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The role of quality metrics in the evolution of AI in health care and implications for generative AI. 质量指标在医疗保健人工智能进化中的作用以及对生成人工智能的影响。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-10-01 Epub Date: 2023-08-10 DOI: 10.1152/physrev.00029.2023
Ryan C Godwin, Ryan L Melvin
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引用次数: 2
Synaptic memory and CaMKII. 突触记忆和CaMKII。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-10-01 Epub Date: 2023-06-08 DOI: 10.1152/physrev.00034.2022
Roger A Nicoll, Howard Schulman

Ca2+/calmodulin-dependent protein kinase II (CaMKII) and long-term potentiation (LTP) were discovered within a decade of each other and have been inextricably intertwined ever since. However, like many marriages, it has had its up and downs. Based on the unique biochemical properties of CaMKII, it was proposed as a memory molecule before any physiological linkage was made to LTP. However, as reviewed here, the convincing linkage of CaMKII to synaptic physiology and behavior took many decades. New technologies were critical in this journey, including in vitro brain slices, mouse genetics, single-cell molecular genetics, pharmacological reagents, protein structure, and two-photon microscopy, as were new investigators attracted by the exciting challenge. This review tracks this journey and assesses the state of this marriage 40 years on. The collective literature impels us to propose a relatively simple model for synaptic memory involving the following steps that drive the process: 1) Ca2+ entry through N-methyl-d-aspartate (NMDA) receptors activates CaMKII. 2) CaMKII undergoes autophosphorylation resulting in constitutive, Ca2+-independent activity and exposure of a binding site for the NMDA receptor subunit GluN2B. 3) Active CaMKII translocates to the postsynaptic density (PSD) and binds to the cytoplasmic C-tail of GluN2B. 4) The CaMKII-GluN2B complex initiates a structural rearrangement of the PSD that may involve liquid-liquid phase separation. 5) This rearrangement involves the PSD-95 scaffolding protein, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs), and their transmembrane AMPAR-regulatory protein (TARP) auxiliary subunits, resulting in an accumulation of AMPARs in the PSD that underlies synaptic potentiation. 6) The stability of the modified PSD is maintained by the stability of the CaMKII-GluN2B complex. 7) By a process of subunit exchange or interholoenzyme phosphorylation CaMKII maintains synaptic potentiation in the face of CaMKII protein turnover. There are many other important proteins that participate in enlargement of the synaptic spine or modulation of the steps that drive and maintain the potentiation. In this review we critically discuss the data underlying each of the steps. As will become clear, some of these steps are more firmly grounded than others, and we provide suggestions as to how the evidence supporting these steps can be strengthened or, based on the new data, be replaced. Although the journey has been a long one, the prospect of having a detailed cellular and molecular understanding of learning and memory is at hand.

