Sexually transmitted diseases最新文献

{"title":"Risk of Sexually Transmitted Infections Among Pregnant Persons With Substance Use Diagnoses.","authors":"Jessica Frankeberger, Florencia Anunziata, Rebecca J Baer, Christina Chambers","doi":"10.1097/OLQ.0000000000002398","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002398","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted infections (STIs) in pregnancy have increased among reproductive-aged women and are associated with adverse maternal and infant outcomes. Identifying high-risk groups for perinatal STIs, including those with differential substance use diagnoses, is essential. This study examines the risk of STIs in pregnancy by specific isolated and co-occurring substance use diagnoses.</p><p><strong>Methods: </strong>Data stem from a population-based study of pregnant individuals with liveborn, singleton deliveries in California from 2011 to 2021. Birth certificates were linked to maternal and infant hospital records, and maternal STIs and substance diagnoses were identified with the International Classification of Diseases (ICD) revision 9 and 10 codes. Modified Poisson regressions with robust error variance estimated the unadjusted and adjusted risk of each STI (chlamydia, gonorrhea, and syphilis) among those with each substance diagnosis (alcohol, tobacco, cannabis, cocaine, stimulants, opioids, and sedatives). Risk was estimated for isolated and comorbid substance diagnoses.</p><p><strong>Results: </strong>Among 4,481,096 pregnant individuals, 31,123 (0.7%) had chlamydia, 4132 (0.1%) had gonorrhea, and 7267 (0.2%) had syphilis. All substance diagnoses were associated with increased risk of STIs. In adjusted models, both isolated and comorbid stimulant diagnoses were associated with some of the highest risk of chlamydia (adjusted risk ratio [aRR] = 3.11-3.63), gonorrhea (aRR = 7.11-9.84), and syphilis (aRR = 13.12-14.30). Generally, those with comorbid substance diagnoses had higher risk of each STI than their counterparts with isolated diagnoses.</p><p><strong>Conclusions: </strong>Those with substance diagnoses, particularly stimulant and/or co-occurring diagnoses, are at elevated risk for STIs in pregnancy. There remains unmet need for prevention, screening, and treatment to address STIs in pregnancy among those with substance use.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":"53 11","pages":"859-864"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184450","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}

{"title":"High Baseline Prevalence and Stable Incidence of Chlamydia and Gonorrhea During the First Year of HIV Pre-Exposure Prophylaxis: A Multicenter Italian Cohort Study.","authors":"Chiara Fusetti, Roberto Rossotti, Serena Reato, Nicholas Brian Bana, Letizia Oreni, Chiara Baiguera, Andrea Giacomelli, Elena Simoncini, Gabriele Cavazza, Massimo Puoti, Andrea Gori, Davide Moschese","doi":"10.1097/OLQ.0000000000002393","DOIUrl":"10.1097/OLQ.0000000000002393","url":null,"abstract":"<p><strong>Introduction: </strong>Concerns persist that HIV pre-exposure prophylaxis (PrEP) may be associated with increased sexually transmitted infections (STIs), but longitudinal data incorporating the pre-PrEP period and standardized screening remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of individuals initiating oral emtricitabine/tenofovir disoproxil fumarate PrEP at 2 STI clinics in Milan, Italy (2018-2024). Participants underwent baseline and quarterly screening (pharyngeal, anal, vaginal swabs and urine nucleic acid amplification testing) for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). We estimated baseline prevalence and interval-specific conditional cumulative incidence across 0 to 3, 3 to 6, 6 to 9, and 9 to 12 months intervals, and described symptomatic and recurrent diagnoses. Finally, we evaluated STI trends across 3 calendar periods: 2018 to 2019, 2020 to 2021, and 2022 to 2024.</p><p><strong>Results: </strong>A total of 1087 individuals were included (median age 35 years [interquartile ranges 30-41]); most were cisgender gay, bisexual, and other men who have sex with men (98.4%). At baseline, 15% (163/1,087) had at least one CT/NG infection. During follow-up, 516 new diagnoses occurred in 359 individuals (33%). Interval-specific conditional cumulative incidence for any CT/NG infection was 13.5%, 15.2%, 17.7%, and 12.7% across the 4 intervals. The majority of infections were asymptomatic. No substantial differences in STI trends were observed across the 3 calendar periods.</p><p><strong>Conclusions: </strong>In this real-world PrEP cohort undergoing quarterly nucleic acid amplification testing screening, CT/NG diagnoses were common at baseline and maintained high but stable incidence during the first year after PrEP initiation, with no clear upward trend over time.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"796-800"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764668","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}

