{"title":"Evolutionary trajectories of beta-lactamase NDM and DLST cluster in <i>Pseudomonas aeruginosa</i>: finding the putative ancestor.","authors":"Parisa Sadeghi, Karim Mahnam, Azhar Salari-Jazi, Ashok Aspatwar, Jamshid Faghri","doi":"10.1080/20477724.2023.2236416","DOIUrl":"10.1080/20477724.2023.2236416","url":null,"abstract":"<p><p><i>Pseudomonas aeruginosa</i> has different antibiotic resistance pathways, such as broad-spectrum lactamases and metallo-β-lactamases (MBL), penicillin-binding protein (PBP) alteration, and active efflux pumps. Polymerase chain reaction (PCR) and sequencing methods were applied for double-locus sequence typing (DLST) and New Delhi metallo-β-lactamase (NDM) typing. We deduced the evolutionary pathways for DLST and NDM genes of P. aeruginosa using phylogenetic network. Among the analyzed isolates, 62.50% of the <i>P. aeruginosa</i> isolates were phenotypically carbapenem resistance (CARBR) isolates. Characterization of isolates revealed that the prevalence of bla<sub>NDM</sub>, bla<sub>VIM</sub>, bla<sub>IMP</sub>, undetermined carbapenemase, and MexAB-OprM were 27.5%, 2%, 2.5%, 12.5%, and 15%, respectively. The three largest clusters found were DLST t20-105, DLST t32-39, and DLST t32-52. The network phylogenic tree revealed that DLST t26-46 was a hypothetical ancestor for other DLSTs, and NDM-1 was as a hypothetical ancestor for NDMs. The combination of the NDM and DLST phylogenic trees revealed that DLST t32-39 and DLST tN2-N3 with NDM-4 potentially derived from DLST t26-46 along with NDM-1. Similarly, DLST t5-91 with NDM-5 diversified from DLST tN2-N3 with NDM-4. This is the first study in which DLST and NDM evolutionary routes were performed to investigate the origin of P. aeruginosa isolates. Our study showed that the utilization of medical equipment common to two centers, staff members common to two centers, limitations in treatment options, and prescription of unnecessary high levels of meropenem are the main agents that generate new types of resistant bacteria and spread resistance among hospitals.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828921","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":"Continued dominance of dengue virus serotype 2 during the recent Central India outbreaks (2019-2021) with evidence of genetic divergence.","authors":"Ankita Agarwal, Ruchi Ganvir, Dipesh Kale, Deepti Chaurasia, Garima Kapoor","doi":"10.1080/20477724.2023.2246712","DOIUrl":"10.1080/20477724.2023.2246712","url":null,"abstract":"<p><p>Central India faced major dengue outbreaks in 2019 and 2021. In the present study, we aimed to identify the dengue virus serotypes and genotypes circulating in Central India during the COVID pre-pandemic year (2019) and ongoing-pandemic year (2021). For this purpose, the suspected cases were first tested by serological assays. Sero-positive samples were then subjected to molecular diagnosis by RT-PCR and semi-nested PCR. The serotypes obtained were confirmed by nucleotide sequencing. A phylogenetic analysis of serotypes was performed to identify the circulating genotypes. All four DENV serotypes were detected during 2019 and 2021, with the predominance of DENV2. Cases with multiple DENV serotype infections were also identified, involving DENV-2 in all the coinfections. Genotyping revealed that DENV-1 (Genotype V, American/African), DENV-2 (Genotype IV, Cosmopolitan), DENV-3 (Genotype III, Cosmopolitan), and DENV-4 (Genotype I) were involved during both outbreaks. DENV-2 detected in 2019 and 2021 has diverged from the previous strains detected in Central India (2016 and 2018), which may account for the higher transmission of DENV-2 during these outbreaks. The detection of heterologous DENV serotypes with high transmission efficiency calls for continuous viral monitoring and surveillance, which will contribute to a better understanding of changing viral dynamics and transmission patterns.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9981501","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}
Dina I Elgendy, Rasha A Elmahy, Alaa Ibrahim Mohamed Amer, Hoda A Ibrahim, Asmaa Fawzy Eltantawy, Fotouh Rashed Mansour, Amina M Salama
