Sachin Phakey, Patricia T Campbell, Katherine B Gibney
{"title":"Epidemiology of scarlet fever in Victoria, Australia, 2007-2017.","authors":"Sachin Phakey, Patricia T Campbell, Katherine B Gibney","doi":"10.1017/S0950268824001298","DOIUrl":"10.1017/S0950268824001298","url":null,"abstract":"<p><p>In the last 10-15 years, there has been a global resurgence of scarlet fever, an infection historically associated with significant morbidity and mortality. It is unknown whether scarlet fever incidence has increased in Australia. We aimed to examine the incidence, predictors and severity of scarlet fever in the state of Victoria, Australia from 2007 to 2017, analyzing scarlet fever emergency department (ED) presentations, hospitalizations and deaths. Of the 1 578 scarlet fever cases during the study period, most occurred in children aged <10 years (1 344, 85%), in males (882, 56%), and during winter and spring months (918, 57%). There were no deaths with scarlet fever, however, 374 cases (24%) were admitted to hospital. The annual incidence of scarlet fever was stable during the study period (mean, 2.5; range, 1.9-3.1 cases per 100 000). Annual incidence was highest in children aged <5 years (19.3 per 100 000), and was 21% higher in males than females, adjusting for age and year (incidence rate ratio, 1.21, 95%CI 1.09-1.34). Whilst scarlet fever ED presentations and hospitalizations were stable in Victoria from 2007 to 2017, the recent identification of a <i>Streptococcus pyogenes</i> variant in Australia associated with epidemic scarlet fever overseas highlights the risk of future outbreaks.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371341","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}
Hannah Charles, Katy Sinka, Ian Simms, Kate S Baker, Gauri Godbole, Claire Jenkins
{"title":"Trends in shigellosis notifications in England, January 2016 to March 2023.","authors":"Hannah Charles, Katy Sinka, Ian Simms, Kate S Baker, Gauri Godbole, Claire Jenkins","doi":"10.1017/S0950268824001006","DOIUrl":"10.1017/S0950268824001006","url":null,"abstract":"<p><p>We reviewed all diagnoses of <i>Shigella</i> species notified to the UK Health Security Agency from January 2016 to March 2023. An overall increase in notifications of shigellosis was seen between 2016 (<i>n</i> = 415/quarter) and 2023 (<i>n</i> = 1 029/quarter). However, notifications dramatically declined between March 2020 and September 2021 during the COVID-19 pandemic (<i>n</i> = 208/quarter) highlighting the impact of travel and social distancing restrictions on transmission. <i>S. sonnei</i> diagnoses were more affected by lockdown restrictions than <i>S. flexneri</i>, most likely due to a combination of species-specific characteristics and host attributes. Azithromycin resistance continued to be associated with epidemics of sexually transmissible S. <i>flexneri</i> (adult males = 45.6% vs. adult females = 8.7%) and <i>S. sonnei</i> (adult males = 59.5% vs. adult females = 14.6%). We detected resistance to ciprofloxacin in <i>S. sonnei</i> from adult male cases not reporting travel at a higher frequency (79.4%) than in travel-associated cases (61.7%). Extensively drug-resistant <i>Shigella</i> species associated with sexual transmission among men almost exclusively had ESBL encoded by <i>bla</i><sub>CTX-M-27</sub>, whereas those associated with returning travellers had <i>bla</i><sub>CTX-M-15</sub>. Given the increasing incidence of infections and AMR, we recommend that enhanced surveillance is used to better understand the impact of travel and sexual transmission on the acquisition and spread of MDR and XDR Shigella species.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371343","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}
Simon Packer, Piotr Patrzylas, Rachel Merrick, Clare Sawyer, Andrew McAuley, William Crowe, Gillian Armstrong, Leonardo Green, Lucy Findlater, Charlie Turner, Obaghe Edeghere, Charlotte Anderson
{"title":"Mpox in UK households: estimating secondary attack rates and factors associated with transmission, May-November 2022.","authors":"Simon Packer, Piotr Patrzylas, Rachel Merrick, Clare Sawyer, Andrew McAuley, William Crowe, Gillian Armstrong, Leonardo Green, Lucy Findlater, Charlie Turner, Obaghe Edeghere, Charlotte Anderson","doi":"10.1017/S0950268824000864","DOIUrl":"10.1017/S0950268824000864","url":null,"abstract":"<p><p>We aimed to estimate the secondary attack rate of mpox among UK household contacts and determine factors associated with transmission to inform public health management of contacts, during the global outbreak in 2022. Information was collected via NHS and public health services and included age, gender, place of residence, setting, and type of contact. Aggregate information was summarized for the UK. Record level data was combined for England, Wales and Northern Ireland, and multivariable