Infectious Disease Reports最新文献

{"title":"Application of PCR-Based Techniques for the Identification of Genetic Fingerprint Diversity of Dominant Bacteria in Fecal Samples of Children with Diarrhea in Vietnam.","authors":"Thi Quy Nguyen, Trong Khoa Dao, Hong Duong Nguyen, Thi Bich Thuy Phung, Thi Thanh Nga Pham, Thi Viet Ha Nguyen, Thi Huong Trinh, Huu Cuong Le, Thi Thu Hong Le, Thi Huyen Do","doi":"10.3390/idr16050075","DOIUrl":"https://doi.org/10.3390/idr16050075","url":null,"abstract":"<p><p>In Vietnam, diarrhea, especially persistent diarrhea, is one of the most common diseases in children, while a significant proportion of cases are negative with pathogens; thus, there is an urgent need to understand gut bacterial dysbiosis. In this study, bacteria in the fecal samples of five healthy and ten diarrheal children were separated from other residues, then adopted to extract their metagenomic DNA for evaluating their diversity based on V3 and V6-V8 regions and the 16S rRNA gene by PCR-RFLP and PCR-DGGE. As a result, bacterial metagenomic DNAs with high quality, quantity and diversity were successfully extracted using a GeneJET kit and a chemical protocol. A sequence analysis of 73 representative DNA fragments from gels indicated a remarkable bacterial dysbiosis in all groups of diarrhea. Viral diarrhea was characterized by extremely reduced bacterial diversity with the blossom of <i>Bifidobacterium</i> and <i>Streptococcus</i>. <i>Streptococcus</i> was also the most abundant in persistent diarrhea. Beneficial bacteria that may play a role in the self- rebalance in intestinal bacterial communities, such as <i>Bifidobacterium</i>, <i>Lactobacillus,</i> and <i>Enterococcus,</i> were seen in all diarrheal groups, while <i>Bacteroides</i> and <i>Akkermansia muciniphila</i> were seen in the healthy group but absent in the diarrheal groups. This study provides additional evidence for a relationship between intestinal bacterial dysbiosis and diarrhea in children, emphasizing an increase in <i>Streptococcus</i>.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"932-951"},"PeriodicalIF":3.4,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Long-Term Changes in Knowledge and Attitudes of Household Contacts of COVID-19 Cases in Northern Spain.","authors":"Noelia Vera-Punzano, Vanessa Bullón-Vela, Carme Miret, Jéssica Pardos-Plaza, Manuel García Cenoz, Pere Godoy, Jesús Castilla, Àngela Domínguez, Diana Toledo, Iván Martínez-Baz","doi":"10.3390/idr16050074","DOIUrl":"https://doi.org/10.3390/idr16050074","url":null,"abstract":"<p><p>This study aims to describe the long-term changes in the knowledge of, and attitudes towards, COVID-19 and its preventive measures in northern Spain. A telephonic survey was performed among household contacts of COVID-19 cases in Catalonia and Navarre between May 2022 and December 2023. Knowledge and attitudes were assessed through 12 questions using a Likert scale, and responses were grouped as correct or incorrect. The change from baseline to the 6-month follow-up was evaluated with the absolute difference (AD) using the proportion of correct answers. At baseline, 299 subjects were contacted, of whom 63.2% (189) completed the 6-month follow-up. Correct knowledge of transmission (>85%) and the use of preventive measures (>92%) were observed at baseline and maintained over time. The attitudes towards face mask use remained adequate over the course of six months (>79%). However, attitudes regarding the use of face masks indoors (AD = -16.4%; <i>p</i> < 0.001) and those who thought that COVID-19 had a negative impact on their lives (AD = -16.5%; <i>p</i> < 0.001) decreased after 6 months. In the post-acute phase of the pandemic, household contacts maintained the correct level of knowledge towards COVID-19, while some attitudes decreased. These results should serve as a guide for health policy makers in decision-making in case of a new increase in the incidence of SARS-CoV-2.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"923-931"},"PeriodicalIF":3.