Reviews in Medical Virology最新文献

{"title":"Adverse Pregnancy Outcomes and Prevalence Associated With Arboviral Infections (Zika, Dengue, and Chikungunya): An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Dazhi Fan, Dongxin Lin, Jiaming Rao, Congcong Guo, Li Sun, Wen Wang, Pengzhen Hu, Li Liu, Yubo Ma, Xiaoling Guo, Juan Liu","doi":"10.1002/rmv.70137","DOIUrl":"10.1002/rmv.70137","url":null,"abstract":"<p><p>Maternal infection with Zika virus (ZIKV), dengue virus (DENV), or chikungunya virus (CHIKV) may increase the risk of adverse pregnancy and foetal outcomes, but evidence credibility varies. The aim of this study is to evaluate and compare the strength of evidence from systematic reviews and meta-analyses on these arboviruses and pregnancy outcomes. PubMed, Web of Science, and Cochrane Library from inception to December 31, 2025 were searched. Two reviewers independently screened studies, extracted data, and assessed methodological quality using AMSTAR 2. Evidence credibility was graded as high, moderate, or weak based on precision, consistency, and small-study effects. Nine meta-analyses were included (five on ZIKV, three on DENV, one on CHIKV). AMSTAR 2 ratings were high (n = 5) and low (n = 4), with lack of protocol registration as the main flaw. High credibility evidence linked maternal ZIKV infection to microcephaly (including severe cases > 3SD) and corpus callosum anomalies. Moderate credibility supported ZIKV associations with decreased brain volume, ventriculomegaly, and other neuroimaging abnormalities, and DENV associations with preterm birth, low birth weight, miscarriage, stillbirth, and postpartum haemorrhage. Prevalence estimates for small for gestational age (ZIKV) had high credibility, and intracranial calcifications and joint abnormalities (ZIKV), small for gestational age and stillbirth (DENV), and intrapartum mother-to-child transmission and symptomatic neonatal infection (CHIKV) had moderate credibility. Most other associations were weak. Strong evidence confirms ZIKV causes severe congenital malformations. DENV shows moderate associations with major adverse outcomes, while evidence for CHIKV remains limited at the meta-analytic level despite emerging primary data. Improved methodological rigour and surveillance are needed to protect maternal and child health. Trial Registration: PROSPERO number: CRD420251150405.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70137"},"PeriodicalIF":5.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Norovirus Stress-Tests Mass Gatherings: From Outbreaks to System Fragility.","authors":"Giancarlo Ceccarelli, Fabio Scarpa, Massimo Ciccozzi, Francesco Branda","doi":"10.1002/rmv.70130","DOIUrl":"https://doi.org/10.1002/rmv.70130","url":null,"abstract":"","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70130"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of HPV35 in African Cervical Pathologies: Prevalence, Contributing Factors, and Vaccine Prospects.","authors":"Alltalents T Murahwa, Mathias Dzobo, Anifrid Mahenge, Patricia Rantshabeng, Racheal S Dube Mandishora","doi":"10.1002/rmv.70129","DOIUrl":"10.1002/rmv.70129","url":null,"abstract":"<p><p>Human papillomavirus (HPV35) is globally associated with only 2% of invasive cervical cancers (ICC) but demonstrates a disproportionately higher prevalence in sub-Saharan Africa, reaching up to 10% in previous reports. In this review, we provide updated data from multiple African countries, revealing high HPV35 prevalence rates in women with precancerous and ICC lesions. Among women with ICC, the highest prevalence of HPV35 was observed in Mozambique (30% and 19%), Kenya (26% and 22%), South Africa (17%), Burkina Faso (13.7%), Zimbabwe (11%), and Tanzania (11.2%). Similarly, in women with precancerous lesions (LSIL/HSIL/CIN1-3), the highest rates were recorded in Tanzania (26%) and Botswana (23% and 20%). These findings highlight a significant and underappreciated burden of HPV35-associated cervical disease in African populations, particularly among women with precancerous and invasive lesions. The findings call for an urgent re-evaluation of current HPV vaccination strategies to consider the inclusion of HPV35, which could profoundly enhance the effectiveness of cervical cancer prevention programs in sub-Saharan Africa.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70129"},"PeriodicalIF":5.