Infectious Medicine最新文献

{"title":"Quantitative association of blood culture volume with contaminant and pathogen recovery","authors":"Amos Cahan ,&nbsp;Nadav Sorek ,&nbsp;Tal Brosh-Nissimov","doi":"10.1016/j.imj.2026.100241","DOIUrl":"10.1016/j.imj.2026.100241","url":null,"abstract":"<div><h3>Background</h3><div>Blood culture contamination is common and associated with adverse outcomes. The relation between blood culture volume and contamination remains under-evaluated. We assess the relation between blood culture volume and commensal-positive culture rate and characterize the relative abundance of contaminant species in low- and high-volume samples.</div></div><div><h3>Methods</h3><div>Analysis of blood cultures processed between August 2017 and August 2023 in an academic community hospital. Blood culture bottles containing 0–10 mL of fluid were included. Clinical data was not available. Contaminants were defined according to the National Healthcare Safety Network list of common commensals. The association between blood volume categories and the proportion of positive cultures was assessed using a linear logistic regression model. Goodness of fit was evaluated by restricted cubic splines and likelihood ratios.</div></div><div><h3>Results</h3><div>Of a total of 146,307 blood culture bottles, 8,918 were excluded. A positive relation between blood volume and culture-positivity rate was found for both pathogens and contaminants, with an increase in odds ratio for culture positivity of 1.033 (95% CI: 1.026–1.041, <em>p</em> &lt; 0.001) and 1.030 (95% CI: 1.018–1.041, <em>p</em> &lt; 0.001) for each additional 1 mL for pathogens and contaminants, respectively. This translates to a 10 per 1000 excess cultures growing contaminants comparing 10 to 2 mL bottles. <em>Cutibacterium</em> was over-represented in high-volume samples. Otherwise, differences in relative abundance between the two volume categories were nonsignificant.</div></div><div><h3>Conclusions</h3><div>The positive association between contaminant growth and blood volume may result from better growth conditions in high volume samples, or suggest that in some cases, contaminant growth may reflect frank bacteremia.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"5 1","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379739","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":"Interventions to improve pneumococcal vaccination coverage: A systematic review and meta-analysis","authors":"Bogdan Cireașă ,&nbsp;Géraldine Leguelinel-Blache ,&nbsp;Bob-Valéry Occéan ,&nbsp;Chris Serrand ,&nbsp;Jean-Marie Kinowski ,&nbsp;Florent Dubois","doi":"10.1016/j.imj.2026.100238","DOIUrl":"10.1016/j.imj.2026.100238","url":null,"abstract":"<div><h3>Background</h3><div><em>Streptococcus pneumoniae</em> is a widely spread human pathogen that can cause infections as severe as meningitis. The pneumococcal vaccination is the optimal approach to prevent morbidity and mortality, but the vaccination coverage is low despite several attempts to improve it. This meta-analysis assesses the impact of the interventions to increase vaccination coverage.</div></div><div><h3>Methods</h3><div>A meta-analytic review and a mixed-effects meta-regression on articles between 2013 and 2023 from PubMed, Web of Science and ScienceDirect that assessed the impact of interventions on pneumococcal vaccination coverage was performed. We included randomized controlled trials (RCTs) and comparative non-RCTs, and excluded reviews, non-comparative or retrospective studies, as well as the ones for which the full text was not available or did not present raw data on vaccination. A subgroup analysis was performed by study design, intervention type, facilitator and population characteristics.</div></div><div><h3>Results</h3><div>16 articles were included out of 349 across three databases. Ten were RCTs and six were non-RCTs. Nine were from the USA, three from France and one from China, Zimbabwe, Singapore and Turkey respectively. Seven studies had physicians and four had pharmacists as facilitators. Most described direct interventions such as education and reminders. Ten focused on at-risk patients. The pooled relative risk (RR) was (1.06 [1.00, 1.13], <em>p</em> = 0.04), with an <em>I</em>² of 17.05%. RCTs reported significantly lower effect sizes compared to non-RCTs (−0.69), <em>p</em> = 0.02. Indirect interventions showed lower effect sizes (−0.45, <em>p</em> = 0.06). Pharmacist-led interventions showed a positive, almost significant effect (0.43, <em>p</em> = 0.07).</div></div><div><h3>Conclusion</h3><div>This meta-analysis offers valuable insights into the factors that influence pneumococcal vaccination coverage and serves as a guide for the development of more effective and targeted strategies.