European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Imported malaria in a non-endemic country: sixteen years of cases in a hospital in the South of Madrid, Spain","authors":"Víctor Antón-Berenguer, Irene Cabrera-Rodrigo, Beatriz Valle-Borrego, Jorge Ligero-López, Francisco J. Merino-Fernández, Sara Gómez-de-Frutos, José Miguel Rubio","doi":"10.1007/s10096-024-04938-0","DOIUrl":"https://doi.org/10.1007/s10096-024-04938-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Malaria keeps on being a serious global health threat, especially in many tropical countries, where it is endemic. Also in non-endemic countries, like Spain, malaria is an issue that requires attention due to the presence of imported cases.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This is a retrospective study, including all patients diagnosed with malaria at Severo Ochoa University Hospital from 2006 to 2022, being classified according to: (I) their type of stay in an endemic area as visiting friends and relatives (VFR), migrants of recent arrival (MRA), or tourism and business (T&amp;B), and (II) the mode of presentation as microscopic (MM) or submicroscopic (SMM) malaria.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In this study, 132 patients (23.7% of all suspected) were diagnosed with malaria. The PCR was the most sensitive technique (99.2%), followed by antigen detection (78.8%) and microscopy (75%), with <i>Plasmodium falciparum</i> being the predominant species (94.7%). VFR was the largest group infected with malaria (69.7%), mostly symptomatic (98.2%) and presenting MM (90.2%). Instead, MRA patients (25%) presented milder (47.4%) or no symptoms (31.6%) and higher cases of SMM (42.4%). Coinfection with another imported pathogen was present in 19 patients (14.4%), being MRA more frequently coinfected (30.3%)</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study shows the need for establishing systems for VFRs to attend pre-travel consultations to reduce malaria imported risk. In the case of MRA, screening for imported diseases should be conducted upon their arrival. Finally, we highlight two cases of co-infection with imported viruses, showing that presence of symptoms resembling malaria from another imported pathogen does not exclude malaria.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"37 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Klebsiella pneumoniae with carbapenemases: high prevalence of sequence type 307 with blaOXA181 in South African community hospitals","authors":"Kafilat Taiwo Salvador-Oke, Johann D. D. Pitout, Gisele Peirano, Kathy-Anne Strydom, Chanel Kingsburgh, Marthie M. Ehlers, Marleen M. Kock","doi":"10.1007/s10096-024-04947-z","DOIUrl":"https://doi.org/10.1007/s10096-024-04947-z","url":null,"abstract":"<p>This study investigated the molecular characteristics of urinary carbapenemase-producing <i>Klebsiella pneumoniae</i> isolates (<i>n</i> = 194) in Gauteng, South Africa, using simple, cost-effective PCR methodologies. Extensively drug resistant (XDR) ST307 with <i>bla</i>_OXA-181 on IncX3 plasmids was endemic in Gauteng community hospitals leaving limited options for treating in- and outpatient urinary tract infections. High-level ceftazidime/avibactam resistance was detected among isolates harbouring <i>bla</i>_OXA-48-like including <i>bla</i>_OXA-181. These findings highlighted the need for genomic methodologies suitable for lower- and middle-income countries to track XDR clones and plasmids in community hospitals. Such results will aid with treatment and stewardship strategies.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"37 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culture and amplification-free nanopore sequencing for rapid detection of pathogens and antimicrobial resistance genes from urine","authors":"Anurag Basavaraj Bellankimath, Crystal Chapagain, Sverre Branders, Jawad Ali, Robert C Wilson, Truls E. Bjerklund Johansen, Rafi Ahmad","doi":"10.1007/s10096-024-04929-1","DOIUrl":"https://doi.org/10.1007/s10096-024-04929-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Urinary Tract Infections (UTIs) are among the most prevalent infections globally. Every year, approximately 150 million people are diagnosed with UTIs worldwide. The current state-of-the-art diagnostic methods are culture-based and have a turnaround time of 2–4 days for pathogen identification and susceptibility testing.