Infection最新文献

{"title":"Hand hygiene infrastructure and point-of-care resource availability in public hospitals in Sierra Leone: a national multicentre cross-sectional study.","authors":"Bobson Derrick Fofanah, Rugiatu Z Kamara, Ibrahim Franklyn Kamara, Nanah Fofanah, Augustus Osborne, Ralph Williams, Emmanuel Marx Kanu, Fatmata B Kargbo, Sia Morenike Tengbe, George Ameh, Binyam Hailu, Reham Ragab, Landry Kabego, Miranda Deeves, Frieder Schaumburg, Julie Storr, Martin P Grobusch, Claire Kilpatrick, Sulaiman Lakoh","doi":"10.1007/s15010-026-02976-8","DOIUrl":"https://doi.org/10.1007/s15010-026-02976-8","url":null,"abstract":"<p><strong>Introduction: </strong>This study explores hospital hand hygiene (HH) infrastructure and point-of-care (POC) resource availability in Sierra Leone's public hospitals.</p><p><strong>Methods: </strong>A multicentre cross-sectional survey was conducted in 19 public hospitals between February to March 2025. Using the World Health Organization (WHO) Ward Infrastructure Survey tool (WIS), 155 wards were assessed. Outcomes included ward-level availability of water, soap, alcohol-based handrub (ABHR), towels, posters, and audits, plus POC indicators such as sink/dispenser density and bedside ABHR access. Analyses were descriptive, with hospital comparisons and modified Poisson regression for selected binary outcomes. Sensitivity analyses used strict and lenient definitions and best-/worst-case assumptions to assess missing data impact. Denominators vary by indicator due to item‑level missingness and skip‑logic inherent to the WHO‑WIS tool.</p><p><strong>Results: </strong>In total, 109 wards with complete hospital-level data were analysed. Ward-level availability was uneven: running water available in 61/105 (58.1%) of wards, soap at all sinks in 64/103 (62.1%), and disposable towels at all sinks in 15/103 (14.6%); 73.4% relied on hand-operated taps. ABHR was reported in 87/107 (81.3%) of wards under strict criteria (lenient criteria = 98.1%), while HH audits and posters were common (> 60%). POC readiness was very low: only 73/1,762 (4.1%) beds had ABHR within reach, 14/145 (9.7%) sinks had the full triad (water, soap, and towels), and median sink density was 0.67 per 10 beds (1/15 beds), below WHO recommendations. Tertiary hospitals had higher adjusted ward-level ABHR availability than secondary (PR = 1.26, p = 0.043). Sensitivity analyses supported the robustness of findings, with prevalence ratios for ABHR (1.22-1.28), running water (0.93-1.02), and soap (1.25-1.30) aligning with adjusted estimates.</p><p><strong>Conclusion: </strong>This first national multicentre survey of hospital HH infrastructure found major systemic gaps, especially in bedside access to essential HH facilities. Despite ward-level ABHR availability, shortages of water, soap, towel, and limited POC access fell below standards. Strengthening HH in similar settings requires investment in basic infrastructure/supplies, strategic resource placement, audits, and behavioural reinforcement.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A three-generation mpox cluster in Chongqing, 2024: transmission chain investigation and phylogenetic characterization.","authors":"Tingting Li, Mingyue Wang, Chunyan Deng, Hua Zhao, Ya Wang, Yu Xia, Li Qi, Jiang Long","doi":"10.1007/s15010-026-02985-7","DOIUrl":"https://doi.org/10.1007/s15010-026-02985-7","url":null,"abstract":"<p><strong>Background: </strong>In recent years, mpox has emerged as a significant public health concern, with the potential for both local and international spread. This study aimed to describe a three-generation mpox cluster and characterize its epidemiological features.</p><p><strong>Methods: </strong>A three-generation mpox cluster was reported between August 19 and 23, 2024, in Chongqing China. Field epidemiology investigations were conducted to identify high-risk exposures and transmission routes and to guide the public health response. Rash lesion samples, anal swabs, pharyngeal swabs, and blood samples were collected from the cases for real-time polymerase chain reaction testing. Genome sequencing was performed to determine the MPXV clade.</p><p><strong>Results: </strong>The cluster comprised three men who have sex with men, aged in their 40s, 30s, and 20s, respectively. All cases had mild symptoms, including perianal or genital rashes. .Case B was exposed to Case A through condomless sexual intercourse four days before symptom onset in Case A. Epidemiological investigation supported transmission through condomless sexual contact along the Case A → B → C chain in August 2024. Samples from Cases A and C were successfully sequenced and identified as MPXV clade IIb, lineage E.3.