Journal of Infection and Public Health最新文献

{"title":"Addressing antimicrobial resistance: Structural insights into cefiderocol’s mode of action and emerging resistance mechanisms","authors":"Mohd Zulkifli Salleh","doi":"10.1016/j.jiph.2025.102871","DOIUrl":"10.1016/j.jiph.2025.102871","url":null,"abstract":"<div><div>Cefiderocol represents a significant advancement in the treatment of multidrug-resistant Gram-negative bacterial infections. Its unique uptake mechanism, leveraging bacterial iron transport pathways for membrane permeation, sets it apart from conventional β-lactam antibiotics. Through its siderophore-mediated drug uptake, cefiderocol efficiently bypasses outer membrane barriers, allowing it to target and penetrate resistant pathogens, including those resistant to carbapenems and other antibiotics. This distinct property positions cefiderocol as a promising therapeutic option for infections caused by <em>Pseudomonas aeruginosa</em>, <em>Acinetobacter baumannii</em>, and Enterobacterales. Despite its promise, resistance to cefiderocol is emerging, driven by mutations in penicillin-binding proteins, impaired siderophore transporter systems, and β-lactamase production. These mechanisms disrupt antibiotic binding, compromise iron transport, and enzymatically inactivate cefiderocol, respectively, limiting its efficacy. This review examines cefiderocol's innovative mode of entry, therapeutic potential, and the challenges posed by resistance, offering insights into its role in the fight against multidrug-resistant pathogens.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102871"},"PeriodicalIF":4.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and safety of 7-day versus 14-day antibiotic therapy for bloodstream infections in adults: A systematic review and meta-analysis with trial sequential analysis","authors":"Chen-Wei Wu ,&nbsp;Chih-Cheng Lai ,&nbsp;Jheng-Yan Wu ,&nbsp;Mei-Chuan Lee","doi":"10.1016/j.jiph.2025.102852","DOIUrl":"10.1016/j.jiph.2025.102852","url":null,"abstract":"<div><div>The optimal duration of antibiotic therapy for bloodstream infections (BSIs) remains uncertain. This meta-analysis with trial sequential analysis (TSA) compared the efficacy and safety of 7-day versus 14-day antibiotic courses in adults. A systematic search of PubMed, Embase, and Cochrane Library identified four randomized controlled trials (4794 patients). The 7-day course showed similar 90-day all-cause mortality (RR 0.94, 95 % CI 0.79–1.12, <em>p</em> = 0.51) and bacteremia relapse rates (RR 1.15, 95 % CI 0.80–1.64, <em>p</em> = 0.45) compared to 14 days. No significant differences were found in adverse events, including acute kidney injury, diarrhea, allergic reactions, and <em>Clostridioides difficile</em> infections. TSA indicated an insufficient information size. While 90-day mortality is an objective endpoint, it may not fully capture clinical recovery or long-term sequelae. Nonetheless, the findings indicate that a 7-day antibiotic course achieves outcomes comparable to a 14-day regimen in non–high-risk patients, supporting shorter durations consistent with antimicrobial stewardship.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102852"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological insights into MERS-CoV dynamics of antibody responses during acute and convalescent phases and their clinical relevance for diagnostics and immunity","authors":"Khalid J. Shrwani ,&nbsp;Ahmad M. Alharbi ,&nbsp;Waleed H. Mahallawi ,&nbsp;Ayed Y. Asiri ,&nbsp;Abdullah M. Assiri ,&nbsp;Abdullah Algaissi ,&nbsp;Anwar M. Hashem ,&nbsp;Radi Alsafi ,&nbsp;Mohammed A. Jubran ,&nbsp;Eyad Gadour ,&nbsp;Soha A. Alghamdi ,&nbsp;Ezzuddin A. Okmi ,&nbsp;Nabil Dhayhi ,&nbsp;Hassan A. Asiri ,&nbsp;Zaki M. Eisa ,&nbsp;Nigel Cunliffe ,&nbsp;Qibo Zhang","doi":"10.1016/j.jiph.2025.102854","DOIUrl":"10.1016/j.jiph.2025.102854","url":null,"abstract":"<div><h3>Introduction</h3><div>Middle East respiratory syndrome (MERS) is a zoonotic viral respiratory disease caused by the Middle East respiratory syndrome coronavirus (MERS-CoV), associated with severe clinical outcomes and high mortality.</div></div><div><h3>Objectives</h3><div>Our study examined the kinetics of anti-MERS-CoV IgM and IgG antibodies during the acute and convalescent phases of infection, focusing on their correlations with clinical variables such as age and viral load.</div></div><div><h3>Methods</h3><div>Serum samples were collected from PCR-confirmed MERS-CoV patients (n = 23) during both phases and compared to healthy controls (n = 23) using validated ELISA-based assays.