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikungunya-Driven Gene Expression Linked to Osteoclast Survival and Chronic Arthralgia.","authors":"Alysson Henrique Urbanski, Vanessa E Maso, Felipe M Martins, André Guilherme da Costa-Martins, Ana Paula B do Nascimento Oliveira, Helder I Nakaya","doi":"10.3390/idr16050073","DOIUrl":"10.3390/idr16050073","url":null,"abstract":"<p><p>Chikungunya fever (CHIKF), caused by the Chikungunya virus (CHIKV), manifests as acute febrile illness often associated with polyarthritis and polyarthralgia. Although the acute symptoms resolve within two weeks, many patients experience prolonged joint pain and inflammation, resembling rheumatoid arthritis (RA). This study aimed to identify molecular markers related to joint pain and chronicity in CHIKV-infected individuals by analyzing blood transcriptomes using bulk RNA sequencing. B- and T-cell receptor (BCR and TCR) diversity was assessed through computational analysis of RNA-seq data, revealing a significant reduction in CDR3 diversity in CHIKV-infected individuals compared to healthy controls. This reduced diversity was associated with the upregulation of genes involved in osteoclast differentiation and activation, particularly through the RANK/RANKL signaling pathway. These findings suggest a potential link between immune dysregulation and enhanced osteoclast activity, which may contribute to the persistence of joint pain in chronic CHIKF. Targeting osteoclast-related pathways could offer therapeutic strategies for managing chronic symptoms in CHIKF patients.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"914-922"},"PeriodicalIF":3.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Yellow Nail Syndrome Complicated with Pulmonary Infection Due to <i>Nocardia cyriacigeorgica</i>.","authors":"Qiuyu Li, Jiajia Zheng, Qiuyue Zhang, Ying Liang, Hong Zhu, Yongchang Sun","doi":"10.3390/idr16050072","DOIUrl":"10.3390/idr16050072","url":null,"abstract":"<p><p>Yellow nail syndrome (YNS) is a rare clinical syndrome characterized by nail bed changes, pulmonary involvement, and lymphatic drainage disorders. Pulmonary involvement usually manifests as bronchiectasis, bronchiolitis, and pleural effusion. There are few studies on yellow nail syndrome combined with opportunistic infection. Here, we report a case of clinically diagnosed YNS combined with <i>Nocardia cyriacigeorgica</i> infection and the course of treatment used, which can provide some useful information for clinicians to better understand this rare illness.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"906-913"},"PeriodicalIF":3.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Parameters as Predictor of Poor Outcomes in Hospitalized Patients with Confirmed Mild-to-Moderate COVID-19.","authors":"Nadya R V Barus, Dicky Levenus Tahapary, Farid Kurniawan, Robert Sinto, Syahidatul Wafa, Wismandari Wisnu, Arif Mansjoer, Calysta Nadya Wijaya, Immanuel Felix, Tri Juli Edi Tarigan, Dante Saksono Harbuwono, Pradana Soewondo","doi":"10.3390/idr16050071","DOIUrl":"10.3390/idr16050071","url":null,"abstract":"<p><p>(1) Background: This study aims to assess visceral fat values, waist circumference (WC), body mass index (BMI), and body fat percentage for their ability to predict poor outcomes during COVID-19 patients' hospitalization; (2) Methods: This study was a prospective cohort of mild-moderate COVID-19 patients hospitalized at Dr. Cipto Mangunkusumo National General Hospital from December 2020 to March 2021. This study includes hospitalized patients over 18 diagnosed with COVID-19 using RT-PCR. Patients who do not have chest radiography, waist circumference, a bioimpedance analyzer (BIA) error, or are unable to stand or mobilize during the examination are excluded from this study. Cox regression was used for multivariate analysis; (3) Results: The study included two hundred sixty-one patients. The median visceral fat value was 10 (equivalent to 100 cm²), the WC was 93.4 cm, the BMI was 26.1 kg/m², and the body fat percentage was 31.5%. Based on multivariate Cox regression, WC was statistically significant as an independent factor influencing poor outcomes in COVID-19 patients (RR 1.037 [95% CI 1.011-1.064]) along with COVID-19 degree of severity (RR 3.063 [95% CI 1.537-6.104]) and comorbidities (RR 2.123 [95% CI 1.017-4.435]); (4) Conclusions: Waist circumference can influence poor outcomes in confirmed COVID-19 patients during hospitalization.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"894-905"},"PeriodicalIF":3.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HEV Infection in the Context of Prior HBV-Related Liver Injury: Case Series.","authors":"Mihaela-Cristina Olariu, Mihai-Cezar Filipescu, Andreea Marilena Pauna, Madalina Simoiu, Alina Maria Borcan","doi":"10.3390/idr16050070","DOIUrl":"10.3390/idr16050070","url":null,"abstract":"<p><p>Hepatitis E virus (HEV) is a common cause of acute hepatitis, with increasing incidence in Europe, including Romania. Concurrently, Romania has a high prevalence of chronic hepatitis B (CHB). There is limited research on the clinical presentation and outcomes of HEV infection in patients with pre-existing chronic hepatitis B (CHB), especially in resource-rich settings. Most literature data come from South, East, and Southeast Asia. A