MMWR. Morbidity and mortality weekly report最新文献

{"title":"Notes from the Field: Suspected Outbreak of Trichinellosis Associated with Undercooked Bear Meat - North Carolina, November 2023.","authors":"Camden D Gowler, Nicole Lee, Tammra Morrison, Vivian Mears, Carl Williams, Aaron Fleischauer, Erica Wilson","doi":"10.15585/mmwr.mm7340a4","DOIUrl":"10.15585/mmwr.mm7340a4","url":null,"abstract":"","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 40","pages":"906-907"},"PeriodicalIF":25.4,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults - National Center for Health Statistics Rapid Surveys System, United States, October-November 2023.","authors":"Brooke S Staley, Lara R Robinson, Angelika H Claussen, Samuel M Katz, Melissa L Danielson, April D Summers, Sherry L Farr, Stephen J Blumberg, Sarah C Tinker","doi":"10.15585/mmwr.mm7340a1","DOIUrl":"10.15585/mmwr.mm7340a1","url":null,"abstract":"<p><p>Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that develops during childhood and can last into adulthood. Data from the National Center for Health Statistics Rapid Surveys System collected during October-November 2023 were used to estimate the prevalence of ADHD diagnosis and treatment among U.S. adults. In 2023, an estimated 15.5 million U.S. adults (6.0%) had a current ADHD diagnosis based on self-report; approximately one half received the diagnosis at age ≥18 years. Approximately one third of adults with ADHD took a stimulant medication to treat their ADHD in the previous year, 71.5% of whom had difficulty getting their ADHD prescription filled because it was unavailable. Approximately one half of adults with ADHD have ever used telehealth for ADHD-related services. Telehealth might have benefits for persons with ADHD, including helping them access behavioral treatment or medication prescriptions for ADHD. This report provides national estimates of the prevalence and treatment of ADHD among U.S. adults to help guide clinical care and regulatory decision-making for ADHD among U.S. adults.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 40","pages":"890-895"},"PeriodicalIF":25.4,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burkholderia multivorans Infections Associated with Use of Ice and Water from Ice Machines for Patient Care Activities - Four Hospitals, California and Colorado, 2020-2024.","authors":"Axel A Vazquez Deida, Kevin B Spicer, Kiara X McNamara, Matthew J Arduino, Paige Gable, Alison L Halpin, Lindsay J Caverly, John J LiPuma, Braden Bardach, Cayla Mayle, Samuel N Baird, Christopher A Czaja, Raymond Chinn, Jane D Siegel, Kiran M Perkins","doi":"10.15585/mmwr.mm7339a4","DOIUrl":"10.15585/mmwr.mm7339a4","url":null,"abstract":"<p><p>Ice machines can harbor water-related organisms, and the use of ice or tap water for clinical care activities has been associated with infections in health care settings. During 2021-2022, a total of 23 cases of infection by Burkholderia multivorans (sequence type ST659) were reported at two southern California hospitals and linked to contaminated ice and water from ice machines. In addition to these 23 cases, this report also includes 23 previously unreported cases of B. multivorans ST659 infections that occurred during 2020-2024: 13 at a northern California hospital, eight at a hospital in Colorado, and two additional cases at one of the southern California hospitals. The same brand of ice machine and brands of filters, descaling, and sanitizing products were used by all four hospitals; B. multivorans was isolated from samples collected from ice machines in two of the hospitals. Whole genome sequencing indicated that all clinical and ice machine isolates were highly genetically similar (0-14 single nucleotide variant differences across 81% of the selected reference genome). Recommendations from public health officials to halt the outbreak included avoiding ice and tap water during clinical care activities. An investigation is ongoing to determine possible sources of ice machine contamination. During outbreaks of water-related organisms in health care facilities, health care personnel should consider avoiding the use of tap water, including ice and water from ice machines, for patient care.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 39","pages":"883-887"},"PeriodicalIF":25.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"QuickStats: Rates of Emergency Department Visits* for Children and Adolescents with Acute Upper Respiratory Infection,^† by Age Group - United States, 2021-2022.","authors":"","doi":"10.15585/mmwr.mm7339a5","DOIUrl":"10.15585/mmwr.mm7339a5","url":null,"abstract":"","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 39","pages":"888"},"PeriodicalIF":25.