{"title":"The risk of complaints against occupational physicians to the medical regulatory body in Ireland.","authors":"Deirdre Gleeson","doi":"10.1093/occmed/kqad136","DOIUrl":"10.1093/occmed/kqad136","url":null,"abstract":"","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risks of occupational mental disorders in Korean civil servants (2009-18).","authors":"B-Y Choi, K-B Min, S-W Ryoo, J-Y Min","doi":"10.1093/occmed/kqae041","DOIUrl":"10.1093/occmed/kqae041","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested that firefighters, police officers and civil servants in the education sector, particularly in Western countries, are vulnerable to mental stress and disorders; however, evidence for this association in South Korea is lacking.</p><p><strong>Aims: </strong>This study aimed to identify whether firefighters, police officers and teachers are at a higher risk for occupational mental health disorders.</p><p><strong>Methods: </strong>We used workers' compensation claims from civil servants (2009-18). Our target population comprised 46 209 civil servants (9009 civil servants in administrative and technical positions, 23 107 police officers, 4417 firefighters and 8676 civil servants in the educational sector). Occupational and environmental medicine physicians and medical doctors defined and confirmed mental disorders. We conducted Cox proportional hazards regression analyses to evaluate civil servants' risk of occupational mental health disorders.</p><p><strong>Results: </strong>Compared with the civil servants in administrative and technical positions, civil servants in the education sector (hazard ratio [HR] = 2.16; 95% confidence interval [CI]:1.65-2.84) showed a statistically significant increased risk of mental disorders; conversely, firefighters did not (HR = 0.80; 95% CI 0.51-1.27). Police officers had a significantly decreased mental disorder risk compared with civil servants in administrative and technical positions (HR = 0.17; 95% CI 0.11-0.25).</p><p><strong>Conclusions: </strong>The risk of occupational mental health disorders was higher in civil servants in the education sector but lower in police officers and firefighters than civil servants in administrative and technical positions. Further studies on civil servants' mental health awareness are required to confirm our results.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accuracy of chest x-ray screening of silica-exposed miners for tuberculosis.","authors":"B Maboso, R I Ehrlich","doi":"10.1093/occmed/kqae043","DOIUrl":"10.1093/occmed/kqae043","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization recommends systematic chest X-ray (CXR) screening for tuberculosis (TB) in silica-exposed workers. However, evidence on the accuracy of CXR screening in such populations is lacking.</p><p><strong>Aims: </strong>To measure the accuracy of CXR screening for active TB in silica-exposed miners, in a population with a high prevalence of silicosis, post-TB lung disease and HIV.</p><p><strong>Methods: </strong>A secondary analysis of data from a miner screening programme in Lesotho was undertaken. We measured the performance of CXR (in participants with and without cough) for 'abnormalities suggestive of TB' against Xpert MTB/RIF (Xpert). The sample size was 2572 and positive Xpert prevalence was 3%.</p><p><strong>Results: </strong>CXR alone had high sensitivity (0.93, 95% confidence interval [CI] 0.87-0.99), but low specificity (0.41, 95% CI 0.39-0.42). Requiring cough and a positive CXR increased specificity (0.79, 95% CI 0.77-0.81), resulting in reduced sensitivity (0.41, 95% CI 0.30-0.52). There was no difference in CXR accuracy by HIV status. However, specificity was markedly reduced in the presence of silicosis (from 0.70, 95% CI 0.68-0.72, to 0.03, 95% CI 0.02-0.04) or past TB history (from 0.59, 95% CI 0.56-0.62 to 0.27, 95% CI 0.25-0.29). Throughout, positive predictive value remained very low (5%) and negative predictive value very high (99%).</p><p><strong>Conclusions: </strong>CXR screening accurately identifies TB-negative CXRs in this population, but post-TB lung disease and silicosis would result in a high proportion of Xpert-negative referrals and an increased risk of unneeded empirical treatment. Adapted screening algorithms, practitioner training and digital access to previous mining CXRs are needed.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mental health and employment outcomes in working-age US adults, 2010-2019.","authors":"J Jou, A Hicks, P J Johnson","doi":"10.1093/occmed/kqae054","DOIUrl":"https://doi.org/10.1093/occmed/kqae054","url":null,"abstract":"<p><strong>Background: </strong>Individuals with severe mental illness experience greater unemployment and barriers to workforce re-entry. However, less is known about additional indicators of employment stability for individuals across mental illness severity.