{"title":"Associations Between Maternal Mental Health and Congenital Syphilis Birth Outcomes: Analysis of Georgia Surveillance Data, 2018-2023.","authors":"Udodirim N Onwubiko, Latasha Terry, Jenna Gettings, Kirsten Oliver, Akilah Spratling, Latoya Lemmons, Kim Booker, Kim Norris, Nicole L Davis","doi":"10.1097/OLQ.0000000000002372","DOIUrl":"10.1097/OLQ.0000000000002372","url":null,"abstract":"<p><strong>Background: </strong>Congenital syphilis (CS) is a preventable yet persistent public health problem in the United States. Maternal mental health conditions (MMHC) during pregnancy may contribute to missed prevention opportunities, but their association with CS outcomes is unclear.</p><p><strong>Methods: </strong>Georgia sexually transmitted infections (STI) surveillance data (2018-2023) were analyzed to assess prebirth MMHC mentions among syphilis-affected pregnancies, their association with CS, and variation by maternal household composition as a proxy for immediate social support. MMHC mentions were identified using rule-based analysis of free-text case narratives from the year before delivery. Modified Poisson regression was used to estimate adjusted prevalence ratios (aPR), and an internal validation substudy informed probabilistic bias adjustment for MMHC misclassification.</p><p><strong>Results: </strong>Among 1684 syphilis-affected pregnancies, 416 (25%) resulted in CS. Prebirth MMHC were documented in 4% and were associated with higher CS prevalence (aPR, 1.5; 95% confidence interval [CI], 1.1-2.1). Although the association did not differ significantly by maternal household composition, it was attenuated among women living with family or partners (aPR, 1.18; 95% CI, 0.57-2.47) compared with those living alone or with nonfamily members (aPR, 1.42; 95% CI, 0.70-2.90). Internal validation indicated MMHC under-ascertainment in surveillance data; bias-adjusted analyses suggested a stronger association with CS, albeit with considerable uncertainty (bias-adjusted PR, 2.1; 95% simulation interval, 0.8-5.0).</p><p><strong>Conclusions: </strong>Prebirth MMHC mentions captured during STI case investigations were associated with increased CS prevalence and may serve as an early indicator of vulnerability. Incorporating mental health-informed follow-up into STI surveillance workflows could enhance care coordination and strengthen CS prevention.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":"53 11","pages":"807-813"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168421","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":"Efficacy of Minocycline- Versus Pristinamycin-Based Regimens for the Treatment of Mycoplasma genitalium Infections: A Scoping Review.","authors":"Miguel Fernández-Huerta, Zaira Moure, Miriam Torrecillas, Berta Fidalgo, Ignacio Fernández, Jesús Trejo-Zahínos, Judit Serra-Pladevall, Mateu Espasa-Soley","doi":"10.1097/OLQ.0000000000002334","DOIUrl":"10.1097/OLQ.0000000000002334","url":null,"abstract":"<p><strong>Background: </strong>In the current scenario, where dual-class resistance to both macrolides and fluoroquinolones in Mycoplasma genitalium is emerging, alternatives are scarce. We aim to estimate the efficacy of minocycline- and pristinamycin-based regimens for the treatment of M. genitalium infections.</p><p><strong>Methods: </strong>In November 2025, two independent Boolean searches were performed in PubMed using the MeSH terms \" Mycoplasma genitalium \" AND \"minocycline\" and \" Mycoplasma genitalium \" AND \"pristinamycin,\" respectively, to identify manuscripts reporting treatment outcomes in M. genitalium urogenital infections using minocycline- and/or pristinamycin-based regimens.</p><p><strong>Results: </strong>Regarding minocycline, six original research studies were finally included for the primary outcome, accounting for 274 M. genitalium infection cases. On the other hand, six studies were also included regarding pristinamycin (three records overlapping with the other search), accounting for 223 M. genitalium cases. The aggregated data estimated that the rate of treatment failure associated with minocycline was 71/274 (25.9% [95% confidence interval, 20.7%-31.1%]), similar to the one estimated for pristinamycin-based therapies of 56/223 (25.1% [95% confidence interval, 19.6%-31.3%]); P = 0.839.</p><p><strong>Conclusions: </strong>This review provides comprehensive evidence-based data regarding the efficacy of minocycline- and pristinamycin-based regimens for the treatment of M. genitalium infections. Consequently, this work presents a consolidated analysis to help support updates to clinical guidelines, suggesting the preferential use of minocycline over pristinamycin for the treatment of multidrug-resistant infections due to its greater accessibility and lower cost.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"832-837"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718148","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}

