Infection最新文献

{"title":"Antimicrobial treatment for 7 versus 14 days in patients with bacteremia: a meta-analysis of randomized controlled trials.","authors":"Marlene Prager, Felix Bergmann, Lena Pracher, Dragan Copic, Jasmin Zessner-Spitzenberg, Georg Gelbenegger, Heimo Lagler, Nicole Harrison, Heinz Burgmann, Markus Zeitlinger, Anselm Jorda","doi":"10.1007/s15010-025-02562-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02562-4","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal duration of antibiotic treatment in patients with bacteremia is a matter of ongoing debate.</p><p><strong>Methods: </strong>We conducted a meta-analysis of randomized controlled trials that compared 7 days with 14 days of antimicrobial treatment in adults with bacteremia. The systematic search included trials published until December 2024. Efficacy outcomes included 90-day all-cause mortality, recurrence of bacteremia and mean length of hospital stay. Safety outcomes included the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash or emergence of antibiotic resistance.</p><p><strong>Results: </strong>The final analysis included four randomized controlled trials with a total of 4790 participants. Death by day 90 occurred in 321 (13.3%) of 2406 patients receiving antibiotic treatment for 7 days and 342 (14.3%) of 2384 patients receiving antibiotic treatment for 14 days (RR 0.93 [95% CI, 0.81 to 1.07)]; p = 0.30; prediction interval 0.74 to 1.17). The mean hospital stay did not differ significantly (mean difference - 0.18 days [95% CI, -1.03 to 0.67]; p = 0.69; prediction interval - 2.57 to 2.22). Recurrence of bacteremia was similar between antibiotic treatment for 7 days (64 [2.7%] of 2406) and antibiotic treatment for 14 days (56 [2.3%] of 2384) (RR 1.14 [95% CI, 0.80 to 1.63)]; p = 0.47; prediction interval 0.64 to 2.03). Safety outcomes, including the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash, and antibiotic resistance, were similar between groups.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that 7-day and 14-day antimicrobial treatment is associated with a similar efficacy and safety profile in patients with bacteremia.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247727","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 rise in severe necrotizing fasciitis- another consequence of the COVID-19 pandemic?","authors":"Alexander Eijkenboom, Jan Friederichs, Simon Hackl, Sven Hungerer","doi":"10.1007/s15010-025-02564-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02564-2","url":null,"abstract":"<p><strong>Purpose: </strong>During the COVID-19 pandemic restrictions such as social distancing, lockdowns and mask mandates were imposed by Germany's government. After these interventions were abolished, an increase in group A streptococcal infections, including necrotizing fasciitis, was observed in our Level 1 trauma center. The aim of this study was to evaluate the incidence of type I and type II necrotizing fasciitis (NF) before, during and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>165 patients with severe NF, treated in our Level 1 trauma center, were included between 2010 and 2023. Patients were categorized into a pre-mask, mask and post-mask group, according to their date of admission relative to the COVID-19 pandemic. Clinical parameters and patient characteristics were assessed between groups.</p><p><strong>Results: </strong>In the pre-mask group, type I NF (69%) was more common than type II NF (31%). In the mask group 95% of patients had type I NF. In the post-mask group, Streptococcus pyogenes triggered type II NF dominated with 74% of all cases. There was a significant increase in NF type II cases in the post-mask group compared to the pre-mask and mask-group (p < 0.001). Patients with NF in the post-mask group appeared significantly healthier and tended to be younger than patients before and during the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>This study supports the hypothesis that the general population has acquired an \"immune debt\" following the COVID-19 pandemic, resulting in an increase in necrotizing fasciitis incidence, especially triggered by Streptococcus pyogenes, after restrictions such as mask mandates and social distancing were lifted.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215726","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":"Diagnosis and treatment of invasive pulmonary aspergillosis in critically ill intensive care patients: executive summary of the German national guideline (AWMF 113-005).","authors":"Dominic Wichmann, Martin Hoenigl, Philipp Koehler, Christina Koenig, Frederike Lund, Sebastian Mang, Richard Strauß, Markus A Weigand, Christian Hohmann, Oliver Kurzai, Claus Heußel, Matthias Kochanek","doi":"10.1007/s15010-025-02572-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02572-2","url":null,"abstract":"<p><strong>Purpose: </strong>The executive summary of the guideline aims to provide the most relevant recommendations on the diagnosis and treatment of invasive pulmonary aspergillosis in critically ill patients in the intensive care unit.