Clinical Microbiology and Infection最新文献

{"title":"Safety of pertussis vaccination in pregnancy and effectiveness in infants: A Danish national cohort study 2019-2023.","authors":"Helene Kildegaard, Andreas Jensen, Peter H S Andersen, Tine Dalby, Mie Agermose Gram, Øjvind Lidegaard, Lone Graff Stensballe","doi":"10.1016/j.cmi.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.03.014","url":null,"abstract":"<p><strong>Objectives: </strong>Recent surges in pertussis spread have renewed focus on pertussis vaccination strategies. Denmark implemented pertussis vaccination during pregnancy in 2019 to protect infants under three months. This nationwide study assessed the real-world safety and effectiveness of acellular pertussis vaccination during pregnancy.</p><p><strong>Methods: </strong>Using nationwide Danish registers, we included all pregnancies beyond 24 gestational weeks and all liveborn children from November 1, 2019, to June 1, 2023, with follow-up until December 31, 2023. Maternal safety outcomes included hypertension, preeclampsia, chorioamnionitis, preterm birth, and stillbirth. Infant safety outcomes included neonatal mortality, neonatal intensive care unit admission and sepsis. Vaccine effectiveness was evaluated against laboratory-confirmed pertussis and related hospital contacts. For maternal safety, vaccinated individuals were matched 1:1 to unvaccinated individuals based on gestational days, calendar week and region. Infant outcomes were assessed among the cohort of all liveborn children with follow-up until 3 months of age. Analyses were adjusted for a range of demographic, socioeconomic and medical characteristics.</p><p><strong>Results: </strong>Among 50,851 vaccinated and 50,851 unvaccinated individuals during pregnancy, initial analyses showed an increased risk of hypertension and preeclampsia following pertussis vaccination. However, after adjusting for influenza and Covid-19 vaccination during pregnancy, pertussis vaccination was not associated with increased risks of any maternal safety outcomes including hypertension (incidence rate ratio (IRR) 0.98, 0.94-1.02), mild preeclampsia (0.97, 0.92-1.02), and severe preeclampsia or HELLP syndrome (0.95, 0.86-1.05). Among 215,974 liveborn children, 108,350 were exposed to the vaccine. Vaccination was not associated with adverse infant outcomes and yielded a 72% (42%-87%) effectiveness against laboratory-confirmed pertussis (9 vs. 32 events).</p><p><strong>Conclusion: </strong>Pertussis vaccination in pregnancy was effective in preventing infant pertussis and was not associated with adverse pregnancy or infant outcomes. Future studies should, however, examine whether other vaccines or the administration of multiple vaccines during pregnancy pose an increased maternal risk of hypertensive disorders in pregnancy.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing large language models for antibiotic prescribing in different clinical scenarios: which performs better?","authors":"Andrea De Vito, Nicholas Geremia, Davide Fiore Bavaro, Susan K Seo, Justin Laracy, Maria Mazzitelli, Andrea Marino, Alberto Enrico Maraolo, Antonio Russo, Agnese Colpani, Michele Bartoletti, Anna Maria Cattelan, Cristina Mussini, Saverio Giuseppe Parisi, Luigi Angelo Vaira, Giuseppe Nunnari, Giordano Madeddu","doi":"10.1016/j.cmi.2025.03.002","DOIUrl":"10.1016/j.cmi.2025.03.002","url":null,"abstract":"<p><strong>Objectives: </strong>Large language models (LLMs) show promise in clinical decision-making, but comparative evaluations of their antibiotic prescribing accuracy are limited. This study assesses the performance of various LLMs in recommending antibiotic treatments across diverse clinical scenarios.</p><p><strong>Methods: </strong>Fourteen LLMs, including standard and premium versions of ChatGPT, Claude, Copilot, Gemini, Le Chat, Grok, Perplexity, and Pi.ai, were evaluated using 60 clinical cases with antibiograms covering 10 infection types. A standardized prompt was used for antibiotic recommendations focusing on drug choice, dosage, and treatment duration. Responses were anonymized and reviewed by a blinded expert panel assessing antibiotic appropriateness, dosage correctness, and duration adequacy.</p><p><strong>Results: </strong>A total of 840 responses were collected and analysed. ChatGPT-o1 demonstrated the highest accuracy in antibiotic prescriptions, with 71.7% (43/60) of its recommendations classified as correct and only one (1.7%) incorrect. Gemini and Claude 3 Opus had the lowest accuracy. Dosage correctness was highest for ChatGPT-o1 (96.7%, 58/60), followed by Perplexity Pro (90.0%, 54/60) and Claude 3.5 Sonnet (91.7%, 55/60). In treatment duration, Gemini provided the most appropriate recommendations (75.0%, 45/60), whereas Claude 3.5 Sonnet tended to over-prescribe duration. Performance declined with increasing case complexity, particularly for difficult-to-treat microorganisms.