{"title":"Unveiling the link between rainfall, temperature, and childhood undernutrition in Bangladesh using spatial analysis","authors":"J. R. Khan, K. Bakar, M. S. Hossain","doi":"10.1088/2752-5309/ace2e0","DOIUrl":"https://doi.org/10.1088/2752-5309/ace2e0","url":null,"abstract":"Child undernutrition is still a major public health concern in Bangladesh in spite of significant decline in the last few years. Climate change may impact the prevalence of undernutrition and its geographical variability through food security and recurring outbreaks of disease, as well as impede efforts to reduce the undernutrition burden. This study aims to evaluate rainfall and temperature associated with childhood malnutrition in Bangladesh. A spatial mixed effect logistic regression model was used to estimate the association between undernutrition (measured by the composite index of anthropometric failure) and residential area-level rainfall and temperatures, controlling for covariates and spatial effects of residential locations using national data from the 2017 to 2018 Bangladesh Demographic and Health Survey. Our findings indicate that an increase in rainfall was associated with increased odds of undernutrition [adjusted odds ratio (AOR) 1.15, 95% confidence interval (CI) 1.07–1.24], whereas an increase in temperature was associated with decreased odds of undernutrition (AOR 0.86, 95% CI 0.80–0.93). We also found statistically significant structured and unstructured spatial variations in undernutrition, indicating locational effects. Investing in infrastructure and education could be potential strategies for mitigating the negative effects of climate change. High-risk regions in terms of climatic change and malnutrition could be given priority for intervention implementation.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45310309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nu Quy Linh Tran, Hieu K T Ngo, N. T. Tuong Vy, T. Dang, S. Nghiem, Huu Quyen Nguyen, D. Phung
{"title":"The association between high ambient temperature and risk of hospitalization: a time-series study in eight ecological regions in Vietnam","authors":"Nu Quy Linh Tran, Hieu K T Ngo, N. T. Tuong Vy, T. Dang, S. Nghiem, Huu Quyen Nguyen, D. Phung","doi":"10.1088/2752-5309/ace646","DOIUrl":"https://doi.org/10.1088/2752-5309/ace646","url":null,"abstract":"Viet Nam is among the countries most threatened by and vulnerable to climate change and extreme weather events. However, research on the temperature-morbidity relationship at the national scale has been scarce. This study aimed to assess the impact of high temperatures on the risk of hospital admissions for all causes and heat-sensitive diseases across eight ecological regions in Vietnam. The study utilized a longitudinal dataset that included hospitalization and meteorological data from eight provinces representing eight regions in Vietnam. A time series analysis was applied using the generalized linear and distributed lag models with a quasi-Poisson family to examine the temperature-hospitalization association in each province. A random-effects meta-analysis was used to calculate the pooled estimate of risk for the national scale. The country-level pooled effects (%, [95% CI]) indicated that a 1 °C increase above the threshold temperature (19 °C) increased the hospitalization risk for all causes and infectious diseases by 0.8% [0.4%–1.2%] and 2.4% [1.02%–1.03%], respectively at lag 0–3 d. The effects of heat on respiratory diseases and mental health disorders were not significant. At the regional level, the association varied across eight regions, of which the Northern parts tended to have a higher risk than the Southern. This is among very few national-scale studies assessing hospitalization risk associated with high temperatures across eight ecological regions of Vietnam. These findings would be useful for developing evidence-based heat-health action plans.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49398383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Climate change-related mass migration requires health system resilience","authors":"A. Clark-Ginsberg, A. Chandra","doi":"10.1088/2752-5309/ace5ca","DOIUrl":"https://doi.org/10.1088/2752-5309/ace5ca","url":null,"abstract":"Mass migration driven by climate change-related shocks and stresses is already occurring. We argue for a need for resilient health systems to ensure migration is adaptive, not detrimental, to health. We make this argument for two reasons. First, without resilience, large and sudden population increases such as from migration may strain health systems. Second, while health system resilience-building efforts are occurring, these tend to focus on crises that are substantially different from climate change-related mass migration—most notably because migrants are not threats but instead people with resources and capacity as well as needs. Then, articulating a health system as a large and complex sociotechnical infrastructure, we outline three salient features of health systems resilient to climate change-related mass migration: rapid ability to shift and adapt, multi-stakeholder collaboration, and transformation. We conclude by suggesting the resources, which policymakers need for achieving health system resilience from this sociotechnical perspective.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45693095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Mendoza, T. Benney, Casey S. Olson, E. Crosman, Shawn A Gonzales, Mamta Chaudhari, Corbin Anderson