logistic regression was used to determine factors associated with transmission. The secondary attack rate among UK household mpox contacts was 4% (60/1 526). Sexual contact with the index case was associated with a 11-fold increase in adjusted odds of becoming a case in England, Wales, and Northern Ireland (95% CI 5.5-22, <i>p</i> < 0.001). Household contacts outside of London had increased odds compared to London residents (adjusted OR 2.9, 95%CI 1.6-5.4, <i>p</i> < 0.001), while female contacts had reduced odds of becoming a case (aOR: 0.41, 95% CI: 0.15-0.95). We found a low overall secondary attack rate among household mpox contacts with strong evidence of increased transmission risk associated with sexual contact. This evidence will inform the risk assessment of contacts and support prioritization of those with close intimate contact for follow up.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361349","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}
Hannah L Moore, Charlie Turner, Chris Rawlinson, Cong Chen, Neville Q Verlander, Charlotte Anderson, Gareth J Hughes
{"title":"Risk factors for COVID-19 transmission in England: a multilevel modelling study using routine contact tracing data.","authors":"Hannah L Moore, Charlie Turner, Chris Rawlinson, Cong Chen, Neville Q Verlander, Charlotte Anderson, Gareth J Hughes","doi":"10.1017/S0950268824001043","DOIUrl":"10.1017/S0950268824001043","url":null,"abstract":"<p><p>Contact tracing for COVID-19 in England operated from May 2020 to February 2022. The clinical, demographic and exposure information collected on cases and their contacts offered a unique opportunity to study secondary transmission. We aimed to quantify the relative impact of host factors and exposure settings on secondary COVID-19 transmission risk using 550,000 sampled transmission links between cases and their contacts. Links, or 'contact episodes', were established where a contact subsequently became a case, using an algorithm accounting for incubation period, setting, and contact date. A mixed-effects logistic regression model was used to estimate adjusted odds of transmission. Of sampled episodes, 8.7% resulted in secondary cases. Living with a case (71% episodes) was the most significant risk factor (aOR = 2.6, CI = 1.9-3.6). Other risk factors included unvaccinated status (aOR = 1.2, CI = 1.2-1.3), symptoms, and older age (66-79 years; aOR = 1.4, CI = 1.4-1.5). Whilst global COVID-19 strategies emphasized protection outside the home, including education, travel, and gathering restrictions, this study evidences the relative importance of household transmission. There is a need to reconsider the contribution of household transmission to future control strategies and the requirement for effective infection control within households.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361350","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}
Lisa Glaser, Ross Harris, Tehreem Mohiyuddin, Jennifer A Davidson, Sharon Cox, Colin N J Campbell
{"title":"Analyzing the seasonality of tuberculosis case notifications in the UK, 2000-2018.","authors":"Lisa Glaser, Ross Harris, Tehreem Mohiyuddin, Jennifer A Davidson, Sharon Cox, Colin N J Campbell","doi":"10.1017/S095026882400092X","DOIUrl":"10.1017/S095026882400092X","url":null,"abstract":"<p><p>Globally, there is seasonal variation in tuberculosis (TB) incidence, yet the biological and behavioural or social factors driving TB seasonality differ across countries. Understanding season-specific risk factors that may be specific to the UK could help shape future decision-making for TB control. We conducted a time-series analysis using data from 152,424 UK TB notifications between 2000 and 2018. Notifications were aggregated by year, month, and socio-demographic covariates, and negative binomial regression models fitted to the aggregate data. For each covariate, we calculated the size of the seasonal effect as the incidence risk ratio (IRR) for the peak versus the trough months within the year and the timing of the peak, whilst accounting for the overall trend. There was strong evidence for seasonality (<i>p</i> < 0.0001) with an IRR of 1.27 (95% CI 1.23-1.30). The peak was estimated to occur at the beginning of May. Significant differences in seasonal amplitude were identified across age groups, ethnicity, site of disease, latitude and, for those born abroad, time since entry to the UK. The smaller amplitude in older adults, and greater amplitude among South Asians and people who recently entered the UK may indicate the role of latent TB reactivation and vitamin D deficiency in driving seasonality.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343930","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}
