Journal of Urban Health-Bulletin of the New York Academy of Medicine最新文献

{"title":"Built Environment Change over Time Using Google Street View Assessments of Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Cities.","authors":"Stephen J Mooney, Cara M Smith, Elizabeth W Spalt, Logan Piepmeier, Amanda J Gassett, Greta Gunning, Jordan A Carlson, Kelly R Evenson, Earle C Chambers, Martha Daviglus, Gina S Lovasi, Pedro T Gullón, Jana A Hirsch, Jesse J Plascak, Andrew G Rundle, Dustin Fry, Michael D M Bader, Joel D Kaufman, Robert Kaplan","doi":"10.1007/s11524-025-00980-1","DOIUrl":"10.1007/s11524-025-00980-1","url":null,"abstract":"<p><p>Google Street View's historical imagery is a promising data source for measuring neighborhood conditions over time. However, images are not available for all years. To assess bias that may arise due to a mismatch between the year imagery is available and the year of researcher interest, we assessed prevalence of change in 20 commonly assessed built environment features between the oldest and newest available high-quality images (median difference 10.5 years, range from 2007 to 2023) on Street View at 2118 total locations in four US cities representing the Hispanic Community Health Study/Study of Latinos (New York City, Chicago, Miami, and San Diego). Seventeen (85%) of the features were the same in more than 90% of images; only litter differed in more than 20%. Patterns of change were consistent across all four cities and not notably different in tracts with higher or lower median household incomes. For built environment features reflecting sidewalk conditions and disinvestment in neighborhoods not selected for their known rapid change, auditing an image that does not temporally match the time of etiological interest is unlikely to be a major source of bias.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"670-679"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227398","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":"Moderating Effects of the Low-Income Housing Tax Credit on Associations Between Race and Elevated Blood Pressure in Chicago.","authors":"Tiffany H Xie, Monica E Peek, Corey E Tabit, Elizabeth L Tung","doi":"10.1007/s11524-025-00983-y","DOIUrl":"10.1007/s11524-025-00983-y","url":null,"abstract":"<p><p>While there is growing awareness of discriminatory housing policies and their adverse impacts on health, little is known about how housing policy may promote health equity. We focused on the Low-Income Housing Tax Credit (LIHTC), the largest affordable housing program in the United States, and examined how living in neighborhoods with LIHTC housing may moderate associations between elevated blood pressure and race/ethnicity in Chicago, IL. A retrospective cohort included 15,339 adult patients at an academic medical center from 2018 to 2019. We used mixed-effects hierarchal logistic regression models to examine elevated blood pressure (diastolic blood pressure ≥ 90 mmHg or systolic blood pressure ≥ 140 mmHg) as a function of race/ethnicity, LIHTC, and race/ethnicity-LIHTC interaction effects, adjusting for patient- and neighborhood-level covariates. A majority were female (63.2%) and non-Hispanic Black (57.6%), with an average age of 50.2 years (SD 19.1). One in ten (9.9%) patients lived in a census tract with LIHTC. Overall, Black patients had 2.52 times the adjusted odds of elevated blood pressure compared to White patients (95% CI = 2.25-2.82). In models examining the moderating effects of LIHTC, the odds ratio of hypertension in Black patients vs. White patients was reduced from 2.62 to 1.52, representing a 67.9% reduction in the difference between Black and White patients. Notably, Black patients, who have been disproportionately impacted by discriminatory housing policies, were the only group found to have moderating effects associated with LIHTC. Housing policies may mitigate neighborhood effects associated with racial disparity, possibly supporting efforts to achieve health equity.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"520-529"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327582","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":"Improving Cross-Sector Collaborations between Healthcare and Housing: Challenges and Strategies Identified by Unhoused People with Complex Health Needs.","authors":"Emmy Tiderington, Nora Sullivan, Michael Yedidia, Joel C Cantor","doi":"10.1007/s11524-025-00966-z","DOIUrl":"10.1007/s11524-025-00966-z","url":null,"abstract":"<p><p>There is growing recognition of the need for collaboration between the healthcare and housing sectors to address the needs of people experiencing homelessness. This study explores how these cross-sector collaborations can be improved from the perspective of those with histories of homelessness and complex health needs. In-depth, semi-structured qualitative interviews (N = 23) were used to (1) understand the challenges faced by people with complex health needs when navigating services at the intersection of healthcare and housing and (2) identify strategies for improving these services. While some participants reported accessing cross-sector services, many found those efforts to be lacking and ineffective. Participants reported receiving support with healthcare needs from housing providers