Open Forum Infectious Diseases最新文献

{"title":"Characteristics and Outcomes of Direct-Acting Antiviral Experienced Patients with Hepatitis C Undergoing Retreatment at an Essential Hospital in the United States.","authors":"Alejandro De La Hoz, Amin Pooja, Anna Kancharla, Elissa M Schechter-Perkins, Glorimar Ruiz-Mercado, Marielle Baldwin, David Nunes, Jessica L Taylor","doi":"10.1093/ofid/ofae704","DOIUrl":"https://doi.org/10.1093/ofid/ofae704","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) guidelines recommend direct-acting antiviral (DAA) rescue regimens in cases of treatment failure, and first-line regimens for reinfection. In patients with barriers to follow-up after treatment, it is difficult to determine if HCV viremia represents failure or reinfection. Patients are often retreated with rescue regimens despite higher costs. We compared the outcome of first-line vs rescue therapy in DAA experienced patients whose prior outcome was indeterminate.</p><p><strong>Methods: </strong>This retrospective cohort study included DAA experienced adults undergoing retreatment at a hospital in Massachusetts between January 2016 and May 2022. We used descriptive statistics to characterize the population. For patients with an indeterminate prior HCV treatment outcome, we compared the groups' characteristics and outcomes.</p><p><strong>Results: </strong>We included 112 patients. The mean age was 52 years (SD: 12.2), 80.4% were male, and 42.9% were White. Nearly 1 in 4 (25%) reported active substance use. Outcomes of prior DAA treatment included sustained virologic response at 12 weeks in 39.3% (n = 44) and treatment failure in 27.7% (n = 31). The prior treatment outcome was indeterminate in 33% (n = 37). We compared the outcomes of patients with an indeterminate treatment outcome retreated with first-line vs rescue therapy. Sustained virologic response at 12 weeks (66.7 vs 52.7%), treatment failure (0% vs 10.5%), and indeterminate outcome (33.3% vs 36.8%) were similar between the groups (<i>P</i> = .502).</p><p><strong>Conclusions: </strong>Outcomes with first-line DAAs were comparable to rescue medications for retreatment of patients with DAA experience and an indeterminate prior treatment outcome. Our findings can help decrease treatment-level barriers for HCV treatment.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae704"},"PeriodicalIF":3.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864990","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":"Skin Color Representation in Infectious Disease Textbooks.","authors":"Jessica Thornton, Allison Giuffre, Sarah Donohue, Fauzia Hollnagel, Jessica Tischendorf","doi":"10.1093/ofid/ofae703","DOIUrl":"10.1093/ofid/ofae703","url":null,"abstract":"<p><p>Darker skin is underrepresented in medical textbooks. This may contribute to inequity in our system. We assessed skin color representation in infectious disease textbooks and compared diseases associated with social stigma to those not stigmatized. Images depicting conditions associated with social stigma were significantly more common on darker skin.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae703"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829458","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":"Effectiveness of the 2023-2024 Omicron XBB.1.5-containing mRNA COVID-19 Vaccine (mRNA-1273.815) in Preventing COVID-19-related Hospitalizations and Medical Encounters Among Adults in the United States.","authors":"Hagit Kopel, Andre B Araujo, Alina Bogdanov, Ni Zeng, Isabelle Winer, Jessamine P Winer-Jones, Tianyi Lu, Morgan A Marks, Machaon Bonafede, Van Hung Nguyen, David Martin, James A Mansi","doi":"10.1093/ofid/ofae695","DOIUrl":"https://doi.org/10.1093/ofid/ofae695","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the vaccine effectiveness (VE) of mRNA-1273.815, a 2023-2024 Omicron XBB.1.5-containing mRNA COVID-19 vaccine, at preventing COVID-19-related hospitalizations and any medically attended COVID-19 in adults.</p><p><strong>Methods: </strong>In a linked electronic health record-claims dataset, we identified US adults (≥18 years) who received the mRNA-1273.815 vaccine (exposed cohort) between 12 September and 15 December 2023, matched 1:1 to individuals who did not receive a 2023-2024 updated COVID-19 vaccine (unexposed cohort). Cohorts were balanced using inverse probability of treatment weighting on demographics, vaccination and infection history, and underlying medical conditions. Study cohorts were followed until 31 December 2023 for COVID-19-related hospitalizations and medically attended COVID-19. Cox regression was used to estimate hazard ratios and VE. Subgroup analyses were performed for adults ≥50 years, adults ≥65 years, and individuals with underlying medical conditions.