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

{"title":"Examining Experiences of Gender Identities, Roles, and Relations among Men with Same-Gender Sexual Histories: Implications of Gender Nonconformity on Access to Quality Healthcare in Urban Ghana.","authors":"Amos Apreku, Gamji Rabiu Abu-Ba'are, Debbie Dada, Marcel Foster, Melissa A Stockton, Gloria A Aidoo-Frimpong, Oneil Fahd Osei Kuffour, Gilbert Adjei, Adom Manu, Kwasi Torpey, Laura Nyblade, LaRon E Nelson, Carmen H Logie","doi":"10.1007/s11524-025-00964-1","DOIUrl":"10.1007/s11524-025-00964-1","url":null,"abstract":"<p><p>Globally, MSM experience severe health disparities, including an increased risk of HIV acquisition. In Ghana's urban centers, these disparities are influenced by intersectional stigma related to sexuality and gender nonconformity, yet limited research exists on the role of gender in driving stigma in the day-to-day interactions of MSM. This study is aimed at understanding (1) the experiences of gender identity and roles among MSM in Ghana and (2) how these experiences of gender shape daily urban life in Ghanaian social interactions, including interpersonal interactions in healthcare settings. We conducted a qualitative description using secondary data generated from focus groups and in-depth interviews with adult MSM and health care workers in Accra and Kumasi, Ghana. Data were analyzed using qualitative content analysis. We identified five factors that describe the experiences of gender roles, identities, and relations and identified one theme regarding the influence of gender on MSM daily life. First, understandings of gender roles were influenced by local binary gendered expectations regarding (1) appearance and presentation, (2) physical characteristics and personality traits, and (3) household and community responsibilities. The experience of gender identity was informed by perceptions of its (4) relationship to or (5) independence from physical anatomy. In Ghana, men's gender nonconformity and its linkages to discrimination are complex, context dependent, and evolving. The interplay between gender nonconformity and same-gender sex stigma undermines access to quality health care and threatens the well-being of Ghanaian MSM.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"413-422"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671664","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":"Is Income and Racial Residential Segregation Associated with 13-Year Changes in Body Mass Index? A Longitudinal Analysis in the Brazilian Pró-Saúde Cohort Study.","authors":"Joanna M N Guimarães, Ana Paula Vasconcelos, Marcelo Cunha, Eduardo Faerstein","doi":"10.1007/s11524-024-00949-6","DOIUrl":"10.1007/s11524-024-00949-6","url":null,"abstract":"<p><p>Neighborhoods or residential environments have physical and social attributes which may contribute to inequalities in the overweight and obesity pandemic. We examined the longitudinal associations of baseline neighborhood-level income and racial residential segregation (using the Gi* statistic: low, medium, high) with changes in body mass index (BMI in kg/m²), using geocoded data from 1821 civil servants in the municipality of Rio de Janeiro, Brazil, followed-up for approximately 13 years (baseline wave 1: 1999, wave 2: 2001-2002, wave 3: 2006-2007, wave 4: 2012-2013). Linear mixed effects models using BMI measured in all four study waves were performed, accounting for gender, race, length of residence, education and time-dependent age, and per capita family income. After adjustments, both income and racial segregation were positively associated with BMI differences (but not BMI changes) over time, in a dose-response pattern. For income segregation, mean differences in BMI for participants living in high and medium vs. low segregated neighborhoods were 1.04 kg/m² (β = 1.04; 95% CI 0.47, 1.62) and 0.86 kg/m² (0.86; 0.33, 1.39), respectively. For racial segregation, mean differences in BMI for participants living in high and medium vs low segregated neighborhoods were 0.71 kg/m² (0.71; 0.14, 1.29) and 0.30 kg/m² (0.30; - 0.24, 0.83), respectively. We also showed a moderate to strong correlation between racial and income segregation at baseline. Strategies to reduce BMI and obesity-related health inequalities should include special efforts aimed at segregated neighborhoods and its obesogenic environments.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"250-258"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933296","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":"Persistent Effect of Redlining on Survival from Screenable Cancers in Washington State, 2000-2018.","authors":"Solmaz Amiri, Anthippy Petras, Dedra Buchwald","doi":"10.1007/s11524-025-00973-0","DOIUrl":"10.1007/s11524-025-00973-0","url":null,"abstract":"<p><p>This study examined the extent to which the 1930s Home Owners' Loan Corporation (HOLC) redlining grades are associated with contemporary survival from screenable cancers among residents of three largest cities in Washington State. Redling assigned a mortgage security metric to neighborhoods. We used 2000-2018 data from the Washington State Cancer Registry to examine differences in survival from all-cause and cancer-specific mortality for breast (n = 14,725), cervical (n = 