{"title":"Efficacy of artemether against toxocariasis in mice: parasitological and immunopathological changes in brain, liver, and lung.","authors":"Dina I Elgendy, Rasha A Elmahy, Alaa Ibrahim Mohamed Amer, Hoda A Ibrahim, Asmaa Fawzy Eltantawy, Fotouh Rashed Mansour, Amina M Salama","doi":"10.1080/20477724.2023.2285182","DOIUrl":"10.1080/20477724.2023.2285182","url":null,"abstract":"<p><p>Toxocariasis is a zoonosis that represents a serious threat to public health particularly in tropical and subtropical areas. Currently, albendazole, the most effective drug for treating visceral toxocariasis, shows moderate efficacy against the larvae in tissues and has some adverse effects. Artemether is an antiparasitic drug mainly used in the treatment of malaria and showed effectiveness against numerous helminthic infections. Besides, it possesses potent anti-inflammatory, antiapoptotic, antifibrotic, and neuroprotective properties. Thus, the study's aim was to investigate artemether's effects in comparison with albendazole on the therapeutic outcome of experimental toxocariasis. For this aim, 140 laboratory-bred mice were divided into four main groups: uninfected control, treatment control, albendazole-treated, and artemether-treated groups. The treatment regimens were started at the 15<sup>th</sup> dpi (early treatment), and at the 35<sup>th</sup> dpi (late treatment). The effectiveness of treatment was determined by brain larval count, histopathological, immunohistochemical, and biochemical examination. Artemether showed more effectiveness than albendazole in reducing brain larval counts, markers of brain injury including NF-κB, GFAP, and caspase-3, the diameter and number of hepatic granulomas, hepatic oxidative stress, hepatic IL-6, and TG2 mRNA, and pulmonary inflammation and fibrosis. The efficacy of artemether was the same when administered early or late in the infection. Finally, our findings illustrated that artemether might be a promising therapy for <i>T. canis</i> infection and it could be a good substitution for albendazole in toxocariasis treatment.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398623","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":"Human mpox: global trends, molecular epidemiology and options for vaccination.","authors":"Lorenzo Subissi, Paola Stefanelli, Giovanni Rezza","doi":"10.1080/20477724.2023.2258641","DOIUrl":"10.1080/20477724.2023.2258641","url":null,"abstract":"<p><p>The eradication of smallpox and the cessation of vaccination have led to the growth of the susceptible human population to poxviruses. This has led to the increasing detection of zoonotic orthopoxviruses. Among those viruses, monkeypox virus (MPV) is the most commonly detected in Western and Central African regions. Since 2022, MPV is causing local transmission in newly affected countries all over the world. While the virus causing the current outbreak remains part of clade II (historically referred to as West African clade), it has a significant number of mutations as compared to other clade II sequences and is therefore referred to as clade IIb. It remains unclear whether those mutations may have caused a change in the virus phenotype. Vaccine effectiveness data show evidence of a high cross-protection of vaccines designed to prevent smallpox against mpox. These vaccines therefore represent a great opportunity to control human-to-human transmission, provided that their availability has short time-frames and that mistakes from the recent past (vaccine inequity) will not be reiterated.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10268631","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}
Maryam Akbari, Hossein Heli, Ahmad Oryan, Gholamreza Hatam
{"title":"A novel outlook in the delivery of artemisinin: production and efficacy in experimental visceral leishmaniasis.","authors":"Maryam Akbari, Hossein Heli, Ahmad Oryan, Gholamreza Hatam","doi":"10.1080/20477724.2023.2212347","DOIUrl":"10.1080/20477724.2023.2212347","url":null,"abstract":"<p><p>The visceral form of leishmaniasis (VL), due to infection by <i>Leishmania infantum</i>, is a neglected tropical disease. The accessible therapeutic options are limited. Artemisinin is an efficient antileishmanial product with poor biological availability that requires high repetition of therapeutic doses in VL. Solid lipid nanoparticles (SLNs) provide targeted delivery, increase bioavailability and reduce toxicity of the traditional therapeutic strategy. The spherical shape artemisinin-loaded SLNs were prepared in a particle diameter of 222.0 ± 14.0 nm. The SLNs showed no particular toxic effect on the parasites, whereas the native artemisinin demonstrated a significant toxicity rate of 31% in viability of the promastigotes at the 250 µg/ml concentration. The therapeutic efficacy of the artemisinin-loaded SLNs was demonstrated in the experimental VL, using the <i>L. infantum</i>-infected BALB/c mice, in the present study. The 10 and 20 mg/kg doses of artemisinin-loaded SLNs showed higher level of antileishmanial efficacy compared with the free artemisinin. There was a significant diminishing of the parasite burden in liver (84.7 ± 4.9%) and spleen (85.0 ± 3.1%) and hepatosplenomegaly by the artemisinin-loaded SLNs treated at 20 mg/kg compared to the free artemisinin. Therefore, the present study supports the superior efficacy of artemisinin-loaded SLNs over the free artemisinin and could be considered as a new therapeutic strategy in the treatment of leishmaniasis.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816433","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}