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19-Associated Hospitalizations Among U.S. Adults Aged ≥18 Years - COVID-NET, 12 States, October 2023-April 2024.","authors":"Christopher A Taylor, Kadam Patel, Huong Pham, Pam Daily Kirley, Breanna Kawasaki, James Meek, Lucy Witt, Patricia A Ryan, Libby Reeg, Kathy Como-Sabetti, Adrienne Domen, Bridget Anderson, Sophrena Bushey, Melissa Sutton, H Keipp Talbot, Emma Mendez, Fiona P Havers","doi":"10.15585/mmwr.mm7339a2","DOIUrl":"10.15585/mmwr.mm7339a2","url":null,"abstract":"<p><p>Among adults, COVID-19 hospitalization rates increase with age. Data from the COVID-19-Associated Hospitalization Surveillance Network were analyzed to estimate population-based COVID-19-associated hospitalization rates during October 2023-April 2024 and identify demographic and clinical characteristics of adults aged ≥18 years hospitalized with COVID-19. Adults aged ≥65 years accounted for 70% of all adult COVID-19-associated hospitalizations, and their COVID-19-associated hospitalization rates were higher than those among younger adult age groups. Cumulative rates of COVID-19-associated hospitalization during October 2023-April 2024 were the lowest for all adult age groups during an October-April surveillance period since 2020-2021. However, hospitalization rates among all adults aged ≥75 years approached one COVID-19-associated hospitalization for every 100 persons. Among adults hospitalized with COVID-19, 88.1% had not received the 2023-2024 formula COVID-19 vaccine before hospitalization, 80.0% had multiple underlying medical conditions, and 16.6% were residents of long-term care facilities (LTCFs). Guidance for adults at high risk for severe COVID-19 illness, including adults aged ≥65 years and residents of LTCFs, should continue to focus on adopting measures to reduce risk for contracting COVID-19, advocating for receipt of recommended COVID-19 vaccinations, and seeking prompt outpatient antiviral treatment after receipt of a positive SARS-CoV-2 test result.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 39","pages":"869-875"},"PeriodicalIF":25.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in COVID-19 Outpatient Antiviral Treatment Among Adults Aged ≥65 Years by Age Group - National Patient-Centered Clinical Research Network, United States, April 2022-September 2023.","authors":"Claire M Quinlan, Melisa M Shah, Carol E DeSantis, J Bradford Bertumen, Christine Draper, Faraz S Ahmad, Jonathan Arnold, Kenneth H Mayer, Thomas W Carton, Lindsay G Cowell, Samantha Smith, Sharon Saydah, Jefferson M Jones, Pragna Patel, Melissa Briggs Hagen, Jason Block, Emily H Koumans","doi":"10.15585/mmwr.mm7339a3","DOIUrl":"10.15585/mmwr.mm7339a3","url":null,"abstract":"<p><p>Adults aged ≥65 years experience the highest risk for COVID-19-related hospitalization and death, with risk increasing with increasing age; outpatient antiviral treatment reduces the risk for these severe outcomes. Despite the proven benefit of COVID-19 antiviral treatment, information on differences in use among older adults with COVID-19 by age group is limited. Nonhospitalized patients aged ≥65 years with COVID-19 during April 2022-September 2023 were identified from the National Patient-Centered Clinical Research Network. Differences in use of antiviral treatment among patients aged 65-74, 75-89, and ≥90 years were assessed. Multivariable logistic regression was used to estimate the association between age and nonreceipt of antiviral treatment. Among 393,390 persons aged ≥65 years, 45.9% received outpatient COVID-19 antivirals, including 48.4%, 43.5%, and 35.2% among those aged 65-75, 76-89, and ≥90 years, respectively. Patients aged 75-89 and ≥90 years had 1.17 (95% CI = 1.15-1.19) and 1.54 (95% CI = 1.49-1.61) times the adjusted odds of being untreated, respectively, compared with those aged 65-74 years. Among 12,543 patients with severe outcomes, 2,648 (21.1%) had received an outpatient COVID-19 antiviral medication, compared with 177,874 (46.7%) of 380,847 patients without severe outcomes. Antiviral use is underutilized among adults ≥65 years; the oldest adults are least likely to receive treatment. To prevent COVID-19-associated morbidity and mortality, increased use of COVID-19 antiviral medications among older adults is needed.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 39","pages":"876-882"},"PeriodicalIF":25.