Infection最新文献

{"title":"A fatal pediatric case of meningitis and streptococcal toxic shock syndrome caused by emm12 Streptococcus pyogenes strain in Jiangsu, China, 2024.","authors":"Lili Huang, Zhenhua Liu, Zhenjiang Bai, Mi Zhou, Panpan Lv, Yue Jiang, Mingliang Chen","doi":"10.1007/s15010-025-02638-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02638-1","url":null,"abstract":"<p><p>A 23-month-old boy was admitted to our hospital with onset of fever and paroxysmal cough but progressed to death on Day 9. Streptococcus pyogenes was positive in cerebrospinal fluid and blood by next-generation sequencing, and was cultured from sputum. The isolate was resistant to erythromycin, clindamycin, and tetracycline. By genomic analysis, the isolate was identified to be emm12 of global Clade II and harbor mobile genetic elements of ICE-emm12 and ΦHKU.vir, carrying resistance genes ermB and tetM. We report a fatal case of meningitis case complicated with streptococcal toxic shock syndrome caused by emm12 S. pyogenes in China, which is rare in this country.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000472","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":"Use of fexinidazole in gambiense human African trypanosomiasis: a retrospective analysis of cases treated in Lui Hospital, South Sudan (2018-2024).","authors":"Francesca Mariotti, Riccardo Paggi, Matteo Basilico, Sofia Pettenuzzo, Grant Sebit Benson, Abiodun Amodu, Lorenzo Zammarchi, Stefano Rusconi, Chiara Scanagatta, Giovanni Putoto, Stefano Dacquino, Elena Gelormino","doi":"10.1007/s15010-025-02633-6","DOIUrl":"https://doi.org/10.1007/s15010-025-02633-6","url":null,"abstract":"<p><strong>Purpose: </strong>Fexinidazole, an oral molecule, replaced pentamidine and combined treatment with nifurtimox and eflornithine (NECT) therapy for stage 1 and non-severe stage 2 gambiense human African Trypanosomiasis (g-HAT), respectively. The study aims to evidence differences of outcome at discharge and adverse drug reactions (ADRs) between fexinidazole and pentamidine/NECT regimens in patients with stage 1 and non-severe stage 2 g-HAT admitted to Lui Hospital (Western Equatoria, South Sudan), a historical g-HAT focus.</p><p><strong>Methods: </strong>Data of patients (n = 86) admitted to Lui Hospital from July 2018 to June 2024 with g-HAT diagnosis were included. Among them, we considered for the analysis patients eligible for both fexinidazole and pentamidine/NECT regimens (i.e. patients without symptoms/signs compatible with severe stage 2 g-HAT).</p><p><strong>Results: </strong>In the study population 17% of patients were registered with an unfavourable outcome (signs or symptoms of g-HAT at discharge or death attributable to g-HAT or g-HAT treatment occurred during hospitalization). No significant differences between fexinidazole and pentamidine/NECT in terms of outcome at discharge (23% vs. 6%, p = 0.230) and ADRs frequency (70% vs. 50%, p = 0.181) were reported. Although fexinidazole cohort experienced more gastro-intestinal ADRs than pentamidine/NECT cohort (63% vs. 19%, p = 0.005), discontinuation of oral treatment has not been recorded.</p><p><strong>Conclusion: </strong>Patients treated with fexinidazole and pentamidine/NECT showed similar results in terms of outcome at discharge and ADRs, in line with current data available in literature. However, few real-life studies on efficacy of fexinidazole treatment were published: to our knowledge, this is the first one conducted in South Sudan.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992450","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":"Genetic and clinical risk factors for anti-tuberculosis drug-induced liver injury: insights from a prospective cohort study in central Ethiopia.","authors":"Caroline Klindt, Andre Fuchs, Kristina Behnke, Carola Dröge, Kirsten Alexandra Eberhardt, Hans Christian Orth, Frieder Pfäfflin, Andreas Schönfeld, Tamara Nordmann, Million Getachew Mesfun, Verena Keitel, Tom Luedde, Tafese Beyene Tufa, Björn-Erik Ole Jensen, Torsten Feldt","doi":"10.1007/s15010-025-02632-7","DOIUrl":"https://doi.org/10.1007/s15010-025-02632-7","url":null,"abstract":"<p><strong>Purpose: </strong>Drug-induced liver injury (DILI) is a relevant adverse event of tuberculosis treatment (TBT) especially in sub-Saharan Africa, but data remains limited. Genetic hepatic transport proteins polymorphisms (HTPP) are potential contributors. This study aimed to assess frequency and timing of DILI, identify risk factors, and explore the association of HTPP with DILI risk in Ethiopian TBT-patients.</p><p><strong>Methods: </strong>In this prospective study, 424 confirmed tuberculosis patients in Ethiopian were recruited before initiation of TBT. Liver function tests were conducted during the first 8 weeks of treatment. Baseline evaluations included sociodemographic-, lifestyle- and clinical data including testing for viral co-infections, and HTPP as well as liver stiffness measurement by transient elastography (TE). Multivariable logistic regression, Cox proportional hazards models, and Fine and Gray competing risks analyses were employed for statistical analysis.