more frequently than assistance with housing needs from healthcare providers. They described challenges related to provider turnover, perceived stigma and discrimination, and insufficient resources. Proposed solutions included modernizing and centralizing care, providing an effective balance of in-person and virtual offerings with an emphasis on in-person services, and improving provider sensitivity to reduce stigma against service recipients. These findings align with existing research on cross-sector collaborations in other fields and highlight the need for comprehensive, compassionate care tailored to the unique needs of people experiencing homelessness. The study also underscores the urgent need for more effective implementation and evaluation of these cross-sector efforts to improve outcomes for this vulnerable population.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"530-539"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702053","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":"Programmatic, Environmental, and Temporal Predictors of Violence, Overdose, and Self-Injury in Homeless Shelters in Toronto, Canada, 2012-2021.","authors":"Nick Kerman, Marcos Sanches, Sean A Kidd, Vicky Stergiopoulos","doi":"10.1007/s11524-025-00984-x","DOIUrl":"10.1007/s11524-025-00984-x","url":null,"abstract":"<p><p>People experiencing homelessness have high rates of violent victimization, overdose, suicidality, and non-suicidal self-injury. These health-related critical incidents contribute to high mortality rates among homeless populations, making their prevention a critical public health goal. The objective of this study was to identify trends and correlates of physical violence, overdose, and self-injury in homeless shelters in Toronto, Canada. A retrospective study was conducted using administrative data on health-related critical incidents in Toronto's shelter system from 2012 to 2021. Log-linked negative binomial regression models were fitted to (a) predict physical violence, overdose, and self-injury incident counts during the study period by year, season, and pandemic onset, and (b) examine programmatic, environmental, and temporal correlates of these outcomes, with separate analyses performed for the pre-pandemic and pandemic periods. Shelter-based physical violence (incidence rate ratio [IRR] 1.08; 95% confidence interval [CI] 1.06-1.11), overdose (IRR 1.20; CI 1.13-1.26), and self-injury (IRR 1.16; CI 1.11-1.21) incidents increased over the study period, with the rates of the increases for violence (IRR 1.10; CI 1.00-1.20) and overdoses (IRR 1.66; CI 1.48-1.86) intensifying during the COVID-19 pandemic. Larger congregate shelters had higher rates of violence, overdose, and self-injury, whereas shelter-based hotels had lower incident rates. Critical incidents were also higher during the winter, and there was an increased rate of overdoses during cheque week. The development of smaller shelters that offer greater privacy to service users warrants further examination to advance safety in shelter settings. Increasing access to naloxone and other substance use supports, especially during check week, is also recommended for reducing drug-related harms.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"564-575"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250513","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":"Gun Free Zones in Alcohol-Serving Establishments and Risk for Firearm Violence: A Cross-Sectional, Geospatial Study in Texas.","authors":"Paul M Reeping, Hannah S Laqueur, Rose M C Kagawa","doi":"10.1007/s11524-024-00928-x","DOIUrl":"10.1007/s11524-024-00928-x","url":null,"abstract":"<p><p>To date, there have been no peer-reviewed studies in the United States estimating the impact of gun-free zone policies in alcohol-serving establishments on rates of firearm violence in and around such establishments. In this study, we utilized a cross-sectional design to estimate the impact of Texas's 51% alcohol law, which prohibits the carrying of firearms in establishments that generate over half of their revenue from alcohol sales. The analysis focused on the difference in shooting incidents in and around establishments with and without firearm carrying prohibitions in 2021 and 2022. After adjusting for establishment type (bar/restaurant), alcohol sales volume, census tract level demographic factors, and the number of nearby restaurants and bars, results indicated that gun-prohibiting bars experienced significantly fewer shootings compared to those that allowed guns. Specifically, establishments that were gun-prohibited had 37% fewer shootings within 50 m than those that were gun-allowing, with a 95% confidence interval ranging from 60% fewer to 0.2% fewer. This association was more prominent in bars than in restaurants. The protective association with gun-prohibited status diminished with increased distance from the establishments; results were not significant at 100 m. Our study findings align with research suggesting that gun-free zones can reduce firearm violence. However, future studies using quasi-experimental designs that can better support causal inference are needed to support such a conclusion, as are studies exploring the efficacy of such policies in various settings and over longer periods.