{"title":"Correlates of Group Sex Participation Among Cisgender Men Who Have Sex With Men in Seattle, WA.","authors":"Lisa A Niemann, David A Katz, Lauren R Violette, Andy Cornelius-Hudson, Jakar Delacruz, Sarah J McDougal, Vanessa M McMahan, Joanne D Stekler","doi":"10.1097/OLQ.0000000000002386","DOIUrl":"10.1097/OLQ.0000000000002386","url":null,"abstract":"<p><strong>Background: </strong>Group sex events (GSEs) have potential implications for transmission and acquisition of HIV and sexually transmitted infections (STIs).</p><p><strong>Methods: </strong>We analyzed survey data from Project DETECT, a Centers for Disease Control and Prevention-funded study evaluating point-of-care tests. Our analytical sample included cisgender gay, bisexual, and other men who have sex with men (cisGBMSM) seeking HIV/STI testing who reported at least one anal sex partner in the past 3 months. We defined recent GSE as a sexual encounter in the past 3 months involving more than two people. Poisson regression compared demographic characteristics and behaviors between participants and partners of participants who reported GSE participation versus ≥2 sex partners but no recent GSEs.</p><p><strong>Results: </strong>Recent GSE was reported at 707 (36%) of 1991 study visits by 1539 unique participants. Participants who reported bacterial STI diagnosis in the past 3 months (prevalence ratio [PR] = 1.31, 95% confidence interval [CI] = 1.16-1.49) and current PrEP use (PR = 1.49, 95% CI = 1.32-1.69) were more likely to report a GSE than to report ≥2 sex partners and no GSE. Partners recently diagnosed with an STI (PR = 1.21, 95% CI = 1.06-1.37) and partners with other concurrent partners (PR = 1.91, 95% CI = 1.62-2.26) were more likely to be partners of participants who reported GSE than participants with ≥2 partners but no GSE.</p><p><strong>Conclusions: </strong>GSE participation was common among cisGBMSM. While GSE participation was associated with some predictors of HIV infection, GSE participants were more likely to use PrEP. Healthcare for cisGBMSM should include assessing GSE participation and discussing strategies for HIV/STI prevention in the context of GSE.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"775-786"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679479","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}

{"title":"Looking Down the Road: Development of a Future Syphilis Vaccine.","authors":"Arlene C Seña, Lorenzo Giacani, Caroline E Cameron, Melissa J Caimano, Michael Marks, Mathew A Beale, Linda Grillová, Suzanne Day, Kimberly A Workowski, Adele Schwartz-Benzaken, Kelly L Hawley","doi":"10.1097/OLQ.0000000000002397","DOIUrl":"10.1097/OLQ.0000000000002397","url":null,"abstract":"","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"877-883"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798011","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":"Demographic and clinical factors associated with Syphilis treatment initiation in a tribal health system: a retrospective cohort study.","authors":"Andrea Blair, Ashley Comiford, Molly Feder, Jorge Mera","doi":"10.1097/OLQ.0000000000002436","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002436","url":null,"abstract":"<p><strong>Background: </strong>American Indian/Alaska Native (AI/AN) individuals are disproportionately burdened by syphilis compared with other racial and ethnic groups. Early syphilis treatment is important to reduce transmission and prevent negative health outcomes. Understanding the characteristics of individuals who test positive and the factors associated with initiating treatment will support syphilis prevention and treatment efforts.</p><p><strong>Methods: </strong>Cherokee Nation conducted a retrospective cohort study of individuals who tested positive for syphilis between 2016 and 2023. Data were collected from electronic health records and analyzed descriptively using counts and percentages and inferentially using Chi-square tests and multivariable logistic regression.</p><p><strong>Results: </strong>Overall, 356 individuals tested positive for syphilis and 314 (88.2%) initiated treatment. Most individuals who tested positive were ≤ 34 years (60.7%), single (83.4%), diagnosed during the COVID-19 pandemic (75.8%), residing in a county with a Cherokee Nation clinic (84.3%), and had a non-emergency healthcare visit within one year (70.5%). Approximately half (52.0%) had documented substance use and 31.2% had an STI co-infection within one year. Individuals diagnosed outside of an emergency department or urgent care setting had higher odds of initiating treatment compared with those diagnosed in an emergency department or urgent care setting (aOR=2.01, 95% CI: 1.02-3.97). Individuals with an STI co-infection had higher odds of initiating treatment compared with those without an STI co-infection (aOR=2.96, 95% CI: 1.19-7.33).</p><p><strong>Conclusions: </strong>This study suggests that focusing public health and clinical syphilis treatment efforts on emergency department and urgent care providers and patients may increase syphilis treatment initiation.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224859","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}