Ca2+/钙调蛋白依赖性蛋白激酶II(CaMKII)和长时程增强(LTP)是在十年内发现的,并且从那时起就密不可分。然而,就像许多婚姻一样,它也有起有落。基于CaMKII独特的生物化学性质,在与LTP形成任何生理连接之前,它被认为是一种记忆分子。然而,正如本文所述,CaMKII与突触生理和行为之间令人信服的联系花了几十年的时间。新技术在这一旅程中至关重要,包括体外脑切片、小鼠遗传学、单细胞分子遗传学、药理学试剂、蛋白质结构和双光子显微镜,以及被这一令人兴奋的挑战吸引的新研究人员。这篇综述追踪了这段旅程,并评估了40年后这段婚姻的状态。集体文献促使我们提出一个相对简单的突触记忆模型,包括以下驱动过程的步骤:1)Ca2+通过N-甲基-d-天冬氨酸(NMDA)受体进入激活CaMKII。2) CaMKII经历自身磷酸化,导致组成型、Ca2+非依赖性活性和NMDA受体亚基Glu22B结合位点的暴露。3) 活性CaMKII易位到突触后密度(PSD)并与GluN2B的细胞质C尾结合。4) CaMKII-GluN2B复合物引发PSD的结构重排,其可能涉及液-液相分离。5) 这种重排涉及PSD-95支架蛋白、α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体(AMPAR)及其跨膜AMPAR调节蛋白(TARP)辅助亚基,导致AMPAR在PSD中积累,这是突触增强的基础。6) 改性PSD的稳定性通过CaMKII-GluN2B复合物的稳定性来维持。7) 通过亚基交换或全酶间磷酸化的过程,CaMKII在面对CaMKII蛋白转换时保持突触增强。还有许多其他重要的蛋白质参与突触棘的扩大或驱动和维持增强的步骤的调节。在这篇综述中,我们批判性地讨论了每个步骤背后的数据。很明显,其中一些步骤比其他步骤更有根据,我们就如何加强或根据新数据替换支持这些步骤的证据提出了建议。尽管这是一段漫长的旅程,但对学习和记忆有详细的细胞和分子理解的前景就在眼前。
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引用次数: 5
Mitochondria in health, disease, and aging. 线粒体与健康、疾病和衰老有关。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2023-10-01 Epub Date: 2023-04-06 DOI: 10.1152/physrev.00058.2021
John S Harrington, Stefan W Ryter, Maria Plataki, David R Price, Augustine M K Choi

Mitochondria are well known as organelles responsible for the maintenance of cellular bioenergetics through the production of ATP. Although oxidative phosphorylation may be their most important function, mitochondria are also integral for the synthesis of metabolic precursors, calcium regulation, the production of reactive oxygen species, immune signaling, and apoptosis. Considering the breadth of their responsibilities, mitochondria are fundamental for cellular metabolism and homeostasis. Appreciating this significance, translational medicine has begun to investigate how mitochondrial dysfunction can represent a harbinger of disease. In this review, we provide a detailed overview of mitochondrial metabolism, cellular bioenergetics, mitochondrial dynamics, autophagy, mitochondrial damage-associated molecular patterns, mitochondria-mediated cell death pathways, and how mitochondrial dysfunction at any of these levels is associated with disease pathogenesis. Mitochondria-dependent pathways may thereby represent an attractive therapeutic target for ameliorating human disease.

众所周知,线粒体是通过产生ATP来维持细胞生物能量的细胞器。尽管氧化磷酸化可能是线粒体最重要的功能,但线粒体在代谢前体的合成、钙调节、活性氧的产生、免疫信号传导和细胞凋亡中也是不可或缺的。考虑到线粒体职责的广度,线粒体是细胞代谢和稳态的基础。意识到这一意义,转化医学已经开始研究线粒体功能障碍如何代表疾病的前兆。在这篇综述中,我们提供了线粒体代谢、细胞生物能量学、线粒体动力学、自噬、线粒体损伤相关分子模式、线粒体介导的细胞死亡途径的详细概述,以及这些水平的线粒体功能障碍如何与疾病发病机制相关。线粒体依赖性途径因此可能是改善人类疾病的一个有吸引力的治疗靶点。
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引用次数: 0
Obstructive nephropathy and molecular pathophysiology of renal interstitial fibrosis. 梗阻性肾病与肾间质纤维化的分子病理生理学。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-10-01 Epub Date: 2023-07-13 DOI: 10.1152/physrev.00027.2022
Rikke Nørregaard, Henricus A M Mutsaers, Jørgen Frøkiær, Tae-Hwan Kwon

The kidneys play a key role in maintaining total body homeostasis. The complexity of this task is reflected in the unique architecture of the organ. Ureteral obstruction greatly affects renal physiology by altering hemodynamics, changing glomerular filtration and renal metabolism, and inducing architectural malformations of the kidney parenchyma, most importantly renal fibrosis. Persisting pathological changes lead to chronic kidney disease, which currently affects ∼10% of the global population and is one of the major causes of death worldwide. Studies on the consequences of ureteral obstruction date back to the 1800s. Even today, experimental unilateral ureteral obstruction (UUO) remains the standard model for tubulointerstitial fibrosis. However, the model has certain limitations when it comes to studying tubular injury and repair, as well as a limited potential for human translation. Nevertheless, ureteral obstruction has provided the scientific community with a wealth of knowledge on renal (patho)physiology. With the introduction of advanced omics techniques, the classical UUO model has remained relevant to this day and has been instrumental in understanding renal fibrosis at the molecular, genomic, and cellular levels. This review details key concepts and recent advances in the understanding of obstructive nephropathy, highlighting the pathophysiological hallmarks responsible for the functional and architectural changes induced by ureteral obstruction, with a special emphasis on renal fibrosis.

