"10.1016/j.lanplh.2025.101289","url":null,"abstract":"<div><div>Health harms from climate change are partly driven by health-care emissions. Physician perspectives on the related ethical dilemmas of professional responsibilities, health equity, and trade-offs between individual health choices and the environmental impact of health care are not well described in current literature. We performed a cross-sectional survey of US-based physicians between July 18, 2023, and May 28, 2024 to assess related perspectives, and we analysed the results by the respondents’ perceived impact of climate change on their patients’ health (moderate–high impact <em>vs</em> no–to–low impact). 529 surveys were delivered, of which 304 (57·5%) were returned. 113 (37·4%) of 302 respondents reported that climate change had a moderate–high impact on their patients’ health, whereas 249 (82·5%) respondents viewed climate change as having greater health impacts on patients with less access to health care. 105 (35·0%) of 300 respondents reported that the environmental impact of health care should be reduced even if it requires limiting treatment options of similar effectiveness. In response to hypothetical scenarios, the patients in the moderate-high impact group was more willing to place such limits (adjusted predicted probability=50%) than the no–to–low impact group (adjusted predicted probability=25%, difference=25% [95% CI 13–38]). In addition, the patients in the moderate-high impact group (adjusted predicted probability=86%) was more willing to initially trial a less effective but less environmentally toxic antihypertensive medicine than the no–to–low impact group (adjusted predicted probability=69%, difference=17% [95% CI 6–27]). A sample of US-based physicians accepted their health care-related responsibilities towards climate change and viewed its health impacts as inequitable. Perceptions of the health impact of climate change influenced willingness to accept limited treatment options for environmental reasons.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101289"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the short-term mortality effects of wildfire smoke in Europe: a multicountry epidemiological study in 654 contiguous regions","authors":"Anna Alari PhD ,&nbsp;Joan Ballester PhD ,&nbsp;Carles Milà PhD ,&nbsp;Prof Tarik Benmarhnia PhD ,&nbsp;Mikhail Sofiev PhD ,&nbsp;Andreas Uppstu PhD ,&nbsp;Risto Hänninen DSci ,&nbsp;Prof Cathryn Tonne ScD","doi":"10.1016/j.lanplh.2025.101296","DOIUrl":"10.1016/j.lanplh.2025.101296","url":null,"abstract":"<div><h3>Background</h3><div>Fine particulate matter (PM_2·5) from wildfire smoke could be more harmful to human health than that from other sources. Evidence of the short-term association between wildfire-related PM_2·5 and mortality in Europe remains sparse, leading to uncertainties in the fire-related PM_2·5 mortality burden.</div></div><div><h3>Methods</h3><div>In this retrospective, multicountry epidemiological study, we used the EARLY-ADAPT database to obtain daily mortality records in 654 contiguous subnational regions from 32 European countries, representing a population of 541 million individuals. We combined these data with daily estimates of fire-related and non-fire-related PM_2·5 from the System for Integrated Modelling of Atmospheric Composition model during 2004–22. Regional and pooled associations between daily fire-related PM_2·5 and all-cause and cause-specific mortality were quantified using quasi-Poisson regression. We compared deaths attributable to fire-related PM_2·5 using relative risks (RRs) specific to fire-related PM_2·5 versus total PM_2·5.</div></div><div><h3>Findings</h3><div>Our study data included 95⸱3 million daily deaths for all-cause mortality, 19⸱5 million daily deaths for cardiovascular mortality, and 3⸱9 million daily deaths for respiratory mortality from Jan 1, 2004, until the latest available year in each country. Pooled cumulative (lags 0–7) RRs associated with a 1 μg per m³ increase in fire-related PM_2·5 were 1⸱007 (95% CI 1⸱004–1⸱010) for all-cause mortality, 1⸱009 (1⸱006–1⸱013) for cardiovascular mortality, and 1⸱013 (1⸱008–1⸱019) for respiratory mortality. RRs were larger for fire-related PM_2·5 than for non-fire-related PM_2·5. Using RRs for total (fire-related and non-fire-related) PM_2·5 underestimated the fire-related PM_2·5 attributable mortality by 93%.</div></div><div><h3>Interpretation</h3><div>Associations with all-cause and cause-specific mortality were larger for fire-related compared with non-fire-related PM_2·5. Assuming wildfire PM_2·5 has the same effect as total PM_2·5 substantially underestimates the mortality burden of wildfire smoke.