Souad Oirdi Zahir, Mounia El Khadir, Samia Alaoui Boukhris, Dafr-Allah Benajah, Sidi Adil Ibrahimi, Laila Chbani, Mohamed El Abkari, Bahia Bennani
{"title":"Helicobacter pylori vacA allelic combination, dupA, cagE and cagA genotypes and their associations with gastric diseases among Moroccan population.","authors":"Souad Oirdi Zahir, Mounia El Khadir, Samia Alaoui Boukhris, Dafr-Allah Benajah, Sidi Adil Ibrahimi, Laila Chbani, Mohamed El Abkari, Bahia Bennani","doi":"10.7883/yoken.JJID.2024.061","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.061","url":null,"abstract":"<p><p>The combination of the four regions of vacA with cagA, cagE, dupA genes and cagA-EPIYA motifs, was studied to find the most likely combination that can be used as a disease determinant marker in Moroccan population. A total of 838 H. pylori positive obtained from consenting patients, that were previously analyzed by PCR to characterize vacA-s -m, -i regions, cagE status and cagA 3' region polymorphism, were used to characterize vacA-d region and to determine dupA gene status. The analysis shows the predominance of the less virulent combination (vacA(s2m2i2d2)dupA(-)cagE(-)cagA(-)), and shows that the risk of gastric cancer is 13.33 fold higher (1.06-166.37)) in patients infected by strains harboring vacA(s1m1i1d1)dupA(-)cagE(+)cagA(2EPIYA-C) compared to patients with gastritis without lesions and infected by H.pylori strains harboring vacA(s2m2i2d2)dupA(-)cagE(-)cagA(-). The infection with strains harboring vacA(s1m1i1d1)dupA(+)cagE(+)cagA(1EPIYAC) genotype combination represents a risk factor for gastric ulcer and duodenal ulcer (the Odds Ratio (95% CI) were 16 (1.09-234.24) and 6.54 (1.60-26.69) respectively) compared to patients with gastritis without lesions. These results suggest that the combination of the active form of vacA genotypes, dupA gene status and the number of EPIYA-C motif may be considered helpful markers to discriminate between several gastric diseases.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Chen, Pengfei You, Xiaoyan Chen, Huafeng Li, Na Zhang, Guangyun Zhang, Conghong Xu, Chunling Ma, Yanli Zhang, Tiegang Lv
{"title":"Genetic characteristics and phylogenetic analysis of coxsackievirus A6 isolated in Linyi, China, 2022-2023.","authors":"Jie Chen, Pengfei You, Xiaoyan Chen, Huafeng Li, Na Zhang, Guangyun Zhang, Conghong Xu, Chunling Ma, Yanli Zhang, Tiegang Lv","doi":"10.7883/yoken.JJID.2024.072","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.072","url":null,"abstract":"<p><p>Hand, foot and mouth disease (HFMD) was one of the most common infectious disease in the past few decades. After 2013, coxsackievirus A6 (CVA6) has replaced enterovirus 71 (EV-A71) and coxsackievirus A16 (CVA16), becoming the predominant pathogen responsible for HFMD in many areas in China. The objective of this study is to investigate the genetic characteristics and molecular epidemiology of CVA6 in Linyi from 2022 to 2023. A total of 965 HFMD cases were enrolled in this study and analyses based on VP1 nucleotide sequences were performed to determine the evolutionary trajectory of CVA6. In 2022, 281 (281/386, 72.8%) were positive for enterovirus (EVs), and 217 (217/281, 77.2%) were CVA6 positive. In 2023, 398 (398/579, 68.7%) samples were positive for EVs, and 243 (243/398, 61.1%) were CVA6 positive. Six sequences were selected from each year for the homology analysis. The results showed that 12 strains isolated in Linyi were far from the prototype strain (AY421764) and the first CVA6 strain reported in China (JQ364886). Phylogenetic analysis showed that the CVA6 strains isolated in Linyi all belonged to D3 subgenotype. CVA6 is emerging as a common pathogen causing HFMD in Linyi, and continuous surveillance of HFMD etiological agents is necessary.