{"title":"Pollution hot spots and the impact of drive-through COVID-19 testing sites on urban air quality","authors":"D. Mendoza, T. Benney, Casey S. Olson, E. Crosman, Shawn A Gonzales, Mamta Chaudhari, Corbin Anderson","doi":"10.1088/2752-5309/ace5cb","DOIUrl":"https://doi.org/10.1088/2752-5309/ace5cb","url":null,"abstract":"To be successful, commitments to climate change and environmental policy will require critical changes in human behavior and one important example is driving and idling. Idling is defined as running a vehicle’s motor while not in motion. Idling studies have repeatedly demonstrated that this behavior is costly, harmful to human health, and highly polluting. However, with the onset of COVID-19, the use of drive-through services to provide food, pharmaceuticals, and medical testing has increased. To understand this phenomenon further, we worked cooperatively with our government partners to compare the concentrations of PM2.5 at three regulatory sensor locations with nearby drive-through COVID-19 testing sites during average to elevated pollution days. Salt Lake City, UT (USA), where this study was undertaken, has seen a dramatic rise in drive-through services since the onset of the pandemic and community concern is also high due to poor local air quality. More importantly, the Salt Lake Valley is home to one of the largest research grade air quality networks in the world. Fine particulate matter sensors were installed or already in place at or adjacent to COVID-19 testing sites in the area, and we used data from nearby Utah Division of Air Quality monitors to provide comparative PM2.5 concentrations. Due to their placement (e.g., further distance from large roads and other emitting sources), we found that testing sites showed lower PM2.5 concentrations during average air quality days despite increased idling rates. However, when urban pollution rates were elevated due to atmospheric inversions, extensive idling around testing sites led to hyper local PM2.5 concentrations or pollution hot spots. This suggests that idling has serious compounding effects in highly polluted urban areas and policies minimizing vehicle emissions from idling and congestion could conceivably curtail pollutant exposure in a range of settings.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49191999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Green, N. Cooper, C. D. de Silva, Prateek Bahl, Shovon Bhattacharjee, Mohamed Mahmoud Abdelkareem Mahmoud, C. Doolan, R. MacIntyre
{"title":"Demonstrating the most effective interventions to improve classroom air quality. What novel in situ tests of real-world conditions show is still missing in our guidance","authors":"D. Green, N. Cooper, C. D. de Silva, Prateek Bahl, Shovon Bhattacharjee, Mohamed Mahmoud Abdelkareem Mahmoud, C. Doolan, R. MacIntyre","doi":"10.1088/2752-5309/ace5c9","DOIUrl":"https://doi.org/10.1088/2752-5309/ace5c9","url":null,"abstract":"Over 20 years ago a report commissioned by the European Commission identified air quality in schools as a public health priority. Despite this concern, little action was taken in the following two decades. Over the last two years as classrooms were increasingly recognised as hotspots for the transmission of SARS-CoV-2, renewed interest and resources have been made available in response to this issue. Questions remain, however, over how best to achieve safer classroom air. Our analysis assessed a range of in situ interventions to remove particulate matter (PM2.5) and carbon dioxide from inside a populated classroom. Our approach used saline spray and volunteers’ exhalations as our source of PM2.5 and carbon dioxide to explore the ability of high efficiency particulate air (HEPA) filters, natural ventilation and a recirculating A/C unit to remove these air pollutants which collectively provided a novel set of data. For a total window opening of 1.86 m2 for a 181.7 m3 classroom with a HEPA filter with a 703m3/hr clean air delivery rate, our results confirmed that outdoor air was needed to purge the room to reduce carbon dioxide levels that otherwise rose to >1000 ppm in 12 min. Cross and natural ventilation reduced levels of PM2.5 and carbon dioxide very effectively—in under 5 and 10 min respectively during low levels of outside PM2.5. We conclude that natural ventilation supplemented with the use of HEPA filters is the most effective way to reliably improve indoor air quality year-round, balancing the need to have easy to enact approaches to reduce the buildup of PM2.5, airborne viruses and carbon dioxide. These results highlight an important knowledge gap. Without having localised real-time outdoor air pollution sensing, evidence-based decisions cannot be made about how often, and for how long, windows can safely remain open to purge classrooms in times of poor quality outdoor air.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46821011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Johnson, M. Bell, Nicholas Perez, Robert Dubrow, N. Deziel