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"5 1","pages":"Article 100238"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189087","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":"The diagnostic value of Xpert detection combined with nanopore sequencing for tuberculosis in HIV/AIDS patients","authors":"Chang Song ,&nbsp;Chunyan Zhao ,&nbsp;Dan Luo ,&nbsp;Aichun Huang ,&nbsp;Chaoyan Xu ,&nbsp;Jieqing Zhong ,&nbsp;Yujie Mo ,&nbsp;Zhentao Huang ,&nbsp;Xiaoshi Lin ,&nbsp;Zhouhua Xie ,&nbsp;Qingdong Zhu","doi":"10.1016/j.imj.2026.100237","DOIUrl":"10.1016/j.imj.2026.100237","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a major cause of death in HIV/AIDS patients, where diagnosis is complicated by atypical presentation and paucibacillary disease. Current diagnostic methods have limitations in speed or sensitivity. This study evaluates the diagnostic value of rapid, portable nanopore sequencing for TB in this high-risk population.</div></div><div><h3>Methods</h3><div>Clinical data and diagnostic results were collected from 59 HIV/AIDS patients with suspected tuberculosis. The diagnostic performance of nanopore sequencing was compared with AFB staining, TB-DNA testing, Xpert, and solid mycobacterial culture, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Kappa coefficient, and the area under the receiver operating characteristic curve (AUC). Additionally, this study further evaluated the diagnostic performance of nanopore sequencing in combination with AFB staining, TB-DNA testing, Xpert, and culture methods.</div></div><div><h3>Results</h3><div>Nanopore sequencing showed the highest performance among all methods, with a sensitivity of 60.50%, specificity of 90.50%, PPV of 92.00%, NPV of 55.90%, and AUC of 0.76. When used in combination with other methods, nanopore sequencing and Xpert achieved the best diagnostic performance, with a sensitivity of 71.10%, specificity of 85.70%, PPV of 90.00%, NPV of 62.10%, Kappa value of 0.523, and an AUC of 0.78.</div></div><div><h3>Conclusions</h3><div>The combination of nanopore sequencing and Xpert demonstrates excellent diagnostic performance for diagnosing TB in HIV/AIDS patients.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"5 1","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038350","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":"Combination of minocycline and ciprofloxacin enhances the inhibitory effect of tumor necrosis factor-alpha production in lipopolysaccharide-stimulated THP-1 monocytic cells","authors":"Ippei Sakamaki ,&nbsp;Yukie Tanaka ,&nbsp;Hiromichi Iwasaki","doi":"10.1016/j.imj.2025.100214","DOIUrl":"10.1016/j.imj.2025.100214","url":null,"abstract":"<div><h3>Background</h3><div>Tetracyclines, such as minocycline (MINO), are widely used in the treatment of infectious diseases. Japanese spotted fever (JSF) is usually treated with MINO. When MINO alone is ineffective in treating severe cases of JSF with complications, patients can be successfully treated with tetracycline combined with a quinolone such as ciprofloxacin (CPFX). However, the mechanisms underlying the efficacy of combination therapies remain unclear. We focused on cytokine suppression caused by antimicrobial agents.</div></div><div><h3>Methods</h3><div>THP-1 cells (2 × 10⁵/mL) were stimulated with 0.1 µg/mL lipopolysaccharide (LPS) and various concentrations of CPFX, MINO, or CPFX+MINO. TNF-α levels in the supernatant were measured using enzyme-linked immunosorbent assay (ELISA) after 4 h of stimulation.</div></div><div><h3>Results</h3><div>MINO or CPFX alone significantly inhibited TNF-α and chemokine production, and their combination exerted an even greater inhibitory effect than either drug alone.</div></div><div><h3>Conclusions</h3><div>Combination therapy with MINO and CPFX enhanced the inhibitory effects on inflammatory cytokine and chemokine production <em>in vitro</em>. This combination therapy is expected to provide both antimicrobial and anti-inflammatory effects. Enhanced cytokine modulation by antibiotics may be a key mechanism in the treatment of severe infectious diseases such as JSF.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579422","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":"MCPyV small T antigen enhances HPV16 oncogene expression, promotes Ca Ski cell proliferation, and reduces 5-fluorouracil-induced apoptosis in cervical cancer cells","authors":"Tahereh Pakdel ,&nbsp;Mohammad Kargar ,&nbsp;Ali Farhadi ,&nbsp;Mahdokht Hossein Aghdaei ,&nbsp;Leila Kohan","doi":"10.1016/j.imj.2025.100222","DOIUrl":"10.1016/j.imj.2025.100222","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer is primarily associated with persistent infection by high-risk human papillomaviruses (HR-HPVs), whose oncoproteins modulate key cellular pathways involved in proliferation and apoptosis. Merkel cell polyomavirus (MCPyV) has also been detected in cervical tissues, and its small T (sT) protein shares functional similarities with HR-HPV oncoproteins, suggesting a potential role in tumorigenesis.