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Distribution and antimicrobial susceptibility pattern of CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli isolated in Chubu region, Japan.","authors":"Kazuya Itadani, Yoshimi Oonishi, Harumi Hisada, Tomoaki Tanaka, Shingo Mizunaga, Yuka Yamagishi, Hiroshige Mikamo","doi":"10.7883/yoken.JJID.2024.079","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.079","url":null,"abstract":"<p><p>The widespread prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli limits treatment options and is a worldwide problem. The aim of this study was to investigate the antimicrobial susceptibility and ESBL-type of 204 strains of CTX-M-type ESBLs-producing E. coli isolated from 2011 to 2017 in the Chubu region of Japan. Minimal inhibitory concentrations were determined in accordance with the guidelines of the Clinical and Laboratory Standards Institute. Genes encoding CTX-M group β-lactamases were detected by PCR amplification. The CTX-M subtypes were determined using sequence analysis. The CTX-M-9 group was the most frequently detected ESBL group, and CTX-M-27 was the most frequently detected ESBL gene. CTX-M-15-producing strains showed significantly lower rates of susceptibility to tazobactam/piperacillin (TAZ/PIPC) than those by CTX-M-14 and -27-producing strains. Additional analysis of secondary β-lactamases revealed that most of the OXA-1-positive strains were CTX-M-15-producing strains (94.7%). These strains displayed significantly lower susceptibility rates to TAZ/PIPC (47.4%), sulbactam/ampicillin (SBT/ABPC) (0.0%), and amikacin (AMK) (73.7%) than those by OXA-1-negative strains, suggesting that the high non-susceptibility rate of the CTX-M-15-producing strain was due to the co-carriage of OXA-1. The CTX-M-15-producing strains showed reduced susceptibility to TAZ/PIPC, SBT/ABPC, and AMK, presumably due to the co-carriage of OXA-1.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case of Food Poisoning Caused by Campylobacter jejuni due to Ingestion of Undercooked Chicken Meal with Subsequent Development of Guillain-Barré Syndrome.","authors":"Satoru Akase, Hiromi Obata, Wakaba Okada, Dai Saiki, Noriko Konishi, Keiko Yokoyama, Kenji Sadamasu","doi":"10.7883/yoken.JJID.2024.108","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.108","url":null,"abstract":"<p><p>Campylobacter jejuni is one of the major bacteria that causes diarrhea in humans. It has been associated with many cases of food poisoning in Japan caused by eating raw or undercooked chicken meat, chicken liver, and grilled chicken (Yakitori). Campylobacter jejuni is also known as the preceding infection pathogen of Guillain-Barré syndrome (GBS), which causes considerable health impact on humans. In January 2022, in a case of C. jejuni food poisoning that occurred at a restaurant in Tokyo, one of four patients with diarrhea developed GBS. The poisoning is presumed to have been caused by undercooked chicken dishes. Recently, it was one of the common cases in Japan. Moreover, C. jejuni isolates from three patients, including the patient with GBS, had the same genotype (ST22, HS19, and LOS A). This genotype was frequently detected from patients with GBS in our past surveys. Our findings confirmed that the patient developed GBS via food poisoning after consuming undercooked chicken dish.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Humberto Antonio Salazar-Sesatty, Edeer Iván Montoya-Hinojosa, Verónica Villarreal-Salazar, Cynthia Aracely Alvizo-Baez, Adrián Camacho-Ortiz, Luis Daniel Terrazas-Armendariz, Itza Eloisa Luna-Cruz, Juan Manuel Alcocer-González, Licet Villarreal-Treviño, Samantha Flores-Treviño
{"title":"Biofilm Eradication and Inhibition of Methicillin-resistant Staphylococcus Clinical Isolates by Curcumin-Chitosan Magnetic Nanoparticles","authors":"Humberto Antonio Salazar-Sesatty, Edeer Iván Montoya-Hinojosa, Verónica Villarreal-Salazar, Cynthia Aracely Alvizo-Baez, Adrián Camacho-Ortiz, Luis Daniel Terrazas-Armendariz, Itza Eloisa Luna-Cruz, Juan Manuel Alcocer-González, Licet Villarreal-Treviño, Samantha Flores-Treviño","doi":"10.7883/yoken.jjid.2024.034","DOIUrl":"https://doi.org/10.7883/yoken.jjid.2024.034","url":null,"abstract":"</p><p>Biofilm-producing methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and coagulase-negative Staphylococci (MR-CoNS) are a clinical challenge for the treatment of healthcare-associated infections. As alternative antimicrobial options are needed, we aimed to determine the effect of curcumin-chitosan magnetic nanoparticles on the biofilm of staphylococcal clinical isolates. MRSA and CoNS clinical isolates were identified by MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed by broth microdilution. Nanoparticles were synthesized by co-precipitation of magnetic nanoparticles (MNP) and encapsulation by ionotropic gelation of curcumin (Cur) and chitosan (Chi). Biofilm inhibition and eradication by nanoparticles with and without the addition of