{"id":"https://openalex.org/W7225199727","doi":"https://doi.org/10.3389/fpubh.2026.1975461","title":"Association between microplastic exposure and reduced semen quality and the mediating role of gut microbiota","display_name":"Association between microplastic exposure and reduced semen quality and the mediating role of gut microbiota","publication_year":2026,"publication_date":"2026-11-03","ids":{"openalex":"https://openalex.org/W7225199727","doi":"https://doi.org/10.3389/fpubh.2026.1975461"},"language":"en","primary_location":{"id":"doi:10.3389/fpubh.2026.1975461","doi":"https://doi.org/10.3389/fpubh.2026.1975461","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1975461","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1975461/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1975461/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5068146943","display_name":"Yecui Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yecui Zhang","raw_affiliation_strings":["Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University","Pediatric Research Institute, Children\u2019s Hospital Affiliated to Shandong University (Jinan Children\u2019s Hospital)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University","institution_ids":["https://openalex.org/I154099455"]},{"raw_affiliation_string":"Pediatric Research Institute, Children\u2019s Hospital Affiliated to Shandong University (Jinan Children\u2019s Hospital)","institution_ids":["https://openalex.org/I154099455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160472733","display_name":"Letian Han","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I134738993","display_name":"Shandong University of Traditional Chinese Medicine","ror":"https://ror.org/0523y5c19","country_code":"CN","type":"education","lineage":["https://openalex.org/I134738993"]},{"id":"https://openalex.org/I4210159257","display_name":"Affiliated Hospital of Shandong University of Traditional Chinese Medicine","ror":"https://ror.org/052q26725","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210159257"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Letian Han","raw_affiliation_strings":["Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine","Shandong Provincial Key Laboratory of Neuroprotective Drugs, Shandong Qidu Pharmaceutical Co. Ltd","The First Clinical School, Shandong University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I4210159257"]},{"raw_affiliation_string":"Shandong Provincial Key Laboratory of Neuroprotective Drugs, Shandong Qidu Pharmaceutical Co. Ltd","institution_ids":[]},{"raw_affiliation_string":"The First Clinical School, Shandong University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I134738993"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160552719","display_name":"Yanling Wu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yanling Wu","raw_affiliation_strings":["Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University","institution_ids":["https://openalex.org/I154099455"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100682553","display_name":"Qian Zhang","orcid":"https://orcid.org/0000-0001-8648-6467","observed_orcids":["https://orcid.org/0000-0001-8648-6467","https://orcid.org/0000-0002-3859-6503"]},"institutions":[{"id":"https://openalex.org/I4210159257","display_name":"Affiliated Hospital of Shandong University of Traditional Chinese Medicine","ror":"https://ror.org/052q26725","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210159257"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Qianqian Zhang","raw_affiliation_strings":["Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I4210159257"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130103182","display_name":"Yihe Wei","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210159257","display_name":"Affiliated Hospital of Shandong University of Traditional Chinese Medicine","ror":"https://ror.org/052q26725","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210159257"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yihe Wei","raw_affiliation_strings":["Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I4210159257"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160556834","display_name":"Wenwen Ge","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210159257","display_name":"Affiliated Hospital of Shandong University of Traditional Chinese Medicine","ror":"https://ror.org/052q26725","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210159257"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Wenwen Ge","raw_affiliation_strings":["Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Reproductive and Genetic Center of Integrated Traditional and Western Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine","institution_ids":["https://openalex.org/I4210159257"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5160436130","display_name":"Zhiping Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I154099455","display_name":"Shandong University","ror":"https://ror.org/0207yh398","country_code":"CN","type":"education","lineage":["https://openalex.org/I154099455"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Zhiping Wang","raw_affiliation_strings":["Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University","institution_ids":["https://openalex.org/I154099455"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5160436130"],"corresponding_institution_ids":["https://openalex.org/I154099455"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.73106227,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10753","display_name":"Microplastics