Eurosurveillance最新文献

{"title":"Doxycycline post-exposure prophylaxis (doxyPEP): balancing promise and prudence in the prevention of sexually transmitted infections.","authors":"Fiona Lyons, Adam Shanley","doi":"10.2807/1560-7917.ES.2025.30.26.2500454","DOIUrl":"10.2807/1560-7917.ES.2025.30.26.2500454","url":null,"abstract":"","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 26","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring all-cause mortality surveillance during the Iberian Peninsula power outage, Spain, 28 April 2025.","authors":"David García-García, Inmaculada León-Gómez, Lucía Pérez-Marín, Diana Gómez-Barroso","doi":"10.2807/1560-7917.ES.2025.30.26.2500405","DOIUrl":"10.2807/1560-7917.ES.2025.30.26.2500405","url":null,"abstract":"<p><p>A general power outage affected the Iberian Peninsula on 28 April 2025. We explored all-cause mortality in Spain using the monitoring system MoMo. Starting 28 April, over 3 days, 147 excess deaths (95% CI: - 35 to 330) appeared to occur in the country, corresponding to a 4.2% increase over expected mortality. A larger significant 7.9% increase was estimated in 65-84-year-olds (94 excess deaths; 95% CI: 63 to 125). While MoMo cannot attribute such excesses to specific causes, findings highlight the usefulness of real-time surveillance systems for assessing large-scale emergencies.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 26","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent <i>Cryptosporidium parvum</i> outbreaks: molecular characterisation supporting epidemiological investigations leads to identification of different implicated food items, Sweden, 2019.","authors":"Ioana Bujila, Marie Jansson-Mörk, Joanna Nederby-Öhd, Anette Hansen, Mats Lindblad, Karolina Fischerstöm, Matilda Bragd, Ingela Hall, Nilla Lindroos, Caroline Rönnberg, Moa Rehn, Jessica Beser","doi":"10.2807/1560-7917.ES.2025.30.26.2400643","DOIUrl":"10.2807/1560-7917.ES.2025.30.26.2400643","url":null,"abstract":"<p><p>In Sweden, an increase in the number of notified cases of cryptosporidiosis was observed 1 October-31 December 2019 (462 domestic cases). Although a single national outbreak was initially suspected, molecular and epidemiological analyses revealed two concurrent national outbreaks and three local outbreaks. <i>Cryptosporidium parvum</i> subtype IIdA22G1c and IIdA24G1 were identified as the cause of the national outbreaks and subtype IIdA20G1e and IIdA21G1 as the cause of the local outbreaks. A case-case study comparing exposures in IIdA22G1c to IIdA24G1 revealed that cases with subtype IIdA22G1c (n = 48) were associated with consumption of a fresh fruit-and-vegetable juice (adjusted odds ratio (aOR) = 17; 95% confidence interval (CI): 1.8-169; p = 0.002). In the local outbreaks with subtype IIdA20G1e and IIdA21G1, cohort studies suggested that cases were associated with consumption of salads. Several coinciding outbreaks with different <i>C. parvum</i> subtypes explained the increase of cryptosporidiosis, and molecular typing was crucial in guiding relevant cross-disciplinary collaboration.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 26","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-border outbreak of <i>Yersinia enterocolitica</i> bioserotype 2/O:9 infections associated with consumption of French unpasteurised soft goat's milk cheese, 2024.","authors":"Cyril Savin, Nathalie Fredriksen, Clémentine Calba, Lorraine Puzin, Arnaud Felten, Stéphane Larréché, Anthony Roche, Martine Denis, Anne-Sophie Le Guern, Fanny Chereau","doi":"10.2807/1560-7917.ES.2025.30.26.2500002","DOIUrl":"10.2807/1560-7917.ES.2025.30.26.2500002","url":null,"abstract":"<p><p>In March 2024, the French genomic surveillance of enteric yersiniosis identified a cluster of lineage 2/3-9b <i>Yersinia enterocolitica</i> isolates, corresponding to bioserotype 2/O:9. An outbreak investigation was conducted to identify the source and implement control measures. A total of 175 confirmed cases were identified in France with sampling dates between 27 January and 23 August. Case interviews and trace-back investigations identified unpasteurised soft goat's milk cheese from one manufacturer in France as the probable source of the outbreak. <i>Yersinia enterocolitica</i> belonging to the same cluster