oxacillin was assessed on staphylococcal strains. Cur-Chi-MNP showed antimicrobial activity on planktonic cells of MRSA and MR-CoNS strains and inhibited biofilm of MRSA. The addition of OXA to Cur-Chi-MNP increased biofilm inhibition and eradication activity against all Staphylococci strains (p=0.0007); higher biofilm activity was observed in early biofilm stages. Cur-Chi-MNP showed antimicrobial and biofilm inhibition activity against <i>S. aureus</i>. The addition of OXA increased biofilm inhibition and eradication activity against all Staphylococci strains. A combination treatment of Cur-Chi-MNP and OXA could be potentially used to treat staphylococcal biofilm-associated infections in its early stages before the establishment of biofilm bacterial cells.</p>\u0000<p></p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mei Koyama, Satoshi Hiroi, Yuki Hirai, Atsushi Kaida
{"title":"Prevalence of human adenovirus type 3 associated with pharyngoconjunctival fever in children in Osaka, Japan during and after the COVID-19 pandemic","authors":"Mei Koyama, Satoshi Hiroi, Yuki Hirai, Atsushi Kaida","doi":"10.7883/yoken.jjid.2024.035","DOIUrl":"https://doi.org/10.7883/yoken.jjid.2024.035","url":null,"abstract":"</p><p>Since the COVID-19 pandemic has affected the epidemiological pattern of pharyngoconjunctival fever (PCF) caused by human adenovirus (HAdV), the prevalence and type distribution of HAdVs associated with PCF among children in Osaka, Japan, between 2019 and 2023 have been analyzed. The number of reported PCF cases in Osaka decreased from 2020 to 2022, followed by an unprecedented increase in 2023. HAdV-C strains, including types C1, C2, and C5, were annually detected in pathogen surveillance in Osaka. HAdV-B3 was not detected for 2 years and 9 months from March 2020, and the number of detections increased from July 2023. In total, HAdV-B3 was the most frequently detected (27 of 52 strains), and genetic analysis of its hexon hypervariable regions showed that, except for one strain, the HAdV-B3 strains identified after 2022 had different amino acid substitutions compared to those identified in 2019 and 2020. These results suggest that the PCF epidemic in 2023 was predominantly caused by variant strains of HAdV-B3, and children who have not acquired immunity against HAdV-B3 between 2020 and 2022 were thought to be infected. The impact of COVID-19 on the prevalence of HAdV infections needs to be continuously evaluated through surveillance.</p>\u0000<p></p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A descriptive epidemiology in syphilis in Tokyo, 2019-2022","authors":"Yukari Murata, Atsushi Yoshida, Eriko Suzuki, Asamoe Ogawa, Konomi Murauchi, Miyoko Hoshi, Yoshiko Somura, Yoshiyuki Sugishita, Itaru Nishizuka, Kazuhisa Yoshimura","doi":"10.7883/yoken.jjid.2024.012","DOIUrl":"https://doi.org/10.7883/yoken.jjid.2024.012","url":null,"abstract":"</p><p>The number of syphilis cases in Tokyo has been found to increase in recent years. We conducted a descriptive epidemiology to elucidate the actual status of syphilis. Data on age, sex, disease stage, and presumed sexual partner of syphilis cases reported in Tokyo were tabulated and analyzed. A total of 9,419 syphilis cases have been reported between 2019 and 2022. There was a particularly sharp rise in the number of reported cases from 2021 to 2022. Comparing 2020 to 2022, the number of syphilis cases among women in their 20s, rapidly increased, more than triple. Furthermore, the number of pregnant women among syphilis cases increased in 2022. Despite the rapid increase in the number of young women with syphilis, there has been no increase in cases of congenital syphilis. One of the reasons may be that syphilis was detected early in pregnancy due to the high antenatal checkup rate in Tokyo. However, the continued incidence of syphilis among young women may increase congenital syphilis in the future. Public health strategy should include educational activities targeting high-risk populations or adolescents, early and appropriate testing, and treatment for preventing progression of syphilis.