Oyetunde T Oyeyemi, Olumide Ogundahunsi, Mirjam Schunk, Ramzy G Fatem, Lisa M Shollenberger
{"title":"Neglected tropical disease (NTD) diagnostics: current development and operations to advance control.","authors":"Oyetunde T Oyeyemi, Olumide Ogundahunsi, Mirjam Schunk, Ramzy G Fatem, Lisa M Shollenberger","doi":"10.1080/20477724.2023.2272095","DOIUrl":"10.1080/20477724.2023.2272095","url":null,"abstract":"<p><p>Neglected tropical diseases (NTDs) have become important public health threats that require multi-faceted control interventions. As late treatment and management of NTDs contribute significantly to the associated burdens, early diagnosis becomes an important component for surveillance and planning effective interventions. This review identifies common NTDs and highlights the progress in the development of diagnostics for these NTDs. Leveraging existing technologies to improve NTD diagnosis and improving current operational approaches for deployment of developed diagnostics are crucial to achieving the 2030 NTD elimination target. Point-of-care NTD (POC-NTD) diagnostic tools are recommended preferred diagnostic options in resource-constrained areas for mapping risk zones and monitoring treatment efficacy. However, few are currently available commercially. Technical training of remote health care workers on the use of POC-NTD diagnostics, and training of health workers on the psychosocial consequences of these diagnostics are critical in harnessing POC-NTD diagnostic potential. While the COVID-19 pandemic has challenged the possibility of achieving NTD elimination in 2030 due to the disruption of healthcare services and dwindling financial support for NTDs, the possible contribution of NTDs in exacerbating COVID-19 pandemic should motivate NTD health system strengthening.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49691874","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}
Chigozie A Ogwara, Jennifer W Ronberg, Sierra M Cox, Briana M Wagner, Jacqueline W Stotts, Gerardo Chowell, Anne C Spaulding, Isaac Chun-Hai Fung
{"title":"Impact of public health policy and mobility change on transmission potential of severe acute respiratory syndrome coronavirus 2 in Rhode Island, March 2020 - November 2021.","authors":"Chigozie A Ogwara, Jennifer W Ronberg, Sierra M Cox, Briana M Wagner, Jacqueline W Stotts, Gerardo Chowell, Anne C Spaulding, Isaac Chun-Hai Fung","doi":"10.1080/20477724.2023.2201984","DOIUrl":"10.1080/20477724.2023.2201984","url":null,"abstract":"<p><p>To study the SARS-CoV-2 transmission potential in Rhode Island (RI) and its association with policy changes and mobility changes, the time-varying reproduction number, R<sub>t</sub>, was estimated. The daily incident case counts (16 March 2020, through 30 November 2021) were bootstrapped within a 15-day sliding window and multiplied by Poisson-distributed multipliers (λ = 4, sensitivity analysis: 11) to generate 1000 estimated infection counts, to which EpiEstim was applied to generate R<sub>t</sub> time series. The median R<sub>t</sub> percentage change when policies changed was estimated. The time lag correlations were assessed between the 7-day moving average of the relative changes in Google mobility data in the first 90 days, and R<sub>t</sub> and estimated infection count, respectively. There were three major pandemic waves in RI in 2020-2021: spring 2020, winter 2020-2021 and fall-winter 2021. The median R<sub>t</sub> fluctuated within the range of 0.5-2 from April 2020 to November 2021. Mask mandate (18 April 2020) was associated with a decrease in R<sub>t</sub> (-25.99%, 95% CrI: -37.42%, -14.30%). Termination of mask mandates on 6 July 2021 was associated with an increase in R<sub>t</sub> (36.74%, 95% CrI: 27.20%, 49.13%). Positive correlations were found between changes in grocery and pharmacy, R<sub>t</sub> retail and recreation, transit, and workplace visits, for both R<sub>t</sub> and estimated infection count, respectively. Negative correlations were found between changes in residential area visits for both Rt and estimated infection count, respectively. Public health policies enacted in RI were associated with changes in the pandemic trajectory. This ecological study provides further evidence of how non-pharmaceutical interventions and vaccination slowed COVID-19 transmission in RI.