Journal de mycologie medicale最新文献

{"title":"Ketoconazole-loaded microspone film coating agent for superficial fungal infection: design, preparation and characterization","authors":"Zhaowei Jin ,&nbsp;Danqing Wu ,&nbsp;Yangnan Chen ,&nbsp;Yanqiu Long ,&nbsp;Yan Liu ,&nbsp;Zhiyun Zheng ,&nbsp;Shuangying Gui ,&nbsp;Yuzhe Huang ,&nbsp;Ning He","doi":"10.1016/j.mycmed.2025.101551","DOIUrl":"10.1016/j.mycmed.2025.101551","url":null,"abstract":"<div><div>Ketoconazole (KCZ), an imidazole antifungal drug, is constrained by its low solubility and poor stability, restricting its effective absorption and bioavailability. This study introduces a KCZ-loaded microsponge based film coating agent (KCZ-MSF), designed to enhance the transdermal absorption and bioavailability of KCZ. The KCZ-MS was prepared by emulsion solvent evaporation method and the composition of the prescription was optimized by Box-Behnken design (BBD). Moreover, characterization of the optimized KCZ-MS was conducted using scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC). The film coating agent's preparation was further optimized through orthogonal experiments, converting the optimized KCZ-MS into a film coating agent suitable for topical skin application. The KCZ-MS showed a spherical porous structure with a mean particle size of 22.42 ± 8.45 μm, a drug loading efficiency of 20.74 %, entrapment efficiency of 92.12 %, and good compatibility between the drug and excipients. The optimized KCZ-MSF displayed good physical properties. <em>In vitro</em> transdermal experiments revealed that the skin retention of KCZ-MSF surpassed that of commercially available KCZ cream at 6, 12, and 24 h. The pharmacokinetic experiment results indicate that the area under the curve (<em>AUC</em>_0–24) of KCZ-MSF 420.71 ± 21.77 μg/(g·h) is 2.05 times that of KCZ film coating agent (KCZ-F) and 1.29 times that of commercially available ketoconazole cream. Therefore, KCZ-MSF presents a more promising platform for the treatment of superficial skin fungal infections.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101551"},"PeriodicalIF":2.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874773","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":"Identification, quantification, and bioactivity of Vitex negundo phenolic acids as efficacious anti-candidal and antibiofilm agents targeting Candida albicans","authors":"Neha Jaiswal,&nbsp;Awanish Kumar","doi":"10.1016/j.mycmed.2025.101550","DOIUrl":"10.1016/j.mycmed.2025.101550","url":null,"abstract":"<div><div>Phenolic acids derived from the leaf of <em>Vitex negundo</em> have been widely recognized for their natural antifungal properties. This study evaluates the bioactive potential of these phenolic acids against <em>Candida albicans</em>, a significant fungal pathogen responsible for various infections in humans. The total phenolic content (TPC) of the plant extract was quantified using the Folin-Ciocalteu reagent and expressed in terms of gallic acid equivalent (GAE), with a TPC of 90.1 ± 3.36 mg GAE/g dry weight extract. The antioxidant activity, measured through the DPPH radical scavenging assay, demonstrated a substantial inhibition rate of 60.776 ± 2.32 % at 1 mg/mL concentration. LCMS analysis identified 18 phenolic acids, with p-coumaric acid showing the highest concentration at 34.3575 µg/ml. <em>In-silico</em> screening highlighted chlorogenic acid, caffeic acid, coumaric acid, and 2,4-dihydroxybenzoic acid having the top four compounds with antifungal potential, which was further validated through <em>in-vitro</em> assays. Caffeic acid emerged as the most potent anti-candidal agent (among these 4 shortlisted compounds) with an MIC of 64 ± 2.31 µg/ml, exhibiting both fungistatic and fungicidal effects. The FE-SEM analysis confirmed the complete eradication of <em>C. albicans</em> biofilm and significant membrane damage post-treatment with caffeic acid. These findings underscore the dual mechanisms of action, i.e., antioxidant and anti-candidal potential of <em>V. negundo</em> phenolic extracts, presenting them as promising candidates for developing natural anti-candidal therapeutics. Future research should explore the molecular interactions and potential synergistic effects with other antimicrobial agents to enhance efficacy and mitigate drug resistance development.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101550"},"PeriodicalIF":2.