</p>\u0000<p></p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Re-emerging, under-recognized zoonotic, and neglected tropical diseases in Hawaiʻi","authors":"Rodson Zorilla, Lauren Ching, Tiana Elisara, Kenton Kramer, Vivek Ramchandra Nerurkar","doi":"10.7883/yoken.jjid.2023.476","DOIUrl":"https://doi.org/10.7883/yoken.jjid.2023.476","url":null,"abstract":"</p><p>Hawaiʻi, the United States’ most western geographic state in the Pacific, is intermediate between the North and South American continents and Indo-Pacific regions, including Japan. The Hawaiian Islands’ tropical environmental conditions provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates a conducive environment for-transmission of various zoonotic diseases that affect both humans and animals. Hawaiʻi has experienced an increase in outbreaks of dengue, leptospirosis, and murine typhus. Further, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk places and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaborations between private and government institutions. One Health should focus its efforts on neglected tropical diseases (NTD) and prioritize intervention development to control and prevent the transmission of diseases that spread between animals and humans. This review will focus on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawaiʻi: leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika infections.</p>\u0000<p></p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microelimination of Hepatitis C in patients with substance use and dual disorders – a Portuguese study","authors":"Isabela Faria, Rita Facão, Filipa Murta, Rúben Carvalho, Carla Silva, Ilda Murta, Cristina Valente","doi":"10.7883/yoken.jjid.2024.056","DOIUrl":"https://doi.org/10.7883/yoken.jjid.2024.056","url":null,"abstract":"</p><p>Chronic hepatitis C is a serious condition with relevant public health implications. In Portugal, the prevalence of detectable HCV antibodies is about 0,54%, with higher values in risk groups. Compared to the general population, the prevalence of HCV infection is higher in individuals with psychiatric disorders. There are no studies reporting the prevalence of HCV antibodies in Portuguese psychiatric patients, or in patients with substance use disorders.We carried an observational, prospective study during a period of one year, for patients followed at the Dual Pathology Outpatient and Inpatient Unity of the Coimbra Hospital and University Center, and patients were tested for HCV antibodies. Of 149 patients, 17.4% had positive HCV antibodies and 7.38% had detectable HCV RNA. Patients with confirmed CHC were mostly male inpatients, aged 50 to 59 years, and reported unprotected sex with more than one concurrent partner in the previous six months; their main psychiatric diagnosis was “Disorders due to use of multiple specified psychoactive substances, including medications”.This study reports a very high prevalence of positive HCV antibodies and confirmed CHC in patients followed in the Dual Pathology Outpatient and Inpatient Unity. This prevalence is higher than in general Portuguese population.</p>\u0000<p></p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nosocomial outbreak of SARS-CoV-2 in a hospital ward during the Omicron variant-dominant wave with a review of the relevant literature","authors":"Hilary Osaka, Yasuaki Tagashira, Hiroaki Takeuchi, Yukie Tanaka, Kousuke Tanimoto, Yoshiaki Gu","doi":"10.7883/yoken.jjid.2023.464","DOIUrl":"https://doi.org/10.7883/yoken.jjid.2023.464","url":null,"abstract":"</p><p>Clusters of nosocomial coronavirus disease 2019 (COVID-19) were reported globally during the recent pandemic. Unfortunately, these clusters negatively impacted inpatient morbidity, mortality, and hospital functions. Using epidemiological data and whole genome sequencing (WGS) of SARS-CoV-2, the present study investigated an outbreak of COVID-19 at a university hospital. Eight inpatients and 13 healthcare workers tested positive for SARS-CoV-2 during a one-month period. Whole genome sequencing (WGS) of the virus in 11 patients revealed that two variants of concern belonging to the Omicron sublineages, BA.2.3 and BA1.1.2, had caused the outbreak during a time when the proportion of the Omicron lineage in the community was changing. When variants of concern are undergoing mutation, a response to the outbreak should be made with multiple variants in mind, even in the absence of epidemiological data showing close contact or other potential vectors of infection, and awareness about infection prevention and control should be raised to safeguard patient safety.</p>\u0000<p></p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}