{"title":"Steam cracker facilities in the United States: operations, emissions, and sociodemographic patterns of surrounding populations","authors":"N. Johnson, M. Bell, Nicholas Perez, Robert Dubrow, N. Deziel","doi":"10.1088/2752-5309/acdcb2","DOIUrl":"https://doi.org/10.1088/2752-5309/acdcb2","url":null,"abstract":"Background: Production of shale gas in the United States (US) increased more than 10-fold from 2008 to 2021, yielding greater quantities of hydrocarbon feedstocks and incentivizing expansion of petrochemical facilities. Steam crackers (SCs) convert hydrocarbon feedstocks into ethylene and propylene (the building blocks of plastics), while releasing toxic chemicals and greenhouse gases (GHGs). Analyses of environmental health and justice impacts of SCs are limited. Methods: We described SC operations, locations, and emissions, and evaluated sociodemographic characteristics of populations residing near SCs to better understand potential public health hazards and inform future studies. We summarized and described industry-reported emissions from the US Environmental Protection Agency’s Toxic Release Inventory and GHG Reporting Program. We compared population characteristics of US Census block groups ⩽5 km and >5 km from a steam cracker-containing facility (SCF) within the same county. Results: We identified 32 SCFs across five US states, with most in Texas and Louisiana. Toxic chemicals with the greatest reported cumulative air emissions in 1987–2019 were: ethylene, propylene, hydrochloric acid, benzene, n-hexane, 1,3-butadiene, ammonia, toluene, vinyl acetate, and methanol. Reported total annual GHG emissions were 4% higher in 2019 versus 2010, with total GHG emissions of >650 million metric tons (carbon dioxide equivalents) in 2010–2019. We found that 752 465 people live in census block groups ⩽5 km from an SCF, regardless of county. Compared to block groups >5 km away within the same county, block groups closer to SCFs had statistically significantly lower median incomes ($54 843 vs $67 866) and more vacant housing (15% vs 11%), and higher proportions of residents who were non-Hispanic Black (31% vs 19%) and unemployed (8% vs 6%). Conclusion: SCs emit substantial amounts of GHGs and toxic chemicals in locations with historically disadvantaged populations. Future research could further evaluate the accuracy of reported emissions, conduct monitoring in proximate communities, and assess population-level health impacts.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45141949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Woeckel, A. Schneider, J. Cyrys, K. Wolf, C. Meisinger, M. Heier, A. Peters, S. Breitner
{"title":"Ambient air temperature and temperature variability affecting blood pressure—a repeated-measures study in Augsburg, Germany","authors":"M. Woeckel, A. Schneider, J. Cyrys, K. Wolf, C. Meisinger, M. Heier, A. Peters, S. Breitner","doi":"10.1088/2752-5309/acdf10","DOIUrl":"https://doi.org/10.1088/2752-5309/acdf10","url":null,"abstract":"Ambient air temperature and temperature variability are supposed to influence blood pressure (BP); however, findings are inconsistent. We examined the effects of short-term changes in ambient temperature and temperature variability on systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP) in a repeated-measures study. Repeated BP measurements were available for 3184 participants from the German population-based Cooperative Health Research in the Region of Augsburg (KORA) S4 survey (1999–2001) and two follow-up examinations (2006–08 and 2013–14). Daily meteorological data were obtained from fixed measurement stations including air temperature and diurnal temperature range (DTR). We used confounder-adjusted additive mixed models to examine immediate (same-day, lag 0), delayed (lag 1 to lag 4), and cumulative (up to lag 0–13) exposure effects. Decreases in air temperature were associated with increases in SBP, DBP, and MAP, while we observed no effects for PP at all. For example, a 1 °C decrease in the 14-day moving average (lag 0–13) mean air temperature was associated with a 0.54% [95% confidence interval [95%CI]: 0.41%;0.68%] increase in SBP. Furthermore, decreasing DTR was linked to increasing SBP, DBP, and MAP measures. In the sensitivity analyses, results were found to be robust. Examination of exposure–response functions according to season revealed, that associations for summer and winter can be considered linear, while we detected non-linear functions in spring and autumn. Furthermore, exposure–response functions also differed in the three different surveys. As BP levels influence the risk of cardiovascular mortality, our results show the importance of considering temperature and its variation as potential risk factors. As ongoing climate change affects temperature variability, it is important to understand how the body adapts to changing ambient temperatures.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48685750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Avula, Joyce M Cheng, M. McCormack, M. Pavelack
{"title":"Extreme temperature and storm exacerbations of pediatric asthma: evidence and prevention strategies","authors":"V. Avula, Joyce M Cheng, M. McCormack, M. Pavelack","doi":"10.1088/2752-5309/acdf11","DOIUrl":"https://doi.org/10.1088/2752-5309/acdf11","url":null,"abstract":"Asthma is the most common chronic disease in children and a main cause of hospitalizations, with substantial costs to patients, families, and society. Existing disparities in asthma will likely be impacted by the increasing adverse consequences of climate change and the disproportionate impact on low-income and minority communities. Increased extreme temperatures, weather events, air pollution, and allergens linked to climate change exacerbate pediatric asthma. There is a need for greater understanding of the climate change-related risk factors specifically impacting pediatric asthma exacerbations, increased