and Plastic Pollution","score":0.9657999873161316,"subfield":{"id":"https://openalex.org/subfields/2310","display_name":"Pollution"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10753","display_name":"Microplastics and Plastic Pollution","score":0.9657999873161316,"subfield":{"id":"https://openalex.org/subfields/2310","display_name":"Pollution"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10116","display_name":"Sperm and Testicular Function","score":0.022600000724196434,"subfield":{"id":"https://openalex.org/subfields/2743","display_name":"Reproductive Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10686","display_name":"Effects and risks of endocrine disrupting chemicals","score":0.0044999998062849045,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/microplastics","display_name":"microplastics","score":0.8529999852180481},{"id":"https://openalex.org/keywords/sperm-quality","display_name":"semen quality","score":0.9629999995231628},{"id":"https://openalex.org/keywords/sperm-motility","display_name":"sperm motility","score":0.9580000042915344},{"id":"https://openalex.org/keywords/gut-microbiota","display_name":"gut microbiota","score":0.9779999852180481},{"id":"https://openalex.org/keywords/mediating-effect","display_name":"mediating effect","score":0.6290000081062317},{"id":"https://openalex.org/keywords/male-reproductive-toxicity","display_name":"male reproductive toxicity","score":0.7239999771118164},{"id":"https://openalex.org/keywords/polyethylene-terephthalate","display_name":"polyethylene terephthalate","score":0.7680000066757202},{"id":"https://openalex.org/keywords/polypropylene","display_name":"polypropylene","score":0.6959999799728394},{"id":"https://openalex.org/keywords/polyvinyl-butyral","display_name":"polyvinyl butyral","score":0.6269999742507935},{"id":"https://openalex.org/keywords/environmental-pollution","display_name":"environmental pollution","score":0.4569999873638153}],"concepts":[{"id":"https://openalex.org/C2778080409","wikidata":"https://www.wikidata.org/wiki/Q2916689","display_name":"Semen quality","level":3,"score":0.6987000107765198},{"id":"https://openalex.org/C2778093475","wikidata":"https://www.wikidata.org/wiki/Q9715","display_name":"Semen","level":2,"score":0.6966999769210815},{"id":"https://openalex.org/C539455810","wikidata":"https://www.wikidata.org/wiki/Q739734","display_name":"Gut flora","level":2,"score":0.609000027179718},{"id":"https://openalex.org/C2781087480","wikidata":"https://www.wikidata.org/wiki/Q17145","display_name":"Sperm","level":2,"score":0.607699990272522},{"id":"https://openalex.org/C42407357","wikidata":"https://www.wikidata.org/wiki/Q521","display_name":"Physiology","level":1,"score":0.5942000150680542},{"id":"https://openalex.org/C61716771","wikidata":"https://www.wikidata.org/wiki/Q496","display_name":"Feces","level":2,"score":0.5612000226974487},{"id":"https://openalex.org/C3020110884","wikidata":"https://www.wikidata.org/wiki/Q695416","display_name":"Outpatient clinic","level":2,"score":0.5565000176429749},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.5260999798774719},{"id":"https://openalex.org/C3020630785","wikidata":"https://www.wikidata.org/wiki/Q2916689","display_name":"Sperm quality","level":3,"score":0.5227000117301941},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.4943999946117401},{"id":"https://openalex.org/C2777632594","wikidata":"https://www.wikidata.org/wiki/Q27116486","display_name":"Sperm motility","level":3,"score":0.4878000020980835},{"id":"https://openalex.org/C2777589648","wikidata":"https://www.wikidata.org/wiki/Q1501844","display_name":"Semen analysis","level":4,"score":0.37700000405311584},{"id":"https://openalex.org/C2780225158","wikidata":"https://www.wikidata.org/wiki/Q1657393","display_name":"Electroejaculation","level":4,"score":0.3693000078201294},{"id":"https://openalex.org/C16685009","wikidata":"https://www.wikidata.org/wiki/Q335057","display_name":"Andrology","level":1,"score":0.3659000098705292},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.35850000381469727},{"id":"https://openalex.org/C61470247","wikidata":"https://www.wikidata.org/wiki/Q7229825","display_name":"Population study","level":3,"score":0.3393999934196472},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.3382999897003174},{"id":"https://openalex.org/C99432707","wikidata":"https://www.wikidata.org/wiki/Q3427345","display_name":"Reproductive toxicity","level":3,"score":0.28439998626708984},{"id":"https://openalex.org/C146304588","wikidata":"https://www.wikidata.org/wiki/Q961652","display_name":"Case-control study","level":2,"score":0.25609999895095825},{"id":"https://openalex.org/C2777338322","wikidata":"https://www.wikidata.org/wiki/Q280156","display_name":"Male