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863768","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":"Voriconazole in the management of invasive pulmonary aspergillosis in patients with severe liver disease: balancing efficacy and hepatotoxicity","authors":"Caopei Zheng ,&nbsp;Xin Zhang ,&nbsp;Yingmin Ma ,&nbsp;Yulin Zhang","doi":"10.1016/j.mycmed.2025.101549","DOIUrl":"10.1016/j.mycmed.2025.101549","url":null,"abstract":"<div><div>Patients with severe liver disease (SLD) are prone to developing invasive pulmonary aspergillosis (IPA) due to immunodeficiency and microbial translocation, leading to high mortality rates. Although voriconazole is the first-line treatment for IPA, its use in patients with SLD is challenging due to the risk of hepatotoxicity. In this population, reduced hepatic blood flow and enzyme activity, compromised bile excretion, and increased intestinal permeability collectively affect voriconazole metabolism, resulting in a prolonged half-life, drug accumulation, and higher incidence of adverse events (AEs). Therapeutic drug monitoring (TDM) is essential to optimize voriconazole therapy, ensuring plasma concentrations within the therapeutic range (1.0-5.0 mg/L) while minimizing toxicity risks. This review highlights the risk factors for IPA in patients with SLD, the mechanisms of voriconazole-induced hepatotoxicity, its pharmacokinetics in this population, and current research on dose optimization. We emphasize the necessity of closely monitoring voriconazole plasma concentration, liver function, and inflammatory markers during treatment. For patients with SLD, we recommend a loading dose of 200 mg every 12 hours, with subsequent maintenance doses reduced to 1/4-1/3 of the standard dose, though the evidence remains limited. We call for large-scale clinical trials to define optimal dosing, efficacy, and safety of voriconazole for IPA in patients with SLD, providing clinicians with clearer treatment guidelines and improving patient outcomes.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101549"},"PeriodicalIF":2.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844234","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":"Epidemiological and Microbiological aspects of Candidozyma auris (Candida auris) in Latin America: A literature review","authors":"Mariana Lanna ,&nbsp;Josefina Lovatto ,&nbsp;João N. de Almeida Junior ,&nbsp;Eduardo A. Medeiros ,&nbsp;Arnaldo L. Colombo ,&nbsp;Guillermo García-Effron","doi":"10.1016/j.mycmed.2025.101546","DOIUrl":"10.1016/j.mycmed.2025.101546","url":null,"abstract":"<div><div>Candidozyma auris (Candida auris) is an emerging multidrug-resistant fungal pathogen that poses a significant public health threat worldwide, particularly in Latin America, where resources for controlling outbreaks may be limited. Since the first case was reported in Venezuela in 2012, the fungus has spread to several other Latin American countries, including Colombia, Panama, Brazil, Mexico, Chile, Peru, and Argentina, manifesting as isolated cases or outbreaks, with varying prevalence. This review provides a comprehensive overview of the epidemiology and microbiological characteristics of <em>C. auris</em> in Latin America. Using data from 2012 to 2024, we examined epidemiological trends, antimicrobial resistance patterns, and the molecular mechanisms underlying resistance in Latin American isolates. Additionally, we discuss factors that may facilitate the spread of <em>C. auris</em> in the region.</div><div>Countries near the equator tend to have higher incidences of <em>C. auris</em> and a greater prevalence of antifungal resistance. Immigration and medical tourism may further contribute to the spread of <em>C. auris</em> to southern countries. However, the lack of laboratory resources and trained personnel remains the primary risk factor for the silent dissemination of <em>C. auris</em> in the region.</div><div>Conclusions: We emphasize the urgent need for coordinated public health responses to improve laboratory capabilities in Latin American hospitals, effectively combating the spread of this pathogen.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101546"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816996","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":"Cerebellar abscess caused by Cladophialophora bantiana involving an elderly Japanese woman","authors":"Kenta Nakamoto ,&nbsp;Hideharu Hagiya ,&nbsp;Shinnosuke Fukushima ,&nbsp;Kohei Oguni ,&nbsp;Yukika Yokoyama ,&nbsp;Koji Iio ,&nbsp;Shuichiro Hirano ,&nbsp;Takashi Yaguchi ,&nbsp;Sayaka Ban ,&nbsp;Akira Watanabe ,&nbsp;Hiroki Okunobu ,&nbsp;Atsuhito Suyama ,&nbsp;Marina Kawaguchi ,&nbsp;Yousuke Sazumi ,&nbsp;Fumio Otsuka","doi":"10.1016/j.mycmed.2025.101548","DOIUrl":"10.1016/j.mycmed.2025.101548","url":null,"abstract":"<div><div>Phaeohyphomycosis is a rare fungal infection that presents significant challenges in diagnosis and treatment. Herein, we document a case of a cerebellar abscess caused by Cladophialophora bantiana. A 77-year-old woman with type 2 diabetes mellitus and a previous history of diffuse large B-cell lymphoma gradually developed ataxia and was transferred to an emergency department. Head imaging investigations indicated a cerebellar mass and the patient underwent an emergent endoscopic drainage. Although bacterial cultures of the drainage specimen yielded no growth, a dematiaceous fungus was isolated and subsequently identified as C. bantiana <em>through ITS sequencing analysis. The patient received antifungal combination therapy, initially with</em> liposomal amphotericin B and voriconazole, and finally posaconazole and 5-fluorocytosine. Brain abscesses caused by C. bantiana are rarely documented, and an optimal treatment strategy has yet to be established. Given the high fatality rate, an early surgical intervention is crucial for both diagnosis and treatment. The present case was successfully treated with minimally invasive surgical intervention alongside the antifungal combination therapy.