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"618-626"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583423","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 Economic Burden of Healthcare Utilization: Findings from a Health and Well-Being Survey in Informal Settlements of Freetown, Sierra Leone.","authors":"Sullaiman Fullah, Dora Vangahun, Ibrahim Gandi, Sia Morenike Tengbe, Braima Koroma, Samira Sesay, Eliud Kibuchi, Rajith W D Lakshman, Ibrahim Juldeh Sesay, Abu Conteh, Samuel Saidu, Helen Elsey, Zahidul Quayyum, Bintu Mansaray, Lana Whittaker, Neele Wiltgen Georgi, Motto Nganda, Rachel Tolhurst, Noemia Teixeira de Siqueira Filha","doi":"10.1007/s11524-025-00960-5","DOIUrl":"10.1007/s11524-025-00960-5","url":null,"abstract":"<p><p>The fragile health system in Sierra Leone undermines healthcare, leading to substantial patient costs. We aimed to estimate the economic burden and inequalities in healthcare in urban informal settlements in Freetown, Sierra Leone. A cross-sectional survey was conducted in three informal settlements in Freetown in April and May 2023 to collect data on healthcare usage within and outside the boundaries of the informal settlements. Catastrophic expenditures were estimated using the payer's household budget. Logistic regression explored socioeconomic characteristics associated with catastrophic expenditures. Inequalities in healthcare expenditures were assessed through concentration curves and indices. A total of 2575 participants reported healthcare utilization. Dwarzark (US$6.9) and Moyiba (US$7.1) had higher costs than Cockle Bay (US$5.5) when utilizing healthcare within the communities. Households incurred higher costs when seeking healthcare outside their informal settlements than within (US$14 vs US$ 7). Over half of the households across the settlements incurred catastrophic expenditures when seeking care outside the communities (57%), with the poorest wealth quintile (poorest, 89%; wealthier, 12%) incurring in higher incidence. Attending informal healthcare had a protective effect against catastrophic expenditure for healthcare within the communities. Age + 35, residence in Dwarzark and Moyiba, and length of residence + 4 years were associated with catastrophic expenditures. Healthcare expenditure was progressive in Dwarzark and equally distributed across wealth quintiles in the other communities. Our findings indicate the need to provide accessible, affordable, and good-quality healthcare within communities to alleviate the catastrophic costs of healthcare utilization. The regulation of informal health providers and their integration into the formal health system should be considered.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"692-712"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587762","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":"From Vulnerability to Strength: Transforming Health Systems for Climate Resilience.","authors":"Musa Hussain, Nashmia Khan, Grace Morton, Elana Kieffer, Ann Kurth","doi":"10.1007/s11524-025-00972-1","DOIUrl":"10.1007/s11524-025-00972-1","url":null,"abstract":"<p><p>In the face of escalating climate-related challenges, the resilience of healthcare systems is paramount. As was seen during COVID-19, the climate crisis exemplifies the critical need for a resilient workforce and robust healthcare infrastructure amidst increasing impacts including infrastructure disruptions, rising costs, and exacerbated health disparities. Structurally vulnerable communities, particularly those of color, face disproportionate exposure to climate risks, highlighting the urgent need for equitable resilience strategies. A focus on multifaceted approaches to fortifying healthcare systems against climate change includes emphasizing decarbonization, adaptability, data-driven planning, and support of sustainable infrastructure and health workers. The importance of integrating climate awareness into clinical and public health practices is underscored, promoting proactive measures and community engagement. Strategies to mitigate carbon footprint and enhance healthcare delivery can be enacted including with some federal and philanthropic funding support. This comprehensive approach ensures that healthcare systems remain robust, equitable, and responsive in the face of ongoing and future climate crisis challenges.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"680-691"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781570","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":"Spatiotemporal Analysis of Fentanyl-Associated Overdose Deaths in Chicago, IL, USA.","authors":"Hyojung Kang, Kaylee Janakos, Csaba Varga","doi":"10.1007/s11524-025-00986-9","DOIUrl":"10.1007/s11524-025-00986-9","url":null,"abstract":"<p><p>Overdose deaths involving fentanyl represent a major public health crisis in the USA. This study investigates the spatiotemporal dynamics of fentanyl-involved deaths before, during, and after the COVID-19 pandemic and examines how sociodemographic factors influence these deaths across geographic regions. Using a retrospective ecological approach, we analyzed data on ZIP code-level fentanyl-related deaths in Cook County, IL, between 2018 and 2023, obtained from the Medical Examiner's Office and linked with sociodemographic data from the