</p><p><strong>Conclusions: </strong>This three-generation mpox cluster was caused by MPXV clade IIb and was transmitted through condomless sexual contact. The findings suggest possible pre-symptomatic transmission of MPXV. Health education and sustained surveillance are essential for mpox prevention and control.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogen and host biomarkers to aid early diagnosis and prognosis of tuberculous meningitis.","authors":"Urvashi B Singh, K P Angitha, A K Adarsh, Kiran Bala, Naveet Wig, Achal Kumar Srivastava, Uma Kanga","doi":"10.1007/s15010-026-02941-5","DOIUrl":"https://doi.org/10.1007/s15010-026-02941-5","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) is the most sinister form of extrapulmonary tuberculosis (EPTB), associated with high mortality due to delayed diagnosis and limited sensitivity of conventional and molecular tests. Current study evaluated the diagnostic utility of Lipoarabinomannan antigen (LAM) detection in CSF and urine and explored host inflammatory biomarkers for diagnosis and prognosis of TBM.</p><p><strong>Methods: </strong>This prospective observational cohort study enrolled 80 HIV-negative adults with presumptive TBM at a tertiary care center. Patients were classified according to the uniform TBM case definition, based on clinical, CSF, radiological, and microbiological findings. CSF samples were subjected to AFB microscopy, liquid culture (MGIT-960), GeneXpert MTB/RIF (GX), and LAM lateral flow assay. Urine LAM was performed at baseline. Serum and CSF levels of IL-1β, IL-6, TNF-α, IFN-γ, IL-17 A, and IP-10 were measured at baseline and after 1 month of treatment.</p><p><strong>Results: </strong>Among 80 HIV-negative participants, 23 (28.7%) had definite TBM and 46 (57.5%) had probable TBM. CSF LAM sensitivity and specificity against microbiological reference standards were 43.5% and 80.7%, while urine LAM sensitivity (60.9%) and specificity 82.5% were higher. Against composite reference standards, both CSF and urine LAM showed reduced sensitivity but achieved 100% specificity. Serum IL-1β demonstrated the highest diagnostic performance for distinguishing TBM from non-TBM patients (AUC 0.943; sensitivity 88.9%, specificity 90.9%). Elevated serum and CSF IP-10 levels were associated with on-treatment mortality, whereas declining IL-6 and TNF-α levels correlated with treatment response.</p><p><strong>Conclusion: </strong>LAM detection in CSF and urine may serve as a useful adjunct to existing diagnostic approaches for TBM when interpreted alongside clinical, radiological, and microbiological findings. Host inflammatory biomarkers, especially IL-1β and IP-10, show additional diagnostic and prognostic value. Combining LAM testing with cytokine biomarkers may improve early diagnosis and efficient clinical management of TBM. However, larger multicentre studies are required to validate these findings before routine clinical implementation.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of protective effect after benzathine penicillin G prophylaxis for recurrent cellulitis: a 14-day window of efficacy.","authors":"Kyung Hun Park, Dohyeon Park, Jin Kyeong Jeong, Young Hoon Hwang, Donghwan Kim, Jung Soo Son, Chan Mi Lee, Chang Kyung Kang, Pyoeng Gyun Choe, Wan Beom Park, Nam Joong Kim","doi":"10.1007/s15010-026-03008-1","DOIUrl":"https://doi.org/10.1007/s15010-026-03008-1","url":null,"abstract":"<p><strong>Purpose: </strong>Following the administration of prophylactic intramuscular benzathine penicillin G (BPG) for recurrent cellulitis, the precise duration of its protective effect remains unclear. We aimed to evaluate the prophylactic efficacy of BPG against recurrent cellulitis under various assumed durations of prophylaxis.</p><p><strong>Methods: </strong>This retrospective observational study included 73 patients who received BPG prophylaxis for cellulitis. We compared cellulitis episodes between the prophylaxis and non-prophylaxis periods, and analyzed the timing of recurrence after BPG administration. A multivariable time-varying Cox regression analysis was performed, with time after BPG injection as the time-varying covariate.</p><p><strong>Results: </strong>An analysis of 592 patient-years revealed 310 recurrences. Under the assumption of a 14-day prophylactic window after BPG administration, the recurrence rate was significantly lower during the prophylaxis period than during the non-prophylaxis period (incidence rate ratio [IRR], 0.57; 95% confidence interval [CI], 0.33-0.99; P = .045). In contrast, when assuming prophylactic windows of 21 and 28 days, the IRRs were 0.74 (P= .154) and 0.92 (P= .642), respectively. Among the cellulitis episodes that occurred within 10 weeks of BPG administration, 43% occurred between days 15 and 28. After adjusting for lymphedema, the risk of recurrence was significantly lower within 14 days of BPG administration (adjusted hazard ratio, 0.54; 95% CI, 0.31-0.94; P= .030).