Journal of Epidemiology and Community Health最新文献

{"title":"Estimating the risk reduction in disability incidence by adhering to recommendation-based physical activity in older adults: a cohort study.","authors":"Masasnori Morikawa, Kenji Harada, Satoshi Kurita, Chiharu Nishijima, Kazuya Fujii, Daisuke Kakita, Yukari Yamashiro, Naoto Takayanagi, Motoki Sudo, Hiroyuki Shimada","doi":"10.1136/jech-2024-223574","DOIUrl":"https://doi.org/10.1136/jech-2024-223574","url":null,"abstract":"<p><strong>Background: </strong>The WHO recommends ≥150 min/week of moderate-to-vigorous physical activity (MVPA) for older adults, while the Japanese Ministry of Health, Labour and Welfare suggests ≥6000 steps/day. However, the potential of meeting these recommendations to reduce the incidence of disability remains unclear.</p><p><strong>Methods: </strong>This study included 4079 community-dwelling older people from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. Physical activity was measured using triaxial accelerometers over 1 month, with 12-month data used in sensitivity analyses. Disability incidence was defined as new certification by the Japanese Long-Term Care Insurance system for 58 months. To compare the cumulative incidence of disability between adherent and non-adherent groups, we applied the parametric g-formula accounting for sociodemographic, physical and medical covariates.</p><p><strong>Results: </strong>For MVPA adherence, disability incidence was reduced by -2.17% (95% CI -4.50% to 0.16%). Continuous MVPA adherence over 12 months significantly reduced disability incidence by -3.15% (95% CI -6.08% to -0.22%). A significant reduction in severe disability incidence was observed with MVPA adherence (-1.18%, 95% CI -3.59% to -0.17%). Subgroup analyses indicated greater reductions in disability incidence among individuals aged <75 years (-2.56%, 95% CI -4.81% to -0.31%). For daily step adherence, the largest risk reduction was observed in the subgroup of older adults aged ≥75 years (-4.40%, 95% CI -10.12% to 1.33%), although the CI was wide.</p><p><strong>Conclusions: </strong>Adherence to recommendation-based physical activity may effectively prevent disability in community-dwelling Japanese older adults.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between neighbourhood socioeconomic disadvantage and body mass index: longitudinal evidence from the Household, Income and Labour Dynamics in Australia Survey (2006-2021).","authors":"Jennifer Nkemdilim, Venurs Loh, Rebecca A Reid, Jerome N Rachele","doi":"10.1136/jech-2025-223799","DOIUrl":"https://doi.org/10.1136/jech-2025-223799","url":null,"abstract":"<p><strong>Background: </strong>Obesity prevalence differs by neighbourhood. One such characteristic of these neighbourhoods is the level of socioeconomic disadvantage. Understanding the nature of neighbourhood socioeconomic inequalities is important for shaping targeted interventions and policies to promote equitable access to resources and opportunities that support healthy living. The aim of this study was to examine associations between neighbourhood socioeconomic disadvantage and body mass index (BMI) over a 16-year period among a population-representative Australian sample.</p><p><strong>Methods: </strong>This study used data from 208 309 observations collected between 2006 and 2021 from the Household, Income and Labour Dynamics in Australia Survey. Neighbourhood disadvantage was measured via a census-derived index, and participants self-reported height and weight, which was computed to BMI. Data were analysed using multilevel and fixed effects regression to examine overall associations, trends over time and changes in neighbourhoods with changes in BMI.</p><p><strong>Results: </strong>There was an overall association between neighbourhood socioeconomic disadvantage and BMI. BMI was higher among those in the most disadvantaged neighbourhoods compared with the least disadvantaged neighbourhoods (β=1.31, 95% CI 1.15 to 1.46). BMI trends over time were widening with greater increases in BMI among those in the most disadvantaged neighbourhoods (Q1: β=0.04, 95% CI 0.02 to 0.06 and Q2: β=0.05, 95% CI 0.03 to 0.06). Changes in the level of neighbourhood socioeconomic disadvantage were positively associated with changes in BMI, with the strongest association among those transitioning to more disadvantaged neighbourhoods (Q1: β=0.10, 95% CI 0.02 to 0.18 and Q2: β=0.08, 95% CI 0.02 to 0.15).</p><p><strong>Conclusions: </strong>Using methodologically rigorous epidemiological approaches along with longitudinal, national data, this study found strong evidence of neighbourhood socioeconomic inequalities in BMI. Understanding the neighbourhood-level mechanisms likely to exacerbate these inequalities remains a future research priority.