as the case isolates was isolated from 23 samples from the manufacturer and a goat farm supplying milk to the dairy. Cheeses from the manufacturer were recalled in France. A Rapid Alert System for Food and Feed (RASFF) notification was issued, allowing the identification of cheese distribution from the manufacturer to 29 countries. An Epipulse alert led to the identification of seven additional cases in Belgium, Luxembourg and Norway, illustrating the value of international warning systems. This outbreak demonstrates risks with consumption of unpasteurised cheese and emphasises the need of rigorous good hygiene practices on dairy farms and dairies, especially when milk is processed without pasteurisation.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 26","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance of severe acute respiratory infections associated with SARS-CoV-2, influenza virus and RSV using ICD-10 codes: a case definition accuracy study across five European countries, 2021 to 2023.","authors":"Miguel Angel Sanchez Ruiz, Diogo Fp Marques, Frederikke Kristensen Lomholt, Lasse Skafte Vestergaard, Susana Monge, Marcos Lozano Álvarez, Gudrun Aspelund, Marianna Thordardottir, Ausra Dziugyte, John-Paul Cauchi, Tjarda M Boere, Irene K Veldhuijzen, Elina Seppälä, Håkon Bøås, Trine Hessevik Paulsen, Ausenda Machado, Ana Paula Rodrigues, Mariette Hooiveld, Luis Alves de Sousa, Ana Torres, Carlos Carvalho, Baltazar Nunes","doi":"10.2807/1560-7917.ES.2025.30.27.2400748","DOIUrl":"10.2807/1560-7917.ES.2025.30.27.2400748","url":null,"abstract":"<p><p>BACKGROUNDSurveillance of severe acute respiratory infections (SARI) using ICD-10 codes from electronic health records (EHR) lacks consensus on optimal case-defining codes.AIMWe determined codes that maximise sensitivity (Se) and positive predictive value (PPV) for SARI associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus and respiratory syncytial virus (RSV) in Denmark, Iceland, Malta, Norway and Spain.METHODSWe included hospitalisations from week 21/2021 to 39/2023, with ICD-10 diagnostic codes for respiratory disease (three-character codes J00-J99) or COVID-19 (U07.1, U07.2, country-specific codes for Denmark). We assessed Se and PPV of individual codes against laboratory results. Based on Se and PPV rank-sum, we selected the top 10 codes and combined them into 10 sets per pathogen. We identified sets that maximised the clinical utility index (CUI = Se × PPV), categorised as excellent (≥ 0.81), good (0.64-0.80), satisfactory (0.49-0.63) and poor (< 0.49).RESULTSWe assessed 395,163 hospitalisations for SARI-SARS-CoV-2, 313,418 for SARI-influenza and 192,936 for SARI-RSV, all tested. For SARI-SARS-CoV-2, code U07.1 (B34.2A, B97.2A for Denmark) had excellent utility in Denmark, Malta, Norway, Spain (≥ 0.82), and good utility in Iceland (0.79). For SARI-influenza, J09, J10 and J11 performed excellently in Denmark, Norway, Spain (≥ 0.83), satisfactorily in Malta (0.52), and poorly in Iceland (0.43). For SARI-RSV, J12, J20 and J21 achieved highest CUI but had poor utility (0.17-0.34).CONCLUSIONSCOVID-19- and influenza-specific three-character ICD-10 codes accurately identified SARI associated with SARS-CoV-2 and influenza virus. For SARI-RSV, four-character codes should be explored. We recommend context-specific assessments in countries adopting EHR-based surveillance.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 27","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autochthonous transmission of <i>Trichophyton indotineae</i> through sexual contact, France, 2024.","authors":"Arnaud Jabet, Thibault Chiarabini, Christophe Hennequin, Fabrice Bouscarat, Nadia Valin, Romuald Cruchet, Nicolas Boo, Johan Chanal, Christine Schuttler, Myriam Kirstetter, Anne-Cécile Normand, Arnaud Fekkar, Valérie Pourcher, Renaud Piarroux, Gentiane Monsel","doi":"10.2807/1560-7917.ES.2025.30.26.2500416","DOIUrl":"10.2807/1560-7917.ES.2025.30.26.2500416","url":null,"abstract":"<p><p><i>Trichophyton indotineae</i> is an emerging difficult to diagnose dermatophyte species associated with terbinafine resistance, which was initially described in South-Asian and Middle-Eastern countries. We report four cases of sexually transmitted dermatophytosis caused by <i>T. indotineae</i> in two female sex-workers, including one transgender woman, and two men who have sex with men. All four cases were acquired in Europe, highlighting the risk of pathogen spread through sexual contact outside initial endemic areas.