肾脏在维持全身稳态方面起着关键作用。这项任务的复杂性体现在器官独特的结构上。输尿管梗阻通过改变血流动力学、改变肾小球滤过和肾脏代谢、诱发肾实质结构畸形,最重要的是肾纤维化,极大地影响肾脏生理。持续的病理变化会导致慢性肾脏疾病,目前影响全球约10%的人口,是全球死亡的主要原因之一。关于输尿管梗阻后果的研究可以追溯到19世纪。即使在今天,实验性单侧输尿管梗阻(UUO)仍然是肾小管间质纤维化的标准模型。然而,该模型在研究管状损伤和修复方面存在一定的局限性,并且对人类翻译的潜力有限。然而,输尿管梗阻为科学界提供了丰富的肾脏(病理)生理学知识。随着先进的组学技术的引入,经典的UUO模型一直保持着相关性,并在分子、基因组和细胞水平上有助于理解肾纤维化。这篇综述详细介绍了梗阻性肾病的关键概念和最新进展,强调了输尿管梗阻引起的功能和结构变化的病理生理特征,特别强调了肾纤维化。
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引用次数: 0
Leveraging physiology and artificial intelligence to deliver advancements in health care. 利用生理学和人工智能在医疗保健领域取得进步。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2023-10-01 Epub Date: 2023-04-27 DOI: 10.1152/physrev.00033.2022
Angela Zhang, Zhenqin Wu, Eric Wu, Matthew Wu, Michael P Snyder, James Zou, Joseph C Wu

Artificial intelligence in health care has experienced remarkable innovation and progress in the last decade. Significant advancements can be attributed to the utilization of artificial intelligence to transform physiology data to advance health care. In this review, we explore how past work has shaped the field and defined future challenges and directions. In particular, we focus on three areas of development. First, we give an overview of artificial intelligence, with special attention to the most relevant artificial intelligence models. We then detail how physiology data have been harnessed by artificial intelligence to advance the main areas of health care: automating existing health care tasks, increasing access to care, and augmenting health care capabilities. Finally, we discuss emerging concerns surrounding the use of individual physiology data and detail an increasingly important consideration for the field, namely the challenges of deploying artificial intelligence models to achieve meaningful clinical impact.

在过去的十年里,医疗保健领域的人工智能经历了显著的创新和进步。重大进展可归因于利用人工智能转换生理数据以促进医疗保健。在这篇综述中,我们探讨了过去的工作如何塑造了这个领域,并确定了未来的挑战和方向。我们特别关注三个发展领域。首先,我们概述了人工智能,特别关注最相关的人工智能模型。然后,我们详细介绍了人工智能如何利用生理学数据来推进医疗保健的主要领域:自动化现有的医疗保健任务,增加获得医疗保健的机会,以及增强医疗保健能力。最后,我们讨论了围绕个人生理学数据使用的新问题,并详细说明了该领域日益重要的考虑因素,即部署人工智能模型以实现有意义的临床影响的挑战。
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引用次数: 0
Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: current understanding and future directions. 机械超负荷诱导骨骼肌肥大的机制:目前的理解和未来的方向。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2023-10-01 Epub Date: 2023-06-29 DOI: 10.1152/physrev.00039.2022
Michael D Roberts, John J McCarthy, Troy A Hornberger, Stuart M Phillips, Abigail L Mackey, Gustavo A Nader, Marni D Boppart, Andreas N Kavazis, Paul T Reidy, Riki Ogasawara, Cleiton A Libardi, Carlos Ugrinowitsch, Frank W Booth, Karyn A Esser