</div></div><div><h3>Funding</h3><div>The European Commission, EU Horizon Europe, the European Research Council, and the Research Council of Finland.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101296"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global assessment of population exposure to multiple climate-related hazards from 2003 to 2021: a retrospective analysis","authors":"Zélie Stalhandske PhD ,&nbsp;Marleen C de Ruiter PhD ,&nbsp;Jonathan Chambers PhD ,&nbsp;Sandra Zimmermann MSc ,&nbsp;Felipe J Colón-González PhD ,&nbsp;Nivedita Sairam PhD ,&nbsp;Prof David N Bresch PhD ,&nbsp;Chahan M Kropf PhD","doi":"10.1016/j.lanplh.2025.101295","DOIUrl":"10.1016/j.lanplh.2025.101295","url":null,"abstract":"<div><h3>Background</h3><div>The climate crisis is increasingly recognised as a health crisis, driven in part by the growing frequency and intensity of climate-related hazards, such as heatwaves and wildfires. These hazards can coincide, potentially leading to compound impacts. However, little is known about where and how often such combinations occur globally. This study aims to map historical population exposure to multiple interacting climate-related hazards and identify regions that have been most affected.</div></div><div><h3>Methods</h3><div>In this retrospective study, we analysed global data from the 2024 <em>Lancet</em> Countdown on health and climate change, International Best Track Archive for Climate Stewardship, The Inter-Sectoral Impact Model Intercomparison Project, and WorldPop from 2003 to 2021 at a 0·25° resolution to examine the population that was exposed to combinations of six climate hazards: heatwaves, droughts, wildfires (PM_2·5), extreme precipitation, river floods, and tropical cyclones. We identified administrative level 1 regions based on several hotspot definitions and did detailed case studies in the most exposed regions.</div></div><div><h3>Findings</h3><div>We detail how frequently people at each grid point have been exposed to various combinations of hazards, revealing both regular patterns and rare, region-specific occurrences. Our analysis indicates an increase in per-person exposure to many hazards during the study period, with a more pronounced rise in multihazard exposure than single-hazards. Between 2003–12 and 2012–21, per-person exposure to three or more hazards increased by 69%. Heatwaves were the most common hazard and also showed the clearest trend, largely driving the observed increases in both single-hazard and multihazard exposure. Multihazard hotspots vary depending on the specific definition used. For instance, exposure to multiple hazards is explained by the seasonality of hazards, which leads them to co-occur in the same months. Additionally, incorporating specific vulnerable age groups into our analysis reveals hotspots that consider the sociodemographic characteristics of the regions.</div></div><div><h3>Interpretation</h3><div>These findings highlight the importance of incorporating multihazards into climate and health risk assessments. Our study enables an examination of historical events to deepen our understanding of interactions between hazards. Given the rarity of many hazard combinations, traditional epidemiological methods might fall short. Thus, alternative approaches, such as storyline development, are essential to enhance our preparation for future multihazard occurrences. This work finally serves as a crucial baseline future multihazard risk assessment under different climate and socioeconomic scenarios.</div></div><div><h3>Funding</h3><div>MYRIAD-EU, Netherlands Organisation for Scientific Research, Horizon 2020, and German Academic Scholarship Foundation.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101295"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compound and cascading effects of climatic extremes on dengue outbreak risk in the Caribbean: an impact-based modelling framework with long-lag and short-lag interactions","authors":"Chloe Fletcher MSc ,&nbsp;Giovenale Moirano PhD ,&nbsp;Tilly Alcayna MPH ,&nbsp;Leslie Rollock DrPH ,&nbsp;Cédric J Van Meerbeeck PhD ,&nbsp;Roché Mahon PhD ,&nbsp;Adrian Trotman MPhil ,&nbsp;Laura-Lee Boodram PhD ,&nbsp;Tia Browne MSc ,&nbsp;Sabu Best BSc ,&nbsp;Daniela Lührsen MSc ,&nbsp;Avriel R Diaz MA ,&nbsp;Willy Dunbar PhD ,&nbsp;Catherine A Lippi PhD ,&nbsp;Prof Sadie J Ryan PhD ,&nbsp;Felipe J Colón-González PhD ,&nbsp;Anna M Stewart-Ibarra PhD ,&nbsp;Prof Rachel Lowe PhD","doi":"10.1016/j.lanplh.2025.06.003","DOIUrl":"10.1016/j.lanplh.