</p><p><strong>Aims: </strong>This study aims to examine associations between mental illness severity, use and adequacy of mental health treatment, and indicators of employment stability.</p><p><strong>Methods: </strong>In this repeated cross-sectional study, 2010-2019 data from the U.S. National Survey of Drug Use and Health were used to construct multivariate logistic regression models predicting the odds of part-time employment, past-year work interruption, number of past-year employers, and past-month health-related work absence by mental illness severity and adequacy of mental health treatment.</p><p><strong>Results: </strong>Compared to individuals with no mental illness, those with any and severe mental illness had significantly higher odds of part-time employment (adjusted odds ratios [AORs] = 1.51 and 2.16, 95% confidence intervals [CIs] 1.4-1.6 and 2.0-2.3), multiple past-year employers (AORs = 1.78 and 2.34, CIs 1.7-1.9 and 2.1-2.6), past-year work interruption (AORs = 1.69 and 2.20, CIs 1.6-1.8 and 2.1-2.4), and >7 days of past-month work absence (AORs = 2.51 and 3.82, CIs 2.3-2.8 and 3.3-4.5). Among respondents with mental illness, perceived inadequacy of mental treatment predicted higher odds of all adverse employment outcomes.</p><p><strong>Conclusions: </strong>Compared to those with no mental illness, individuals with mental illness of any severity have higher odds of employment instability. Policy and programmatic support aimed at addressing the needs of individuals with mental illness, including access to adequate mental health treatment, are needed to facilitate continued, competitive employment.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H Yang, S Kim, S-H Yoo, Y Mun, M L Choi, J A Lee, E Song
{"title":"Sleep quality according to chronotype in nurses working 8-hour shifts.","authors":"H Yang, S Kim, S-H Yoo, Y Mun, M L Choi, J A Lee, E Song","doi":"10.1093/occmed/kqae029","DOIUrl":"10.1093/occmed/kqae029","url":null,"abstract":"<p><strong>Background: </strong>To date, studies have been focused on sleep disturbances of nurses working during night shifts. There is a lack of understanding regarding the sleep quality of nurses working in the rapid rotation system for each type of shift work.</p><p><strong>Aims: </strong>To determine the relationship between chronotype and sleep quality according to shift type (i.e. day, evening and night shifts) in nurses working 8-hour rotating shifts.</p><p><strong>Methods: </strong>A cross-sectional, descriptive study was conducted from two tertiary hospitals in South Korea from December 2021 to September 2022, including nurses working 8-hour rotating shifts (N = 74). They completed questionnaires to measure general, occupational and sleep-related characteristics, chronotype, insomnia severity and daytime sleepiness. Additionally, sleep parameters were collected from actigraphy and sleep diaries for 7 days.</p><p><strong>Results: </strong>A total of 64% of nurses had an evening chronotype and 37% of nurses had an intermediate chronotype. Nurses had significantly less total sleep time and worsened sleep latency and efficiency during the day shift compared to other shift types. Compared to nurses with an intermediate chronotype, those with an evening chronotype had poorer sleep quality during day shift work.</p><p><strong>Conclusions: </strong>Strategies to enhance nurses' sleep quality during day shifts should consider a two-level approach: individual approaches, such as improving sleep hygiene, and administrative approaches, such as establishing a chronotype-based shift system for scheduling.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G Palermo, S D'Angelo, G Ntani, G Bevilacqua, K Walker-Bone
{"title":"Work and Retirement Among Women: The Health and Employment After Fifty Study.","authors":"G Palermo, S D'Angelo, G Ntani, G Bevilacqua, K Walker-Bone","doi":"10.1093/occmed/kqae035","DOIUrl":"10.1093/occmed/kqae035","url":null,"abstract":"<p><strong>Background: </strong>Women increasingly work beyond age 50+ but their occupational health is under-researched.</p><p><strong>Aims: </strong>To investigate what jobs older contemporary women do, when they exit their jobs and what factors predict job exit.</p><p><strong>Methods: </strong>Data came from the Health and Employment After Fifty cohort, which recruited women aged 50-64 at baseline in 2013-14 and has followed them up annually collecting: demographic, lifestyle and work information. Exits from employment were mapped longitudinally over five follow-ups. Time-to-first event Cox regression analyses were used to identify risk factors for job exit.