</div></div><div><h3>Results</h3><div>IgM levels peaked in the acute phase and declined significantly in the convalescent phase, while IgG levels were sustained and markedly higher during recovery. Correlation analyses revealed positive relationships between antibody levels and patient age (acute IgM: r = 0.56, p &lt; 0.01; convalescent IgG: r = 0.59, p &lt; 0.01) and viral loads (acute IgM: r = 0.97, p &lt; 0.0001; acute IgG: r = 0.87, p &lt; 0.0001; convalescent IgG: r = 0.91, p &lt; 0.0001). These results concluded that age-associated enhancements in antibody responses and the role of humoral immunity in viral clearance.</div></div><div><h3>Conclusion</h3><div>The current study highlights the diagnostic value of anti-MERS-CoV IgM and IgG measurements and their utility in developing therapeutic and vaccine strategies adapted to high-risk populations.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102854"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review","authors":"Bertrand Drugeon ,&nbsp;Claire M. Rickard ,&nbsp;Jessica A. Schults ,&nbsp;Jérémy Guenezan ,&nbsp;Olivier Mimoz","doi":"10.1016/j.jiph.2025.102851","DOIUrl":"10.1016/j.jiph.2025.102851","url":null,"abstract":"<div><div>Healthcare-associated infections remain a major concern, with vascular access devices contributing substantially to infection risk. Effective skin disinfection is essential for preventing catheter-related infections (CRIs). This narrative review compares the efficacy and safety of chlorhexidine gluconate (CHG) and povidone-iodine (PVI), while also addressing often-underexamined factors such as product availability, application techniques, antimicrobial resistance and environmental impact. Evidence supports the use of 2 % CHG in 70 % isopropyl alcohol as the most effective strategy to reduce CRIs, although PVI remains an alternative in patients with CHG intolerance or in low-resource settings. Environmental analyses highlight the higher persistence and potential ecological risk of CHG compared with PVI. Despite widespread guidelines, significant discrepancies persist in recommended concentrations, application methods, and target populations. Based on literature synthesis, we propose standardising the use of 2 % CHG-IPA where feasible, developing tailored recommendations for high-risk groups, and incorporating environmental and economic considerations into future infection prevention strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102851"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiographic alterations in patients treated for acute Lassa Fever: Description of results from a phase II clinical trial in Nigeria","authors":"Cyril Erameh ,&nbsp;Oladele Oluwafemi Ayodeji ,&nbsp;Augusto Meneguim ,&nbsp;Kevin Okwaraeke ,&nbsp;Osahogie Edeawe ,&nbsp;Enomen Ekata ,&nbsp;ThankGod Akhigbe ,&nbsp;Nelson Adedosu ,&nbsp;Chukwuyem Abejegah ,&nbsp;Sampson Owhin ,&nbsp;Liasu Ahmed ,&nbsp;Till Omansen ,&nbsp;Meike Pahlmann ,&nbsp;Georg Goliasch ,&nbsp;Alexandre Duvignaud ,&nbsp;Peter Akhideno ,&nbsp;Sylvanus Okogbenin ,&nbsp;Stephan Günther ,&nbsp;Marie Jaspard ,&nbsp;Michael Ramharter ,&nbsp;Mirjam Groger","doi":"10.1016/j.jiph.2025.102858","DOIUrl":"10.1016/j.jiph.2025.102858","url":null,"abstract":"<div><h3>Background</h3><div>Lassa virus (LASV) leads to high case fatality among hospitalized patients in West Africa. While the pathophysiology of the disease is poorly understood, cardiac pathology is suspected to constitute an important feature of severe Lassa Fever (LF). We report an analysis of electrocardiogram (ECG) findings of patients enrolled in a clinical trial comparing ribavirin with favipiravir for the treatment of LF.</div></div><div><h3>Methods</h3><div>This randomized controlled open-label phase II clinical trial conducted at two reference hospitals for LF treatment in Nigeria, assessed the tolerability, safety and pharmacokinetics of favipiravir compared to ribavirin in the treatment of acute LF. Hospitalized adult participants with RT-PCR-confirmed mild LF were eligible to participate. Baseline and follow-up ECG readings were performed.</div></div><div><h3>Findings</h3><div>From August 2021 to October 2022, 40 patients were included in the study (48 % female), and 36 completed the 10-day follow-up period. ECG alterations were similarly distributed between treatment arms and observed in 18 (45 %) participants, namely, T-wave inversion (n = 14; 35 %), conduction disorders (n = 5; 13 %), ST-segment elevation (n = 4; 10 %), and arrythmia (n = 2; 5 %). 36 % (n = 9) of the alterations observed subsided by the end of the study.