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the differential effects on employment of a community wealth building programme in England: a difference-in-differences study.","authors":"Tanith C Rose, Konstantinos Daras, Mick McKeown, Tom Lloyd Goodwin, Julian Manley, Benjamin Barr","doi":"10.1136/jech-2024-223499","DOIUrl":"https://doi.org/10.1136/jech-2024-223499","url":null,"abstract":"<p><strong>Background: </strong>People-centred initiatives to create and retain local wealth, such as Community Wealth Building (CWB), have potential to stimulate regional economic regeneration that addresses economic inequalities by increasing the economic inclusion of more disadvantaged groups. Preston, a relatively deprived city in England, has implemented a CWB programme that has been associated with improvements in local wages and well-being. We estimated the effect of Preston's CWB programme on employment and examined differential effects by disability status and other equality dimensions.</p><p><strong>Methods: </strong>We conducted a difference-in-differences analysis combined with entropy balancing to estimate the effect of the introduction of the CWB programme in Preston on local employment rates, using individual-level data from the Annual Population Survey collected between 2011 and 2019. We performed subgroup analysis to investigate whether the effect on employment was modified by disability, ethnic group, sex or education level.</p><p><strong>Results: </strong>We analysed survey responses from 95 476 individuals. The introduction of the CWB programme was associated with an increase in the employment rate of 4% (95% CI 2.4% to 5.7%) among people living in Preston, compared with what would have been expected in the absence of the programme. The effect on employment was greater among people with disabilities, minority ethnic groups, men and people with lower levels of education.</p><p><strong>Conclusions: </strong>Our findings indicate that CWB can have a positive impact on employment over a relatively short period of time, which disproportionately benefits people with disabilities and other disadvantaged groups. This evidence can be used to inform the development, implementation and evaluation of CWB strategies in other places. Preston's CWB programme may represent a strategy to achieve more equitable economic growth and reduce health inequalities.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/jech-2025-224300","DOIUrl":"https://doi.org/10.1136/jech-2025-224300","url":null,"abstract":"","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic position, alcohol use and alcohol-attributable emergency department visits.","authors":"Brendan T Smith, Claire Benny, Alessandra T Andreacchi, Naomi Schwartz, Christine M Warren, Samantha Forbes, Erin Hobin","doi":"10.1136/jech-2024-222476","DOIUrl":"10.1136/jech-2024-222476","url":null,"abstract":"<p><strong>Background: </strong>Differential vulnerability to alcohol contributes to socioeconomic inequities in alcohol-attributable harm. This study aimed to estimate the sex-/gender-specific joint effects of socioeconomic position (SEP) and heavy episodic drinking or volume of alcohol use on 100% alcohol-attributable emergency department (ED) visits.</p><p><strong>Methods: </strong>We conducted a cohort study among 36 900 men and 39 700 women current and former alcohol consumers aged 15-64 from population-representative Canadian Community Health Surveys (2003-2008) linked to administrative ED visit data through 2017 in Ontario and Alberta. We estimated sex-/gender-specific associations between SEP (both education and income) and heavy episodic drinking (≥5 standard drinks on one occasion, at least monthly) or volume of alcohol use (standard drinks per week) on incident alcohol-attributable ED visits and assessed additive interactions using the Synergy Index (S).</p><p><strong>Results: </strong>Lower levels of education (eg, less than high school vs Bachelor's degree or above: men: adjusted HR (aHR)=3.71, 95% CI 2.47 to 5.58; women: aHR=1.75, 95% CI 1.15 to 2.68) and income (eg, quintile (Q)1 vs Q5, men: aHR=2.07, 95% CI 1.35 to 3.17; women: aHR=1.84, 95% CI 0.91 to 3.71) were associated with increased rates of alcohol-attributable ED visits. Among men and women, superadditive joint effects (ie, greater than the sum of both exposures experienced independently) were observed between low SEP (education and income) and heavy episodic drinking and higher volume of alcohol use on alcohol-attributable ED visits.</p><p><strong>Interpretation: </strong>Our results indicate that individuals with lower SEP experience increased vulnerability to alcohol use and related harms. These findings highlight the urgent need for population-level interventions that reduce both the high burden and socioeconomic inequities in alcohol-attributable harm.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"416-423"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonality in mortality and its impact on life expectancy levels and trends across Europe.","authors":"Isabella Marinetti, Dmitri A Jdanov, Domantas Jasilionis, Marília Nepomuceno, Nazrul Islam, Fanny Janssen","doi":"10.1136/jech-2024-223050","DOIUrl":"10.1136/jech-2024-223050","url":null,"abstract":"<p><strong>Background: </strong>Seasonal fluctuations in mortality affect annual life expectancy at birth (e₀). Nevertheless, evidence on the impact of seasonal mortality on longevity is very limited and mainly restricted to assessing season-specific mortality levels due to shocks (e.g., heatwaves and influenza epidemics). We investigated the influence of seasonality in mortality on life expectancy levels and temporal trends across 20 European countries during 2000-2019.