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 26","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autochthonous outbreak of respiratory diphtheria caused by <i>Corynebacterium diphtheriae</i>, Germany, September 2024.","authors":"Anja Berger, Alexandra Dangel, Katja Bengs, Sandra Schlotmann, Peter Thomaßen, Claudia Maday, Carmen Rubach, Inas Abdelgawad, Gabriele Namaschk, Lena Schneider, Delphine Perriat, Franziska Badenschier, Cornelius Rau, Mark Muscat, Andreas Sing","doi":"10.2807/1560-7917.ES.2025.30.27.2500116","DOIUrl":"10.2807/1560-7917.ES.2025.30.27.2500116","url":null,"abstract":"<p><p>In September 2024, a school-aged child (P1), unvaccinated against diphtheria, was hospitalised with severe respiratory diphtheria caused by toxigenic <i>Corynebacterium diphtheriae.</i> P1 subsequently died from the disease. The child's mother (P2) had pharyngitis 9 days before the onset of symptoms of P1 and subsequently tested positive for <i>C. diphtheriae</i>. In multilocus sequence typing (MLST), the <i>C. diphtheriae</i> isolates from P1 and P2 were of sequence type (ST) 574. In core genome (cg)MLST, they were clonal, suggesting recent human-to-human transmission. This indicates the first autochthonous respiratory diphtheria outbreak by toxigenic <i>C. diphtheriae</i> in Germany since 1984 with epidemiologically- and molecularly-confirmed transmission. Furthermore, the isolates were close to isolates from patients with cutaneous diphtheria among people experiencing homelessness in two major German cities in 2023 and 2024, and to isolates from an outbreak among newly arriving migrants across several European countries, including Germany, detected in 2022. This indicates transmission beyond vulnerable groups. Our findings illustrate the potential of <i>C. diphtheriae</i> spreading further from patients with cutaneous diphtheria and even causing outbreaks of respiratory diphtheria. Given the potentially serious complications of respiratory diphtheria, including death, equitably achieving and maintaining high vaccination coverage among the whole population, especially among vulnerable people is essential.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 27","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergent informal use of doxycycline post- and pre-exposure prophylaxis among men who have sex with men and transgender and gender diverse people, the Netherlands, 2024.","authors":"Buhari Teker, Elske Hoornenborg, Maarten F Schim van der Loeff, Anders Boyd, Janneke Cm Heijne, Maria Prins, Udi Davidovich, Henry Jc de Vries, Vita W Jongen","doi":"10.2807/1560-7917.ES.2025.30.26.2400707","DOIUrl":"10.2807/1560-7917.ES.2025.30.26.2400707","url":null,"abstract":"<p><p>BACKGROUNDDoxycycline post-exposure and pre-exposure prophylaxis (doxyPEP/PrEP) to prevent sexually transmitted infections (STIs) is not part of standard practice in the Netherlands but may be used informally (without prescription).AIMWe assessed informal use and intention to use doxyPEP/PrEP among men who have sex with men (MSM) and transgender and gender diverse people in the Netherlands.METHODSBetween 26 February and 6 May 2024, we conducted an online survey on informal doxyPEP/PrEP use in the preceding 6 months and intention to use. We assessed the determinants of recent informal use and high intention to use using risk ratio regression.RESULTSOf the 1,633 participating individuals (96.7% MSM) 246 (15%) reported doxyPEP/PrEP use in the preceding 6 months. Informal use was more common among participants who used HIV PrEP or were living with HIV, had ≥ 15 anonymous sexual partners, engaged in chemsex, wanted to protect themselves, got advice from others to use doxyPEP/PrEP and believed doxyPEP/PrEP is safe. High intention to use (n = 1,063 (65%) participants) was more common among participants using HIV PrEP or living with HIV, who wanted to have condomless sex, who wanted to protect others from STIs and who perceived doxyPEP/PrEP as effective and safe.CONCLUSIONAlthough doxyPEP/PrEP is not formally recommended in the Netherlands, survey participants reported informal use and a high intention to use. These findings, combined with the global increase of antimicrobial resistance (AMR), stress the need for close monitoring and further research on the AMR effects of doxyPEP/PrEP use.