</p><p><strong>Results: </strong>Overall, 859 335 matched pairs of mRNA-1273.815 recipients and unexposed adults were identified. The mean (standard deviation) age was 63 (16) years. More than 60% of individuals in both cohorts had an underlying medical condition. Among the overall adult population, VE was 60.2% (95% confidence interval, 53.4-66.0) against COVID-19-related hospitalization and 33.1% (30.2-35.9) against medically attended COVID-19 over a median follow-up of 63 (interquartile range: 44-78) days. VE estimates by age and underlying medical conditions were similar.</p><p><strong>Conclusions: </strong>These results demonstrate the significant protection provided by mRNA-1273.815 against COVID-19-related hospitalizations and any medically attended COVID-19 in adults, regardless of vaccination history, and support Centers for Disease Control and Prevention recommendations to stay up-to-date with COVID-19 vaccination to prevent COVID-19-related outcomes, including hospitalizations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae695"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847068","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":"Baseline Statin Use Appears to Protect Against Severe COVID-19.","authors":"Eric A Meyerowitz, Arthur Y Kim","doi":"10.1093/ofid/ofae697","DOIUrl":"10.1093/ofid/ofae697","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae697"},"PeriodicalIF":3.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818615","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":"The Rise of <i>Candida auris</i> in Mauritius.","authors":"Dooshanveer C Nuckchady","doi":"10.1093/ofid/ofae696","DOIUrl":"10.1093/ofid/ofae696","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae696"},"PeriodicalIF":3.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807678","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":"Who to Boost When: The Effect of Age and Dosing Interval on Delta and Omicron COVID-19 Incidence in the Open-label Phase of the COVE Trial.","authors":"Dean Follmann, Xiaowei Wang, Lindsey R Baden, Hana M El Sahly, Brandon Essink, Peter Gilbert, Holly E Janes, Colleen F Kelley, Megan A Berman, Ian Frank, Eric Chu, Weiping Deng, Frances Priddy, Avika Dixit, Joanne E Tomassini, Rituparna Das, Jacqueline Miller, Honghong Zhou","doi":"10.1093/ofid/ofae689","DOIUrl":"https://doi.org/10.1093/ofid/ofae689","url":null,"abstract":"<p><strong>Background: </strong>To help inform COVID-19 vaccination recommendations, we evaluated the impact of age and dosing interval on clinical benefit of a third dose of mRNA-1273.</p><p><strong>Methods: </strong>Approximately 17 000 participants from the phase 3 Coronavirus Efficacy trial who previously received 2 doses of 100 µg mRNA-1273 were evaluated for COVID-19 between September 2021 and April 2022 during uptake of a third booster dose of 50 µg of mRNA-1273. Cox models assessed booster relative efficacy of a third dose.</p><p><strong>Results: </strong>Initial booster relative efficacy against Delta COVID-19 was 83% (95% confidence interval, 60-93) 14 days postdose and 83% (67-91) 60 days later. Initial booster efficacy against Omicron COVID-19 was 56% (44-65) at 14 days postdose and 4% (-27 to 28) 120 days later. For those aged ≥65 years, initial booster efficacy against Omicron COVID-19 was 86% (69-93) compared with 50% (36-61) for those <65 years. Placebo crossover to 2 doses of mRNA-1273 induced a median 5-month difference from the second to third dose between the original randomized arms. Postboost, the mRNA-1273 arm had a 24% (16%, 32%) lower risk of Omicron COVID-19 compared to the placebo-mRNA-1273 arm. Modeling predicted a 41% postboost reduction in Omicron COVID-19 for a 15- versus 7-month interval between the second and third doses.</p><p><strong>Conclusions: </strong>Boosting reduced Delta COVID-19 risk by 83% through 2 months and reduced Omicron COVID-19 risk by 56% but declined by 4 months. A 15- versus 7-month dosing interval predicted a 41% postboost reduction in Omicron COVID-19 but increased preboost risk.</p><p><strong>Primary funding source: </strong>The National Institutes of Health/National Institute of Allergy and Infectious Diseases. <b>Registration for the COVE Trial. </b> ClinicalTrials.gov ID# NCT04470427.