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Small islands developing states in the Caribbean are exposed to increasingly frequent and intense extreme climatic events, which can exacerbate outbreaks of climate-sensitive infectious diseases. Few forecasting tools incorporate the compound and cascading effects of multiple delayed climatic indicators on disease outbreak risk. We aimed to create an impact-based modelling framework that employs interactions between climatic predictors to forecast the probability of a climate-sensitive infectious disease outbreak 3 months ahead, and to investigate the compound and cascading effects of temperature and long-lag and short-lag standardised precipitation index (SPI) on dengue outbreak risk in Barbados.</div></div><div><h3>Methods</h3><div>We developed a modelling framework to predict the probability of a dengue outbreak in Barbados with a 3-month lead time. We assessed the relationships between dengue incidence and interacting long-lag and short-lag hydrometeorological predictors with confirmed cases from 1999 to 2022 and a Bayesian hierarchical framework accounting for seasonal and interannual variation. With this long–short-lag interaction model, we piloted a dengue early warning system in Barbados for the International Cricket Council Men's Twenty20 World Cup in June, 2024, as a real-world prospective example.</div></div><div><h3>Findings</h3><div>We found that a three-way interaction between the 3-month averaged mean temperature anomaly lagged by 3 months, 6-month SPI (SPI-6) lagged by 5 months, and SPI-6 lagged by 1 month best predicted dengue outbreak risk in Barbados. Our findings showed that long-lag dry (lagged by 5 months), mid-lag hot (lagged by 3 months), and short-lag wet (lagged by 1 month) conditions led to the greatest dengue risk. During cross-validation from 2012 to 2022, the model exhibited a true positive rate (TPR) of 81% and a false positive rate (FPR) of 29%, outperforming a baseline model representing standard practice with a TPR of 68% and an FPR of 48%. For the Twenty20 World Cup, the model predicted a 95% outbreak probability due to epidemiological and climatic conditions, which was shared with the Barbados Ministry of Health and Wellness ahead of the tournament.</div></div><div><h3>Interpretation</h3><div>Our impact-based modelling framework with long-lag and short-lag interactions explicitly accounted for the compound and cascading effects of drought, heat, and excessively wet conditions on dengue outbreak risk in Barbados. The model is being implemented in a national dengue early warning system with ongoing monitoring and evaluation to ensure its reliability and usefulness in operational contexts. Future work could explore the applicability of this methodology to modelling or predicting climate-sensitive infectious diseases in other endemic settings.</div></div><div><h3>Funding</h3><div>Wellcome Trust, Horizon Europe, European Development Fund, and Royal Society.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101279"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the climate sensitivity of infectious diseases: a conceptual framework","authors":"Tilly Alcayna MPH ,&nbsp;V Bhargavi Rao PhD ,&nbsp;Prof Rachel Lowe PhD","doi":"10.1016/j.lanplh.2025.101291","DOIUrl":"10.1016/j.lanplh.2025.101291","url":null,"abstract":"<div><div>Infectious diseases pose a substantial threat to public health, affecting billions and straining health-care systems worldwide. There is growing concern over how anthropogenic climate change might aggravate the global burden of climate-sensitive infectious diseases. In this Personal View, we propose a framework for understanding what makes an infectious disease climate-sensitive. Drawing on existing literature, we identify three key characteristics of climate-sensitive diseases—seasonality, geographical boundaries, and interannual variation linked to climate phenomena. We define climate sensitivity as the responsiveness of pathogen, host, and disease vector traits (a measurable feature of an organism that affects its fitness) to changes in climate, regardless of whether these changes arise from natural variability or anthropogenic forcing of the climate. We discuss how infectious diseases show different degrees of climate sensitivity (from high to low), with the recognition that classifications of infectious diseases might evolve as new research emerges. We review evidence from ecological and modelling studies showing the non-linear and delayed effects of climate variability and change on pathogen, vector, and host traits, highlighting the importance of both climatic and non-climatic factors, such as population immunity, globalisation, and poverty, in identifying disease distribution and driving transmission patterns. We highlight that infectious disease transmission risk is inextricably linked to planetary health issues. Finally, we discuss how leveraging this understanding can enhance infectious disease outbreak prevention, preparedness, and response through the development of climate services for health, including early warning systems, thereby improving climate change adaptation strategies and health system resilience.