attention to health disparities, and development of strategies for prevention and management. This perspective piece describes selected research on temperature and storm-related asthma exacerbations in children and includes a discussion on possible mechanisms for weather phenomena and climate change associations, research gaps, and possible solutions related to secondary prevention (figure 1).","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43945859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early-life oxidative stress due to air pollution. A scoping review focusing on identifying potential ‘-OMICS’ biomarkers from body fluids","authors":"J. Coumans, S. Al Jaaidi","doi":"10.1088/2752-5309/acdd18","DOIUrl":"https://doi.org/10.1088/2752-5309/acdd18","url":null,"abstract":"Exposure to air pollution (AP) is inevitable in daily life and an increasing number of epidemiological studies have reported that exposure to ambient particulate matter (PM) is associated with adverse health outcomes. Intrauterine, childhood, and adolescence are vulnerable periods, during which PM exposure can cause molecular changes, potentially leading to changes in metabolism and development. PM-induced oxidative stress is the underlying mechanism. Biomarkers can be used as illustrative measures of PM exposure to facilitate the assessment of potential health effects and provide a better understanding of the underlying mechanisms. The purpose of this scoping review is to report -OMICS biomarkers found in body fluids that are primarily related to oxidative stress and are already used to evaluate ambient AP exposure, as well as to identify knowledge gaps. Web of Science, PubMed, and Scopus databases were independently searched for all studies published between January 2013 and December 2022 that reported on -OMICS signature changes during pregnancy, childhood, and adolescence. Of the initial 757 articles, 36 met our inclusion criteria and reported on genomic, epigenomic, transcriptomic, proteomic, lipidomic, and metabolomic biomarkers. The findings of this scoping review indicate that exposure to various ambient pollutants in early life can cause oxidative stress. Integrating biomarkers from top-down -OMICS studies in an epidemiological context may provide a clear picture of the biomarker selection process to establish a causal relationship between PM exposure and disease pathogenesis. This knowledge could lead to the conceptualization and subsequent development of novel preventative strategies.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42214627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina Xeni, R. Oliva, Farjana Jahan, R. Iqbal, A. Naser, Md. Mahbubur Rahman, L. Fleming, Matthew O'Madigan Gribble, K. Makris
{"title":"Epidemiological evidence on drinking water salinity and blood pressure: a scoping review","authors":"Christina Xeni, R. Oliva, Farjana Jahan, R. Iqbal, A. Naser, Md. Mahbubur Rahman, L. Fleming, Matthew O'Madigan Gribble, K. Makris","doi":"10.1088/2752-5309/ace076","DOIUrl":"https://doi.org/10.1088/2752-5309/ace076","url":null,"abstract":"In addition to diet, drinking water can be an important contributor to the total body burden of salts. Water salinity (defined as the amount of dissolved salts in a body of water) has been associated with adverse health effects. We mapped the current research on drinking water salinity and its effects on blood pressure (BP). We aimed to identify knowledge gaps in the methodology and tools used in the epidemiological literature to address water salinity effects on BP. We performed a scoping review of epidemiological studies by searching PubMed and Web of Science databases from 1980 to 2022. Reviews, study comparisons, meta-analyses, commentaries, viewpoints, correspondence, protocols, studies in clinical settings, animal or in vitro studies, or not in English, were excluded. Epidemiologic studies including systolic/diastolic BP and/or the risk of hypertension as the main health outcome and drinking water salts (sodium, potassium, calcium, magnesium, including electrical conductivity and total dissolved solids) as the main exposures were included. After screening 246 articles, 29 articles were retained. Most studies were conducted in Bangladesh and USA (n = 9 and n = 9, respectively). The majority of studies were cross-sectional (n = 18; 62%). The study populations were adults (55%) or children (35%) or both (10%). Only eight (28%) studies did not collect urine samples and only three studies (10%) did not record participant BP. About half of the studies (n = 15, 52%) reported a positive significant (p < 0.05) association between salts in drinking water and higher BP and/or risk of hypertension; while 24% and 24% reported non-significant (p > 0.05) and significant (p < 0.05) negative associations (with lower BP mainly attributed to higher Mg, Ca, and K (rather than Na) levels in drinking water). More longitudinal studies are warranted to investigate the impact of drinking water salinization on cardiovascular health and risk of hypertension. Under a changing climate, this may be particularly important for coastal populations, as sea level rise in combination with the overexploitation of groundwater would differentially perturb the salinity of their drinking water supplies.","PeriodicalId":72938,"journal":{"name":"Environmental research, health : ERH","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61193509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}