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This study first establishes an optical density culture-based method for spiking healthy urine samples with the six most prevalent uropathogens. Urine samples were spiked at clinically significant concentrations of 10³-10⁵ CFU/ml. Three DNA extraction kits (BioStic, PowerFood, and Blood and Tissue) were investigated based on the DNA yield, average processing time, elution volume, and the average cost incurred per extraction. After DNA extraction, the samples were sequenced using MinION and Flongle flow cells.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The Blood and Tissue kit outperformed the other kits based on the investigated parameters. Using nanopore sequencing, all the pathogens and corresponding genes were only identified at a spike concentration of 10⁵ CFU/ml, achieved after 10 min and 3 hours of sequencing, respectively. However, some pathogens and antibiotic-resistance genes (ARG) could be identified from spikes at 10³ colony formation units (CFU/mL). The overall turnaround time was five hours, from sample preparation to sequencing-based identification of pathogen ID and antimicrobial resistance genes.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study demonstrates excellent promise in reducing the time required for informed antibiotic administration from 48 to 72 h to five hours, thereby reducing the number of empirical doses and increasing the chance of saving lives.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"31 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of a loop-mediated isothermal amplification (LAMP) method for Candida glabrata detection","authors":"H. Yahaya, Y. K. Cheah, H. Y. Chee, L. T. L. Than","doi":"10.1007/s10096-024-04934-4","DOIUrl":"https://doi.org/10.1007/s10096-024-04934-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Loop-mediated isothermal amplification (LAMP) is a simple and rapid nucleic acid method for DNA amplification at a constant temperature. The “gold standard” culture method for yeast detection, has low sensitivity with severe consequences, increasing morbidity and mortality rates. Here, we report the development of a LAMP method for the specific detection of <i>C. glabrata</i>.</p><h3 data-test=\"abstract-sub-heading\">Methodology</h3><p>The specific LAMP primers for <i>C. glabrata</i> detection were designed and evaluated.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The LAMP assay accurately detected <i>C. glabrata</i> with no cross-reactivity with other <i>Candida</i> species.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The developed molecular method would be a promising tool in the management of invasive candidiasis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"6 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for infection after carbapenem-resistant Acinetobacter baumannii colonization","authors":"Maddalena Peghin, Filippo Givone, Maria de Martino, Raja Waqar Ali, Elena Graziano, Miriam Isola, Paolo Antonio Grossi","doi":"10.1007/s10096-024-04936-2","DOIUrl":"https://doi.org/10.1007/s10096-024-04936-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Predicting infection risk in carbapenem-resistant Acinetobacter baumannii (CRAB) colonized patients may help in improving timely appropriate antibiotic therapy. This study aims to explore risk factors for developing infections in hospitalized patients with previous CRAB colonization.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We performed an observational retrospective cohort study at ASST Sette Laghi-Varese Hospital between January 2020 and December 2022. All consecutive adult (&gt; 18 years old) hospitalized patients with documented colonization by CRAB at any anatomical site or with CRAB infections preceded by CRAB colonization were included. Univariate and multivariate analyses were performed to investigate infection risk factors.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Overall, 144 patients were included in the study: 104 colonized only and 40 infected patients. Colonization and infection rates significantly changed over the years (2020–2022, p &lt; 0.001). The incidence of infections in CRAB carriers was 27.8% (40/144). Median time from colonization to infection was 4 days (IQR 1-8.5). Overall, inhospital mortality was 32.7% and 55.0% in colonized only and infected patients, respectively. At the multivariable logistic regression cardiovascular disease (OR 5.83, 95% CI 1.12–30.43, p = 0.037), COVID-19 (OR 3.72, 95% CI 1.16–11.91, p = 0.027) and intensive care unit (ICU) admission (OR 8.83, 95% CI 2.94–26.51, p &lt; 0.001) were risk factors independently associated with cardiovascular disease CRAB infection after colonization.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>We observed an increased infection risk in patients colonized with CRAB with cardiovascular disease, COVID-19 and admitted in ICU setting. Additional evidence is needed to identify predictors of infection in colonized patients.