review of the literature on HEV and HBV co-infection indicates a severe prognosis, particularly in patients with underlying liver disease. However, the cases in this study, which did not display cirrhosis, showed varied outcomes. The role of anti-HBV treatment in improving prognosis remains uncertain and warrants further investigation. Acute HEV infection superimposed on chronic HBV infection poses significant clinical challenges, with outcomes ranging from full recovery to fatality. Preventive measures, including sanitation and vaccination against HBV, are crucial. More studies are needed to establish effective treatment protocols for this co-infection. In this study, we will analyze the clinical setting, diagnosis, particularities, and outcomes of five such cases of dual hepatotropic viral infection recorded over a period of 6 years (2018-2023) at a large Infectious Diseases clinic in Bucharest, Romania.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"888-893"},"PeriodicalIF":3.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptospirosis Incidence Post-Flooding Following Storm Daniel: The First Case Series in Greece.","authors":"Irene Poulakida, Ourania S Kotsiou, Stylianos Boutlas, Despoina Stergioula, Georgia Papadamou, Konstantinos I Gourgoulianis, Dimitrios Papagiannis","doi":"10.3390/idr16050069","DOIUrl":"10.3390/idr16050069","url":null,"abstract":"<p><p>The present study investigates the public health impact of flooding on leptospirosis incidence after Storm Daniel in Thessaly, Greece, in September 2023. A notable increase in cases was observed, with seven cases of female patients and a mean age of 40.2 years, indicating a significant risk among working-age adults. From the end of September to the beginning of November 2023, a total of 35 patients from flood-prone areas presented to the Emergency Department of the Tertiary University Hospital of Larissa. Diagnosis of leptospirosis was established by meeting the criteria suggested by the national public health organisation (EODY)-compatible clinical course, epidemiological exposure, molecular and serologic confirmation by the detection of immunoglobulin M antibodies to leptospira spp. using a commercially available enzyme-linked immunosorbent assay and real-time quantitative PCR for the molecular detection of leptospira. The larger part (84.6%) of leptospirosis cases were associated with contact with floodwater. The majority of these patients (71.4%) were from the prefecture of Larissa, followed by 14.3% from the prefecture of Karditsa, 8.6% from the prefecture of Trikala, and 5.7% from the prefecture of Magnesia. Occupational exposure and urbanisation were key risk factors. The most prevalent clinical feature was rash (69.2%), followed by fever (61.5%) and myalgia (30.7%). The findings emphasise the need for robust public health strategies, improved sanitation, rodent control, and protective measures for sanitation workers. The data highlight the broader implications of climate change on public health and the necessity for ongoing surveillance and community education to mitigate future outbreaks.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"880-887"},"PeriodicalIF":3.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ongoing Excess Hospitalizations for Severe Pediatric Group A Streptococcal Disease in 2023-2024-A Single-Center Report.","authors":"Nina Schöbi, Andrea Duppenthaler, Matthias Horn, Andreas Bartenstein, Kristina Keitel, Matthias V Kopp, Philipp K A Agyeman, Christoph Aebi","doi":"10.3390/idr16050067","DOIUrl":"10.3390/idr16050067","url":null,"abstract":"<p><p>A Europe-wide outbreak of invasive pediatric group A streptococcal infections (iGAS) began in fall 2022. Here, we report the evolution of GAS hospitalizations in children and adolescents during the second outbreak year in 2023-2024 at a tertiary center in Switzerland. Using prospective monitoring of all in-patient GAS cases below 16 years of age, including those with iGAS, we compared case frequencies and clinical characteristics in three time periods (2013-2020; 2022-2023; 2023-2024). Annual GAS hospitalizations increased from a median of 25 cases (range 11-28) in 2013-2020 to 89 and 63 cases, respectively, in 2022-2023 and 2023-2024. iGAS cases evolved similarly (2013-2020, 4 cases (3-8); 2022-2023, 32 cases; 2023-2024, 21 cases). The decline in cases from 2022-2023 to 2023-2024 included all types of GAS organ involvement, except suppurative infections in the head area, which remained largely unchanged (48 vs. 45 cases). Pleural empyema declined from 13 to 7 cases, possibly explained by a poor overlap of the GAS and influenza curves, respectively, in 2023-2024 compared to 2022-2023. These data document the prolongation of the GAS outbreak into its second winter season in 2023-2024.