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101548"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737803","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":"Invasive fungal infection caused by Magnusiomyces capitatus in a pediatric patient with Burkitt lymphoma: Case report and review of literature","authors":"Jose Antonio Soler-Simón ,&nbsp;Diannet Quintero-García ,&nbsp;Álvaro Pou-Blázquez ,&nbsp;María José González-Abad ,&nbsp;David Ruano-Domínguez ,&nbsp;Amelia Martínez-de-Azagra-Garde ,&nbsp;Montserrat Nieto-Moro ,&nbsp;Marta Taida García-Ascaso","doi":"10.1016/j.mycmed.2025.101547","DOIUrl":"10.1016/j.mycmed.2025.101547","url":null,"abstract":"<div><h3>Introduction</h3><div>invasive fungal infection is a serious problem in immunosuppressed patients, particularly those with hematological or oncological diseases. Recently, more cases of emerging pathogens, such as <em>Magnusiomyces capitatus,</em> have been reported.</div></div><div><h3>Clinical case</h3><div>a 4-year-old male diagnosed with stage IV sphenoidal Burkitt lymphoma, undergoing immunosuppressive treatment and with severe neutropenia, developed sepsis of abdominal origin, requiring admission to the Intensive Care Unit. He received empirical antibiotic and antifungal therapy, with isolation of <em>M. capitatus</em> in blood cultures and peritoneal fluid. Despite adjusting antifungal therapy, the patient died 15 days after due to the progression of the invasive fungal infection.</div></div><div><h3>Discussion</h3><div><em>M. capitatus</em> infections are reported more frequently in immunocompromised patients. A review of pediatric cases published in the literature identified a total of 16 cases (8 males and 8 females, median age 6 years). Most cases had an underlying hemato-oncological disease and were in an immunosuppressed state. In contradistinction to what is observed in adults, only three cases (18.8 %) had received antifungal prophylaxis. <em>M. capitatus</em> is a dimorphic yeast that is intrinsically resistant to echinocandins and has a significant mortality rate, both in studied series and in ours (50 %).</div></div><div><h3>Conclusions</h3><div>a rapid and accurate diagnosis of <em>M. capitatus</em> infection is essential to control invasive fungal infection, which could improve patient survival.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101547"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816998","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":"Head skin infection by Candida auris: A case report","authors":"Jueting Tang,&nbsp;Kaiying Yang,&nbsp;Zhixin Cui,&nbsp;Yanhong Guan,&nbsp;Zelun Li","doi":"10.1016/j.mycmed.2025.101544","DOIUrl":"10.1016/j.mycmed.2025.101544","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida auris</em> is a recently discovered yeast species first found in 2009 in the ear discharge of a patient in Japan. Known for its high mortality rate, strong transmissibility, ability to cause hospital outbreaks, and resistance to multiple drugs, it has earned the nickname \"superbug\". Currently, there are five main clades of <em>Candida auris</em> identified, including the South Asian, East Asian, South African, South American, and a newly discovered fifth clade in Iran. Infection cases have been documented in over 40 countries across six continents, drawing global attention. In 2022, the World Health Organization (WHO) designated <em>Candida auris</em> as a top priority pathogen in their inaugural list of fungal threats to health. The lack of standardized and effective treatment protocols and prevention strategies has resulted in numerous treatment and control failures. To delve deeper into the clinical management strategies and hospital infection control measures for Candida auris, we conducted a retrospective analysis of a <em>Candida auris</em> infection case and briefly reviewed relevant literature.</div></div><div><h3>Case presentation</h3><div>A 54-year-old male patient with a complex medical history developed a <em>Candida auris</em> infection, presenting with ulcerative scalp lesions. The medical team implemented local wound care measures, including iodophor disinfection and infrared therapy, and strictly adhered to the hospital's infection control protocols, successfully controlling the <em>Candida auris</em> infection without any nosocomial transmission.</div></div><div><h3>Conclusion</h3><div>This case study highlights the importance of individualized treatment and tailored infection control measures implemented through interdisciplinary teamwork. The successful management underscores the potential for containing the spread of Candida auris, offering valuable insights for future strategies against this emerging multidrug-resistant pathogen. However, the complex challenges in diagnosing, treating, and controlling <em>Candida auris</em> infections emphasize the imperative need to enhance research and establish standardized protocols.