</p><p><strong>Results: </strong>Cumulative DILI incidence was 16.0% with 4.2% classified as severe occurring most commonly within the first two weeks. Urban residence (OR 2.00, 95% CI 1.03-3.84; HR 1.80, 95% CI 1.00-3.22) was associated with increased DILI risk. In the competing risks model, urban residence (sHR 6.26, p = 0.010) and pathologic TE (sHR 5.23, p = 0.005) predicted severe DILI. The investigated HTPPs were not significantly associated with DILI.</p><p><strong>Conclusion: </strong>DILI is a common early complication of TBT in Ethiopian patients. Assessment of sociodemographic factors and TE before TBT may help identify high-risk individuals and offers a pragmatic approach for DILI management in resource-limited settings.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992400","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":"Correction: Current trends on antifungal prophylaxis in solid organ transplantation: a study from ESCMID-EFISG, ESCMID-ESGICH, SITA, and SEIMC-GESITRA-IC.","authors":"Jon Salmanton-García, Alessandro Giacinta, Maddalena Giannella, Antonio Vena, Patricia Muñoz, Oliver A Cornely, Maricela Valerio","doi":"10.1007/s15010-025-02625-6","DOIUrl":"https://doi.org/10.1007/s15010-025-02625-6","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952593","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":"Sero-prevalence of measles and rubella immunoglobulin G serum antibody in individuals 1-30 years old in England in 2018: implications for subsequent outbreaks prediction.","authors":"Khitam Muhsen, Yoon Hong Choi, Jemma Walker, Nick Andrews, Helen I McDonald, Kevin Brown, Elizabeth Miller","doi":"10.1007/s15010-025-02630-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02630-9","url":null,"abstract":"<p><strong>Purpose: </strong>Measles outbreaks have occurred across England since mid-2023. We estimated measles and rubella antibody seroprevalence among individuals in 2018 in English regions outside London, and estimated the effective reproduction number (Re) for measles to predict the potential for outbreaks.</p><p><strong>Methods: </strong>Using validated enzyme-linked immunosorbent assays, anti-Measles and anti-Rubella IgG antibodies were measured in residual sera from 3758 1-30-year-olds born after introduction of measles-mumps-rubella vaccination who submitted samples to clinical laboratories outside London. The measles Re was calculated using seronegatives defined by the manufacturer's cutoff, mixture modelling, and vaccination coverage data.</p><p><strong>Results: </strong>Using the manufacturer's cutoffs, the overall proportion seronegative to measles was 9.2% (95% confidence interval 8.3-10.1), and 10.3% (9.4-11.3) had equivocal results. The respective estimates for rubella were lower at 5.2% (4.6-6.0) and 5.4% (4.7-6.1). For both viruses, equivocal proportions increased with age, consistent with antibody waning. Mixture modelling for measles identified a common seronegative distribution across age groups, with lower proportions seronegative than using the manufacturer's cutoff. Re for measles using the manufacturer's seronegative cutoff (~ 150 mille international units/mL) was 1.00, versus 0.38 and 0.51 using the mixture model and vaccination coverage, respectively.</p><p><strong>Conclusions: </strong>Re for measles estimated from seroepidemiology using an antibody cut-off similar to that considered a correlate of protection for measles was a more accurate predictor of recent measles resurgences outside London than those estimated using mixture modelling of seronegatives or coverage data. Seroepidemiological studies are a useful adjunct to coverage data in monitoring population immunity and in predicting the potential for measles outbreaks.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952733","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":"Machine learning identifies clinical sepsis phenotypes that translate to the plasma proteome.","authors":"Thilo Bracht, Maike Weber, Kerstin Kappler, Lars Palmowski, Malte Bayer, Karin Schork, Tim Rahmel, Matthias Unterberg, Helge Haberl, Alexander Wolf, Björn Koos, Katharina Rump, Dominik Ziehe, Ulrich Limper, Dietrich Henzler, Stefan Felix Ehrentraut, Thilo von Groote, Alexander Zarbock, Katrin Marcus-Alic, Martin Eisenacher, Michael Adamzik, Barbara Sitek, Hartmuth Nowak","doi":"10.1007/s15010-025-02628-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02628-3","url":null,"abstract":"<p><strong>Background: </strong>Sepsis therapy is still limited to treatment of the underlying infection and supportive measures. To date, various sepsis subtypes were proposed, but therapeutic options addressing the molecular changes of sepsis were not identified. With the aim of a future individualized therapy, we used machine learning (ML) to identify clinical phenotypes and their temporal development in a prospective, multicenter sepsis cohort and characterized them using plasma proteomics.