</p><p><strong>Discussion: </strong>There is significant variability among LLMs in prescribing appropriate antibiotics, dosages, and treatment durations. ChatGPT-o1 outperformed other models, indicating the potential of advanced LLMs as decision-support tools in antibiotic prescribing. However, decreased accuracy in complex cases and inconsistencies among models highlight the need for careful validation before clinical utilization.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global impact of US policy changes: the ESCMID perspective","authors":"ESCMID Executive Committee","doi":"10.1016/j.cmi.2025.03.001","DOIUrl":"10.1016/j.cmi.2025.03.001","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 5","pages":"Page 676"},"PeriodicalIF":10.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human alveolar echinococcosis-global, regional, and national annual incidence and prevalence rates.","authors":"Britta Lundström-Stadelmann, Ali Rostami, Caroline F Frey, Paul R Torgerson, Seyed Mohammad Riahi, Kimia Bagheri, Marc Kaethner, Anja Lachenmayer, Guido Beldi, Robin B Gasser, Andrew Hemphill","doi":"10.1016/j.cmi.2025.01.034","DOIUrl":"10.1016/j.cmi.2025.01.034","url":null,"abstract":"<p><strong>Background: </strong>Alveolar echinococcosis (AE) of humans is a disease caused by the larval (metacestode) stage of the 'fox tapeworm' Echinococcus multilocularis. AE primarily affects the liver and, like cancer, can spread to surrounding or distant organs. Its slow progression and resemblance to malignant tumours emphasise the critical importance of early detection and intervention, as there is no highly effective vaccine against AE. Although recognised as a neglected disease, there has been no recent, comprehensive review of the distribution, incidence and prevalence of AE in humans around the world.</p><p><strong>Objectives: </strong>To estimate the global, regional, and national annual incidence rates and prevalences of human AE in endemic countries.</p><p><strong>Sources: </strong>Incidence and prevalence data were obtained from published articles from 1980 to 2024, accessible via public databases.</p><p><strong>Content: </strong>This article provides a brief background on E. multilocularis, its biology and impact; reviews the geographic distribution and incidence of AE; and gives a perspective on the prevention and control of this neglected disease in humans.</p><p><strong>Implications: </strong>The AE burden in humans is substantial and emphasises the need for enhanced public awareness, surveillance, prevention, and control, particularly in under-resourced communities to mitigate the health, economic, and psychological impact of AE.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reprint of: From medical editors: a call to the global infectious diseases and clinical microbiology community","authors":"Angela Huttner,&nbsp;Marc Bonten,&nbsp;Joshua Davis,&nbsp;Leonard Leibovici,&nbsp;Thomas Tängdén,&nbsp;Ilan Schwartz","doi":"10.1016/j.cmi.2025.02.020","DOIUrl":"10.1016/j.cmi.2025.02.020","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 4","pages":"Pages 492-493"},"PeriodicalIF":10.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ORCHESTRA Delphi consensus: diagnostic and therapeutic management of SARS-CoV-2 infection in patients with rheumatological diseases.","authors":"Maria Giulia Caponcello, Paula Olivares Navarro, Cecilia Bonazzetti, Caterina Campoli, Alessia Savoldi, Elisa Gentilotti, Antonella d'Arminio Monforte, Sergio Lo Caputo, Lucía Otero-Varela, Isabel Castrejón, Evelina Tacconelli, Jesús Rodríguez-Baño, Zaira R Palacios-Baena, Dolores Mendoza Mendoza, Virginia Moreira Navarrete, Alessandro Tomelleri, Lotta Ljung, Teresa Martins Rocha, Pedro Palma, Zaira R Palacios-Baena, Elena Salamanca-Rivera, María Paniagua-García, Angelo Fassio, Riccardo Bixio, Enrico Tombetti, Fabrizio Conti","doi":"10.1016/j.cmi.2025.02.030","DOIUrl":"10.1016/j.cmi.2025.02.030","url":null,"abstract":"<p><strong>Objectives: </strong>The clinical management of COVID-19 in immunocompromised patients remains a challenge. This work aimed to develop a consensus to establish recommendations for the clinical, diagnostic, and therapeutic management of patients with rheumatic diseases and COVID-19.