Diagnostic microbiology and infectious disease最新文献

{"title":"Platelet distribution width in patients with influenza A virus-induced acute respiratory distress syndrome: An old indicator with promising clinical application","authors":"Xiang Fang ,&nbsp;Jinhui Gao ,&nbsp;Ziyi Zhang ,&nbsp;Xuanzhe Yang ,&nbsp;Qin Wang ,&nbsp;Jiajia Wang","doi":"10.1016/j.diagmicrobio.2024.116657","DOIUrl":"10.1016/j.diagmicrobio.2024.116657","url":null,"abstract":"<div><div>This study aims to investigate the predictive value of platelet distribution width (PDW) in patients with influenza A virus (IAV) infection. The clinical data of 105 IAV-infected patients was collected and analyzed. We found that creatine kinase (CK), Acute Physiology and Chronic Health Evaluation (APACHE) II score, PDW, and red blood cell distribution width (RDW) were independent risk factors for acute respiratory distress syndrome (ARDS) development. PDW was more effective in predicting ARDS development than CK and RDW, and comparable to APACHE II score. Among ARDS patients, PDW showed a positive correlation with duration of invasive ventilation, APACHE II score, and Sequential Organ Failure Assessment (SOFA) score, and a negative correlation with the arterial pressure of oxygen/inspiratory fraction of oxygen (PaO₂/FiO₂) level. Furthermore, PDW showed high predictive efficiency for septic shock and 28-day mortality. Taken together, this study demonstrated a promising clinical value of PDW in patients with IAV-induced ARDS.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116657"},"PeriodicalIF":2.1,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined antifungal therapy with immunostimulation for refractory cutaneous and peritoneal mucormycosis caused by Rhizopus microsporus","authors":"Rania Mhenni ,&nbsp;Sarah Dellière ,&nbsp;Chiheb Ben Maaouia ,&nbsp;Samia Hamane ,&nbsp;Benjamin Deniau ,&nbsp;Thibault Mahévas ,&nbsp;Maité Chaussard ,&nbsp;Maxime Coutrot ,&nbsp;Lucie Guillemet ,&nbsp;Alexandru Cupaciu ,&nbsp;Alexandre Pharaboz ,&nbsp;Thais Walter ,&nbsp;Louis Boutin ,&nbsp;Mourad Benyamina ,&nbsp;Hélène Corte ,&nbsp;Charles Delale ,&nbsp;Marc Chaouat ,&nbsp;Amélie Guihot ,&nbsp;Fanny Lanternier ,&nbsp;Alexandre Alanio ,&nbsp;Emmanuel Dudoignon","doi":"10.1016/j.diagmicrobio.2024.116653","DOIUrl":"10.1016/j.diagmicrobio.2024.116653","url":null,"abstract":"<div><div>Mucormycosis is a fungal infection typically affecting immunocompromised patients. Here, we report a severe case of invasive cutaneous and peritoneal mucormycosis caused by <em>Rhizopus microsporus</em>, successfully treated with a combination of antifungal therapy, PD-1 inhibitor, and interferon-gamma. We highlight the importance of personalized immunotherapy in refractory cases of invasive mucormycosis.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116653"},"PeriodicalIF":2.1,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic techniques for visceral leishmaniasis: An overview of methods used in East Africa","authors":"Vincent Obino Orucho ,&nbsp;Ankit Gupta ,&nbsp;Rael Jepkogei Masai ,&nbsp;Erick Ondari ,&nbsp;Om Prakash Singh ,&nbsp;Benuel Nyagaka ,&nbsp;Angamuthu Selvapandiyan","doi":"10.1016/j.diagmicrobio.2024.116655","DOIUrl":"10.1016/j.diagmicrobio.2024.116655","url":null,"abstract":"<div><div>Leishmanias is a parasitic infection caused by a protozoan belonging to the genus <em>Leishmania</em> and transmitted by sand fly, <em>Phlebotomus</em> fly in the old world and <em>Lutzomyia</em> in the New world. The disease is prevalent in the tropics, subtropics, and Southern Europe, where it affects about 1.5 million to 2 million people annually. India, Bangladesh, Sudan, South Sudan, Brazil and Ethiopia account for up to 90% of all the VL cases. While <em>Leishmania</em> cases in Asia are declining, cases in East Africa especially in Somalia, Sudan, South Sudan, Ethiopia and Kenya have been increasing. The rise in East African cases is partially attributed to ongoing armed conflicts especially in Somalia, Sudan and Southern Sudan, which has displaced people and increased their exposure to sand fly bites. Migration from endemic to non-endemic regions, misdiagnosis, famine, malnutrition, climate change and an increase in HIV cases are other contributing factors. The clinical diagnosis of <em>Leishmania</em> in East Africa combines the patient's clinical signs with either serological or parasitological test, with rK39 strip and microscopy being the major methods used. Diagnosis of the condition remains challenging, as current techniques have limitations, including the inability to detect parasites in tissue, the need for specialized expertise, prohibitive costs of testing equipment, low antibody titers, and the risk of misdiagnosis due to co-infections with diseases such as HIV, tuberculosis, malaria and typhoid. Various techniques, including serological and molecular parasitological methods, have been employed in attempts to address these challenges, but with limited success. This article therefore, reviews some of the techniques that have been used in <em>Leishmania</em> diagnosis in East Africa and discusses other available new techniques with aim of overcoming the current challenges.