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Safety of Nucleic Acid Amplification Technology Combined With Serological Tests for Screening Blood Donors: A Systematic Review and Meta-Analysis.","authors":"Heloise Skiavine Madeira, Aline Ávila Brustolin, Marcos Elias da Silva Almeida, Maiara Vanusa Guedes Ribeiro, Raul Gomes Aguera, Fernando Américo Jorge, Luciana Dias Ghiraldi, Débora de Castro Moreira, Maria Valdrinez Campana Lonardoni, Dennis Armando Bertolini, Leyde Daiane de Peder, Claudinei Mesquita da Silva, Daniele Stéfanie Sara Lopes Lera-Nonose, Áquila Carolina Fernandes Herculano Ramos-Milaré, Jorge Juarez Vieira Teixeira","doi":"10.1002/rmv.70117","DOIUrl":"10.1002/rmv.70117","url":null,"abstract":"<p><p>No laboratory test performed to date provides an absolute guarantee for detecting infectious agents. Nucleic acid amplification techniques/tests (NAT) associated with serological tests can increase safety and provide greater diagnostic accuracy for patients. We investigated the added safety of NAT technology combined with serological tests for screening blood donors for Hepatitis C virus (HCV), human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Data were obtained from a systematic search conducted up until march 30, 2024 in five electronic databases: PubMed, Web of Science, Scopus, Embase, and the Cochrane library. Twenty-nine studies, published between 1998 and 2023, were included in the review. Notably, HBV infection was predominant among donors with positive NAT results, with 425 cases, including 373 with positive serology and 52 with negative serology. Data from the diagnostic window period (WP) indicated the highest number of HBV infection cases, with 154 reported. Of the 29 included studies, 10 reported cases of occult HBV infection and diagnostic WP infection. Thirteen studies identified donors during the occult HBV infection period, and 17 identified WP cases. Meta-analyses of positive NAT results following negative serological screening for HBV, HCV, and HIV revealed a significantly pooled frequency (p < 0.001). Positive NAT results retrieved from donors with negative serological HBV and HCV showed a significantly combined frequency (p < 0.001), while for HIV occurs the opposite (p = 0.085). For HBV, HBC and HIV serological tests and NAT-positive results, the pooled frequency was significantly (p < 0.001). The findings demonstrate the positive relationship and safety of molecular technology in screening blood donors for HBV, HCV, and HIV using serological tests. Molecular testing remains a valuable tool for detecting and elucidating bloodborne infections.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70117"},"PeriodicalIF":5.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics, Motivation, and Challenges of Global Research on Dengue Vaccination.","authors":"Doris Klingelhöfer, Markus Braun, Isabelle M Kramer, Christina A Naser, David A Groneberg, Dörthe Brüggmann","doi":"10.1002/rmv.70122","DOIUrl":"10.1002/rmv.70122","url":null,"abstract":"<p><p>Due to the sharp increase in dengue infections in recent years, developing effective and regionally adapted vaccines is imperative. This requires research strategies aimed at vaccines that are free of side effects and effective for all four serotypes. Currently, two vaccines are licenced in some countries, each with certain restrictions. Advanced vaccines are in demand. This study, therefore, analyzes what has been done so far, by whom, and under what conditions. Who has benefited, and where is there an urgent need for further research? An advanced strategy with chronological, geographical, and socio-economic patterns was applied to answer these questions. A total of 1758 publications and 137 clinical studies were identified. The results show that the pharmaceutical industry dominates the research both in their countries of origin and in their study sites. Sustainable collaboration between academic institutions, industry, and government agencies is crucial for research on DENV_VAC. However, this generally applies to vaccine research, in which universities and industry play an important role. Depending on historical networking, better or worse conditions have developed for regional research. The Global South is exemplified by South American nations like Brazil, which is actively developing its vaccine, as well as by Southeast Asian countries such as India, which is also pursuing the development of its vaccine. Africa is not represented in the research, although there is evidence of virus circulation and a potentially underestimated disease burden. Financial support comes mainly from government agencies, except in France and Japan, where industry sets the research framework. This results in a clear regional concentration of research, which can be explained by the lack of access to reliable monitoring and serological data, but also by the regional interests of pharmaceutical companies, their resources, and financial support. This is what future research must be concerned with.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70122"},"PeriodicalIF":5.