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interim Effectiveness Estimates of 2024 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Hospitalization - REVELAC-i Network, Five South American Countries, March-July 2024.","authors":"Erica E Zeno, Francisco Nogareda, Annette Regan, Paula Couto, Marc Rondy, Jorge Jara, Carla Voto, Maria Paz Rojas Mena, Nathalia Katz, Maria Del Valle Juarez, Estefanía Benedetti, Francisco José de Paula Júnior, Walquiria Aparecida Ferreira da Almeida, Carlos Edson Hott, Paula Rodríguez Ferrari, Natalia Vergara Mallegas, Marcela Avendaño Vigueras, Chavely Domínguez, Marta von Horoch, Cynthia Vazquez, Eduardo Silvera, Hector Chiparelli, Natalia Goni, Laura Castro, Perrine Marcenac, Rebecca J Kondor, Juliana Leite, Martha Velandia, Eduardo Azziz-Baumgartner, Ashley L Fowlkes, Daniel Salas","doi":"10.15585/mmwr.mm7339a1","DOIUrl":"10.15585/mmwr.mm7339a1","url":null,"abstract":"<p><p>To reduce influenza-associated morbidity and mortality, countries in South America recommend annual influenza vaccination for persons at high risk for severe influenza illness, including young children, persons with preexisting health conditions, and older adults. Interim estimates of influenza vaccine effectiveness (VE) from Southern Hemisphere countries can provide early information about the protective effects of vaccination and help guide Northern Hemisphere countries in advance of their season. Using data from a multicountry network, investigators estimated interim VE against influenza-associated severe acute respiratory illness (SARI) hospitalization using a test-negative case-control design. During March 13-July 19, 2024, Argentina, Brazil, Chile, Paraguay, and Uruguay identified 11,751 influenza-associated SARI cases; on average, 21.3% of patients were vaccinated against influenza, and the adjusted VE against hospitalization was 34.5%. The adjusted VE against the predominating subtype A(H3N2) was 36.5% and against A(H1N1)pdm09 was 37.1%. These interim VE estimates suggest that although the proportion of hospitalized patients who were vaccinated was modest, vaccination with the Southern Hemisphere influenza vaccine significantly lowered the risk for hospitalization. Northern Hemisphere countries should, therefore, anticipate the need for robust influenza vaccination campaigns and early antiviral treatment to achieve optimal protection against influenza-associated complications.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 39","pages":"861-868"},"PeriodicalIF":25.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress Toward Poliomyelitis Eradication - Pakistan, January 2023-June 2024.","authors":"Chukwuma Mbaeyi, Anwaar Ul Haq, Rana Muhammad Safdar, Zainul Khan, Melissa Corkum, Elizabeth Henderson, Zubair M Wadood, Muhammad Masroor Alam, Richard Franka","doi":"10.15585/mmwr.mm7336a2","DOIUrl":"10.15585/mmwr.mm7336a2","url":null,"abstract":"<p><p>Since its launch in 1988, the Global Polio Eradication Initiative has made substantial progress toward the eradication of wild poliovirus (WPV), including eradicating two of the three serotypes, and reducing the countries with ongoing endemic transmission of WPV type 1 (WPV1) to just Afghanistan and Pakistan. Both countries are considered a single epidemiologic block. Despite the occurrence of only a single confirmed WPV1 case during the first half of 2023, Pakistan experienced widespread circulation of WPV1 over the subsequent 12 months, specifically in the historical reservoirs of the cities of Karachi, Peshawar, and Quetta. As of June 30, 2024, eight WPV1 cases had been reported in Pakistan in 2024, compared with six reported during all of 2023. These cases, along with more than 300 WPV1-positive environmental surveillance (sewage) samples reported during 2023-2024, indicate that Pakistan is not on track to interrupt WPV1 transmission. The country's complex sociopolitical and security environment continues to pose formidable challenges to poliovirus elimination. To interrupt WPV1 transmission, sustained political commitment to polio eradication, including increased accountability at all levels, would be vital for the polio program. Efforts to systematically track and vaccinate children who are continually missed during polio vaccination activities should be enhanced by better addressing operational issues and the underlying reasons for community resistance to vaccination and vaccine hesitancy.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 36","pages":"788-792"},"PeriodicalIF":25.