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116655"},"PeriodicalIF":2.1,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunodominant Molecules for the Immunodiagnosis of Strongyloides stercoralis Infection","authors":"Cíntia de Lima Oliveira ,&nbsp;Joelma Nascimento de Souza ,&nbsp;Nilo Manoel Pereira Vieira Barreto ,&nbsp;Weslei Almeida Costa Araújo ,&nbsp;Joana R. Sousa ,&nbsp;Victor Amazonas Pereira Maraux ,&nbsp;Carina da Silva Pinheiro ,&nbsp;Maria Gabriela Almeida ,&nbsp;Márcia Cristina Aquino Teixeira ,&nbsp;Neci Matos Soares","doi":"10.1016/j.diagmicrobio.2024.116649","DOIUrl":"10.1016/j.diagmicrobio.2024.116649","url":null,"abstract":"<div><div>This study aimed to identify immunodominant molecules with potential for <em>S. stercoralis</em> infection immunodiagnosis. Serum samples were tested by an IgG-ELISA using <em>Strongyloides venezuelensis</em> soluble (AgS) and membrane (AgM) antigens, and its protein fractions (&lt;100 and &gt;100 kDa). Proteins were tested by one- and two-dimensional (2D) gel immunoblotting. The ELISA results showed sensitivities, ranging from 82.3 to 85.3 %, while specificities ranged from 60.0 to 93.3 %. Cross-reactivities were observed with sera from individuals infected with other helminths. Immunoreactive protein bands were revealed by Western blotting using both antigens, and a band with molecular weight around 140 kDa of AgS showed 100 % sensitivity and specificity, without cross-reactivity. The 2D immunoblotting revealed 7 spots in the 140 kDa protein with the <em>S. stercoralis</em> pool of serums. The pre-selection of <em>Strongyloides</em> immunodominant proteins that are highly specific and free from cross-reactions is essential for the production of recombinant antigens for the immunodiagnosis of strongyloidiasis.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116649"},"PeriodicalIF":2.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Enterococcus faecalis and the red complex bacteria analyzed by the Checkerboard technique for DNA-DNA hybridization in endodontic infections: A systematic review and meta-analysis","authors":"Mario Alberto Alarcón-Sánchez ,&nbsp;Ruth Rodríguez-Montaño ,&nbsp;Julieta Sarai Becerra-Ruiz ,&nbsp;Sarah Monserrat Lomelí-Martínez ,&nbsp;Seyed Ali Mosaddad ,&nbsp;Artak Heboyan","doi":"10.1016/j.diagmicrobio.2024.116654","DOIUrl":"10.1016/j.diagmicrobio.2024.116654","url":null,"abstract":"<div><div>Endodontic infections include conditions such as pulp necrosis, apical periodontitis, abscesses, granulomas, and periapical cysts. Detection of pathogenic microorganisms responsible for these diseases is essential for accurate diagnosis and future therapy. <em>Enterococcus faecalis, Porphyromonas gingivalis, Tannerella forsythia,</em> and <em>Treponema denticola</em> were analyzed qualitatively and quantitatively using the Checkerboard methodology for DNA-DNA hybridizations as a bacterial identification tool. Clinical investigations have shown a significant frequency of these microorganisms. The present systematic review and meta-analysis aimed to determine the prevalence of <em>E. faecalis</em> and red complex bacteria (RCB) (<em>P. gingivalis, T. forsythia,</em> and <em>T. denticola</em>) analyzed by the Checkerboard DNA-DNA hybridization technique in endodontic infections. This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines—electronic databases: PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar. Statistical analysis was performed using STATA V.15 software. Seventeen articles were included, of which a total of 620 samples were evaluated. Five hundred sixty-seven samples were taken from infected root canals, 34 samples from periradicular tissues, and 27 samples from periapical abscesses of infected teeth. The prevalence of <em>E. faecalis</em> in endodontic infections in all studies was 74 %, of <em>P. gingivalis</em> was 63 %, of <em>T. forsythia</em> 46 %, and of <em>T. denticola</em> 58 %. The presence of bacteria such as <em>E. faecalis</em> reduces the efficiency of endodontic therapy and leads to recurring infections. It is recognized that \"RCB\" can be identified in endodontic lesions; however, they are not usually prominent. The DNA-DNA hybridization approach is critical for identifying bacteria and detecting difficult-to-culture microorganisms, making it a helpful and cost-effective tool for directing personalized endodontic treatments.