</p><p><strong>Data and methods: </strong>We used harmonised weekly population-level mortality data from the Human Mortality Database. Seasonal contributions to life expectancy at birth and age 65, by sex, were estimated using the excess mortality approach and decomposition analysis. Time-series analysis was used to evaluate the impact on long-term mortality trends.</p><p><strong>Results: </strong>Seasonal mortality had a substantial but stable impact on e₀ between 2000 and 2019. On average, we found an annual reduction in life expectancy due to seasonal excess mortality of 1.14 years for males and 0.80 years for females. Deaths in the elderly population (65+) were the main driver of this impact: around 70% and 90% of these reductions in life expectancy were attributable to older ages. Excess mortality in winter had the strongest impact on annual life expectancy, especially in Portugal and Bulgaria (around 0.8-year loss on e₀).</p><p><strong>Conclusions: </strong>The study revealed significant cross-country variations in contributions of seasonal mortality. The most pronounced effects were observed in winter months and at older ages. These findings underscore the need for timely and targeted public health interventions to mitigate excess seasonal mortality.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"466-473"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential impact of cervical cancer in immigrant women: a decade-long epidemiological study in the Marche Region, Italy.","authors":"Katiuscia Di Biagio, Raffaella Bracci, Chiara Peconi, Beatrice Gasperini, Sonia Manasse, Marco Pompili, Donatella Sarti, Alice Lanari, Emilia Prospero","doi":"10.1136/jech-2024-222564","DOIUrl":"https://doi.org/10.1136/jech-2024-222564","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is primarily caused by persistent human papilloma virus (HPV) infections, with significant disparities observed in its burden, especially affecting immigrant populations from high HPV prevalence regions. This study evaluates the incidence and severity of cervical cancer in immigrant women in the Marche region, Italy, from 2010 to 2019.</p><p><strong>Methods: </strong>We employed a detailed analysis of population-based data from the Marche Cancer Registry using the age-standardised incidence rates (IRs) and Poisson regression models for in situ cervical cancer (ISCC) and infiltrating cervical cancer (ICC).</p><p><strong>Results: </strong>The IRs for ICC and ISCC among immigrant women are alarmingly higher compared with their Italian counterparts; IR for ICC in immigrant women is 26.5 per 100 000 women-years, compared with 7.9 in Italian women. For ISCC, the IR is 55.1 for immigrants versus 29.2 for Italians.Immigrant women showed a median age at diagnosis for ICC of 49 years, almost a decade younger than Italian women, and they were more likely to have squamous cell histology, which is linked to high-risk HPV strains.</p><p><strong>Conclusions: </strong>The study reveals a substantially higher incidence of both ISCC and ICC among immigrant women with ICC diagnosed 8 years previously. These findings underscore the pressing need for culturally and linguistically tailored public health interventions, including improved access to screening and vaccination for HPV, to address the elevated risk and earlier onset of cervical cancer in immigrant women in Italy. The study highlights the critical role of preventive measures in reducing health disparities and enhancing the efficacy of public health policies.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":"79 6","pages":"410-415"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic disease prevalence and preventive care among Ontario social housing residents compared with the general population: a population-based cohort study.","authors":"Gina Agarwal, Homa Keshavarz, Ricardo Angeles, Melissa Pirrie, Francine Marzanek, Francis Nguyen, Jasdeep Brar, J Michael Paterson","doi":"10.1136/jech-2024-222762","DOIUrl":"10.1136/jech-2024-222762","url":null,"abstract":"<p><strong>Background: </strong>Older adults living in social housing report poor health and access to healthcare services. This study aimed to estimate the prevalence of chronic diseases, influenza vaccination and cancer screenings among social housing residents versus non-residents in Ontario, Canada.</p><p><strong>Methods: </strong>We conducted a population-based cohort study for all health-insured Ontarians alive and aged 40 or older as of 1 January 2020. Social housing residents were identified using postal codes. Validated health administrative data case definitions were used to identify individuals with diabetes, hypertension, chronic obstructive pulmonary disease, asthma, congestive heart failure and cardiovascular disease. Influenza vaccination and mammography, Pap and colorectal cancer screenings were identified among screen-eligible residents using health administrative data.