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"32 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Report of an unusual association of Oropouche Fever with Guillain-Barré syndrome in Cuba, 2024","authors":"José Raúl de Armas Fernández, Carilda Emilia Peña García, Belsy Acosta Herrera, Iliovanys Betancourt Plaza, Yaimara Gutiérrez de la Cruz, Sonia Resik Aguirre, Vivian Kourí Cardellá, María Guadalupe Guzmán Tirado","doi":"10.1007/s10096-024-04941-5","DOIUrl":"https://doi.org/10.1007/s10096-024-04941-5","url":null,"abstract":"<p>Oropouche virus is the aetiological agent of Oropouche fever. At present, this is currently considered one of the most important vector-borne diseases in Latin America. On 27 May 2024, the Ministry of Public Health of Cuba reported the first ever outbreak of Oropouche fever. In this report, we describe three human cases of Oropouche virus infection with symptoms and signs of neurological disease and clinical diagnosis of Guillain-Barré Syndrome. This study offers insights regarding that Oropouche virus is a causal agent of neurological disorders and it could be involved in the etiology of the Guillain-Barré Syndrome.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"35 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningitis and intracranial abscess due to Mycoplasma pneumoniae in a B cell-depleted patient with multiple sclerosis","authors":"Dominik Madžar, Florian T. Nickel, Veit Rothhammer, Philipp Goelitz, Walter Geißdörfer, Roger Dumke, Roland Lang","doi":"10.1007/s10096-024-04935-3","DOIUrl":"https://doi.org/10.1007/s10096-024-04935-3","url":null,"abstract":"<p><i>Mycoplasma pneumoniae</i>, a frequent respiratory pathogen, can cause neurological disease manifestations. We here present a case of <i>M. pneumoniae</i> as cause of meningitis and occurrence of an intracranial abscess as a complication of mastoiditis with septic cerebral venous sinus thrombosis in a patient with multiple sclerosis on anti-CD20 therapy.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"11 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142220260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long-term impact of an antimicrobial stewardship program in febrile neutropenia: an 8 years follow up","authors":"Bahar Madran, Şiran Keske, Burhan Ferhanoğlu, Nil M. Mandel, Önder Ergönül","doi":"10.1007/s10096-024-04939-z","DOIUrl":"https://doi.org/10.1007/s10096-024-04939-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To describe the long-term effects of an ASP among febrile neutropenia (FN) patients.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A quasi-experimental study was conducted between 2015 and 2023 at a tertiary care hospital in Istanbul, Türkiye. The ASP was implemented for FN patients, and the effects were assessed before and after the ASP interventions, which included FN clinical pathways and regular multi-disciplinary meetings with relevant healthcare workers.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 489 FN episodes of 290 patients were included, 42% were female, and the mean age was 56 years (SD: 15, range: 18–89 years). After the intervention, the rate of appropriate antimicrobial therapy at the levels of starting (<i>p</i> = 0.005), switching (<i>p</i> &lt; 0.001), and de-escalation/discontinuation, (<i>p</i> &lt; 0.001) significantly increased. Another positive impact of the ASP was a significant reduction in candidemia (from 4.88 to 0.74, <i>p</i> = 0.004), as well as a significant reduction in the 90-day mortality rate (from 19 to 5%, <i>p</i> &lt; 0.001). In multivariate analysis, having a gram-negative bloodstream infection, prolonged days with fever, and a high risk for neutropenia were found to be significant predictors of 90-day mortality, while follow-up with ASP significantly reduced mortality.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Implementation of ASP led to reduced candidemia and LOS without increasing mortality, even in a country with a high rate of antimicrobial resistance. Implementation of sustainable ASP for FN patients is critical in combating antimicrobial resistance.