</p><p><strong>Results: </strong>At baseline, 4436 women participated, 64% of whom were working. The proportions of women working at 50-54, 55-60 and over 60 years were 86%, 79% and 38%, respectively. Amongst all women, after adjustment for age, managing comfortably financially and not coping with the mental demands of the job were associated with exit. Risk factors for job exit differed in the age bands: 50-54; 55-59 and >60 years, reflecting socio-economic status, markers of health (musculoskeletal pain and poor self-rated health) and work factors (under-appreciation, job dissatisfaction, temporary/permanent contracts, coping with work's physical demands).</p><p><strong>Conclusions: </strong>Factors contributing to exit from work among older women differ by age group, after controlling for perceived financial position, age and mental demands of the job. A number of work characteristics predict job exit and suggest that employers can play an important role in supporting women to continue working until older ages. Identification and treatment of musculoskeletal pain could also enable work amongst older women.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Akhanemhe, S A M Stevelink, A Corbett, C Ballard, H Brooker, B Creese, Dag Aarsland, Adam Hampshire, Neil Greenberg
{"title":"Cardiovascular and lifestyle risk factors of mild cognitive impairment in UK veterans and non-veterans.","authors":"R Akhanemhe, S A M Stevelink, A Corbett, C Ballard, H Brooker, B Creese, Dag Aarsland, Adam Hampshire, Neil Greenberg","doi":"10.1093/occmed/kqae027","DOIUrl":"10.1093/occmed/kqae027","url":null,"abstract":"<p><strong>Background: </strong>The link between poor cardiovascular health (CVH), lifestyle and mild cognitive impairment (MCI) has been well established in the general population. However, there is limited research exploring these associations in ageing UK veterans.</p><p><strong>Aims: </strong>This study explored the risk of MCI and its association with nine CVH and lifestyle risk factors (including diabetes, heart disease, high cholesterol, high blood pressure, obesity, stroke, physical inactivity, the frequency of alcohol consumption and smoking) in UK veterans and non-veterans.</p><p><strong>Methods: </strong>This prospective cohort study comprised data from the PROTECT study between 2014 and 2022. Participants comprised of UK military veterans and non-veterans aged ≥50 years at baseline. Veteran status was defined using the Military Service History Questionnaire. CVH and lifestyle risk factors were defined using a combination of self-report measures, medication history or physical measurements. MCI was defined as the presence of subjective and objective cognitive impairment.</p><p><strong>Results: </strong>Based on a sample of 9378 veterans (n = 488) and non-veterans (n = 8890), the findings showed the risk of MCI significantly reduced in veterans with obesity, those who frequently consumed alcohol and were physically inactive compared to non-veterans. The risk of MCI significantly increased in veterans with diabetes (hazards ratio [HR] = 2.22, 95% confidence interval [CI] 1.04-4.75, P ≤ 0.05) or high cholesterol (HR = 3.11, 95% CI 1.64-5.87, P ≤ 0.05) compared to veterans without.</p><p><strong>Conclusions: </strong>This study identified CVH and lifestyle factors of MCI in UK veterans and non-veterans. Further work is needed to understand these associations and the underpinning mechanisms which could determine intervention strategies to reduce the risk of MCI.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Appelbom, A Nordström, A Finnes, R K Wicksell, A Bujacz
{"title":"Healthcare worker burnout during a persistent crisis: a case-control study.","authors":"S Appelbom, A Nordström, A Finnes, R K Wicksell, A Bujacz","doi":"10.1093/occmed/kqae032","DOIUrl":"10.1093/occmed/kqae032","url":null,"abstract":"<p><strong>Background: </strong>During the immediate outbreak of the COVID-19 pandemic, burnout symptoms increased among healthcare workers. Knowledge is needed on how early symptoms developed during the persistent crisis that followed the first pandemic wave.</p><p><strong>Aims: </strong>To investigate if high levels of burnout symptoms during the first pandemic wave led to high burnout and depressive symptoms up to a year later, and if participation in psychological support was related to lower levels of symptoms.</p><p><strong>Methods: </strong>A longitudinal case-control study followed 581 healthcare workers from two Swedish hospitals. Survey data were collected with a baseline in May 2020 and three follow-up assessments until September 2021. The case group was participants reporting high burnout symptoms at baseline. Logistic regression analyses were performed separately at three follow-ups with case-control group assignment as the main predictor and burnout and depression symptoms as outcomes, controlling for frontline work, changes in work tasks and psychological support participation.</p><p><strong>Results: </strong>One out of five healthcare workers reported high burnout symptoms at baseline. The case group was more likely to have high burnout and depressive symptoms at all follow-ups. Participation in psychological support was unrelated to decreased burnout and depressive symptoms at any of the follow-ups.</p><p><strong>Conclusions: </strong>During a persistent crisis, healthcare organizations should be mindful of psychological reactions among staff and who they place in frontline work early in the crisis. To better prepare for future healthcare crises, preventive measures on burnout are needed, both at workplaces and as part of the curricula in medical and nursing education.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D Consonni, G Stoppa, A Binazzi, B Dallari, S Stella, S Rugarli, C Trobbiani, A Biggeri, D Catelan, C Mensi