infertility","level":4,"score":0.25589999556541443}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3389/fpubh.2026.1975461","doi":"https://doi.org/10.3389/fpubh.2026.1975461","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1975461","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1975461/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3389/fpubh.2026.1975461","doi":"https://doi.org/10.3389/fpubh.2026.1975461","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1975461","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1975461/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9922999739646912}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225199727.pdf","grobid_xml":"https://content.openalex.org/works/W7225199727.grobid-xml"},"referenced_works_count":56,"referenced_works":["https://openalex.org/W1893625392","https://openalex.org/W1972441060","https://openalex.org/W2538474177","https://openalex.org/W2568616540","https://openalex.org/W2618503740","https://openalex.org/W2890221285","https://openalex.org/W3024777192","https://openalex.org/W3037405028","https://openalex.org/W3038843217","https://openalex.org/W3084316051","https://openalex.org/W3090593801","https://openalex.org/W3129529765","https://openalex.org/W3206865592","https://openalex.org/W4200605805","https://openalex.org/W4206925937","https://openalex.org/W4211005481","https://openalex.org/W4220858608","https://openalex.org/W4285401848","https://openalex.org/W4292930151","https://openalex.org/W4296018708","https://openalex.org/W4306964318","https://openalex.org/W4307033120","https://openalex.org/W4309099580","https://openalex.org/W4320895096","https://openalex.org/W4321503676","https://openalex.org/W4327683253","https://openalex.org/W4328136826","https://openalex.org/W4383891479","https://openalex.org/W4385431511","https://openalex.org/W4385953717","https://openalex.org/W4386013192","https://openalex.org/W4386475933","https://openalex.org/W4387078982","https://openalex.org/W4387574501","https://openalex.org/W4388283348","https://openalex.org/W4389265926","https://openalex.org/W4389365755","https://openalex.org/W4389924243","https://openalex.org/W4391508525","https://openalex.org/W4392520497","https://openalex.org/W4392919130","https://openalex.org/W4396939005","https://openalex.org/W4398172860","https://openalex.org/W4398794799","https://openalex.org/W4402410399","https://openalex.org/W4402945134","https://openalex.org/W4403762844","https://openalex.org/W4404630467","https://openalex.org/W4404909550","https://openalex.org/W4405175010","https://openalex.org/W4405737845","https://openalex.org/W4406560899","https://openalex.org/W4407121833","https://openalex.org/W4407160507","https://openalex.org/W4407298188","https://openalex.org/W4407875576"],"related_works":["https://openalex.org/W4402945134","https://openalex.org/W4412003778","https://openalex.org/W4415012676","https://openalex.org/W7214644872","https://openalex.org/W4398794799","https://openalex.org/W4409694773","https://openalex.org/W4282937467","https://openalex.org/W7132291960","https://openalex.org/W7223221595","https://openalex.org/W3135440421"],"abstract_inverted_index":{"Background":[0],"Microplastics":[1],"(MPs)":[2],"are":[3],"widely":[4],"prevalent":[5],"in":[6,30,44,96,208,236,247],"the":[7,42,53,86,143,152,188,200,209,256,271],"environment":[8],"and":[9,17,58,77,102,127,176,199,214,238,264,274],"food":[10],"chain,":[11],"leading":[12],"to":[13,26,38,41,51,266,278],"increased":[14,230],"human":[15,45],"exposure":[16,37,57,213,225],"potential":[18,205,241,257],"health":[19,272],"risks.":[20],"Although":[21],"MPs":[22,39],"have":[23],"been":[24],"shown":[25],"induce":[27],"reproductive":[28,65,88],"toxicity":[29],"animal":[31],"models,":[32],"it":[33],"remains":[34],"unclear":[35],"whether":[36],"contributes":[40],"decline":[43],"semen":[46,59,234,262],"quality.":[47],"This":[48,72,219],"study":[49,73,81,220],"aimed":[50],"investigate":[52],"association":[54,210],"between":[55,99,211],"MP":[56,212,224,279],"quality":[60,107,235,263],"among":[61],"men":[62,84,192],"visiting":[63],"assisted":[64,87],"outpatient":[66,89],"clinics":[67],"at":[68],"tertiary":[69,94],"hospitals.":[70],"Methods":[71],"employed":[74],"both":[75],"cross-sectional":[76],"case\u2013control":[78],"designs.":[79],"The":[80,139],"population":[82],"comprised":[83],"attending":[85],"clinic":[90],"of":[91,145,155,191,232,244,260,270],"a":[92,204,240,267],"Grade-A":[93],"hospital":[95],"Jinan,":[97],"China,":[98],"April":[100],"1":[101],"July":[103],"31,":[104],"2023.":[105],"Semen":[106],"parameters":[108],"were":[109,120],"assessed":[110],"using":[111],"an":[112,229],"automated":[113],"sperm":[114,146,195,216],"analyzer.":[115],"Fecal":[116],"microplastic":[117],"(MP)":[118],"levels":[119],"quantified":[121],"via":[122],"laser":[123],"direct":[124],"infrared":[125],"spectroscopy,":[126],"gut":[128,189,201,245],"microbiota":[129,190,202,246],"composition":[130],"was":[131,149],"characterized":[132],"by":[133],"16S":[134],"rRNA":[135],"gene":[136],"sequencing.":[137],"Results":[138],"results":[140],"show":[141],"that":[142,223],"level":[144],"total":[147],"motility":[148,196],"decreased":[150,215],"with":[151,193,228],"higher":[153],"number":[154],"PS":[156],"(":[157,167,178],"\u03b2":[158,168,179],"=":[159,163,169,173,180,184],"\u22120.585,":[160],"95%":[161,171,182],"CI":[162,172,183],"\u22121.071,":[164],"\u22120.098),":[165],"PVB":[166],"\u22120.775,":[170],"\u22121.209,":[174],"\u22120.341),":[175],"PET":[177],"\u22120.0.480,":[181],"\u22120.937,":[185],"\u22120.023).":[186],"Importantly,":[187],"abnormal":[194],"is":[197,226],"dysregulated,":[198],"plays":[203],"mediating":[206,242],"role":[207,243],"motility.":[217],"Conclusion":[218],"provides":[221],"evidence":[222],"associated":[227],"risk":[231],"declined":[233],"men,":[237],"suggests":[239],"this":[248],"relationship.":[249],"These":[250],"findings":[251],"offer":[252],"critical":[253],"insights":[254],"into":[255],"etiological":[258],"clues":[259],"poor":[261],"contribute":[265],"deeper":[268],"understanding":[269],"risks":[273],"mechanistic":[275],"pathways":[276],"related":[277],"pollution.":[280]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-11-04T00:00:00"}