656), colorectal (n = 7,089), and lung (n = 8,365). Survival was examined in HOLC areas graded as A (best); B (still desirable); C (declining); and D (redlined) using Kaplan-Meier and Cox proportional hazards regression techniques. Among patients with breast cancer, the hazard ratio for all-cause mortality was highest for areas graded D followed by C and B. For colorectal and lung cancer, the hazard ratio for all-cause mortality was highest for areas graded C followed by D and B. The estimated marginal slopes for the log hazard of mortality decreased over time in HOLC areas graded A, B, and C for breast and lung cancers, and in areas graded D for colorectal and lung cancers. HOLC grade was not associated with survival among cervical cancer patients. These findings call for efforts to reduce screenable - but often unrecognized - health inequalities associated with residential location.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"290-304"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781578","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":"Social Vulnerability and Biological Aging in New York City: An Electronic Health Records-Based Study.","authors":"Pablo Knobel, Elena Colicino, Itai Kloog, Rachel Litke, Kevin Lane, Alex Federman, Charles Mobbs, Maayan Yitshak Sade","doi":"10.1007/s11524-024-00948-7","DOIUrl":"10.1007/s11524-024-00948-7","url":null,"abstract":"<p><p>Chronological age is not an accurate predictor of morbidity and mortality risk, as individuals' aging processes are diverse. Phenotypic age acceleration (PhenoAgeAccel) is a validated biological age measure incorporating chronological age and biomarkers from blood samples commonly used in clinical practice that can better reflect aging-related morbidity and mortality risk. The heterogeneity of age-related decline is not random, as environmental exposures can promote or impede healthy aging. Social Vulnerability Index (SVI) is a composite index accounting for different facets of the social, economic, and demographic environment grouped into four themes: socioeconomic status, household composition and disability, minority status and language, and housing and transportation. We aim to assess the concurrent and combined associations of the four SVI themes on PhenoAgeAccel and the differential effects on disadvantaged groups. We use electronic health records data from 31,913 patients from the Mount Sinai Health System (116,952 person-years) and calculate PhenoAge for years with available laboratory results (2011-2022). PhenoAge is calculated as a weighted linear combination of lab results, and PhenoAgeAccel is the differential between PhenoAge and chronological age. A decile increase in the mixture of SVI dimensions was associated with an increase of 0.23 years (95% CI 0.21, 0.25) in PhenoAgeAccel. The socioeconomic status dimension was the main driver of the association, accounting for 61% of the weight. Interaction models revealed a more substantial detrimental association for women and racial and ethnic minorities with differences in leading SVI themes. These findings suggest that neighborhood-level social vulnerability increases the biological age of its residents, increasing morbidity and mortality risks. Socioeconomic status has the larger detrimental role among the different facets of social environment.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"240-249"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985237","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":"Expanded Naloxone Distribution by Opioid Overdose Prevention Programs to High-Need Populations and Neighborhoods in New York City.","authors":"Czarina N Behrends, Andrew J Trinidad, Michelle L Nolan, Jennifer Dolatshahi, Alexandra Kingsepp, Ashly E Jordan, Alice E Welch, Alex Harocopos, Leah C Shaw, Traci C Green, Brandon D L Marshall, Bruce R Schackman","doi":"10.1007/s11524-024-00951-y","DOIUrl":"10.1007/s11524-024-00951-y","url":null,"abstract":"<p><p>From 2014 to 2017, the drug overdose death rate per 100,000 in New York City (NYC) increased by 81%, with 57% of overdoses in 2017 involving the opioid fentanyl. In response, overdose education and naloxone dispensing (OEND) efforts were expanded in NYC, informed by neighborhood-level and population-level opioid overdose fatality rates. We describe the demographic and geographical distribution of naloxone by NYC opioid overdose prevention programs (OOPPs; the primary distributor of naloxone to laypersons in NYC) as OEND was expanded in NYC. We developed and examined a measure of high-need naloxone distribution defined by OEND in a high-priority neighborhood, to a high-need population, or from a high-priority OOPP (i.e., syringe services programs, criminal legal-related programs, programs for unhoused people, substance use disorder treatment programs, etc.). We reported recipient-level naloxone dispensing data by OOPP type from April 2018 to March 2019 using descriptive statistics and age-adjusted population rates. We conducted univariable logistic regression analyses to identify predictors of naloxone receipt by race/ethnicity. Of the 69,333 naloxone recipients, 97.3% met our definition for high-need naloxone dispensing, with 55.8% residing in one of 13 high-priority neighborhoods. Naloxone receipt by race/ethnicity varied by OOPP type. Program goals to expand naloxone distribution to high-need populations were met. We observed racial/ethnic differences in receipt of naloxone by program type, which supports using a variety of OOPP program types to reach racially diverse populations.