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116654"},"PeriodicalIF":2.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of PCR compared to conventional culture and sensitivity testing for management of complicated urinary tract infections in adults: Part II.Evaluation of diagnostic concordance, discordant results, and antimicrobial selection efficacy","authors":"Frank L. Spangler ,&nbsp;Cheau Williams ,&nbsp;Michael E. Aberger ,&nbsp;Bradley A. Wilson ,&nbsp;Khaled Ajib ,&nbsp;Shahram S. Gholami ,&nbsp;Henry N. Goodwin Jr. ,&nbsp;Lauren Y. Park ,&nbsp;Moustafa Kardjadj ,&nbsp;DeAndre Derrick ,&nbsp;Thomas K. Huard","doi":"10.1016/j.diagmicrobio.2024.116646","DOIUrl":"10.1016/j.diagmicrobio.2024.116646","url":null,"abstract":"<div><h3>Purpose</h3><div>Complicated urinary tract infections (cUTIs) are difficult to manage due to their polymicrobial nature and resistance to standard therapies. In current clinical practice, the management of a cUTI often starts with broad-spectrum antimicrobials until culture and sensitivity (C&amp;S) results are available, but these diagnostic delays further hinder treatment efficacy. Polymerase Chain Reaction (PCR) offers a faster alternative. This study evaluates PCR's utility compared to C&amp;S, focusing on agreeability, discordant results, clinical outcomes, and antimicrobial selection efficacy to improve cUTI management.</div></div><div><h3>Materials and Methods</h3><div>The clinical study was conducted in two parts: the primary study focused on patients with cUTIs, while the sub-study involved healthy individuals without signs or symptoms of urinary tract infection (UTI). All collected samples underwent analysis using both PCR and C&amp;S for comparison. Building on the first part of the study, the research evaluated outcome measures related to discordant analysis.</div></div><div><h3>Results</h3><div>Overall, our study supports good agreement between PCR and C&amp;S in positive cases (95.32 % at baseline and 88.06 % at end of study (EOS)) but reveals some discordance in negative cases (38.30 % at baseline and 62.91 % at EOS). The negative percent agreement (NPA) in the sub-study on the healthy population was 70.16 %. Further analysis of discordant results revealed that symptomatic patients treated for PCR-positive infections trended toward better clinical outcomes (77.45 % vs. 71.42 %) and higher rates of microbiological eradication (53.92 % vs. 50 %) compared to those treated for C&amp;S-positive infections. Additional analysis on antimicrobial use and microbiological aspects revealed that the PCR group received more oral medication-based treatments, while the C&amp;S group received other forms (intramuscular or bladder irrigation). In cases of discordant results, there were more PCR-positive but culture-negative cases than PCR-negative but culture-positive cases.</div></div><div><h3>Conclusions</h3><div>Our clinical utility study data suggests that PCR-guided management of cUTIs is overall superior to conventional C&amp;S, offering several advantages. PCR has the potential to enhance patient care by enabling the early adoption of narrower antibiotic therapies, improving clinical outcomes, and ensuring the effective selection of antimicrobials. A PCR-guided management plan could be particularly beneficial in managing patients with cUTIs, addressing infections that are occasionally overlooked with current C&amp;S-guided treatment protocols.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116646"},"PeriodicalIF":2.1,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-N-methyl-D-aspartate receptor encephalitis following Human norovirus infection: A case report.","authors":"Yan-Ru Liu,&nbsp;Ying Xiong","doi":"10.1016/j.diagmicrobio.2024.116648","DOIUrl":"10.1016/j.diagmicrobio.2024.116648","url":null,"abstract":"<div><div>Human norovirus (NoV) is the most common viral cause of acute gastroenteritis worldwide. In addition to affecting the digestive system, NoV also affect the neurological systems.</div><div>A 15-month-old girl presented with vomiting and diarrhea for 2 days, along with one seizure. Her stool was NoV-nucleic-acid-positive, and she had normal results for cerebrospinal fluid (CSF), cranial magnetic resonance imaging, and video-electroencephalography (VEEG). She was initially diagnosed with benign convulsions with mild gastroenteritis, but she subsequently developed walking instability, an involuntary chewing-like movement of the oropharynx, and decreased speech. On rechecking, her CSF result was positive for anti-NMDAR antibody. She was diagnosed with anti-NMDAR encephalitis, treatment consisted of intravenous immunoglobulin and glucocorticoid, following which she almost completely recovered.