Mechanisms underlying mechanical overload-induced skeletal muscle hypertrophy have been extensively researched since the landmark report by Morpurgo (1897) of "work-induced hypertrophy" in dogs that were treadmill trained. Much of the preclinical rodent and human resistance training research to date supports that involved mechanisms include enhanced mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling, an expansion in translational capacity through ribosome biogenesis, increased satellite cell abundance and myonuclear accretion, and postexercise elevations in muscle protein synthesis rates. However, several lines of past and emerging evidence suggest that additional mechanisms that feed into or are independent of these processes are also involved. This review first provides a historical account of how mechanistic research into skeletal muscle hypertrophy has progressed. A comprehensive list of mechanisms associated with skeletal muscle hypertrophy is then outlined, and areas of disagreement involving these mechanisms are presented. Finally, future research directions involving many of the discussed mechanisms are proposed.

自从Morpurgo(1897)发表了一篇里程碑式的关于在跑步机训练的狗中“工作诱导的肥大”的报告以来,机械过载诱导的骨骼肌肥大的潜在机制已经得到了广泛的研究。迄今为止,许多临床前啮齿类动物和人类抵抗训练研究都支持这一相关机制,包括增强哺乳动物/雷帕霉素复合物1(mTORC1)的机制靶点信号传导,通过核糖体生物发生扩大翻译能力,增加卫星细胞丰度和肌核增生,以及运动后肌肉蛋白质合成率的提高。然而,过去和新出现的几条证据表明,还涉及为这些过程提供信息或独立于这些过程的其他机制。这篇综述首先提供了骨骼肌肥大机制研究进展的历史记录。然后概述了与骨骼肌肥大相关的机制的综合列表,并提出了涉及这些机制的分歧领域。最后,提出了涉及所讨论的许多机制的未来研究方向。
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引用次数: 0
Physiology of intracellular calcium buffering. 细胞内钙缓冲的生理学。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-10-01 Epub Date: 2023-06-16 DOI: 10.1152/physrev.00042.2022
David Eisner, Erwin Neher, Holger Taschenberger, Godfrey Smith

Calcium signaling underlies much of physiology. Almost all the Ca2+ in the cytoplasm is bound to buffers, with typically only ∼1% being freely ionized at resting levels in most cells. Physiological Ca2+ buffers include small molecules and proteins, and experimentally Ca2+ indicators will also buffer calcium. The chemistry of interactions between Ca2+ and buffers determines the extent and speed of Ca2+ binding. The physiological effects of Ca2+ buffers are determined by the kinetics with which they bind Ca2+ and their mobility within the cell. The degree of buffering depends on factors such as the affinity for Ca2+, the Ca2+ concentration, and whether Ca2+ ions bind cooperatively. Buffering affects both the amplitude and time course of cytoplasmic Ca2+ signals as well as changes of Ca2+ concentration in organelles. It can also facilitate Ca2+ diffusion inside the cell. Ca2+ buffering affects synaptic transmission, muscle contraction, Ca2+ transport across epithelia, and the killing of bacteria. Saturation of buffers leads to synaptic facilitation and tetanic contraction in skeletal muscle and may play a role in inotropy in the heart. This review focuses on the link between buffer chemistry and function and how Ca2+ buffering affects normal physiology and the consequences of changes in disease. As well as summarizing what is known, we point out the many areas where further work is required.