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"2 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142220194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the urinary microbiome in men who have sex with men with and without Chlamydia trachomatis infection","authors":"Kehinde C. Mofolorunsho, Nonkululeko G. Mabaso, Nikita Nundlall, Abidemi O. Ojo, Errol D. Cason, Nathlee S. Abbai","doi":"10.1007/s10096-024-04930-8","DOIUrl":"https://doi.org/10.1007/s10096-024-04930-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The urinary tract is colonized by microbial communities that impact urinary health. Previous studies have suggested that the bacterial composition of the male urinary microbiota is related to STIs. This study assessed the bacterial composition of the urinary microbiome in South African MSM with and without <i>C. trachomatis</i>.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This study used urine samples from MSM attending care at the King Edward VIII hospital and the Aurum Institute in Durban, South Africa. A total of 200 samples were tested for <i>C. trachomatis</i> infection using the Applied Biosystems™ TaqMan^® Assays. Urinary microbiomes of 23 samples were characterized using 16 S rRNA (V3 and V4) gene sequencing on the Illumina MiSeq platform.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Bacterial taxonomic analysis showed a high abundance of <i>Streptococcus</i>, <i>Corynebacterium</i>, and <i>Staphylococcus</i> in all the sequenced samples. Moreover, <i>Prevotella</i> and <i>Lactobacillus</i> were detected in urine samples of MSM. Alpha diversity metrics showed a slight increase in microbial diversity in <i>C. trachomatis</i> positive samples; however, this was not significant (ANOVA, <i>P</i> &gt; 0.05). Principal coordinates analysis (PCoA) showed that the microbiome of <i>C. trachomatis</i> infected MSM was not clearly different from those uninfected. Distinct bacterial communities were not detected between positive and negative samples (PERMANOVA F_1,22= 1.0284, R² = 0.047%, <i>P</i> = 0.385).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Most microbiome studies on MSM to date have focused on the gut microenvironment. Few studies, however, have provided data regarding the normal composition of the male urethral microbiomes or if these microbiomes are associated with male STIs. This study adds to the growing body of knowledge highlighting the urinary microbiome in MSM.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"430 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142220195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiologic trends and changes in humoral immunity and lymphocyte subsets levels among hospitalized children with Mycoplasma pneumoniae infection during 2019-2023.","authors":"Linyan Tang, Kaiwen Zheng, Lanlan Ma, Ling Chen, Yuling Zhao, Li Li, Ke Wang, Jing Zhang, Xing Chen","doi":"10.1007/s10096-024-04901-z","DOIUrl":"10.1007/s10096-024-04901-z","url":null,"abstract":"<p><strong>Purpose: </strong>To understand the changes in humoral immunity and lymphocyte subsets levels among hospitalized children with Mycoplasma pneumoniae (MP) infection from 2019 to 2023.</p><p><strong>Methods: </strong>This study retrospectively analyzed inpatients aged 0-14 years who were diagnosed with MP infection or MP pneumonia in a tertiary hospital from January 2019 to December 2023. The children were divided into three groups: before the implementation of nonpharmaceutical interventions (NPIs), during the implementation of NPIs, and after the NPIs being lifted.</p><p><strong>Results: </strong>A total of 4103 patients were enrolled in this study, of whom 2125 were diagnosed with MP infection and 1978 were diagnosed with MP pneumonia. The number of MP infection cases dramatically decreased early during the implementation of NPIs, and the previous epidemic trend resumed after the NPIs were lifted, with the number of cases during the period 2019-2023 peaked in November 2023. In children aged < 5 years, the levels of IgA and IgM and the percentages of total T cells and cytotoxic T cells in the \"before the implementation of NPIs\" group were greater than those in the other groups, and the percentage of total B cells was lower than that in the other groups. In children aged ≥ 5 years, the IgM level in the \"before the implementation of NPIs\" group was greater than that in the other groups.</p><p><strong>Conclusion: </strong>The number of MP-infected hospitalized children decreased significantly after NPI implementation and reached its highest peak during 2019-2023 in November 2023. After the NPIs were lifted, the level of humoral immunity was decreased and balance lymphocyte subsets were disrupted, especially in children aged < 5 years. We should pay close attention to and prevent MP infection in a timely manner after epidemics caused by large respiratory pathogens.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1837-1845"},"PeriodicalIF":3.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}