</div><div>This case suggests the possibility that NoV infection may be one of the triggers of anti-NMDAR encephalitis. Patients with NoV infections and neurological manifestations should be considered for anti-neuronal antibody testing.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116648"},"PeriodicalIF":2.1,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unrecognized importance of the throat in the early stage of SARS-CoV-2 infection","authors":"Tobias Todsen","doi":"10.1016/j.diagmicrobio.2024.116650","DOIUrl":"10.1016/j.diagmicrobio.2024.116650","url":null,"abstract":"","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116650"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary leptospiral sphingomyelinases as diagnostic markers of leptospirosis in dengue patients co-infected with leptospirosis","authors":"Reetika Chaurasia ,&nbsp;Saipriya Kamaraju ,&nbsp;K.C. Thresiamma ,&nbsp;Chithra Jayaprakash ,&nbsp;C.K. Eapen ,&nbsp;Manjula Sritharan","doi":"10.1016/j.diagmicrobio.2024.116647","DOIUrl":"10.1016/j.diagmicrobio.2024.116647","url":null,"abstract":"<div><div>The study aims to evaluate the diagnostic potential of pathogen-specific leptospiral sphingomyelinases, LipL32, LipL41, and HbpA in human patients with dengue-leptospirosis coinfection. Patients (n-86), upon clinical evaluation, were categorized into Group I (n-37; leptospirosis), Group II (n-39; dengue-leptospirosis coinfection), and Group III (n-10; negative for both dengue and leptospirosis). ELISA identified significant levels of the four leptospiral antigens in the urine of Group I and II, but not in Group III patients. Immunoblot analysis of the urinary proteins with specific antibodies identified the tissue-damaging true sphingomyelinases Sph2 and pore-forming SphH. Urinary leptospiral antigens identified patients with leptospirosis and with dengue-leptospirosis coinfection. Patients with renal damage and proteinuria showed high urinary excretion of anti-leptospiral antibodies, with markedly low values in the serum. Proteinuria resulted in the loss of the circulating proteins, reflected by the low levels of anti-leptospiral antibodies in serum, with urine showing albumin and high levels of anti-leptospiral antibodies.</div><div>IMPORTANCE: The study highlights the diagnostic potential of all four leptospiral antigens. Since early detection of urinary sphingomyelinases is possible, their diagnostic and prognostic potential can be evaluated on a larger sample size. Non-invasive, point-of-care diagnostic devices can be developed for use in endemic regions, particularly during monsoon seasons.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116647"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of metagenomic next-generation sequencing based on alveolar lavage fluid in unexplained lung shadows","authors":"Zehua Zhang ,&nbsp;Lei Zhou ,&nbsp;Haifeng Li ,&nbsp;Ling Li ,&nbsp;Haipeng Liu","doi":"10.1016/j.diagmicrobio.2024.116651","DOIUrl":"10.1016/j.diagmicrobio.2024.116651","url":null,"abstract":"<div><h3>Background</h3><div>Unexplained lung shadows are challenging in respiratory medicine, with both infectious and non-infectious etiologies. Lung biopsy is definitive but invasive, prompting a need for non-invasive alternatives. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) is emerging as a promising diagnostic tool.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 105 patients with unexplained lung shadows, collecting general information, mNGS results from BALF, and clinical diagnosis. We evaluated mNGS's diagnostic performance by comparing with final diagnosis.</div></div><div><h3>Results</h3><div>mNGS showed good diagnostic performance in differentiating infectious from non-infectious causes. The specificity and accuracy for bacteria and fungi exceeded 90%, while the sensitivity and precision for fungi were lower than for bacteria. Atypical pathogens were frequently identified, especially in mixed infections.</div></div><div><h3>Conclusions</h3><div>mNGS of BALF is efficient in diagnosing infectious and non-infectious causes of unexplained lung shadows. While effective for bacteria and fungi detection, the sensitivity and precision for fungi are lower.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"111 3","pages":"Article 116651"},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}