</p><p><strong>Methods: </strong>Routine clinical data and blood samples were collected from 384 patients. Sepsis phenotypes were identified based on clinical measurements and plasma samples from 301 patients were analyzed using mass spectrometry. The obtained data were evaluated in relation to the phenotypes, and supervised ML models were developed enabling prospective phenotype classification.</p><p><strong>Results: </strong>Three sepsis phenotypes were identified. Cluster C was characterized by the highest disease severity and multi-organ failure with leading liver failure. Cluster B showed relevant organ failure, with renal damage being particularly prominent in comparison to cluster A. Time course analysis showed a strong association of cluster C with mortality, while patients in cluster B were likely to change the cluster until day 4. The plasma proteome reflected the clinical features of the phenotypes and showed gradual consumption of complement and coagulation factors with increasing sepsis severity. Supervised ML models allowed the assignment of patients based on only seven widely available features (alanine transaminase (ALT), aspartate transaminase (AST), base excess (BE), international normalized ratio of thrombin time (INR), diastolic arterial blood pressure, systolic arterial blood pressure (BPdia, BPsys) and activated partial thromboplastin time (aPTT)).</p><p><strong>Conclusions: </strong>The identified clinical phenotypes reflected varying degrees of sepsis severity and were mirrored in the plasma proteome. Proteomic profiling offered novel insights into the molecular mechanisms underlying sepsis and enabled a deeper characterization of the identified phenotypes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952745","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":"Infection of the acromioclavicular joint with Mycobacterium bovis following intravesical instillation of Bacillus Calmette-Guerin: a case-based review.","authors":"Maxime Bosse, Benjamin Lardinois, Julie Cadrobbi, Sandrine Van Eeckhoudt, Pauline Sambon, Gaëtan Opsomer, Jeremie Gras, Vanessa Mathys, Kim Laffineur","doi":"10.1007/s15010-025-02610-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02610-z","url":null,"abstract":"<p><strong>Purpose: </strong>Osteoarticular infections caused by intravesical BCG are rare and poorly characterized. This study presents a case of acromioclavicular joint infection caused by Mycobacterium bovis BCG, alongside a systematic review aimed at improving our understanding of the infection's clinical features, diagnosis, treatment and outcomes.</p><p><strong>Methods: </strong>This systematic review included all published cases of osteoarticular infections due to M. bovis BCG following intravesical BCG instillation, as identified through a PubMed search conducted up to 1 May 2025. The search used combinations of keywords related to 'BCG', 'bladder', and 'osteoarticular infection'. One additional case from our institution was added. Clinical, biological, radiological, treatment and outcome data were extracted and analyzed.</p><p><strong>Results: </strong>We reviewed 67 cases, classified as vertebral (n = 45), prosthetic joint (n = 18), and native joint (n = 4). The affected patients were predominantly men (98.5%), with a mean age of 74.1 ± 9.2 years. The median delay in months between the first instillation and the diagnosis was 23 [IQR 13.0-48.0]. Fever was uncommon (20.5%), while elevated C-reactive protein levels were frequent (80%). Imaging (CT/MRI) played a key role in diagnosis by showing images consistent with infection in all cases in which it was used. Treatment typically involved rifampicin and isoniazid for 12 months, alongside ethambutol for two months. Outcomes were favorable in 90.6% of cases, with one death attributed to the infection.</p><p><strong>Conclusion: </strong>Though rare, M. bovis BCG osteoarticular infections should be considered in patients with unexplained joint symptoms following BCG therapy. Early diagnosis and appropriate therapy are essential for optimal management.