Leann Denich, Joyce M Cheng, Courtney R Smith, Marsha Taylor, Robin Atkinson, Eva Boyd, Linda Chui, Lance Honish, Leah Isaac, Ashley Kearney, Jennifer J Liang, Victor Mah, Anna J W Manore, Zachary D McCormic, Cynthia Misfeldt, Celine Nadon, Kane Patel, Davendra Sharma, Alexander Todd, April Hexemer
{"title":"A multi-provincial outbreak of <i>Salmonella</i> Newport infections associated with red onions: A report of the largest <i>Salmonella</i> outbreak in Canada in over 20 years.","authors":"Leann Denich, Joyce M Cheng, Courtney R Smith, Marsha Taylor, Robin Atkinson, Eva Boyd, Linda Chui, Lance Honish, Leah Isaac, Ashley Kearney, Jennifer J Liang, Victor Mah, Anna J W Manore, Zachary D McCormic, Cynthia Misfeldt, Celine Nadon, Kane Patel, Davendra Sharma, Alexander Todd, April Hexemer","doi":"10.1017/S0950268824001055","DOIUrl":"10.1017/S0950268824001055","url":null,"abstract":"<p><p>An investigation into an outbreak of <i>Salmonella</i> Newport infections in Canada was initiated in July 2020. Cases were identified across several provinces through whole-genome sequencing (WGS). Exposure data were gathered through case interviews. Traceback investigations were conducted using receipts, invoices, import documentation, and menus. A total of 515 cases were identified in seven provinces, related by 0-6 whole-genome multi-locus sequence typing (wgMLST) allele differences. The median age of cases was 40 (range 1-100), 54% were female, 19% were hospitalized, and three deaths were reported. Forty-eight location-specific case sub-clusters were identified in restaurants, grocery stores, and congregate living facilities. Of the 414 cases with exposure information available, 71% (295) had reported eating onions the week prior to becoming ill, and 80% of those cases who reported eating onions, reported red onion specifically. The traceback investigation identified red onions from Grower A in California, USA, as the likely source of the outbreak, and the first of many food recall warnings was issued on 30 July 2020. <i>Salmonella</i> was not detected in any tested food or environmental samples. This paper summarizes the collaborative efforts undertaken to investigate and control the largest <i>Salmonella</i> outbreak in Canada in over 20 years.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343929","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}
Carl J E Suster, Anne E Watt, Qinning Wang, Sharon C-A Chen, Jen Kok, Vitali Sintchenko
{"title":"Combined visualization of genomic and epidemiological data for outbreaks.","authors":"Carl J E Suster, Anne E Watt, Qinning Wang, Sharon C-A Chen, Jen Kok, Vitali Sintchenko","doi":"10.1017/S0950268824001092","DOIUrl":"10.1017/S0950268824001092","url":null,"abstract":"<p><p>In epidemiological investigations, pathogen genomics can provide insights and test epidemiological hypotheses that would not have been possible through traditional epidemiology. Tools to synthesize genomic analysis with other types of data are a key requirement of genomic epidemiology. We propose a new 'phylepic' visualization that combines a phylogenomic tree with an epidemic curve. The combination visually links the molecular time represented in the tree to the calendar time in the epidemic curve, a correspondence that is not easily represented by existing tools. Using an example derived from a foodborne bacterial outbreak, we demonstrated that the phylepic chart communicates that what appeared to be a point-source outbreak was in fact composed of cases associated with two genetically distinct clades of bacteria. We provide an R package implementing the chart. We expect that visualizations that place genomic analyses within the epidemiological context will become increasingly important for outbreak investigations and public health surveillance of infectious diseases.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343931","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}
Shixin Xiu, Zhuping Xu, Xuwen Wang, Li Zhang, Qiang Wang, Min Yang, Yuan Shen
{"title":"Varicella vaccine effectiveness evaluation in Wuxi, China: A retrospective cohort study.","authors":"Shixin Xiu, Zhuping Xu, Xuwen Wang, Li Zhang, Qiang Wang, Min Yang, Yuan Shen","doi":"10.1017/S095026882400102X","DOIUrl":"10.1017/S095026882400102X","url":null,"abstract":"<p><p>Varicella is a vaccine-preventable infectious disease. Since 1 December 2018, the varicella vaccine has been included in the local Expanded Programme on Immunization (EPI) in Wuxi, China, and children born after 1 December 2014 are eligible for free vaccination. To evaluate the effect of varicella vaccination in Wuxi city, we selected 382 397 children born from 2012 to 2016 as subjects. Their disease data were obtained from the Chinese Disease Prevention and Control Information System, and their vaccination data were obtained from the Jiangsu Province Vaccination Integrated Service Management Information System. The incidence of breakthrough varicella cases increased in the first 4 years and reached the peak in the fifth year. With the increase of vaccination rate, the incidence of varicella decreased significantly. The vaccine effectiveness (VE) was found to be 88.17%-95.78% for one dose and 98.65%-99.93% for two doses. Although the VE per dose decreased from 99.57% in the first year to 93.04% in the eighth year, it remained high. These findings confirmed the effectiveness of varicella vaccination in children, supported the use of a two-dose varicella vaccination strategy to achieve better protection, and provided important insights into the optimal vaccination strategy for varicella prevention in children.