钙信号传导是许多生理学的基础。细胞质中几乎所有的Ca2+都与缓冲液结合,在大多数细胞的静息水平下,通常只有~1%的Ca2+被自由电离。生理Ca2+缓冲液包括小分子和蛋白质,实验Ca2+指示剂也会缓冲钙。Ca2+和缓冲液之间相互作用的化学性质决定了Ca2+结合的程度和速度。Ca2+缓冲液的生理作用由其结合Ca2+的动力学及其在细胞内的迁移率决定。缓冲程度取决于对Ca2+的亲和力、Ca2+浓度以及Ca2+离子是否协同结合等因素。缓冲作用影响细胞质Ca2+信号的幅度和时间进程,也影响细胞器中Ca2+浓度的变化。它还可以促进Ca2+在细胞内的扩散。Ca2+缓冲影响突触传递、肌肉收缩、Ca2+在上皮细胞中的转运和细菌的杀伤。缓冲液的饱和导致骨骼肌的突触易化和强直性收缩,并可能在心脏的收缩中发挥作用。这篇综述的重点是缓冲化学和功能之间的联系,以及Ca2+缓冲如何影响正常生理和疾病变化的后果。除了总结已知情况外,我们还指出了需要进一步工作的许多领域。
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引用次数: 3
Physiology of sedentary behavior. 久坐行为的生理学。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2023-10-01 Epub Date: 2023-06-16 DOI: 10.1152/physrev.00022.2022
Ana J Pinto, Audrey Bergouignan, Paddy C Dempsey, Hamilton Roschel, Neville Owen, Bruno Gualano, David W Dunstan

Sedentary behaviors (SB) are characterized by low energy expenditure while in a sitting or reclining posture. Evidence relevant to understanding the physiology of SB can be derived from studies employing several experimental models: bed rest, immobilization, reduced step count, and reducing/interrupting prolonged SB. We examine the relevant physiological evidence relating to body weight and energy balance, intermediary metabolism, cardiovascular and respiratory systems, the musculoskeletal system, the central nervous system, and immunity and inflammatory responses. Excessive and prolonged SB can lead to insulin resistance, vascular dysfunction, shift in substrate use toward carbohydrate oxidation, shift in muscle fiber from oxidative to glycolytic type, reduced cardiorespiratory fitness, loss of muscle mass and strength and bone mass, and increased total body fat mass and visceral fat depot, blood lipid concentrations, and inflammation. Despite marked differences across individual studies, longer term interventions aimed at reducing/interrupting SB have resulted in small, albeit marginally clinically meaningful, benefits on body weight, waist circumference, percent body fat, fasting glucose, insulin, HbA1c and HDL concentrations, systolic blood pressure, and vascular function in adults and older adults. There is more limited evidence for other health-related outcomes and physiological systems and for children and adolescents. Future research should focus on the investigation of molecular and cellular mechanisms underpinning adaptations to increasing and reducing/interrupting SB and the necessary changes in SB and physical activity to impact physiological systems and overall health in diverse population groups.

久坐行为(SB)的特点是在坐姿或斜倚姿势下能量消耗低。与理解SB生理学相关的证据可以从采用几种实验模型的研究中获得:卧床休息、固定、减少步数和减少/中断长时间SB。我们检查了与体重和能量平衡、中间代谢、心血管和呼吸系统、肌肉骨骼系统、,中枢神经系统以及免疫和炎症反应。SB过量和延长会导致胰岛素抵抗、血管功能障碍、底物使用向碳水化合物氧化转变、肌肉纤维从氧化型转变为糖酵解型、心肺功能下降、肌肉质量、力量和骨量损失、全身脂肪量和内脏脂肪库增加、血脂浓度和炎症。尽管个体研究之间存在显著差异,但旨在减少/中断SB的长期干预措施对成人和老年人的体重、腰围、体脂百分比、空腹血糖、胰岛素、HbA1c和HDL浓度、收缩压和血管功能产生了微小的益处,尽管临床意义不大。其他与健康相关的结果和生理系统以及儿童和青少年的证据更为有限。未来的研究应侧重于研究支持对增加和减少/中断SB的适应的分子和细胞机制,以及SB和身体活动的必要变化,以影响不同人群的生理系统和整体健康。
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引用次数: 0
The human periconceptional maternal-embryonic space in health and disease. 人类围孕期母胚空间的健康与疾病。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-07-01 DOI: 10.1152/physrev.00050.2021
Inmaculada Moreno, Antonio Capalbo, Aymara Mas, Tamara Garrido-Gomez, Beatriz Roson, Maurizio Poli, Eva Dimitriadis, Xavier Santamaria, Felipe Vilella, Carlos Simon