</div></div><div><h3>Methods</h3><div>This study investigated whether MCPyV sT reduces 5-fluorouracil (5-FU)-induced apoptosis and influences HPV16 oncogene expression and proliferation in Ca Ski cells. The MCPyV sT gene was cloned into a mammalian expression vector, transfected into Ca Ski cells, and confirmed by western blotting. Cytotoxicity assays assessed the effects of MCPyV sT on 5-FU-treated cells, while RT-qPCR quantified viral oncogene expression. Annexin V/PI flow cytometry and Ki-67 immunostaining were used to evaluate apoptosis and proliferation.</div></div><div><h3>Results</h3><div>MCPyV sT expression enhanced cell viability, increased the IC50 of 5-FU, and significantly reduced 5-FU-induced apoptosis. It also markedly upregulated HPV <em>E5</em> and <em>E6/E7</em> mRNA levels (<em>p</em> &lt; 0.001) and promoted proliferation. The combined presence of MCPyV sT and HPV oncoproteins synergistically increased resistance to 5-FU-induced apoptosis, oncogene expression, and cell growth.</div></div><div><h3>Conclusions</h3><div>These findings underscore the potential cooperative effects of viral oncoproteins from distinct viruses in driving therapeutic resistance, highlighting the need for further research into their molecular interactions to inform targeted cervical cancer treatments.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693815","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":"Potential mechanisms linking bacterial factors to the development and progression of multiple sclerosis","authors":"Aysouda Jafari-Nakhjavanlou,&nbsp;Parsa Irajian,&nbsp;Abed Zahedi Bialvaei","doi":"10.1016/j.imj.2025.100219","DOIUrl":"10.1016/j.imj.2025.100219","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is a chronic neurodegenerative and autoimmune disease of the central nervous system (CNS). While the exact etiology remains unclear, emerging evidence suggests that bacterial toxins play significant roles in MS pathogenesis and progression. We aimed to review mechanisms by which bacterial toxins influence MS development, focusing on molecular mimicry, epitope spreading, bystander activation, and blood-brain barrier (BBB) disruption. Specific toxins, including <em>Clostridium perfringens</em> epsilon toxin, <em>Staphylococcus aureus</em> superantigens, and <em>Chlamydia pneumoniae</em> heat shock proteins, demonstrate distinct pathogenic mechanisms in promoting CNS inflammation. Crucially, several toxins disrupt BBB integrity, making it easier for immune cells and cytokines that promote inflammation to enter the CNS and exacerbate neural inflammation. Furthermore, through molecular mimicry and epitope dissemination, bacterial antigens can initiate cross-reacting immune responses that may lead to autoimmune attacks on myelin. This review highlights the complex interplay between bacterial toxins, immune modulation, and genetic susceptibility in MS. Understanding these toxin-mediated pathways reveals the complex interplay between the microbiome and MS pathogenesis, potentially leading to novel therapeutic interventions targeting bacterial contributions to autoimmune neurodegeneration.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693816","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":"Advances in pathogen detection of Pneumocystis jirovecii pneumonia","authors":"Lu Bai ,&nbsp;Yuanyuan Li ,&nbsp;Yantong Li ,&nbsp;Chengping Hu ,&nbsp;Bingrong Zhao","doi":"10.1016/j.imj.2025.100216","DOIUrl":"10.1016/j.imj.2025.100216","url":null,"abstract":"<div><div><em>Pneumocystis jirovecii</em> pneumonia (PJP) is a life-threatening opportunistic fungal infection in immunocompromised populations. Microscopic identification of <em>P. jirovecii</em> cysts or trophozoites in lower respiratory specimens remains the diagnostic gold standard. However, the limited sensitivity, substantial technical demands and prolonged turnaround time inherent to this method hinder its clinical utility for timely and accurate PJP diagnosis. Alternative diagnostic approaches, including cytology, serology, and nucleic acid amplification tests, have been employed, though each carries distinct advantages and limitations. This review evaluates current <em>P. jirovecii</em> detection techniques to guide clinicians in early PJP identification and diagnosis, ultimately improving patient prognosis and reducing healthcare system burdens.