</p><p><strong>Conclusion: </strong>The protective effect of intramuscular BPG against recurrent cellulitis was most pronounced during the first two weeks after administration, supporting the potential utility of individualized, shorter dosing intervals.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising demand for rabies immunoglobulin amid persistent supply constraints: an Italian experience.","authors":"Samuel Lazzarin, Anna Lisa Ridolfo, Cristina Piotti, Andrea Gori, Cristina Gervasoni","doi":"10.1007/s15010-026-03004-5","DOIUrl":"https://doi.org/10.1007/s15010-026-03004-5","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleonasms in infectious diseases: more than just a superfluous misnomer?","authors":"Enrico Schalk","doi":"10.1007/s15010-026-03002-7","DOIUrl":"https://doi.org/10.1007/s15010-026-03002-7","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The PH score for early differentiation of necrotizing fasciitis: a retrospective diagnostic prediction study.","authors":"Yuchen Fan, Zixin Chai, Lu Wang, Xiang Li, Zexin Chen, Wanxin Zhang, Wuwei Lu, Fengqin Miao, Shaolei Ma, Zijing Du, Fangfang Guo","doi":"10.1007/s15010-026-02943-3","DOIUrl":"https://doi.org/10.1007/s15010-026-02943-3","url":null,"abstract":"<p><strong>Background: </strong>Early differentiation of necrotizing fasciitis (NF) from non-necrotizing soft tissue infections (non-NSTI) remains a clinical challenge because delayed diagnosis is associated with substantial morbidity and mortality. Existing diagnostic scoring systems have shown inconsistent performance across different populations and often rely on multiple laboratory variables, limiting their routine clinical applicability. Therefore, this study aimed to develop and internally validate a simple diagnostic score based on routinely available laboratory parameters for the early identification of NF.</p><p><strong>Methods: </strong>A single-center retrospective study enrolled 92 NF and 80 non-NSTI patients (2022-2026). Independent predictors were identified via multivariable logistic regression, and a PH score(Platelet-to-lymphocyte ratio-Hemoglobin Score)was developed and internally validated. Performance was compared with LRINEC, SIARI, and LARINF scores using ROC analysis, with bootstrap and 10-fold cross-validation for internal validation. Calibration and clinical utility were assessed.</p><p><strong>Results: </strong>PLR (OR = 1.02) and Hb (OR = 0.96) were independent predictors. The PH score showed an AUC of 0.853 (95% CI 0.798-0.909), outperforming LRINEC (0.654), SIARI (0.736), and LARINF (0.602). At cutoff ≥ 2, sensitivity 86.7%, specificity 73.4%, accuracy 80.5%. Bootstrap-corrected AUC was 0.847, 10-fold cross-validation AUC 0.852. Calibration was good, and decision curve analysis showed higher net benefit than existing scores.</p><p><strong>Conclusions: </strong>The PH score, incorporating PLR and hemoglobin, is a simple and readily available diagnostic tool for the early differentiation of NF from non-NSTIs. The model showed favorable discrimination, calibration, and internal validation performance and provided greater net benefit than existing scoring systems. External validation in multicenter prospective cohorts is warranted.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive care infection score outperforms inflammatory biomarkers in detecting infection in critically ill patients.","authors":"Noelle Nacke, Christian Hönemann, Bastian Blömer, Stefanie Klatte, Alexander Zarbock, Jens-Christian Schewe, Marie-Luise Rübsam","doi":"10.1007/s15010-026-02984-8","DOIUrl":"https://doi.org/10.1007/s15010-026-02984-8","url":null,"abstract":"<p><strong>Purpose: </strong>Identification of infection in critically ill patients remains challenging, as conventional biomarkers such as C-reactive protein (CRP), procalcitonin (PCT) and white blood cell count (WBC) frequently lack diagnostic accuracy. The Intensive Care Infection Score (ICIS), a host-response biomarker derived from hematological parameters, reflects both innate and adaptive immune response.</p><p><strong>Methods: </strong>To compare diagnostic performance of ICIS, CRP, PCT, and WBC, expert adjudication was used to determine presence or absence of infection. Diagnostic accuracy parameters including receiver operating characteristic curve analysis were calculated.</p><p><strong>Results: </strong>770 samples from 382 critically ill patients were included. ICIS demonstrated the highest diagnostic accuracy with an area under the curve (AUC) of 0.914 (95% CI 0.892-0.933), compared with CRP (AUC 0.889; 95% CI 0.865-0.910), PCT (AUC 0.847; 95% CI 0.819-0.871), and WBC (AUC 0.697; 95% CI 0.663-0.729). At the optimal cut-off value of > 3, ICIS achieved a sensitivity of 80.7% and specificity of 89.3%. ICIS showed the lowest false-positive rate (10.7%) and a negative predictive value of 88.7%.