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae689"},"PeriodicalIF":3.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829465","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":"Natural History of High-Risk Human Papillomavirus in Kenyan and South African Women: Implications for Vaccination Campaigns and Cervical Cancer Screening Programs.","authors":"Anna-Ursula Happel, Elvira Budiawan, Maricianah Onono, Steve Innes, Thesla Palanee-Phillips, Janine Heuvel, Adeebah Rakiep, Sarah Kellow-Webb, Joan Ongere, Imeldah Wakhungu, Zandile Mkhize, La-Donna Kapa, Nompumelelo Sigcu, Smritee Dabee, Gonasagrie Nair, Caitlin Scoville, Nelly R Mugo, Anna-Lise Williamson, Jo-Ann S Passmore, Heather B Jaspan, Renee Heffron","doi":"10.1093/ofid/ofae690","DOIUrl":"10.1093/ofid/ofae690","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV) vaccines and DNA testing roll out in resource-constrained settings. We evaluated the natural history of HPV infections in African women to contribute to normative guidance.</p><p><strong>Methods: </strong>Women aged 16 to 35 years were enrolled from 3 sites in South Africa and Kenya and followed quarterly for 18 months. A subset was recalled 5 years postenrollment, when Papanicolaou smears were conducted. Endocervical swabs were tested for 36 HPV genotypes by HPV Direct Flow. Logistic regression models identified correlations between demographic, biological, or behavioral factors and baseline high-risk HPV (HR-HPV).</p><p><strong>Results: </strong>At enrollment, 158 of 311 women (median age, 23 years; IQR, 20-27) had at least 1 HR-HPV genotype. HPV-52 (13.5%), HPV-16 (9.5%), HPV-58 (9.0%), HPV-18 (8.4%), and HPV-35 (8.4%) were most common. Coinfection with low-risk HPVs (odds ratio, 2.65; 95% CI, 1.59-4.45) were associated with HR-HPV positivity, while reported condom use (odds ratio, 0.57; 95% CI, .34-.98) and older age were protective. Of women with HR-HPV at enrollment, 87.3% cleared at least 1 HR-HPV infection over 18 months and 64.6% cleared all such infections. Few (1.9%) had evidence of high-grade cervical abnormalities, among which HPV-35 was the most prevalent during the study.</p><p><strong>Conclusions: </strong>The high prevalence of HR-HPV emphasizes that HPV vaccination, screening, and testing campaigns in Africa are important. Nonvaccine HPV-35 was as common as HPV-18, suggesting the need to supplement current vaccines with this genotype. HR-HPV clearance was also common, highlighting that clear messaging is needed from health care providers to patients while discussing HPV DNA testing results.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae690"},"PeriodicalIF":3.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807668","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":"Real Clinical Effectiveness of Molnupiravir Against 30-day Mortality Among 74 541 SARS-CoV-2-Positive Patients: A Nationwide Cohort Study From the Czech Republic.","authors":"Tomáš Pavlík, Jiří Jarkovský, Ondřej Šanca, Martina Koziar Vašáková, Pavel Dlouhý, Vladimír Černý, Petr Štourač, Vlastimil Válek, Ladislav Dušek","doi":"10.1093/ofid/ofae685","DOIUrl":"10.1093/ofid/ofae685","url":null,"abstract":"<p><strong>Background: </strong>We examined the clinical effectiveness of molnupiravir in reducing deaths in a real-world cohort of adult patients with COVID-19 during the Omicron outbreak.</p><p><strong>Methods: </strong>This was a population-wide retrospective cohort study in the Czech Republic. We analyzed all 74 541 patients with an officially registered diagnosis of SARS-CoV-2 infection between 1 January and 31 December 2022, aged 18 years or older, treated with molnupiravir. The primary outcome was 30-day all-cause mortality; the secondary outcome was 30-day COVID-19-related mortality. Hazard ratios (HRs) were estimated using stratified Cox regression and the Fine-Gray model.</p><p><strong>Results: </strong>The use of molnupiravir in adult SARS-CoV-2 positive patients was associated with a lower risk of both 30-day all-cause mortality: adjusted HR 0.58 (95% confidence interval, 0.53-0.64; <i>P</i> < .001) and 30-day COVID-19-related mortality: adjusted HR 0.50 (95% confidence interval, 0.42-0.58; <i>P</i> < .001). The effect of molnupiravir was highly significant regardless of sex, Deyo-Charlson Comorbidity Index score, hospitalization status, COVID-19 vaccination status, and patients older than age 65 years.</p><p><strong>Conclusions: </strong>In this cohort study, early initiation of molnupiravir was associated with a significant reduction in 30-day all-cause and COVID-19-related mortality in adult SARS-CoV-2 positive patients.