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693818","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":"Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS","authors":"Uzair Abbas ,&nbsp;Harendra Kumar ,&nbsp;Niaz Hussain ,&nbsp;Ishfaque Ahmed ,&nbsp;Rabeel Nawaz Laghari ,&nbsp;Misha Tanveer ,&nbsp;Mohammad Hadif ,&nbsp;Kashaf Fatima ,&nbsp;Muhib Ullah Khalid ,&nbsp;Khadija Anwar ,&nbsp;Mahtab Khan","doi":"10.1016/j.imj.2025.100211","DOIUrl":"10.1016/j.imj.2025.100211","url":null,"abstract":"<div><div>Diabetes mellitus (DM) is a complex and multifactorial disorder associated with elevated blood sugar levels, poor insulin sensitivity, and inadequate insulin production. It has a major impact on the immune system, making a person more susceptible to and influenced by a variety of infectious illnesses. This narrative review summarizes the relationship between chronic inflammation and high glucose levels in DM, on susceptibility and outcomes in endemic infectious diseases. We focused on impact of DM on disease progression, and treatment response in these infections. Literature was identified through searches of PubMed, Scopus, and Google Scholar, focusing on epidemiologic, clinical, and mechanistic studies. The evidences suggest that immune modulation in DM has profound inverse relations with the outcome of infectious diseases including tuberculosis, COVID-19, and HIV/AIDS. DM increases the risk of developing severe forms of infectious diseases due to downregulation of the immune system which is associated with glycemic control. There is a need to understand the relationship between DM and immunological control for developing methods to reduce these risks and improve outcomes for the affected population.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371320","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":"Microscopic polyangiitis complicated with pulmonary hepatitis B virus infection: A case report and literature review","authors":"Ronghuang Liao ,&nbsp;Lingling Zhang ,&nbsp;Danlan Wang ,&nbsp;Ni Tan","doi":"10.1016/j.imj.2025.100218","DOIUrl":"10.1016/j.imj.2025.100218","url":null,"abstract":"<div><div>Microscopic polyangiitis (MPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis characterized by inflammatory changes in small vessel walls. Its clinical manifestations are nonspecific, and pulmonary involvement often presents as cough and production of sputum, which can be misdiagnosed as pneumonia. However, to the best of our knowledge, no cases of MPA coexisting with pulmonary hepatitis B virus (HBV) infection have been reported. This report describes the first such case. A 66-year-old man presented with a productive cough, swelling of the finger joints, and bilateral hearing loss. Initial imaging suggested pulmonary infection or malignancy. MPA was diagnosed based on positive myeloperoxidase-ANCA serology and vasculitic changes on histopathological examination of a lung biopsy specimen. Metagenomic next-generation sequencing of biopsy tissue revealed HBV, confirming a concurrent pulmonary HBV infection. Treatment with methylprednisolone, rituximab, and entecavir resulted in a favorable outcome.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693819","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":"National trends in burden of enteric infections in China: Shifts from 1990 to 2021","authors":"Huichao Wu ,&nbsp;Menglong Li ,&nbsp;Zuolin Lu ,&nbsp;Jing Huang ,&nbsp;Fuqiang Cui ,&nbsp;Ruitai Shao","doi":"10.1016/j.imj.2025.100213","DOIUrl":"10.1016/j.imj.2025.100213","url":null,"abstract":"<div><h3>Background</h3><div>Enteric infections impose a substantial global health burden annually, especially in countries with inadequate sanitation. This study aims to assess the trends in the burden of enteric infections in China.</div></div><div><h3>Methods</h3><div>Prevalence, incidence, deaths, and disability-adjusted life years (DALYs) attributed to enteric infections by etiology in China were leveraged from the Global Burden of Disease Study 2021. Temporal trends in the burden of enteric infections from 1990 to 2021 were determined by percent changes and average annual percent change (AAPC). Decomposition analysis for percent changes was conducted to understand the contributions of demographic and epidemiological changes.</div></div><div><h3>Results</h3><div>In 2021, China bore 75.15 million incidence cases and 5,590 deaths from enteric infections, with age-standardized incidence and mortality rates of 59.04 per 100,000 and 0.44 per 100,000, respectively. Substantial decreases, mainly driven by epidemiological changes, were observed in incidence cases (−74.12%), deaths (−94.09%), and DALYs (−95.60%) from 1990 to 2021. Simultaneously, age-standardized incidence, mortality, and DALY rates showed decreasing trends for enteric infections and the subtypes in China. Diarrheal diseases were consistently the main constituent of the burden of enteric infections in China.</div></div><div><h3>Conclusions</h3><div>From 1990 to 2021, China has made significant strides in the control of enteric infections. This study underscores the need for continued efforts for the improvement of the health system, and enhanced interventions and health promotion strategies for both young and older populations.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425721","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}