American Community Survey. We first mapped area-level death rates to assess their distribution and then conducted global and local clustering analyses to identify spatial autocorrelations and the locations of high- or low-death-rate areas. A geographically weighted Poisson regression (GWPR) model evaluated the associations between area-level fentanyl-related death rates and the area-level proportion of young adults, males, and individuals with at least a college degree, disability rate, and poverty rate. Spatial analyses found stronger spatial autocorrelations during (2020-2021) and after (2022-2023) the pandemic. Initially, high death rates were concentrated in the downtown area of Chicago, and they expanded to the surrounding areas during and after the pandemic. The GWPR model revealed that an increase in the area-level proportions of poverty, disability, and young adult residents increased the fentanyl-related death rates in most of the areas. Our findings highlight the urgent need to address the evolving dynamics of fentanyl-related overdoses through tailored public health interventions that account for the unique socioeconomic determinants of different regions. Importantly, a comprehensive approach to addressing differences in overdose death rates and their risk factors will be crucial to mitigating this public health crisis.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"627-639"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235749","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":"A Computational Approach to Analyzing Spatiotemporal Trends in Gun Violence and Mental Health Disparities among Racialized Communities in US Metropolitan Areas.","authors":"Fahimeh Mohebbi, Amir Masoud Forati, John R Mantsch, Madeline Campbell, Rina Ghose","doi":"10.1007/s11524-025-00976-x","DOIUrl":"10.1007/s11524-025-00976-x","url":null,"abstract":"<p><p>Gun violence is a leading cause of death and injuries in the USA, adversely affecting physical and mental health among its survivors. Declared as a public health crisis in 2024, It disproportionately affects African Americans. It is linked to discriminatory policies like \"redlining,\" which fostered racial segregation and systemic inequities, perpetuating cycles of violence and mental health disparities. This study explores the relationships between racial segregation, systemic inequities, gun violence, and mental health through a data-driven, longitudinal study (2005-2021) of Milwaukee, WI, a hyper segregated metropolitan region. Our investigation aims to inform evidence-based, place-sensitive policies to promote social justice, reduce disparities, and foster healthy communities. Utilizing location-based demographic and socio-economic data from the U.S. Census, gun violence data from the Wisconsin Incident-Based Reporting System, and mental health data from the CDC's PLACES dataset, we conduct spatial and temporal analyses and geovisualization in GIS. To understand trends and correlations, we conduct time series decomposition, Mann-Kendall trend tests, and entropy statistics. Our findings indicate that racially segregated neighborhoods experience higher rates of gun violence and poorer mental health outcomes. Predominantly African American neighborhoods exhibit patterns of \"consecutive,\" \"sporadic,\" and \"new\" hotspots of gun violence, while predominantly white neighborhoods are characterized as \"cold spots.\" Physical and mental health disparities in Milwaukee indicate similar patterns. The results of this study highlight the profound impact of historical and systemic socioeconomic discrimination on contemporary public health issues.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"604-617"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029101","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":"Do Rental Assistance Programs Relieve Overcrowding for Children?","authors":"Frank Zhu, Andrew Fenelon, Penelope Schlesinger, Danya E Keene","doi":"10.1007/s11524-025-00979-8","DOIUrl":"10.1007/s11524-025-00979-8","url":null,"abstract":"<p><p>Crowded living conditions are associated with negative health outcomes, particularly for children. Federal rental assistance may reduce household crowding by improving access to affordable housing for low-income families. We leveraged NHANES data linked with HUD administrative rental assistance records to examine relationships between different forms of HUD rental assistance and multiple measures of crowding for households with children. We found a statistically significant reduction in the odds of crowding for those currently receiving HUD assistance compared to a control group who entered rental assistance within 2 years of their NHANES interview (95% CI, 0.39 to 0.93). The specific relationships between rental assistance and crowding and the magnitude of these associations varied by rental assistance type (public housing, multi-family, and vouchers). Fewer than 1 in 4 eligible households receive rental assistance. Our findings suggest that expanding access to this resource can reduce household crowding and its adverse impacts on health and well-being.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"511-519"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081774","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}