</div></div><div><h3>Interpretation</h3><div>ECG alterations observed in both treatment arms are compatible with direct cardiac effects of the LASV. The combination of new onset of chest pain combined with the evolution of ECG findings over time are suggestive for the occurrence of perimyocarditis in a subset of patients.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102858"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-center retrospective study on Basidiobolomycosis: Characteristics, management, and outcomes","authors":"Huda Abbag ,&nbsp;Alaa Al Juaid ,&nbsp;Ahmad Alghamdi ,&nbsp;Fatimah Alturkistani","doi":"10.1016/j.jiph.2025.102853","DOIUrl":"10.1016/j.jiph.2025.102853","url":null,"abstract":"<div><div>Gastrointestinal basidiobolomycosis (GIB), a rare fungal infection caused by Basidiobolus ranarum, primarily affects children in tropical regions and often mimics other conditions, leading to delayed diagnosis. This study retrospectively analyzes nine pediatric cases of GIB diagnosed between 2013 and 2023 at a tertiary care center in Saudi Arabia. Patients had a median age of five years, with abdominal symptoms being the most common presentation (77.7 %). Laboratory findings included leukocytosis, eosinophilia, and elevated inflammatory markers. The ascending colon was the most frequently affected site (44.4 %). Histopathological examination confirmed fungal elements in all cases. All patients received voriconazole; 22.2 % were treated with both voriconazole and itraconazole. The mean treatment duration was 16 months. Complete resolution was achieved in 44.4 % of patients, while 22.2 % were lost to follow-up, and 22.2 % remained under treatment. GIB requires a high index of suspicion, particularly in patients with abdominal masses and eosinophilia. Diagnosis using minimally invasive methods and antifungal therapy, particularly voriconazole-based regimens, appear effective in managing this condition.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102853"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of surgical site infections post-cesarean section in Saudi Arabia: A systematic review and meta-analysis","authors":"Najim Z. Alshahrani ,&nbsp;Abdulrahman M. Albeshry ,&nbsp;Mohammed A. Aljunaid ,&nbsp;Mohammed A. Kilani","doi":"10.1016/j.jiph.2025.102855","DOIUrl":"10.1016/j.jiph.2025.102855","url":null,"abstract":"<div><div>This systematic review and meta-analysis evaluated the prevalence, risk factors, and outcomes of surgical site infections (SSIs) following cesarean sections (C/S) in Saudi Arabia, a significant public health concern impacting maternal morbidity and hospital stays. Seven studies, including 7632 women, were analyzed. The pooled prevalence of SSIs post-cesarean section was 3 % (95 % CI: 2 %–4 %), with substantial heterogeneity across studies (I² = 81.8 %). Consistently identified risk factors included Pre-existing diabetes mellitus, Obesity (BMI ≥ 30), and prolonged surgery duration, while hypertension, premature rupture of membranes, and gestational age showed no significant association with SSIs. Most infections were managed effectively with systemic antibiotics, and maternal outcomes were generally favorable, although some cases required prolonged recovery or neonatal intensive care admission. Staphylococcus aureus and Escherichia coli were among the most common causative pathogens. These findings underscore the need for enhanced preventive strategies and standardized protocols to reduce SSI rates and improve maternal and neonatal health outcomes in Saudi Arabia.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102855"},"PeriodicalIF":4.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burkholderia cepacia ST 767 causing a three-year nosocomial outbreak in a hemodialysis unit","authors":"Stéfani T.A. Dantas ,&nbsp;Gousilin R. Silva ,&nbsp;Iranildo A. Fernandes ,&nbsp;Ary Fernandes Júnior ,&nbsp;José C.F. Pantoja ,&nbsp;Carlos H. Camargo ,&nbsp;Juliano L. Gonçalves ,&nbsp;Ivana G. Castilho ,&nbsp;Nathália C.C. Silva ,&nbsp;Vera L.M. Rall","doi":"10.1016/j.jiph.2025.102843","DOIUrl":"10.1016/j.jiph.2025.102843","url":null,"abstract":"<div><h3>Background</h3><div>The risk of bloodstream infections increases in patients undergoing chronic hemodialysis, primarily due to water contamination or improper handling during dialyzer reprocessing. This study aimed to identify virulence factors and gather epidemiological data on the <em>Burkholderia cepacia</em> complex (Bcc), isolated from water and blood cultures during an outbreak in a hemodialysis unit.