</p><p><strong>Methods: </strong>The guideline's work included a systematic literature search, selection and assessment of the data relevant to the issues identified. Key questions included the areas of epidemiology, risk factors, diagnostics, and therapy. They were discussed analogous to a PICO scheme within the guideline committee, with subsequent working groups proposing recommendations for specific key questions, which were then again discussed and finalized by the entire guideline committee.</p><p><strong>Results: </strong>In addition to the classic risk factors (persistent neutropenia, allogeneic stem cell transplantation, congenital or acquired immunodeficiency, etc.), decompensated liver cirrhosis, COPD, solid tumours and viral pneumonia (influenza, COVID-19) have been established as risk factors for critically ill patients in need of intensive care. If there is no adequate improvement or even further clinical deterioration of the respiratory status in critically ill patients, the presence of IPA should be considered and appropriate diagnostic tests should be initiated. Diagnostics should include a CT scan of the chest and a broncho-alveolar lavage with culture for moulds, testing for galactomannan and PCR. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative, with posaconazole (PCZ) or the echinocandins (as an add-on to azole or polyene treatment) being additional options for salvage treatment.</p><p><strong>Conclusion: </strong>Invasive aspergillosis in critically ill patients represents a diagnostic and therapeutic challenge. If indicated, invasive aspergillosis should be considered and appropriate diagnostic tests initiated. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215727","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":"Hemophagocytic lymphohistiocytosis in people living with HIV-a single centre experience.","authors":"Pascal Migaud, Daniela Drauz, Alessia Dalla Pria, Kai Hosmann, Markus Müller, Leyli Ghaeni, Hartmut Stocker","doi":"10.1007/s15010-025-02573-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02573-1","url":null,"abstract":"<p><strong>Background: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that clinically resembles sepsis thus obscuring the underlying condition and delaying its diagnosis and therapy. Among the most common triggers are lymphomas and infectious diseases. Lymphoma-associated HLH appears to be more common in People living with HIV (PLWH).</p><p><strong>Methods: </strong>Retrospective cohort study comprising all adult HIV-infected patients with HLH treated at St. Joseph Hospital Berlin-Tempelhof, Germany, defined by HLH 2004-criteria and the HScore, between April 2020 and November 2024.</p><p><strong>Results: </strong>22 patients were included with at least 5/8 positive HLH criteria and a median HScore of 222 points. Median age was 44 [29-66] years. The median CD4-count at HLH-diagnosis was 100/µL [14-936]. In 8 (36%) patients the HIV-viral load was undetectable. HLH led to the diagnosis of HIV in 6 (27%) patients. In 20/22 patients an LPD was the HLH trigger. Hodgkin's lymphoma, HHV8-positive multicentric Castleman disease and HHV8-positive primary effusion lymphoma accounted for 8 (36%), 5 (23%) and 3 (14%) cases respectively. Kaposi sarcoma inflammatory cytokine syndrome (KICS) HHV8-positive plasmablastic lymphoma, HHV8-positive diffuse large B-cell lymphoma, DLBCL and invasive Aspergillosis were each found in 1 (4%) patient. All patients with Hodgkin's lymphoma had bone marrow involvement. In 1 patient simultaneous malaria and multiple myeloma were diagnosed. 11/22 (50%) patients had HHV8-associated conditions. 5 (23%) patients died within 30 days of the HLH-diagnosis.</p><p><strong>Conclusion: </strong>Lymphomas and HHV8-associated diseases are common triggers of HLH in PLWH and are linked to a high mortality rate.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208466","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":"Global, regional, and national burden of lower respiratory infections and chronic obstructive pulmonary disease, 1990-2021: a systematic analysis from the global burden of disease study 2021.","authors":"Yi-Yuan Wang, Jing Wang, Zhang-Wei Lu, Qian-Qian Zhou, Yang-Guang Cao, Yu-Jie Du, Xue Jin, Bao-Zhu Li","doi":"10.1007/s15010-025-02566-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02566-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the global burden of lower respiratory infections (LRIs) and chronic obstructive pulmonary disease (COPD), focusing on their combined impact across age groups and regions.