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343944","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}
Courtney R Smith, Marsha Taylor, Anna J W Manore, April Hexemer, Bijay Adhikari, David Alexander, Robin Atkinson, Linda Chui, Eleni Galanis, Colette Gaulin, Meghan Griffin, Lance Honish, Ashley Kearney, Victor Mah, Rachel McCormick, Michelle Murti
{"title":"Everything but the kitchen sink: The use of multiple hypothesis generation methods to investigate an outbreak of <i>Salmonella</i> Enteritidis associated with frozen profiteroles and eclairs.","authors":"Courtney R Smith, Marsha Taylor, Anna J W Manore, April Hexemer, Bijay Adhikari, David Alexander, Robin Atkinson, Linda Chui, Eleni Galanis, Colette Gaulin, Meghan Griffin, Lance Honish, Ashley Kearney, Victor Mah, Rachel McCormick, Michelle Murti","doi":"10.1017/S0950268824001067","DOIUrl":"10.1017/S0950268824001067","url":null,"abstract":"<p><p>In December 2018, an outbreak of <i>Salmonella</i> Enteritidis infections was identified in Canada by whole-genome sequencing (WGS). An investigation was initiated to identify the source of the illnesses, which proved challenging and complex. Microbiological hypothesis generation methods included comparisons of <i>Salmonella</i> isolate sequence data to historical domestic outbreaks and international repositories. Epidemiological hypothesis generation methods included routine case interviews, open-ended centralized re-interviewing, thematic analysis of open-ended interview data, collection of purchase records, a grocery store site visit, analytic comparison to healthy control groups, and case-case analyses. Food safety hypothesis testing methods included food sample collection and analysis, and traceback investigations. Overall, 83 cases were identified across seven provinces, with onset dates from 6 November 2018 to 7 May 2019. Case ages ranged from 1 to 88 years; 60% (50/83) were female; 39% (22/56) were hospitalized; and three deaths were reported. Brand X profiteroles and eclairs imported from Thailand were identified as the source of the outbreak, and eggs from an unregistered facility were hypothesized as the likely cause of contamination. This study aims to describe the outbreak investigation and highlight the multiple hypothesis generation methods that were employed to identify the source.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343932","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":"Interleukins in the pathogenesis of influenza and other acute respiratory viral infections.","authors":"Mykchaylo Andreychyn, Larysa Melnyk, Nataliia Zavidniiuk, Natalya Nychyk, Iaryna Iosyk","doi":"10.1017/S0950268824001109","DOIUrl":"10.1017/S0950268824001109","url":null,"abstract":"<p><p>Influenza and other acute respiratory viral infections (ARVIs) are among the most common human diseases. In recent decades, the discovery of cytokines and their significance in the pathogenesis of diseases has led to extensive research on these compounds in various pathologies including ARVIs. The aim of the research was to study the cytokine profile in patients with ARVIs. The cases of 30 patients were investigated. Etiological diagnosis was performed by polymerase chain reaction. Different classes of cytokines in the serum were defined by the enzyme-linked immunosorbent assay (ELISA). The level of cytokines depended on the number of pathogens. The highest levels of pro-inflammatory interleukins and the lowest levels of anti-inflammatory IL-4 were observed in patients with a combination of five or more viruses compared to those with a monoinfection. Analysis of the data showed that in the acute phase, the levels of all studied pro-inflammatory cytokines - IL-2, IL-6, and TNF-α - increased by 8, 39, and 9 times, respectively, compared to those in healthy individuals. In the acute phase of ARVI, the levels of pro-inflammatory cytokines were significantly higher and depended on the severity of the disease. The imbalance of cytokines in the serum has been established in cases of ARVIs, depending on the severity of the disease.</p>","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343933","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}