</p><p><strong>Methods: </strong>A panel of 14 international experts was selected, and Delphi methodology was used for the consensus, after a systematic literature review. Twenty-four questions were formulated and presented to the panel. The experts voted using a 6-point Likert scale (1) 'Strongly disagree' (SD); (2) 'Disagree' (D); (3) 'Somewhat disagree' (SWD); (4) 'Somewhat agree' (SWA); (5) 'Agree' (A); (6) 'Strongly agree' (SA). To establish consensus, simple or cumulative agreement ≥80% was required over a maximum of three rounds. Cumulative agreement was defined as the sum of response percentages on items 1-2 (SD + D); 2-3 (D + SWD); 4-5 (SWA + A); or 5-6 (A + SA), distinguishing a strong degree of agreement (A + SA) or disagreement (SD + D) from a moderate degree of agreement (SWA + A) or disagreement (D + SWD).</p><p><strong>Results: </strong>After the three rounds, consensus was reached on 23 of the 24 questions and 10 recommendations were made.</p><p><strong>Discussion: </strong>The Delphi methodology allowed consensus on recommendations in areas with insufficient scientific evidence, which can be considered for decision-making in the management of patients with rheumatological diseases while awaiting better evidence.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late HIV diagnosis-a tale of successes and failures.","authors":"Cristina Mussini, Enrico Girardi, Jovana Milic, Giovanni Guaraldi, Chloe Orkin","doi":"10.1016/j.cmi.2025.02.036","DOIUrl":"10.1016/j.cmi.2025.02.036","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four months daily rifampicin vs. 3 months daily rifampicin/isoniazid for the treatment of tuberculosis infection in asylum seekers: a randomized controlled trial.","authors":"Alberto Matteelli, Giulia Russo, Luca Rossi, Carlo Cerini, Claudia Cimaglia, Beatrice Formenti, Mirella Dall'Asta, Irene Cristini, Natalia Gregori, Carlotta Ghilardi, Andrea Ciccarone, Letizia Previtali, Gianluca Di Rosario, Daniela Maria Cirillo, Enrico Girardi","doi":"10.1016/j.cmi.2025.02.037","DOIUrl":"10.1016/j.cmi.2025.02.037","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment of tuberculosis (TB) infection is a core intervention of the TB elimination strategy. The WHO recommends both 4 months of daily rifampicin (4R) and 3 months of daily isoniazid/rifampicin (3HR) for preventive therapy, but no trial directly compared the two regimens. We measured the completion rate and tolerability of 4R and 3HR for TB preventive therapy.</p><p><strong>Methods: </strong>We conducted a prospective, open-label, randomized phase 4 superiority trial to demonstrate an increase of at least 15% in the completion rate of 4R over 3HR among asylum seekers in Italy. Asylum seekers were tested for TB infection by the Quantiferon Plus test and offered to participate in the study if infected. The primary outcome was treatment completion, measured by adherence to clinical visits and pill count. Unadjusted Kaplan-Meier curves were used to compare permanent interruptions in the two arms by days of treatment. Generalized linear model for the binomial family and logit link function was performed to determine factors associated with treatment completion.</p><p><strong>Results: </strong>From June 2021 to July 2023, we randomized 113 individuals to 4R and 112 to 3HR. Treatment was completed by 88 subjects (77.9; 95% CI, 69.1-85.1) in the 4R arm and 85 (75.9; 95% CI, 66.9-83.5) in the 3HR arm (p 0.7). The risk ratio for completing treatment was 1.03 (95% CI, 0.89-1.18) in the 4R arm compared with the 3HR arm with a risk difference of 0.03 (95% CI, -0.09 to 0.13). Dropout rates due to side effects (25/113 in 4R vs. 27/112 in 3HR) and the overall rate of adverse events (47/113 in 4R vs. 36/112 in 3HR) were not statistically different in the two groups.</p><p><strong>Discussion: </strong>4R was not superior, in terms of completion rate, to 3HR for the treatment of TB infection among asylum seekers in Italy.</p><p><strong>Trial registration number: </strong>EudraCT 2021-001438-20.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a smartphone application for appropriate antibiotic prescribing at three tertiary hospitals: an international, multicentre stepped-wedge cluster randomized trial.","authors":"Ramzy I Helou, Gaud Catho, Lisa Faxén, Marlies Hulscher, Steven Teerenstra, John Conly, Benedikt D Huttner, Thomas Tängdén, Annelies Verbon","doi":"10.1016/j.cmi.2025.02.026","DOIUrl":"10.1016/j.cmi.2025.02.026","url":null,"abstract":"<p><strong>Objectives: </strong>Smartphone applications (apps) for antibiotic prescribing have been studied in observational studies. Here, we assessed whether the use of a smartphone app increased appropriate antibiotic therapy (AAT) in hospitals.