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952596","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":"Practice guidelines for outpatient parenteral antimicrobial therapy (OPAT) in Germany.","authors":"Lukas Tometten, Ulrike Trost, Linda Jürgens, Stephan Achterberg, Lukas Arenz, Franz Audebert, Markus Bickel, Sebastian Dolff, Rika Draenert, Silke Ewering, Julia Fischer, Anette Friedrichs, Stefan Hagel, Annette Hennigs, Dagmar Horn, Caroline Isner, Elham Khatamzas, Christian Lanckohr, Henriette Lang, Hanna Matthews, Beate Sigrid Müller, Jennifer Neubert, Stefan Schmiedel, Arne Simon, Phil-Robin Tepasse, Frederike Waldeck, Clara Lehmann, Miriam Stegemann","doi":"10.1007/s15010-025-02619-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02619-4","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952765","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":"Doxycycline safety during pregnancy: a large population-based cohort of pregnancies.","authors":"Itamar Ben Shitrit, Daphna Idan, Ariel Avraham Hassidim, Tal Michael, Amalia Levy, Gali Pariente, Eitan Lunenfeld, Sharon Daniel","doi":"10.1007/s15010-025-02622-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02622-9","url":null,"abstract":"<p><strong>Purpose: </strong>Doxycycline is frequently prescribed during pregnancy, yet evidence on fetal safety is inconsistent and often excludes non-live births. We assessed whether exposure during the first or third trimester is associated with major congenital malformations or late-pregnancy adverse outcomes in a population-based cohort that also included stillbirths and terminations.</p><p><strong>Methods: </strong>Using data from Clalit Health Services Southern district, we identified 265,686 pregnancies in women aged 15-45 years (from 1998 to 2017). Pharmacy records classified doxycycline dispensation in the first trimester (≤ 13 weeks) or third trimester (≥ 27 weeks). Crude and adjusted negative-binomial models estimated relative risks (RRs) for total and organ-specific major congenital malformations diagnosed up to age 1 year and for perinatal mortality, preterm birth, low/very-low birthweight, and low Apgar scores. Sensitivity analyses explored dose-response relations and propensity-score-matched cohorts.</p><p><strong>Results: </strong>Among 2,696 first-trimester exposures, major malformations occurred in 7.7% versus 7.0% of 262,990 unexposed pregnancies (SMD = 0.03, p = 0.17). No association with major malformations was observed in both crude (Crude Relative Risk (RR) = 1.10; 95% CI 0.96-1.27) and adjusted (Adjusted RR = 1.07; 95% CI 0.93-1.23) analyses, nor by organ-specific sub-groups. Third-trimester exposure (n = 112) was linked to a higher risk of very-low birthweight, while other late-pregnancy outcomes were comparable to unexposed pregnancies.</p><p><strong>Conclusion: </strong>First-trimester doxycycline use was not associated with increased major congenital malformation risk, and most late-pregnancy outcomes were unaffected. These findings support the relative safety of doxycycline when clinically indicated during pregnancy.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952619","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":"Endothelin-1 in combination with CRB-65 enhance risk stratification in COVID-19 patients.","authors":"Imrana Farhat, Maciej Rosolowski, Katharina Ahrens, Jasmin Lienau, Peter Ahnert, Mathias Pletz, Gernot Rohde, Jan Rupp, Martin Witzenrath, Markus Scholz","doi":"10.1007/s15010-025-02627-4","DOIUrl":"10.1007/s15010-025-02627-4","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 continuously causes severe disease conditions and significant mortality. We evaluate whether easily accessible biomarkers can improve risk prediction of severe disease outcomes.</p><p><strong>Methods: </strong>Our study analysed 426 COVID-19 patients collected by German CAPNETZ and PROGRESS study groups between 2020 and 2021. Troponin T high-sensitive (TnT-hs), procalcitonin (PCT), N-terminal pro brain natriuretic peptide, angiopoietin-2, copeptin, endothelin-1 (ET-1) and lipocalin-2 were measured at enrolment and related to 28d mortality/ICU admission endpoint. Logistic and relaxed LASSO regression were used to evaluate the added value of biomarkers compared to the CRB-65 score and to develop a combined risk prediction model for our endpoint.</p><p><strong>Results: </strong>Of the 426 COVID-19 patients, 64 (15%) reached the endpoint. Among individual biomarkers, ET-1 showed the highest predictive performance (AUC = 0.76, 95% CI: 0.70-0.82). CRB-65 alone had an AUC of 0.63 (95% CI: 0.56-0.70). Our machine learning method identified CRB-65 + ET-1 to be optimal for prediction performance and model sparsity (AUC = 0.77, 95% CI: 0.71-0.83). Decision curve analysis demonstrated its greater net benefit over CRB-65 across large range of risk thresholds. The generalizability of our non-COVID CAP model (CRB-65 + TnT-hs + PCT) to COVID-19 patients was also assessed, yielding an AUC of 0.67 (95% CI: 0.60-0.74) for our primary endpoint. For 28d mortality alone as endpoint, it performed remarkably well (AUC = 0.90, 95% CI: 0.85-0.95).</p><p><strong>Conclusion: </strong>Combining the already established clinical CRB-65 score with ET-1 significantly improves risk prediction of intensive care requirement or death within 28 days in hospitalized COVID-19 patients.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873015","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}