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101291"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global epidemiology of paralytic shellfish poisoning: a systematic search literature review","authors":"Matthew O Gribble PhD ,&nbsp;Baylin J Bennett MPH ,&nbsp;Jahred M Liddie PhD ,&nbsp;William Borchert PhD ,&nbsp;Brigitte A Pfluger PhD ,&nbsp;Jackson S Segars MPH ,&nbsp;Jacob M Keast BSc ,&nbsp;Avneet Hans MD ,&nbsp;Nidhi S Kikkeri MD ,&nbsp;Caitlin Shin MA ,&nbsp;Hugh B Roland PhD ,&nbsp;Sneha Hoysala MPH ,&nbsp;Jacob Kohlhoff BS ,&nbsp;Barrak Alahmad PhD ,&nbsp;Shivaraj Nagalli MD ,&nbsp;William Rushton MD ,&nbsp;Henrik Enevoldsen PhD ,&nbsp;Megan Bell MLIS ,&nbsp;Damiana Fortenberry MLIS ,&nbsp;John R Harley PhD ,&nbsp;Andrea L C Schneider MD","doi":"10.1016/j.lanplh.2025.05.001","DOIUrl":"10.1016/j.lanplh.2025.05.001","url":null,"abstract":"<div><div>We are in the midst of the UN Decade of Ocean Science for Sustainable Development (2021–30), which provides a timely opportunity for the epidemiological community to assess the global burden of thalassogenic diseases such as paralytic shellfish poisoning (PSP). In this epidemiological review, we used systematic search tools to summarise 152 peer-reviewed articles describing human PSP cases. Our analysis revealed that PSP cases have been reported from every inhabited continent; symptoms reported by patients might differ by continent; and exposure sources are not limited to the eponymic shellfish. Furthermore, most cases described lacked demographic details that could aid in a more comprehensive understanding of PSP epidemiology. Overall, this Review highlights PSP as a true global health concern; however, the overall poor quality of available data underscores the need for greater epidemiological attention as an understudied global health challenge.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101271"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate in court","authors":"The Lancet Planetary Health","doi":"10.1016/j.lanplh.2025.101310","DOIUrl":"10.1016/j.lanplh.2025.101310","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101310"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptual framework of women’s food environments and determinants of food acquisition and dietary intake in low- and middle-income countries: a scoping review","authors":"Lydia O’Meara MSc ,&nbsp;Julia de Bruyn PhD ,&nbsp;Tammy Hope MSc ,&nbsp;Marta Fajó-Pascual PhD ,&nbsp;Rachel Hodge MSc ,&nbsp;Christopher Turner PhD ,&nbsp;Mina Stoynova PhD ,&nbsp;Kate Wellard PhD ,&nbsp;Prof Elaine Ferguson ,&nbsp;Paula Dominguez-Salas PhD","doi":"10.1016/j.lanplh.2025.06.004","DOIUrl":"10.1016/j.lanplh.2025.06.004","url":null,"abstract":"<div><div>Women in low-income and middle-income countries (LMICs) are disproportionately affected by malnutrition in all its forms. Diets link human health and environmental sustainability; however, existing food environment frameworks rarely consider the unique needs of women that can differ due to sociocultural norms and lower social status, potentially reducing the effectiveness of nutrition initiatives. We conducted a systematic scoping review of peer-reviewed literature published in English, Spanish, Portuguese, and French to identify determinants of food acquisition and dietary intake of women in LMICs. By synthesising evidence from 518 studies across 125 countries, we identified 143 eco-social, structural, and individual-level determinants to develop an empirically grounded food environment conceptual framework for women. Women’s agency—encompassing decision making and financial autonomy, bargaining power, control over time, and freedom of movement—emerged as a prominent mediator of food acquisition practices and dietary intakes across diverse regions and the rural–urban continuum. Our findings highlight the importance of addressing legislative, structural, and sociocultural determinants mediating women’s agency, alongside other key external and individual-level food environment determinants influencing procurement and consumption of nutritious diets. This empirically grounded conceptual framework can guide research priorities and analytical approaches and identify intervention points for policies and programmes to optimise women’s nutrition.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101280"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}