</p><p><strong>Methods: </strong>Data from 204 countries were analyzed using spatiotemporal Gaussian process regression to estimate LRI and COPD incidence, prevalence, and disability-adjusted life years (DALYs). Age-standardized ratios (ASR) and the Socio-Demographic Index (SDI) were used to compare disease burdens, with trends assessed via linear regression and restricted cubic spline models.</p><p><strong>Results: </strong>In 2021, COPD and LRI caused 360 million cases and 5.9 million deaths, with the highest burden in low-SDI regions. COPD remained the fourth leading cause of death, while LRI dropped to seventh.</p><p><strong>Conclusion: </strong>The bidirectional link between LRI and COPD exacerbates disease progression, disproportionately affecting low-income regions and aging populations. Addressing disparities in healthcare access, improving vaccines, and strengthening public health infrastructure are critical to reducing the global burden of these diseases.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198987","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":"Secondary laryngeal manifestation of cavitary pulmonary tuberculosis.","authors":"Matthias J Neuboeck, Nikolaus Poier-Fabian, Stefan Doppler, Helmut J F Salzer","doi":"10.1007/s15010-025-02570-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02570-4","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198988","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":"No antibiotics for asymptomatic bacteriuria.","authors":"Annika P Schnell","doi":"10.1007/s15010-024-02369-9","DOIUrl":"10.1007/s15010-024-02369-9","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1251-1252"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004124","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":"Post-COVID-19-pandemic changes and clinical characteristics of invasive group a streptococcal infections from 2015 to 2023.","authors":"Markos K Tomidis Chatzimanouil, Susann Rößler, Dennis Nurjadi, Isidoros Iakovidis, Reinhard Berner, Nicole Toepfner, The Dresden G A S Study Group Stefan Richard Bornstein, Roland Aschoff, Martin Bornhäuser, Andreas Güldner, Florian Gunzer, Johannes Herold, Jurek Schultz, Pauline Wimberger, Thomas Zahnert","doi":"10.1007/s15010-024-02413-8","DOIUrl":"10.1007/s15010-024-02413-8","url":null,"abstract":"<p><strong>Purpose: </strong>Since winter 2022, invasive GAS (iGAS) infections have re-emerged in Europe, causing severe diseases in children and adults. We aimed to examine whether this reported post-pandemic increase was associated with an increased disease severity and/or a shift in clinical disease phenotypes.</p><p><strong>Methods: </strong>We performed detailed clinical phenotyping of patients hospitalized with iGAS infections at a 1410-bed tertiary German Medical Center from 01/2015 to 09/2023.</p><p><strong>Results: </strong>One hundred seventy-eight patients were included: 50 children (28.1%) and 128 adults (71.9%). IGAS infections of Q1/2023 exceeded the pre-pandemic average by 551% (1200% for children). The mean age of affected patients shifted significantly post-pandemically (49.5 ± 26.5 to 32.4 ± 28.2 years of age, p < 0.05), mainly due to the higher percentage of children affected with iGAS infections (15.2% pre-pandemic, 44.2% post-pandemic). CFR was significantly lower for children (2%) compared to adults (11.7%) (p < 0.05) and decreased from 13% to 6.5% post-pandemically (p = 0.148). Duration of antibiotic therapy (13.5 (10 to 21) to 10 (9 to 14) days), length of hospital (10 (4 to 25) to 7 (5 to 15) days), and ICU stay (7.0 (2.5 to 18.0) to 5.0 (3.0 to 8.5) days) were shorter post-pandemically. Despite the higher post-pandemic percentage of affected children, PICU admissions (57% before to 32% after), use of catecholamines (28.6% to 11.8%), invasive ventilation (35.7% to 17.6%) and CFR (7% to 0%) were all lower after the pandemic.</p><p><strong>Conclusion: </strong>Children were at higher risk for iGAS infections post-pandemically. The surge of post-pandemic iGAS infections was not accompanied by increased iGAS-associated morbidity and mortality.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"991-1000"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464325","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":"SeptAsTERS- SeptiCyte® RAPID as assessment tool for early recognition of sepsis - a prospective observational study.","authors":"M von der Forst, L Back, K M Tourelle, D Gruneberg, M A Weigand, F C F Schmitt, Maximilian Dietrich","doi":"10.1007/s15010-024-02409-4","DOIUrl":"10.1007/s15010-024-02409-4","url":null,"abstract":"<p><strong>Purpose: </strong>Early recognition of sepsis is critical to patient outcome, with mortality increasing with every hour of delay in treatment. The aim of this study was to investigate the use of a point-of-care molecular host response assay to differentiate sepsis from inflammation after surgery.