</div></div><div><h3>Methods</h3><div>We analyzed 33 Bcc isolates from blood cultures of patients with bacteremia undergoing hemodialysis and 24 isolates from water samples collected between 2019 and 2022. All isolates were tested for virulence factor-encoding genes, including <em>cblA</em>, <em>esmR</em>, <em>zmpA</em>, and <em>zmpB</em>, using polymerase chain reaction (PCR) assays. The isolates were further characterized using Multi-Locus Sequence Typing (MLST) and Pulsed-Field Gel Electrophoresis (PFGE). Biofilm production was assessed on polystyrene microplates at 20°C and 35°C.</div></div><div><h3>Results</h3><div>The genes <em>zmpB</em> and <em>zmpA</em> were present in 100 % and 96.5 % of the isolates, respectively. However, none of the isolates carried the <em>cblA</em> or <em>esmR</em> genes. Within the Bcc, the species <em>B. cepacia</em> (genomovar I) was identified through <em>recA</em> gene sequencing. PFGE analysis revealed that all human- and water-derived isolates shared the same pulsotype, classified as ST-767.</div></div><div><h3>Conclusions</h3><div>Despite routine water disinfection with peracetic acid, the detection of a single pulsotype of this species over three years indicates the persistent of <em>Burkholderia cepacia</em> ST 767 in the plumbing system, leading to the contamination of patients undergoing hemodialysis. This persistence is likely facilitated by biofilm formation, as all water-derived isolates demonstrated biofilm production at 20°C. To exacerbate the situation, all isolates exhibited multidrug resistance, further complicating patient treatment and management.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102843"},"PeriodicalIF":4.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of dengue fever vulnerability in south and southeast asian countries: A multidimensional approach","authors":"Yawen Wang ,&nbsp;Conglu Li ,&nbsp;Shi Zhao ,&nbsp;Guozhang Lin ,&nbsp;Xiaoting Jiang ,&nbsp;Shi Yin ,&nbsp;Mu He ,&nbsp;Qianyu Wu ,&nbsp;Zihao Guo ,&nbsp;Yuchen Wei ,&nbsp;Chao Ren ,&nbsp;Ka Chun Chong","doi":"10.1016/j.jiph.2025.102849","DOIUrl":"10.1016/j.jiph.2025.102849","url":null,"abstract":"<div><h3>Background</h3><div>Climate change is raising the risk of dengue fever outbreaks in South and Southeast Asia, where public health challenges persist. Warmer temperatures promote year-round mosquito breeding and pathogen transmission, particularly in crowded urban areas. This underscores the urgent need for a comprehensive assessment to develop effective prevention strategies and improve health outcomes. This study evaluated the relationship between dengue fever vulnerability and disease incidence in three countries in the region.</div></div><div><h3>Methods</h3><div>Monthly dengue surveillance data from 2012 to 2018 were collected in Sri Lanka, Malaysia, and Thailand, alongside environmental and socioeconomic data. Principal component analysis and binomial regression model were used to calculate the vulnerability index and evaluate the relationship between dengue infection, vulnerability, and its seasonality.</div></div><div><h3>Results</h3><div>The results indicated significant spatial variations in vulnerability across the three countries. High-vulnerability regions included western coastal Sri Lanka, western and southern Thailand, and eastern Malaysia, with notable seasonal fluctuations in high-risk areas. Areas with higher vulnerability levels were associated with increased dengue fever incidence rate ratios (IRRs), particularly in Sri Lanka (IRR= 1.97, 95 % confidence interval [CI]: 1.08–3.65) and Thailand (IRR= 14.56, 95 % CI: 5.55–39.90). Notably, the IRR increased significantly during the warm seasons, particularly in August in Sri Lanka (high vs. low, IRR= 6.11, 95 % CI: 2.83–13.47) and in June in Thailand (middle-high vs. low, IRR= 23.61, 95 % CI: 9.39–61.67).</div></div><div><h3>Conclusions</h3><div>The spatial heterogeneity of dengue vulnerability suggests that targeted public health interventions are essential for mitigating dengue fever risks, particularly in regions vulnerable to climate change.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102849"},"PeriodicalIF":4.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlling the rising burden of the human metapneumovirus (hMPV) infections in vulnerable populations in China","authors":"Amira M. Taha ,&nbsp;Cameron J. Sabet ,&nbsp;Dang Nguyen,&nbsp;Alfonso J. Rodriguez-Morales","doi":"10.1016/j.jiph.2025.102844","DOIUrl":"10.1016/j.jiph.2025.102844","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102844"},"PeriodicalIF":4.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}