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101544"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698034","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":"Disseminated infection with Candida dubliniensis after ravulizumab and treatment with rezafungin – a case report","authors":"Felix Lötsch ,&nbsp;Michael Eder ,&nbsp;Haris Omic ,&nbsp;Konstantin Doberer ,&nbsp;Martina Scharitzer ,&nbsp;Matthias G. Vossen ,&nbsp;Gabriella Muraközy ,&nbsp;Birgit Willinger ,&nbsp;Christof Aigner","doi":"10.1016/j.mycmed.2025.101545","DOIUrl":"10.1016/j.mycmed.2025.101545","url":null,"abstract":"","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101545"},"PeriodicalIF":2.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal microbiota in COPD patients during exacerbations","authors":"Weronika Gawor ,&nbsp;Katarzyna Góralska ,&nbsp;Sandra Galant ,&nbsp;Sebastian Majewski ,&nbsp;Wojciech Piotrowski ,&nbsp;Joanna Miłkowska-Dymanowska ,&nbsp;Justyna Kiszałkiewicz ,&nbsp;Ewa Brzeziańska-Lasota","doi":"10.1016/j.mycmed.2025.101543","DOIUrl":"10.1016/j.mycmed.2025.101543","url":null,"abstract":"<div><div>Acute exacerbations of chronic obstructive pulmonary disease (COPD) results in increased mortality and can be triggered by a range of factors, including microorganisms. Very little studies have examined the role of fungi and fungal diversity in COPD patients. The aim of the study was to determine the role of <em>Candida</em> in COPD during an exacerbation. Oral swabs, sputum, feces and whole blood samples were collected from the AECOPD patients and control group. Mycological and serological analysis were performed. Yeast were statistically significantly more often isolated from the AECOPD group (97.06%) than from the control group (26.32%). 7 species were isolated from the AECOPD, and 3 from the control group. Dominated <em>Candida albicans</em> followed by <em>C. tropicalis</em>. α-diversity was much greater in AECOPD patients than in controls. β-diversity was also assessed. A much higher level of antimycotic resistance was observed in isolates from the AECOPD group, which affects the effectiveness of therapy. Serological tests showed twice the frequency of positive results in the AECOPD group. The mycobiota of AECOPD patients is numerically and taxonomically richer than controls, including species less frequently recorded in humans. Our research confirms that fungal mycobiota may be a potential factor influencing the development of exacerbations and progression of COPD.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101543"},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636895","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":"Fungal Endocarditis in neonates: Case report and review of 79 cases (1983 to 2024)","authors":"Natália Daiane Garoni Martins ,&nbsp;Beatriz dos Santos Bezerra ,&nbsp;Cinthya Alves Esteves ,&nbsp;Luana Rossato","doi":"10.1016/j.mycmed.2025.101542","DOIUrl":"10.1016/j.mycmed.2025.101542","url":null,"abstract":"<div><h3>Purpose</h3><div>Fungal endocarditis in neonates poses a significant clinical challenge, with limited comprehensive data available. The aim of this study was describe a case report and further characterize demographic and clinical aspects of fungal endocarditis in neonates.</div></div><div><h3>Methods</h3><div>We present, a case report of a very low birth weight infant with fungal endocarditis. We also conducted a thorough analysis of 79 documented clinical cases, exploring demographics, clinical characteristics, treatment strategies, and outcomes.</div></div><div><h3>Results</h3><div>The temporal distribution revealed varied trends over the years. The United States had the highest case count, followed by India, Turkey, and Israel. Prematurity was predominant, with extremely low birth weight neonates being most affected. Congenital malformations were present in 10.2 % of cases. Surgical interventions, particularly for vegetative mass removal, were common. <em>Candida albicans</em> was the primary pathogen, followed by <em>Candida parapsilosis</em>. Catheter use was strongly associated with the majority of cases. The overall mortality rate was 38 %. Higher mortality was observed in neonates receiving monotherapy compared to those on combination therapy. Mortality was also significantly higher in neonates with prior bacteremia or fungemia and in those receiving antibiotic therapy without confirmed bacteremia. Conversely, postoperative mortality associated with surgery was 36.4 %, slightly lower than the overall mortality rate, suggesting that surgery may not represent an increased risk.</div></div><div><h3>Conclusion</h3><div>Our study provides comprehensive insights into fungal endocarditis in neonates, highlighting the need for tailored management strategies to improve outcomes.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101542"},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746398","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}