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"459-464"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015156","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":"Examining the Association between Heat Exposure and Crime in Cities across the United States: A Scoping Review.","authors":"Alexander Azan, Jin Choi, Ellicott C Matthay, Frank Pezzella, Mehdi Heris, David C Lee, Byoungjun Kim","doi":"10.1007/s11524-025-00970-3","DOIUrl":"10.1007/s11524-025-00970-3","url":null,"abstract":"<p><p>Growing evidence suggests exposure to high temperatures may result in increased urban crime, a known driver of health and health inequity. Theoretical explanations have been developed to describe the heat-crime relationship without consensus yet achieved among experts. This scoping review aims to summarize evidence of heat-crime associations in U.S. cities. Further examination of empirical and translational inconsistencies in this literature will ensure future studies of urban heat-crime relationships in the U.S., and their policy impacts are informed by a thorough understanding of existing evidence. We performed a comprehensive literature search of empirical studies on heat-crime relationships in U.S. cities published between January 2000 and August 2023. The included studies were qualitatively synthesized based on operationalized exposures, outcomes, covariates, methodologies, theoretical framing, and policy implications. In total, 46 studies were included in this review. Most studies (93%) reported significant, positive associations between urban heat exposure and both violent and non-violent crime outcomes. The shape and strength of these associations varied based on operational definitions of urban heat exposures, crime outcomes, and relevant covariates in employed methods. We also found inconsistencies in the theoretical explanations and policy implications reported across studies. Climate-driven extreme heat events are projected to increase in frequency and severity. Our findings underscore the urgency of refining the understanding and translation of the complex relationship between urban heat and crime. In this review, we highlight opportunities to improve the methodological quality and responsible policy translation of future research in U.S. cities, which has implications for research globally.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"352-378"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606802","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":"Impact of the COVID-19 Pandemic on Social Support Networks of Gay and Bisexual Men with HIV in New York City.","authors":"Jorge H Soler, Victoria A Frye, Vijay Nandi, Melonie Walcott, Abena Bosompem, José E Diaz, Emily Greene, Carl Latkin, Hong Van Tieu","doi":"10.1007/s11524-025-00965-0","DOIUrl":"10.1007/s11524-025-00965-0","url":null,"abstract":"<p><p>The COVID-19 pandemic, and the ensuing social policies enacted to control viral transmission of SARS-CoV-2, has had a significant impact on social support networks. For people living with HIV (PWH), including gay, bisexual, and other men who have sex with men (GBMSM), social support networks serve additional purposes in the self-management of HIV care and psychosocial health. Given the broad-reaching effects of the pandemic, characterizing its impact on specific dimensions of social support networks remains a prime area of investigation. We used egocentric social network data from an on-going longitudinal study of GBMSM with HIV, living in New York City (NYC), to examine changes in the structural, interactional, and functional characteristics of their social support networks from pre- to post-start of the pandemic. We analyzed data from 146 GBMSM who reported a total of 164 social support network members. We found that the average size of social support member networks increased over time, of which 57% and 25% provided companionship and confidant support, respectively. Follow-up questions about how often guidance, tangible, and emotional support was provided (if needed) suggest the quality of support decreased over time. At follow-up, nearly half (49%) of network members were friends, the vast majority (89%) were aware of GBMSM's HIV status, and most (74%) were also living within NYC. Characterizing the changes in social support networks over the course of the COVID-19 pandemic can help identify areas of need and resilience, especially for key populations such as GBMSM with HIV.