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral Pathogens and Pulmonary Fibrosis: EMT-Driven Mechanisms and Insights From Traditional Chinese Medicine.","authors":"Ningzi Zang, Yingxu Wu, Pin Li, Yongming Liu, Shiwen Wang, Jiapeng Leng, Libin Zhan, Xiaodong Lyu, Lijian Pang, Jiaran Wang","doi":"10.1002/rmv.70118","DOIUrl":"10.1002/rmv.70118","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a serious progressive complication of the respiratory system, which is profoundly associated with persistent extracellular matrix (ECM) deposition, fibrosis, and disrupted tissue regeneration. Emerging evidence shows that epithelial-mesenchymal transition (EMT) acts as a key factor in the pathogenesis of this idiopathic interstitial lung disease by connecting long-lasting epithelial damage to fibroblast accumulation and fibrotic processes. Viral pathogens, particularly emerging and re-emerging viruses, such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Influenza Virus, and Dengue Virus (DENV) and also those with oncogenic potential such as Epstein-Barr Virus (EBV), Cytomegalovirus (CMV), and Hepatitis C Virus (HCV), have been demonstrated to be significantly associated with impaired epithelial signalling, persistent inflammation, and EMT induction. This underscores the presence of potential mechanistic overlap between viral infections and fibrotic complications of the respiratory system. On the other hand, investigations have also suggested the capacity of Traditional Chinese Medicine (TCM) agents to modulate various EMT-linked pathways, which are simultaneously involved in both viral infections and IPF development. These common signalling pathways include TGF-β, Wnt/β-catenin, PI3K/AKT, and NF-κB signalling, acting as potential therapeutic targets against fibrotic complications such as IPF. The present review aims to comprehensively describe current evidence on the dynamic cross-talk between viral pathogens, particularly SARS-CoV-2, Influenza Virus, and DENV, EMT, and lung fibrosis. Additionally, it critically discusses how TCM-derived bioactive agents can interfere with these interconnected processes. This review elucidates the mechanistic basis and therapeutic potential of TCM compounds in lung fibrosis, considering the wider context of virus-related EMT dysregulation.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70118"},"PeriodicalIF":5.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147309667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue Fever and Its Burden in Burkina Faso: An Overview.","authors":"Wendimi Fatimata Belem, Ibrahim Sangare, Caroline Gilbert, Wilfried Wenceslas Bazié","doi":"10.1002/rmv.70089","DOIUrl":"10.1002/rmv.70089","url":null,"abstract":"<p><p>Dengue fever is an arbovirus disease caused by the dengue virus and has been diagnosed in Burkina Faso for many years. In recent decades, the disease has become a growing concern, thereby impacting the public health system. Several factors contribute to the pathogenesis of dengue fever, including the immune system and the virulence of different serotypes. Additionally, multiple complex conditions, including the spread of the Aedes mosquito vector and meteorological factors, contribute to the disease's spread. Therefore, effective disease management must be comprehensive, involving strategic combinations including community engagement, mosquito control, and public health measures. This approach has been implemented in Burkina Faso, with some success. Although several studies have focused on viral control, the isolation of virus serotypes, the prevalence and seroprevalence of the disease in specific populations, information on the overall burden of dengue fever is scarce in the country, as it presents classic symptoms similar to those of malaria and some arbovirus diseases encountered in the country. However, limited access to diagnostic tools, an inadequate surveillance system, a lack of awareness among healthcare workers, auto-medication, and ongoing conflicts in the country may lead to an underestimation of its burden and a limited understanding of its epidemiology. Here, we discuss dengue fever and the factors associated with the underestimation of its burden in Burkina Faso, drawing on government documents and published data. This review aims to describe the impact of managing this neglected tropical disease, advocating for improved surveillance and control efforts in the country.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70089"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Viro-Osteopathology: Unresolved Mechanistic Questions in the Pathogenesis of RNA Virus-Associated Bone Disorders.","authors":"Lin Yu, DuJiang Yang, Zhijun Ye, GuoYou Wang","doi":"10.1002/rmv.70099","DOIUrl":"10.1002/rmv.70099","url":null,"abstract":"<p><p>The recent review by Zhang et al. provides a valuable consolidation of clinical evidence linking Dengue virus (DENV), Chikungunya virus (CHIKV), and SARS-CoV-2 to bone-related diseases. While their work aptly highlights this emerging clinical paradigm, our letter offers a critical analysis to propel the field from descriptive association to mechanistic causation. We identify and dissect several substantive gaps in the current narrative. Firstly, we challenge the prevailing yet often circumstantial evidence for direct viral infection of bone cells, arguing for the need to distinguish between productive infection and passive viral presence. Secondly, we call for a more nuanced deconstruction of the \"cytokine storm\" hypothesis, urging the identification of master regulators and a clearer delineation between viral persistence and virally-induced autoimmunity in driving chronic pathology, such as post-CHIKV arthritis. Furthermore, we emphasise the critical need for longitudinal studies to define the long-term trajectory of bone health post-SARS-CoV-2 