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"864-869"},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pertussis Notification Rate and Tdpa Vaccine/Booster Coverage in Adults: An Opportunity for an Epidemiological Observatory in Primary Care.","authors":"Francesco Lapi, Ettore Marconi, Iacopo Cricelli, Alessandro Rossi, Tecla Mastronuzzi, Giovanni Gabutti, Claudio Cricelli","doi":"10.3390/idr16050068","DOIUrl":"10.3390/idr16050068","url":null,"abstract":"<p><p><b>Background</b>: In recent years, Europe has experienced a significant increase in pertussis cases. One reason behind this rise is the decline in diphtheria-tetanus-pertussis (dTap) booster coverage among adults. Currently, Italy lacks a reliable monitoring system to track pertussis infections and vaccine coverage among adults. We therefore evaluated the reliability of a primary care framework to respond to this need. <b>Methods</b>: Using an Italian primary care database for individuals aged 15 or above, we determined the pertussis infection notification rate and dTap vaccine/booster coverage for the timeframe of 2009-2022. <b>Results</b>: In the overall population, we obtained a lifetime occurrence rate of pertussis infections of 7.52 per 10,000 individuals. The annual incidence rates of pertussis infections ranged from 0.008 to 0.001 per 10,000 person-years between 2009 and 2022. A rising trend in dTap vaccine coverage rate (ranging from 8.72 to 16.54 vaccines per 10,000 individuals) was observed during the same period. Notably, those aged 65 or older, smokers, and/or individuals with immunodeficiencies were more likely to receive the dTap vaccine compared to the general population. <b>Conclusions</b>: Given the organization of the Italian public health system, this primary care network might act as a reliable epidemiological monitoring system to keep track of pertussis infections and dTap vaccine coverage in adults. Pertussis cases were underreported, and there was a low uptake of vaccines and boosters. Therefore, it is crucial to closely monitor pertussis notifications and dTap administrations and develop intervention strategies at the national level to enhance vaccine-related prevention.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"870-879"},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherosclerosis and Cardiovascular Complications in People Living with HIV: A Focused Review.","authors":"Michele Salvatore Paternò Raddusa, Andrea Marino, Benedetto Maurizio Celesia, Serena Spampinato, Carmen Giarratana, Emmanuele Venanzi Rullo, Bruno Cacopardo, Giuseppe Nunnari","doi":"10.3390/idr16050066","DOIUrl":"10.3390/idr16050066","url":null,"abstract":"<p><p>The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such as CVD. This paper explores the multifaceted relationship between HIV infection, ART, and cardiovascular health, focusing on the mechanisms by which HIV and ART contribute to increased cardiovascular risk, including the promotion of endothelial dysfunction, inflammation, immune activation, and metabolic disturbances. We highlight the critical roles of HIV-associated proteins-Tat, Nef, and gp120-in accelerating atherosclerosis through direct and indirect pathways that exacerbate endothelial damage and inflammation. Additionally, we address the persistent challenge of chronic inflammation and immune activation in PLWH, factors that are strongly predictive of non-AIDS-related diseases, including CVD, even in the context of effective viral suppression. The impact of ART on cardiovascular risk is examined, with particular attention to the metabolic implications of specific ART regimens, which can influence lipid profiles and body composition, thereby modifying CVD risk. The therapeutic potential of statins, aspirin, and emerging treatments such as PCSK9 inhibitors in mitigating cardiovascular morbidity and mortality among PLWH is discussed, alongside considerations for their use in conjunction with ART. Our review underscores the necessity for a comprehensive, multidisciplinary approach to cardiovascular care in PLWH, which integrates vigilant cardiovascular risk assessment and management with HIV treatment. As we navigate the evolving landscape of HIV care, the goal remains to optimize treatment outcomes while minimizing cardiovascular risk, ensuring that the gains in longevity afforded by ART translate into improved overall health and quality of life for PLWH.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"846-863"},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}