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9789075","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":"Knowledge of the Mpox virus and conspiracy beliefs and their association with self-confidence in managing the virus among Israeli orthopedic surgeons.","authors":"Rawan Masarwa, Yaniv Yonai, Merav Ben-Natan, Yaron Berkovich","doi":"10.1080/20477724.2023.2228040","DOIUrl":"10.1080/20477724.2023.2228040","url":null,"abstract":"<p><p>In 2022, the Mpox viral outbreak signaled a global public health emergency. Infectious disease management and prevention are crucial tasks for healthcare workers. In their line of work, orthopedic surgeons could come across cases of the Mpox virus. The aim of the present study was to explore orthopedic surgeons' knowledge of the Mpox virus, their conspiracy beliefs regarding emerging viral infections, and their self-confidence in managing the Mpox virus. In this cross-sectional survey, 137 orthopedic surgeons completed an online questionnaire. The participants had low knowledge of the Mpox virus, providing on average 11.5 correct answers (SD = 2.68) of a possible 21. In addition, the participants tended to express moderate conspiracy beliefs and to have low self-confidence in managing the Mpox virus. Age 30 or older, a higher knowledge level, and lower conspiracy beliefs predicted greater self-confidence in managing the Mpox virus. In addition, a negative association was found between knowledge of the Mpox virus and conspiracy beliefs. Arab and younger orthopedic surgeons expressed stronger conspiracy beliefs. Interventions should include introduction of material regarding emerging tropical infections in medical curricula and in-service training programs. In addition, special attention should be paid to younger and Arab orthopedic surgeons, as these subgroups may endorse higher conspiracy beliefs.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9668725","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}
Alexandra Martín Ramírez, Lourdes Barón Argos, Marta Lanza Suárez, Claudia Carmona Rubio, Ana Pérez-Ayala, Shamilah R Hisam, José M Rubio
{"title":"Malaria diagnosis using a combined system of a simple and fast extraction method with a lyophilised Dual-LAMP assay in a non-endemic setting.","authors":"Alexandra Martín Ramírez, Lourdes Barón Argos, Marta Lanza Suárez, Claudia Carmona Rubio, Ana Pérez-Ayala, Shamilah R Hisam, José M Rubio","doi":"10.1080/20477724.2023.2232595","DOIUrl":"10.1080/20477724.2023.2232595","url":null,"abstract":"<p><p>Malaria is a parasitic disease distributed in tropical areas but with a high number of imported cases in non-endemic countries. The most specific and sensitive malaria diagnostic methods are PCR and LAMP. However, both require specific equipment, extraction procedures and a cold chain. This study aims to solve some limitations of LAMP method with the optimization and validation of six LAMP assays, genus and species-specific, using an easy and fast extraction method, the incorporation of a reaction control assay, two ways (Dual) of result reading and reagent lyophilization. The Dual-LAMP assays were validated against the Nested-Multiplex Malaria PCR. A conventional column and saline extraction methods, and the use of lyophilized reaction tubes were also assessed. A new reaction control Dual-LAMP-RC assay was designed. Dual-LAMP-<i>P</i>spp assay showed no cross-reactivity with other parasites, repeatability and reproducibility of 100%, a significant correlation between parasite concentration and time to amplification and a LoD of 1.22 parasites/µl and 5.82 parasites/µl using column and saline extraction methods, respectively. Sensitivity and specificity of the six Dual-LAMP assays reach values of 100% or close to this, being lower for the Dual-LAMP-<i>Pm</i>. The Dual-LAMP-RC assay worked as expected. Lyophilized Dual-LAMP results were concordant with the reference method. Dual-LAMP malaria assays with the addition of a new reaction control LAMP assay and the use of a fast and easy saline extraction method, provided low limit of detection, no cross-reactivity, and good sensitivity and specificity. Furthermore, the reagent lyophilization and the dual result reading allow their use in most settings.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9758709","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}
Faith T. T. Hungwe, Katherine M. Laycock, Tlhalefo D. Ntereke, Rorisang Mabaka, Giacomo M. Paganotti
{"title":"A historical perspective on arboviruses of public health interest in Southern Africa","authors":"Faith T. T. Hungwe, Katherine M. Laycock, Tlhalefo D. Ntereke, Rorisang Mabaka, Giacomo M. Paganotti","doi":"10.1080/20477724.2023.2290375","DOIUrl":"https://doi.org/10.1080/20477724.2023.2290375","url":null,"abstract":"Arboviruses are an existing and expanding threat globally, with the potential for causing devastating health and socioeconomic impacts. Mitigating this threat necessitates a One Health approach tha...","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138576939","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}