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae685"},"PeriodicalIF":3.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807675","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":"Development of a City-wide Rapid Antiretroviral Therapy Initiation Toolkit for People Newly Diagnosed With HIV in the Southern United States.","authors":"A C Pettit, A A Ahonkhai, L Pierce, P F Rebeiro, C M Valdebenito, J Woods, L Gregory, C Walton, R Nash, N A Summers, A Van Wylen, D Thompson, M Hayes-Winton, A Eke, L C Pichon, C M Audet","doi":"10.1093/ofid/ofae660","DOIUrl":"https://doi.org/10.1093/ofid/ofae660","url":null,"abstract":"<p><strong>Background: </strong>Rapid antiretroviral therapy (ART) initiation, in which individuals with HIV start treatment within days of diagnosis, is a key component of the United States (US) Ending the HIV Epidemic initiative. The Memphis Metropolitan Statistical Area ranks second in the US for HIV incidence, yet only ∼60% of individuals link to treatment within 1 month of diagnosis. This study aimed to identify barriers and strategies for implementing rapid ART initiation in Memphis.</p><p><strong>Methods: </strong>From August to December 2022, we conducted process mapping guided by the Consolidated Framework for Implementation Research to outline the steps from 3 HIV testing sites to ART prescription at 3 Ryan White-funded clinics in Memphis, Tennessee. We used modified conjoint analyses to prioritize barriers and identify strategies for improving rapid ART implementation, focusing on the importance and feasibility of changes.</p><p><strong>Findings: </strong>Prioritized barriers included intersectional stigma and a lack of access to centralized information about the rapid ART program, branding and logo development, inter- and intra-organizational networking and communication, testing and treatment resources (HIV testing kits and ART starter packs), rapid ART knowledge, and organizational champions. Strategies to address these barriers were compiled into a local rapid ART toolkit.</p><p><strong>Conclusions: </strong>We identified modifiable systemic barriers to rapid ART initiation in Memphis, a community disproportionately affected by HIV. The strategies developed to address these barriers informed the creation of a locally relevant rapid ART toolkit for future evaluation. These methods could be applied in other high-burden areas seeking to develop local rapid ART models.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae660"},"PeriodicalIF":3.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11643345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829479","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":"Incidence and Risk Factors of Ophthalmic Nerve Palsy in Patients With Tuberculous Meningitis: A Retrospective Study and Literature Review.","authors":"Zhen-Tao Fei, Lu Xia, Yang Yang, Dan Ye, Hua-Rui Liu, Ping Liu, Wei Huang, Feng Li, Xu-Hui Liu","doi":"10.1093/ofid/ofae686","DOIUrl":"10.1093/ofid/ofae686","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) can lead to ophthalmic nerve palsy (ONP), a severe neurological complication. This study aims to evaluates the incidence and risk factors for ONP in TBM patients.</p><p><strong>Methods: </strong>This retrospective study included 250 TBM patients from the Shanghai Public Health Clinical Center (2013-2022). Clinical and imaging data were analyzed, with logistic regression identifying risk factors for ONP.</p><p><strong>Results: </strong>ONP occurred in 6.8% (17/250) of TBM patients. Those with ONP had higher intracranial pressure (ICP) (257.69 ± 68.12 mmH2O vs 191.65 ± 91.58 mmH2O; <i>P</i> = 0.012), cerebrospinal fluid protein levels, and a higher prevalence of tuberculomas (29.4% vs 10.7%; <i>P</i> = 0.039). Logistic regression identified pre-treatment ICP, CD4 percentage, and tuberculomas as significant risk factors. Linezolid use was a protective factor for ONP recovery.</p><p><strong>Conclusions: </strong>Six point eight percent (17/250) of patients with TBM developed ONP as a complication. ICP, CD4 counts, and tuberculomas are key predictors. Linezolid shows potential as a therapeutic agent for improving outcomes in TBM patients with neurological complications, warranting further study.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae686"},"PeriodicalIF":3.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813814","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}