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptospirosis Outbreak in Aftermath of Hurricane Fiona - Puerto Rico, 2022.","authors":"Forrest K Jones, Abigail G Medina, Kyle R Ryff, Jessica Irizarry-Ramos, Joshua M Wong, Eduardo O'Neill, Ismael A Rodríguez, Iris Cardona, Lorena Hernández, Alfonso C Hernandez-Romieu, Maile T Phillips, Michael A Johansson, Tesfaye Bayleyegn, Christine Atherstone, Katherine Roguski DeBord, María E Negrón, Renee Galloway, Laura E Adams, Melissa Marzán-Rodríguez","doi":"10.15585/mmwr.mm7335a2","DOIUrl":"10.15585/mmwr.mm7335a2","url":null,"abstract":"<p><p>Leptospirosis, an acute bacterial zoonotic disease, is endemic in Puerto Rico. Infection in approximately 10%-15% of patients with clinical disease progresses to severe, potentially fatal illness. Increased incidence has been associated with flooding in endemic areas around the world. In 2022, Hurricane Fiona, a Category 1 hurricane, made landfall and inundated Puerto Rico with heavy rainfall and severe flooding, increasing the risk for a leptospirosis outbreak. In response, the Puerto Rico Department of Health (PRDH) changed guidelines to make leptospirosis cases reportable within 24 hours, centralized the case investigation management system, and provided training and messaging to health care providers. To evaluate changes in risk for leptospirosis after Hurricane Fiona to that before the storm, the increase in cases was quantified, and patient characteristics and geographic distribution were compared. During the 15 weeks after Hurricane Fiona, 156 patients experienced signs and symptoms of leptospirosis and had a specimen with a positive laboratory result reported to PRDH. The mean weekly number of cases during this period was 10.4, which is 3.6 as high as the weekly number of cases during the previous 37 weeks (2.9). After Hurricane Fiona, the proportion of cases indicating exposure to potentially contaminated water increased from 11% to 35%, and the number of persons receiving testing increased; these factors likely led to the resulting overall surge in reported cases. Robust surveillance combined with outreach to health care providers after flooding events can improve leptospirosis case identification, inform clinicians considering early initiation of treatment, and guide public messaging to avoid wading, swimming, or any contact with potentially contaminated floodwaters.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 35","pages":"763-768"},"PeriodicalIF":25.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact Tracing for Mpox Clade II Cases Associated with Air Travel - United States, July 2021-August 2022.","authors":"Kristin C Delea, Tai-Ho Chen, Kayla Lavilla, Yonette Hercules, Shannon Gearhart, Leigh Ellyn Preston, Christine M Hughes, Faisal S Minhaj, Michelle A Waltenburg, Brittany Sunshine, Agam K Rao, Andrea M McCollum, Kara Adams, Miguel Ocaña, Olubunmi Akinkugbe, Clive Brown, Francisco Alvarado-Ramy","doi":"10.15585/mmwr.mm7335a1","DOIUrl":"10.15585/mmwr.mm7335a1","url":null,"abstract":"<p><p>Monkeypox virus (MPXV) can spread among humans through direct contact with lesions, scabs, or saliva; via respiratory secretions; and indirectly from fomites; via percutaneous injuries; and by crossing the placenta to the fetus during pregnancy. Since 2022, most patients with mpox in the United States have experienced painful skin lesions, and some have had severe illness. During 2021-2022, CDC initiated aircraft contact investigations after receiving reports of travelers on commercial flights with probable or confirmed mpox during their infectious period. Data were collected 1) during 2021, when two isolated clade II mpox cases not linked to an outbreak were imported into the United States by international travelers and 2) for flights arriving in or traveling within the United States during April 30-August 2, 2022, after a global clade II mpox outbreak was detected in May 2022. A total of 113 persons (100 passengers and 13 crew members) traveled on 221 flights while they were infectious with mpox. CDC developed definitions for aircraft contacts based on proximity to mpox cases and flight duration, sent information about these contacts to U.S. health departments, and received outcome information for 1,046 (68%) of 1,538 contacts. No traveler was found to have acquired mpox via a U.S. flight exposure. For persons with mpox and their contacts who had departed from the United States, CDC forwarded contact information as well as details about the exposure event to destination countries to facilitate their own public health investigations. Findings from these aircraft contact investigations suggest that traveling on a flight with a person with mpox does not appear to constitute an exposure risk or warrant routine contact tracing activities. Nonetheless, CDC recommends that persons with mpox isolate and delay travel until they are no longer infectious.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":"73 35","pages":"758-762"},"PeriodicalIF":25.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}