</p><p><strong>Methods: </strong>An antibiotic stewardship app (Firstline.org) was populated with local guidelines and tested in a stepped-wedged cluster randomized trial in three hospitals in the Netherlands, Sweden, and Switzerland. Defined clusters were randomized per hospital for the intervention (use of app) or standard of care. Primary outcome was AAT assessed by chart review in 15 random patients per cluster per intervention period. Secondary outcomes included clinical outcomes and user analytics. A questionnaire identifying barriers to app use was disseminated. Multivariable multilevel logistic models with time periods as fixed effects to adjust for time trend and treatment as fixed effects were employed to estimate the odds ratio of treatment.</p><p><strong>Results: </strong>Twelve clusters in the Netherlands (1085 patients) were included, 12 in Sweden (362 patients) and 8 in Switzerland (653 patients). Overall, AAT was not increased (2.0% [95% CI, -5.92% to 9.97%]) in the intervention arm compared with control across the three centres. Mean frequency of app use by cluster was associated with an AAT increase (1.9% [95% CI, 1.18-2.62%]) across study centres; 3.2% in the Netherlands (p < 0.01), 2.8% in Switzerland (p < 0.01), and remained similar in Sweden (0.4%; p 0.46). No difference was found for the other secondary outcomes. Main barriers for app use reported in the questionnaire were easily forgetting using the app and having other tools to help prescribing antibiotics.</p><p><strong>Discussion: </strong>Overall, the introduction of a stewardship app did not significantly increase AAT, but a prespecified secondary analysis of app use frequency was associated with a small but significant improvement of AAT. Variable uptake of the app, coexisting routes to guidelines and the impact of the COVID-19 pandemic during the trial likely had an impact on the results.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov, trial number NCT03793946.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a difficult-to-treat resistance index to gauge imbalance between countries' antibiotic resistance prevalence and access to antibiotics: a scoping review and concept proposal.","authors":"Morgan K Walker, Emad A Chishti, Christina Yek, Sadia Sarzynski, Sahil Angelo, Jennifer Cohn, Alicia A Livinski, Sameer S Kadri","doi":"10.1016/j.cmi.2025.02.029","DOIUrl":"10.1016/j.cmi.2025.02.029","url":null,"abstract":"<p><strong>Background: </strong>Inferring the impact of antimicrobial resistance on patient outcomes is challenging, given the variability in antibiotic access across countries and over time. By denoting resistance to all highly safe and effective antibiotics, the difficult-to-treat resistance (DTR) definition offers a framework for such assessments globally.</p><p><strong>Objectives: </strong>This study aims to conduct a scoping review to understand the international adoption, scalability, and prognostic utility of DTR and enable solutions to incorporate antibiotic access into the DTR framework.</p><p><strong>Methods: </strong>Data sources: Data sources included Agricola, Embase, Global Index Medicus, PubMed, Scopus, Web of Science: BIOSIS and Core Collection.</p><p><strong>Study eligibility criteria: </strong>Study eligibility criteria included original research publications occurring after January 2018 using the term 'difficult-to-treat resistance' to describe antimicrobial-resistant bacterial isolates demonstrating resistance to all first-line antibiotics (i.e. all β-lactam and fluoroquinolone antibiotics).</p><p><strong>Assessment of risk of bias: </strong>Assessment of risk of bias included Joanna Briggs Institute critical appraisal tool.</p><p><strong>Methods of data synthesis: </strong>We assessed the overall themes of the included studies and classified them into epidemiological, mortality, or antibiotic effectiveness/efficacy studies. Semiquantitative results among studies evaluating the prevalence of resistant bacterial isolates and mortality were reported. We propose a 'DTR index' (DTRi) that extends beyond gram-negative bacteria and complements DTR by estimating national proportions of bacterial isolates resistant to all first-line antibiotics available specifically in that country.</p><p><strong>Results: </strong>DTR was utilized in 57 studies spanning 94 countries. The DTR definition was predominantly applied unmodified and retained prognostic utility in 70% of studies. The variability in access to first-line antibiotics and emergence of newer agents across countries and over time influence practical treatment options that cannot be captured by 'fixed' DTR definitions underscoring the value of the proposed DTRi.</p><p><strong>Conclusions: </strong>The DTRi could appraise the clinical impact of introducing new agents in a country, identify hot zones of resistance-access imbalance, and optimize resource allocation to improve antibiotic resistance outcomes, especially in under-resourced populations.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}