infection, distinguishing transient from permanent metabolic defects. Finally, we propose a unified, comparative research framework utilising advanced models to uncover fundamental principles of virus-bone interactions. This critical perspective underscores the necessity of a deeper, mechanism-driven investigative agenda to inform future therapeutic strategies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70099"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Cytomegalovirus (CMV) Infection in After Kidney Transplant Patients: A Systematic Review and Meta-Analysis.","authors":"Gleice K Jesus, Róger Costa, Gabriel O Franco, Cleyde C S Marconi, Maria B Arriaga, Eduardo M Netto","doi":"10.1002/rmv.70092","DOIUrl":"10.1002/rmv.70092","url":null,"abstract":"<p><p>Kidney transplantation is recognised by the World Health Organisation as the most effective therapy for end-stage renal disease, offering substantial improvements in survival and quality of life. However, the immunosuppression required to prevent graft rejection predisposes recipients to opportunistic infections, among which cytomegalovirus (CMV) remains a leading cause of morbidity and mortality. To determine the incidence of CMV infection in kidney transplant recipients and identify clinical and laboratory predictors and associated risk factors. A systematic review and meta-analysis, registered in PROSPERO (CRD42024524165), was conducted in accordance with PRISMA guidelines. PubMed, Web of Science, and LILACS databases were searched up to 6 March 2024 for cohort studies reporting CMV incidence post-kidney transplantation. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Publication bias was evaluated using funnel plots, Egger's test, Kendall's tau, and the fail-safe N. Fifteen studies met the inclusion criteria, comprising 3888 patients with a mean age of 45.1 years and a mean follow-up of 7.14 months. The pooled incidence of CMV infection was 42% (95% CI: 30%-54%), with high heterogeneity (I² = 98.75%; p < 0.001). Sensitivity analysis confirmed the robustness of the results, and no significant publication bias was detected. The main risk factors were: advanced age, paediatric age (< 5 years), donor-recipient serodiscordance (D+/R-), post-transplant lymphopenia, and reduced cell-specific immunity defect. CMV infection remains a common and clinically significant complication following kidney transplantation. With a high incidence and strong association with specific laboratory and clinical predictors. Individualised prevention strategies and early virological and immunological monitoring, especially in high-risk groups, are essential to reduce morbidity and mortality and preserve graft function. PROTOCOL REGISTRATION: PROSPERO: CRD42024524165.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70092"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological Consequences of CMV Infection: Overview of Pathogenesis and Host Responses.","authors":"Vijayalakshmi Reddy, Lonika Lodha, Shipra Gupta, Reeta S Mani, M A Ashwini","doi":"10.1002/rmv.70095","DOIUrl":"10.1002/rmv.70095","url":null,"abstract":"<p><p>Human cytomegalovirus (CMV), a member of the Herpesviridae family, is a ubiquitous pathogen that causes mild or asymptomatic infection in healthy individuals but leads to severe complications in immunocompromised patients and congenitally infected newborns. CMV exhibits marked neurotropism, and infection of the central nervous system (CNS) can result in a broad spectrum of neurological manifestations, including encephalitis, cognitive impairment, and developmental anomalies such as microcephaly, cerebral palsy, and sensorineural hearing loss. Though the clinical importance of CMV on the nervous system is well known and studied, the molecular mechanisms underlying CMV neuropathogenesis remain incompletely understood. In this review we present current knowledge on CMV infection of the CNS, highlighting the viral and host determinants that influence neurotropism, latency, immune evasion, and neural injury. We discuss important molecular pathways involved in viral entry, replication, and host immune modulation that contribute to CNS pathology. The article summarises recent insights from in vitro and in vivo models elucidating how CMV interacts with cells of CNS to disrupt neurodevelopment and brain homoeostasis. Furthermore, we review the neurological manifestations of CMV with emphasis on long term neurological sequelae of congenital and acquired CMV infection, as well as characteristic radiological findings associated with CMV neuroinfection. Understanding the complex interplay between CMV and the host nervous system is essential for identifying therapeutic targets and developing effective preventive strategies. This review aims to provide a comprehensive overview of CMV neuropathogenesis and to identify critical knowledge gaps that can guide future research on CMV-associated neurological disease.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 1","pages":"e70095"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145864922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}