</p><p><strong>Results: </strong>The prevalence of all chronic diseases was higher among social housing residents across all age groups: 40-59, 60-79 and 80+ years. Influenza vaccination rates in 2018-2019 were lower among social housing residents aged 60-79 and 80+ years. Mammography rates for women aged 50-69 years in 2018-2019 were 10-11% lower among social housing residents across all age groups compared with non-residents. Pap screening rates for women aged 40-69 in 2018-2019 were 6-8% lower among social housing residents. The percentage of colorectal screening in both women and men aged 52-74 was lower (9-10% in men and 6-7% in women) in social housing compared with the general population in 2019-2020.</p><p><strong>Conclusion: </strong>There is a higher prevalence of chronic diseases and lower cancer screening rates among the growing population of older adults in social housing in Ontario, Canada.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"437-444"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Degree of housing damage caused by the Great East Japan Earthquake and all-cause mortality in the community-based cohort study of the Tohoku Medical Megabank Project.","authors":"Naoki Nakaya, Kumi Nakaya, Mana Kogure, Yuka Kotozaki, Rieko Hatanaka, Ippei Chiba, Sayuri Tokioka, Masato Takase, Satoshi Nagaie, Hideki Ohmomo, Takahito Nasu, Nobuo Fuse, Kozo Tanno, Atsushi Hozawa","doi":"10.1136/jech-2024-223084","DOIUrl":"10.1136/jech-2024-223084","url":null,"abstract":"<p><strong>Background: </strong>Natural disasters may have negative health effects on survivors. However, long-term observations on this are lacking. Therefore, this study investigated the association between the degree of housing damage caused by the Great East Japan Earthquake (GEJE) and all-cause mortality using the data from the cohort study conducted by the Tohoku Medical Megabank (TMM) Project in disaster-stricken areas.</p><p><strong>Methods: </strong>The community-based cohort study of the TMM Project which conducted a baseline survey from May 2013 to March 2016 collected data using questionnaires and blood and urine tests. The present large-scale prospective cohort study was a follow-up survey in which the degree of house damage and all-cause mortality were analysed using Cox proportional hazards regression, adjusting for sex, age and other potentially confounding variables. The degree of house damage was categorised into 'did not live in the disaster area', 'no damage', 'small-scale damage' and 'large-scale damage'. Among the 58 320 participants, 1763 deaths were confirmed during the follow-up which averaged 6.5 years.</p><p><strong>Results: </strong>The multivariate analysis showed a hazard ratio (95% CI) of 0.96 (0.82 to 1.13) for those who did not live in the disaster area, 0.98 (0.87 to 1.10) for small-scale damage and 0.98 (0.85 to 1.14) for large-scale damage, compared with no damage, but no significant association with all-cause mortality was observed.</p><p><strong>Conclusion: </strong>The results of this large-scale prospective cohort study of GEJE survivors showed no significant relationship between the degree of house damage and all-cause mortality. Further long-term follow-up studies are needed to examine the long-term health effects of natural disasters on survivors.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"451-458"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of congenital heart defects in people with Down syndrome: a systematic review and meta-analysis.","authors":"Chen-Xi Xu, Lei Chen, Yong Cheng, Yang Du","doi":"10.1136/jech-2023-220638","DOIUrl":"10.1136/jech-2023-220638","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of congenital heart defects (CHD) in Down syndrome (DS) varies considerably across studies (from 16% to 84%). This study aimed to estimate the prevalence of CHD in people with DS (CHD-DS).</p><p><strong>Methods: </strong>PubMed, Web of Science and the Chinese National Knowledge Infrastructure databases were searched through to 5 January 2023. English-language and Chinese-language articles reporting data on the prevalence of CHD in people with DS were included. Two independent observers performed data extraction and we used a random effects model for all statistical analyses by the Comprehensive Meta-Analysis V.3.3.070 software.</p><p><strong>Results: </strong>A pooled analysis, based on 102 studies that included 60 610 individuals, revealed the prevalence of CHD was 49.9% (95% CI: 46.8% to 53.0%) in people with DS. Most of the studies included in this meta-analysis were from North America, Europe and Asia, and subgroup analyses showed a slightly higher prevalence of CHD-DS in Asia (27 studies) compared with North America (28 studies) and Europe (35 studies) (Asia vs North America vs Europe; 54.2% vs 51.6% vs 46.2%).</p><p><strong>Conclusion: </strong>These results demonstrated that approximately one-half of people with DS had CHD, reinforcing the need to screen all newborns suspected of Down syndrome for CHD.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"445-450"},"PeriodicalIF":4.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}