</p><p><strong>Methods: </strong>Three molecular host response assays (SeptiCyte® RAPID) were performed in 61 patients after major abdominal surgery with admission to the intensive care unit and drawn blood cultures. The first (T0) was taken ± 3 h around the time of obtaining blood cultures, the second 24 h later (T24) and the third at discharge from the intensive care unit (Tex). The primary endpoint was the agreement of SeptiCyte® RAPID results with the diagnosis of sepsis. SeptiScore® indicates sepsis probability (low risk 0 - high risk 15). Patients were retrospectively classified into sepsis and inflammation by three blinded experts.</p><p><strong>Results: </strong>25 (42.4%) patients were categorized as \"inflammation\" and 34 (57.6%) patients as \"sepsis\". At T0 and T24 septic patients showed significantly higher mean SeptiScores® of 8.0 (± 2.2 SD) vs. 6.3 (± 2.1 SD) and 8.5 (± 2.1 SD) vs. 6.2 (± 1.8 SD), respectively. The Receiver Operating Curves (ROC) for the ability to discriminate between sepsis and inflammation had an Area Under the Curve (AUC) of 0.71 (T0) and 0.80 (T24).</p><p><strong>Conclusion: </strong>Embedded in a comprehensive diagnostic algorithm molecular host response analysis could broaden the possibilities for infection diagnostics to differentiate between sepsis and inflammatory response after surgery. But validation in larger cohorts is needed.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"953-965"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687006","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":"Piperacillin/tazobactam vs. cefepime or carbapenems for the treatment of bloodstream infections due to bacteria producing chromosomal AmpC beta-lactamase: a systematic review and meta-analysis.","authors":"Lorenzo Onorato, Ilaria de Luca, Annabella Salvati, Caterina Monari, Nicola Coppola","doi":"10.1007/s15010-024-02447-y","DOIUrl":"10.1007/s15010-024-02447-y","url":null,"abstract":"<p><strong>Background: </strong>The best treatment for bloodstream infections (BSI) due to chromosomal AmpC (c-AmpC) producing Enterobacterales is not clearly defined.</p><p><strong>Objectives: </strong>To describe the clinical and microbiological outcomes of patients treated with piperacillin/tazobactam, cefepime or carbapenems for bloodstream infections (BSIs) due to c-AmpC beta-lactamase-producing strains.</p><p><strong>Data sources: </strong>We searched MEDLINE, the Cochrane Library and EMBASE to screen original reports published up to January 2024.</p><p><strong>Study eligibility criteria: </strong>RCTs and observational studies investigating all-cause mortality, clinical failure, microbiological failure or rate of ADRs of patients treated with piperacillin/tazobactam, cefepime or carbapenems.</p><p><strong>Participants: </strong>Patients with bloodstream infections due to c-AmpC producing bacteria.</p><p><strong>Interventions: </strong>Piperacillin/tazobactam, cefepime or carbapenems as targeted treatment.</p><p><strong>Assessment of risk of bias: </strong>We used the Cochrane Risk of Bias Tool for RCTs, and the Newcastle Ottawa scale for observational studies.</p><p><strong>Methods of data synthesis: </strong>We conducted a meta-analysis pooling Risk ratios (RRs) through random effect models.</p><p><strong>Results: </strong>We screened 1,720 original reports, and 20 studies (1 RCTs, 1 case-control study, 18 cohort studies) were included in the analysis, for a total of 2,834 patients. When comparing piperacillin/tazobactam with alternative treatments (cefepime or carbapenems), no significant difference in mortality rate was observed between the treatment groups (RR: 1.1; 95% CI: 0.76-1.58, p = 0.61), while an higher rate of microbiological failure (RR: 1.80; 95% CI: 1.15-2.82, p = 0.01) and clinical failure (RR: 1.54; 95% CI: 1.00-2.40, p = 0.05) was observed among patients receiving piperacillin/tazobactam. No difference was observed in microbiological and clinical failure rate among patients treated with cefepime or carbapenems, with a lower mortality rate in those receiving cefepime (RR: 0.74; 95% CI: 0.59-0.94, p = 0.014).</p><p><strong>Conclusions: </strong>Cefepime represents an excellent alternative to carbapenems for BSI due to AmpC-producing strains, whereas piperacillin/tazobactam is associated with a higher rate of clinical and microbiological failure. There is an urgent need for randomized clinical trials that aim to define the best carbapenem-sparing strategy in these infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1141-1153"},"PeriodicalIF":5.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768382","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}