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 26","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-border spread of a mosaic resistance (OXA-48) and virulence (aerobactin) plasmid in <i>Klebsiella pneumoniae</i>: a European Antimicrobial Resistance Genes Surveillance Network investigation, Europe, February 2019 to October 2024.","authors":"Marius Linkevicius, Erik Alm, Louise Roer, Olov Svartström, Maria Dada-Olorunwa, Kati Räisänen, Felix Reichert, Sophie Möller, Christina Clarke, Martin Cormican, Baiba Niedre-Otomere, Reinis Vangravs, Paulius Greičius, Olga Burduniuc, Maria Anton, Antoni P A Hendrickx, Sandra Witteveen, Vilhelm Müller, Daniel Palm, Diamantis Plachouras, Dominique L Monnet, Henrik Hasman, Anke Kohlenberg","doi":"10.2807/1560-7917.ES.2025.30.27.2500439","DOIUrl":"10.2807/1560-7917.ES.2025.30.27.2500439","url":null,"abstract":"<p><p>An investigation of the European Antimicrobial Resistance Genes Surveillance Network (EURGen-Net) detected the same mosaic IncHI1B(pNDM-MAR) resistance (OXA-48) and virulence (aerobactin) plasmid in 492 <i>Klebsiella pneumoniae</i> isolates from eight European Union countries during 2019-2024. Involvement of various <i>K. pneumoniae</i> sequence types (STs), multiple introductions, followed by large clonal outbreaks of three STs (ST147, ST392, ST45) carrying the plasmid in two countries indicate a high risk for further spread of this plasmid and a potential for difficult-to-treat <i>K. pneumoniae</i> infections to rise.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 27","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human papillomavirus prevalence in first, second and third cervical cell samples from women HPV-vaccinated as girls, Denmark, 2017 to 2024: data from the Trial23 cohort study.","authors":"Mette Hartmann Nonboe, George Maria Napolitano, Jeppe Bennekou Schroll, Berit Andersen, Mary Holten Bennetsen, Sanne Christiansen, Anna Poulsgaard Frandsen, Carsten Rygaard, Rouzbeh Salmani, Estrid Vilma Solyom Høgdall, Elsebeth Lynge","doi":"10.2807/1560-7917.ES.2025.30.27.2400820","DOIUrl":"10.2807/1560-7917.ES.2025.30.27.2400820","url":null,"abstract":"<p><p>BACKGROUNDDanish women vaccinated with the 4-valent human papillomavirus (HPV) vaccine (HPV types: 6/11/16/18) at age 14 in 2008 reached screening age in 2017, allowing assessment of long-term effects on prevalence, persistence and incidence of HPV infections.AIMTo examine the HPV status of cervical samples over time among women vaccinated as girls.METHODSBetween February 2017 and February 2024, residual material from cytology-analysed samples collected through the 'Trial23' study, part of the national screening programme, was tested for HPV16/18 and non-vaccine high-risk (HR) HPV types. Prevalence in first, second and third samples, and persistence and incidence between samples were calculated.RESULTSOver 7 years, 8,659 women provided at least one sample, 5,835 at least two and 2,461 at least three. In 7,800 vaccinated women, HPV16/18 prevalence was 0.4% (95% confidence interval (CI): 0.2-0.5), 0.3% (95% CI: 0.1-0.4) and 0.2% (95% CI: 0.0-0.4) in three consecutive samples. Prevalence of non-vaccine HR HPV was 32% (95% CI: 31-33), 28% (95% CI: 27-29) and 31% (95% CI: 29-33). Persistence of HPV16/18 and non-vaccine HPV among vaccinated women was 40% and 53%. In adjusted analyses comparing vaccinated vs unvaccinated women, incidence was significantly lower for HPV16/18 (adjusted relative risk (aRR) < 0.10) while incidence of non-vaccine HR HPV types was higher (aRR: 1.66; 95% CI: 1.12-2.45). No significant difference was observed for persistence.CONCLUSIONOur study provides real-world evidence of stable protection against HPV16/18 infections in women vaccinated as girls. Less intensive screening seems reasonable until women vaccinated with the 9-valent vaccine reach screening age, when screening should be reconsidered.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 27","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}