{"title":"Sinonasal cancer incidence in Lombardy, Italy, 2008-20.","authors":"D Consonni, G Stoppa, A Binazzi, B Dallari, S Stella, S Rugarli, C Trobbiani, A Biggeri, D Catelan, C Mensi","doi":"10.1093/occmed/kqae034","DOIUrl":"10.1093/occmed/kqae034","url":null,"abstract":"<p><strong>Background: </strong>Epithelial sinonasal cancers (SNC) are rare tumours with recognized associations with known/suspected occupational carcinogens (wood/leather dust, nickel/chromium compounds and formaldehyde). In Italy, a national SNC registry organized as a network of regional registries was established by law in 2008.</p><p><strong>Aims: </strong>To describe SNC time trends, occupational exposures and geographical distribution in Lombardy, North-West Italy, based on population registry data (2008-20).</p><p><strong>Methods: </strong>The Lombardy SNC Registry records epithelial SNCs using various sources. Interviews to collect occupational history are performed using a standardized questionnaire. Using several standard populations, we calculated yearly crude and age-standardized rates (ASRs per 100,000 person-years). Standardized incidence ratios (SIR) at municipality level were calculated, and Bayesian models were fitted to produce smoothed SIR maps.</p><p><strong>Results: </strong>We recorded 827 cases (553 men, 274 women). Crude (world standardized) ASRs were 0.9 (0.4) in men and 0.4 (0.2) in women, with no time trends. Interviews were obtained for 485 (88%) men and 223 (81%) women. Among men, 217 (45%) had been exposed to occupational carcinogens (wood/leather dust: 150/65 cases, 31%/13%), while only 36 women (16%) were exposed. Among 201 men with adenocarcinoma, exposure to wood/leather dust occurred in 103/50 cases (75%/50%). Areas with elevated SIRs associated with leather dust were found in the Western areas. Exposure to wood dust was more widespread.</p><p><strong>Conclusions: </strong>This study found a high frequency of occupational exposures (wood and leather dust), particularly in men with SNC. Employment in shoe industries clustered in the Western part, while work in furniture industries was less spatially structured.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Occupational exposures and sarcoidosis: a rapid review of the evidence.","authors":"M Rezai, A Nayebzadeh, S Catli, D McBride","doi":"10.1093/occmed/kqae016","DOIUrl":"10.1093/occmed/kqae016","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a rare, multisystem, inflammatory condition associated with the formation of granulomas. Diagnosis can be challenging because of non-specific symptoms complicating epidemiological investigations of its aetiology. Despite research efforts, a review of the current state of the evidence is needed.</p><p><strong>Aims: </strong>To assess the evidence for an association between occupational exposures and the development of sarcoidosis. To determine if workers in any occupation are at a greater risk of developing sarcoidosis.</p><p><strong>Methods: </strong>This rapid review follows the methodology suggested by the World Health Organization. Two electronic databases were systematically searched until April 2022. The methodological quality of the studies was critically appraised, and a best-evidence approach was used to synthesize the results.</p><p><strong>Results: </strong>Titles and abstracts of 2916 articles were screened, with 67 full-text articles reviewed for eligibility. Among the 13 studies eligible for this review, none were of high quality (i.e. low risk of bias). Six studies exploring the association between sarcoidosis and a range of occupations and exposures, and one previous systematic review were of low quality reporting inconsistent findings. Six studies examined the risk of sarcoidosis associated with occupational silica exposure, two of which were of acceptable quality. Overall, the study methodologies and results were inadequate to support causal relationships.</p><p><strong>Conclusions: </strong>There is limited evidence of acceptable methodological quality to assess the risk of sarcoidosis associated with occupational exposures. There is a growing body of research examining occupational exposure to silica and sarcoidosis. Additional high-quality confirmatory research is needed.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}