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"423-431"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665216","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":"Community Acceptability of the First State-Authorized Overdose Prevention Center in the United States.","authors":"Leah C Shaw, Jacqueline E Goldman, Catherine A Lenox, Maxwell S Krieger, Brandon D L Marshall, Alexandria Macmadu","doi":"10.1007/s11524-025-00978-9","DOIUrl":"https://doi.org/10.1007/s11524-025-00978-9","url":null,"abstract":"<p><p>Overdose prevention centers (OPCs) offer supervised environments for drug consumption and harm reduction services, yet their implementation in the United States (US) remains limited. The present study analyzed the perspectives of residents and employees within a 0.75-mile radius of the first state-authorized OPC in the US (N=125). Surveys revealed that 74% supported an OPC opening in their neighborhood, with a slightly higher proportion (81%) favoring an OPC elsewhere in the city. Support for an OPC was associated with greater perceived visibility of homelessness in the neighborhood (p=0.04) and younger age (p=0.01) but was not significantly associated with other socio demographics. While participants were generally supportive, some expressed concerns about increased drug activity. Findings may have been impacted by grassroots education and public awareness campaigns. Results emphasize the importance of engaging with community members to build support for evidence-based harm reduction interventions such as OPCs.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":"102 2","pages":"476-481"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013347","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":"Less-Lethal Weapons and Civilian Injury in Police Use of Force Encounters: A Multi-agency Analysis.","authors":"Kevin Petersen, Christopher S Koper, Bruce G Taylor, Weiwei Liu, Jackie Sheridan-Johnson","doi":"10.1007/s11524-024-00940-1","DOIUrl":"10.1007/s11524-024-00940-1","url":null,"abstract":"<p><p>Police use-of-force is a growing public health concern, with recent estimates suggesting that over 70,000 people are injured by police each year. To reduce the risk of injury to civilians, most police agencies authorize the use of various less-lethal weapons. However, to date, there is little consensus as to which types of less-lethal weapons are most effective at reducing injury risk. In this study, we test the differential effects of less-lethal weapons on civilian injury and injury severity using data on 2348 use-of-force incidents originating from 17 large urban and metropolitan law enforcement agencies from 2015 to 2019. Specifically, we assess the injury risks associated with conducted energy devices, chemical agents, impact weapons, and police canines, while controlling for a robust set of officer, civilian, and situational characteristics. Our results indicate that chemical agents reduce the risk of hospitalization or death significantly more than other weapon types, while police canines increase the risk of all injury outcomes significantly more than other weapon types. Adjusting for incident characteristics, chemical agents are predicted to cause hospitalization or death in 4% of cases, compared to 13% for conducted energy devices, 16% for impact weapons, and 37% for police canines. These findings suggest that civilian injury may be reduced through use-of-force policies that prioritize less severe modalities of force, though more research is needed on the contextual and long-term effects of these weapons.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"389-399"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631744","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":"Drug Overdose Death among Residents of Urban Census Tracts: How Granular Geographical Analyses Uncover Socioenvironmental Correlates in Cuyahoga County, Ohio.","authors":"Ryan McMaster, Luma Masarweh-Zawahri, Karen Coen Flynn, Vaishali S Deo, Daniel J Flannery","doi":"10.1007/s11524-024-00939-8","DOIUrl":"10.1007/s11524-024-00939-8","url":null,"abstract":"<p><p>Geostatistical data aggregated at state, county, municipality, or ZIP code levels often are utilized for assessing drug overdose epidemic impact and planning resource distribution. Data aggregated at these levels may obscure critical disparities among populations experiencing high rates of drug-related mortality (DRM), especially in densely populated urban areas. Our research was centered on Cuyahoga County (Cleveland), OH, which ranks 15th in the USA for drug-related mortality. This study built on recent efforts that adopted a finer geographical lens by examining DRM rates at the census tract level. Our investigation used Cuyahoga County census tracts with high and low DRM rates and compared them with Cuyahoga County census tracts with high and low levels of opportunity as developed by a publicly available, statewide opportunity index. Analyzing DRM data from 2014 to 2022, we found that the odds of an individual experiencing DRM in low-opportunity areas were quadruple the odds for someone in high-opportunity zones. Our findings highlight the critical need for more granular geographic analysis in urban areas, where heterogenous socioenvironmental conditions appear to correlate with significant heterogeneity in the ways in which residents experience the risk of dying from a drug overdose. By focusing on smaller areas, this approach provides a clearer understanding of the DRM landscape that could facilitate the prioritization of more targeted, culturally centered, public health interventions.</p>","PeriodicalId":49964,"journal":{"name":"Journal of Urban Health-Bulletin of the New York Academy of Medicine","volume":" ","pages":"445-458"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774213","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}