</p><p><strong>Conclusion: </strong>ICIS demonstrated good diagnostic performance in critically ill patients and can contribute to antimicrobial stewardship as a novel host-response diagnostic.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifungal prophylaxis in patients with haematological malignancies receiving chemotherapy or haematopoietic stem cell transplantation: a systematic review and network meta-analysis.","authors":"Ruonan Shao, Xinyi Li, Yuqing Cui, Xiaomeng Feng, Kanchao Chen, Qingxiang Huang, Yuping Fan, Xiaolei Pei, Xin Chen, Sizhou Feng","doi":"10.1007/s15010-026-02989-3","DOIUrl":"https://doi.org/10.1007/s15010-026-02989-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare systemic antifungal prophylaxis for proven/probable invasive fungal disease (IFD) in high-risk haematology populations using randomised controlled trials, with separate mortality, discontinuation, and formulation analyses.</p><p><strong>Methods: </strong>Six databases and conference sources were searched to 2 September 2026. Bayesian random-effects network meta-analysis included RCTs with traceable proven/probable IFD definitions. Mixed-policy, setting, formulation, mortality, and discontinuation analyses were reported separately.</p><p><strong>Prospero: </strong>CRD420261490010 (retrospective).</p><p><strong>Results: </strong>Twenty-one RCTs (42 arms; 6,338 participants; 363 events) informed the primary network. Versus inactive control, voriconazole (OR 0.042, 95% CrI 0.001-0.793) and liposomal amphotericin B (OR 0.335, 95% CrI 0.127-0.819) had credible intervals excluding 1. Posaconazole suspension showed favourable but imprecise estimates. No mortality comparison demonstrated clear benefit (17 RCTs; 582 deaths). Exploratory peri-HSCT analyses suggested fewer IFDs but more discontinuations with itraconazole. In AML/MDS chemotherapy, posaconazole effects were comparator-dependent. Direct evidence did not distinguish delayed-release tablets from suspension.</p><p><strong>Conclusion: </strong>No regimen was consistently superior across settings and outcomes. Voriconazole and liposomal amphotericin B had the clearest evidence versus inactive control. Posaconazole effects were comparator-dependent; peri-HSCT itraconazole showed fewer IFDs but more discontinuations. No mortality benefit was established. Prophylaxis should be risk-adapted to clinical setting, baseline mould risk, formulation, tolerability, and feasibility.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare bacterial infections and metagenomics: current diagnostic and therapeutic challenges-a literature review.","authors":"Marta Tworuszka, Daria Gliwa, Anna Kurek-Górecka, Łukasz Sędek","doi":"10.1007/s15010-026-02992-8","DOIUrl":"https://doi.org/10.1007/s15010-026-02992-8","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to summarize the diagnostic and therapeutic challenges associated with rare bacterial infections, with particular focus on Whipple's disease, melioidosis, Lemierre's syndrome, and nocardiosis. It also evaluates the clinical utility of emerging molecular diagnostic techniques, particularly polymerase chain reaction (PCR) and metagenomic next-generation sequencing (mNGS), in improving pathogen identification. The primary research question concerns how advances in molecular microbiology may enhance the early diagnosis and targeted treatment of these infections.</p><p><strong>Methods: </strong>A narrative literature review with a structured search strategy was conducted. PubMed/MEDLINE and Scopus were searched for studies published between January 1998 and April 2026 using MeSH terms and keywords related to rare bacterial infections and molecular diagnostics. Eligible peer-reviewed articles in English or Polish, including original studies, reviews, meta-analyses, and selected case reports, were included. Data extraction and study selection were performed independently by two reviewers.</p><p><strong>Results: </strong>Rare bacterial infections are frequently associated with delayed diagnosis due to nonspecific clinical manifestations, limited clinician awareness, negative culture results, and restricted access to advanced diagnostic methods. Molecular techniques improve detection sensitivity and identify pathogens not recoverable by routine culture. For metagenomic sequencing this comes at the cost of reduced specificity. In these infections the supporting evidence comes largely from case reports and small single-center series.</p><p><strong>Conclusion: </strong>Rare bacterial infections remain a significant diagnostic and therapeutic challenge. Broader implementation of advanced molecular diagnostic techniques, increased clinical awareness, and standardized diagnostic strategies are needed to reduce diagnostic delay. Whether this in turn reduces morbidity and mortality requires prospective evaluation.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}