{"title":"Meet a Colleague.","authors":"Casey N Pinto","doi":"10.1097/OLQ.0000000000002428","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002428","url":null,"abstract":"","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207924","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}

{"title":"Mpox and sexually transmitted infections: syndemic drivers of transmission and disease outcomes-A Narrative Review.","authors":"Ankita Ray, Tanu Bhati","doi":"10.1097/OLQ.0000000000002438","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002438","url":null,"abstract":"<p><p>The worldwide outbreak of mpox (formerly monkeypox) in 2022 emerged as a public health emergency posing greater threat to persons with sexually transmitted infections (STIs). This outbreak featured an increase in overlap between mpox and STIs reflecting evolving transmission dynamics in sexual networks. Epidemiological data reveal that STIs such as human immunodeficiency virus (HIV), Chlamydia trachomatis, herpes simplex virus, syphilis have been frequently associated with mpox infection highlighting the role of sexual contact in its transmission. A narrative review was conducted using PubMed and Google Scholar to identify relevant literature published between 2008 and 2026, focusing on mpox, STIs, co-infections, and pregnancy outcomes. Evidence suggests that biological, behavioural and structural factors may interact to influence mpox transmission and clinical outcomes. STI co-infection may be associated with mucosal invasion and immune modulation plausibly affecting disease progression, however direct mechanistic evidence remains limited. Although mpox infection has majorly affected gay, bisexual and other men who have sex with men (GBMSM), its severity in women particularly during pregnancy raises concerns regarding vertical transmission and maternal and neonatal complications. This review highlights current evidence on mpox-STI co-infections, and applies a syndemic framework to interpret their co-occurrence within biological, behavioural and structural contexts. While this perspective provides understanding regarding transmission patterns, further research is needed to establish the extent of these interactions. Recognizing these factors is important for screening, early diagnosis and management strategies to mitigate future outbreaks and impact of mpox. Summary: This narrative review on mpox and STI co-infections explores syndemic interactions, transmission dynamics and implications for disease outcomes and public health management.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207979","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}

{"title":"One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis in People Living with HIV: A Systematic Review and Meta-Analysis.","authors":"Martin Cevallos-Cueva, Sümeyye Aktaş, Luiza Fenalte Streher, Ana Clara Felix De Farias Santos, Lorena Oliveira Fonseca, Ayşe Deniz Gökengin, Henry J C De Vries","doi":"10.1097/OLQ.0000000000002437","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002437","url":null,"abstract":"<p><p>Despite the current recommendations of the CDC and IUSTI, controversy persists regarding the adequate dose and duration of benzathine penicillin G (BPG) for early syphilis in people living with HIV (PLWH). PubMed, Embase, and Cochrane were searched from inception to October 2025 for studies comparing a single-dose versus a 3-dose BPG regimen in PLWH with early syphilis. A random-effects meta-analysis was performed using risk ratios (RRs) with 95% confidence intervals (CIs). The primary outcome included serologic cure, defined as a ≥4-fold (2-dilution) decline from baseline in antibody titers measured by nontreponemal (lipoidal antigen) tests, including rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) tests, at 6 and 12 months. A total of 8 studies, including 2randomized controlled trials (RCTs) and 6observational studies, were included. Pooled analysis showed no significant difference in serologic cure between a single-dose versus 3-dose BPG at 6months (RR 1.00; 95% CI 0.93 to 1.07; P = 0.95) or 12 months (RR 0.98; 95% CI 0.92 to 1.04; P = 0.46). Overall, our pooled results did not show a significant difference between single-dose and 3-dose BPG. However, our study did not evaluate selected high-risk subgroups, particularly individuals with advanced immunosuppression or untreated HIV infection. Thus, a potential benefit of enhanced therapy in these specific populations cannot be entirely ruled out, underscoring the need for future RCTs focused on these subgroups and designed to stratify or adjust for key disease-modifying factors.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207992","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}