Pregnancy is established during the periconceptional period as a continuum beginning with blastocyst attachment to the endometrial epithelial surface followed by embryo invasion and placenta formation. This period sets the foundation for the child and mother's health during pregnancy. Emerging evidence indicates that prevention of downstream pathologies in both the embryo/newborn and pregnant mother may be possible at this stage. In this review, we discuss current advances in the periconceptional space, including the preimplantation human embryo and maternal endometrium. We also discuss the role of the maternal decidua, the periconceptional maternal-embryonic interface, the dialogue between these elements, and the importance of the endometrial microbiome in the implantation process and pregnancy. Finally, we discuss the myometrium in the periconceptional space and review its role in determining pregnancy health.

妊娠是在围孕期作为一个连续体开始,囊胚附着在子宫内膜上皮表面,然后是胚胎侵入和胎盘形成。这一时期为儿童和母亲在怀孕期间的健康奠定了基础。新出现的证据表明,在这一阶段预防胚胎/新生儿和孕妇的下游病理可能是可能的。在这篇综述中,我们讨论了目前在围孕期空间的进展,包括着床前人类胚胎和母体子宫内膜。我们还讨论了母体蜕膜的作用,孕周母胚界面,这些元素之间的对话,以及子宫内膜微生物组在着床过程和妊娠中的重要性。最后,我们讨论了子宫肌层在围孕期空间和回顾其在决定妊娠健康的作用。
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引用次数: 1
Long-term variability of human health-related solar ultraviolet-B radiation doses for the 1980s to the end of the 21st century. 20世纪80年代至21世纪末与人类健康有关的太阳紫外线b辐射剂量的长期变异性。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-07-01 DOI: 10.1152/physrev.00031.2022
Christos Zerefos, Ilias Fountoulakis, Kostas Eleftheratos, Andreas Kazantzidis

Solar ultraviolet-B (UV-B) radiation has played a crucial role in the evolution of life on Earth, and potential changes in its levels could affect the health and functionality of humans and the ecosystems. UV exposure presents both risks and benefits to humans. However, optimal UV-B radiation exposure depends on several environmental and physiological factors and cannot be easily determined. The present document provides a review of the current state of knowledge relative to the effects of UV-B radiation on human health. A brief description of the physical mechanisms that control the levels of solar UV-B radiation at the Earth's surface is provided, with special emphasis on the role of ozone and the importance of the Montreal Protocol. A comprehensive review of studies reporting current trends in levels of surface solar UV-B radiation and projections of future levels reveals the dominant role of climatic changes in the long-term variability of UV-B radiation and its impact on the development of melanomas as well as eye disorders. The review provides strong evidence that despite the success of the Montreal Protocol and the expected ozone recovery, the future evolution of the levels of solar UV-B radiation at the Earth's surface is not certain.

太阳紫外线b (UV-B)辐射在地球上生命的进化中起着至关重要的作用,其水平的潜在变化可能影响人类和生态系统的健康和功能。紫外线照射对人类既有风险也有益处。然而,最佳的UV-B辐射暴露取决于几个环境和生理因素,并不能轻易确定。本文件审查了目前有关紫外线- b辐射对人类健康影响的知识状况。本文简要介绍了控制地球表面太阳紫外线- b辐射水平的物理机制,特别强调臭氧的作用和《蒙特利尔议定书》的重要性。一项关于地表太阳UV-B辐射水平当前趋势和未来水平预测的研究综述揭示了气候变化在UV-B辐射的长期变异性及其对黑色素瘤和眼部疾病发展的影响中的主导作用。该审查提供了强有力的证据,表明尽管《蒙特利尔议定书》取得了成功,并且预期臭氧将得到恢复,但地球表面太阳紫外线- b辐射水平的未来演变仍不确定。
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引用次数: 0
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