Sexually transmitted diseases最新文献

{"title":"Sequential Sex Practices and the Likelihood of Bacterial Sexually Transmitted Infections and Urethritis in Men Who Have Sex With Women.","authors":"Mary Bridget Waters, Laura C Chambers, Lisa E Manhart, Sarah S Romano, Anjuli D Wagner, Tim W Menza, Christine M Khosropour","doi":"10.1097/OLQ.0000000000002369","DOIUrl":"10.1097/OLQ.0000000000002369","url":null,"abstract":"<p><strong>Background: </strong>Mathematical modeling studies suggest that sequential sex practices (SSPs) among men who have sex with men are necessary to produce observed rates of bacterial sexually transmitted infections (STIs). Nearly all models of bacterial STIs in opposite-sex partnerships have focused exclusively on urogenital infections, although SSPs may lead to extragenital infections. The frequency of SSPs and their associations with bacterial STIs among men who have sex with women (MSW) is not well-characterized.</p><p><strong>Methods: </strong>We utilized data from a 6-month cohort study of male urethritis in Seattle, WA (2014-2018); our analysis included MSW aged ≥16 y. Each month, participants completed questionnaires ascertaining SSPs, were evaluated for nongonococcal urethritis (NGU), and provided urine samples for urethral bacterial STI testing. We identified the most frequent SSPs reported at participants' last sexual encounter before testing and used generalized estimating equations to estimate the probability of positive urethral STI and of NGU.</p><p><strong>Results: </strong>The 184 participants included in the analysis reported 528 sexual encounters; 76% of sexual encounters included >1 sex act. The most frequently reported SSPs were insertive oral sex followed by vaginal sex (57.4%), vaginal sex only (19.5%), and vaginal sex followed by insertive oral sex (9.5%). Overall, participants had four positive urethral STI tests and 14 cases of NGU without a positive urethral STI test.</p><p><strong>Conclusions: </strong>Among MSW, there are clear patterns in the frequency of types of sex and SSPs. These data can inform the development of more robust mathematical models of bacterial STI transmission among MSW.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"679-684"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303142","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":"Patient Information, Motivations, and Behavioral Skills during Early Implementation of Doxy-PEP in New York City.","authors":"Paul A D'Avanzo, Craig J Heck, Emma Tucker, Jason Zucker","doi":"10.1097/OLQ.0000000000002361","DOIUrl":"10.1097/OLQ.0000000000002361","url":null,"abstract":"<p><strong>Background: </strong>Doxycycline postexposure prophylaxis (doxy-PEP) has been shown to be an effective strategy for preventing bacterial sexually transmitted infections; however, factors affecting its uptake, persistence, and effective use have yet to be thoroughly explored. This study qualitatively assessed the information, motivations, and behavioral skills (IMB) related to doxy-PEP uptake and use among a health-seeking sample in New York City.</p><p><strong>Methods: </strong>Between July 2023 and January 2024, in-depth semistructured interviews were conducted with 14S patients attending an academic sexual health clinic in Northern Manhattan. Transcripts were analyzed using an IMB framework-guided thematic analysis with additional deductive codes to identify subthemes.</p><p><strong>Results: </strong>Half of the patients interviewed were using doxy-PEP at the time of interview (n = 7). Major IMB themes included Information: doxy-PEP Knowledge/Awareness, and Information: doxy-PEP Information Sources; Motivations: sexually transmitted infections Vulnerability, Motivations: Concerns about Side-Effects, and Motivations: Concerns about Antimicrobial Resistance; and Behavioral Skills: doxy-PEP Access, and Behavioral Skills: Timing of Sexual Activity.</p><p><strong>Conclusions: </strong>This qualitative analysis identified several IMB factors that may help guide ongoing efforts to increase equitable access and effective use of doxy-PEP. Patients were generally well-informed about doxy-PEP, though some confusion regarding the strategy was noted, which supports ongoing patient education. Specific concerns related to antimicrobial resistance emerged as factors that may affect both intention and motivation to adopt and continue using doxy-PEP, emphasizing the importance of resistance monitoring. Finally, complementary behavioral strategies that were described, such as the \"clumping\" of sexual partners, require additional study to discern how this may affect long-term doxy-PEP effective use.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"720-725"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017264","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":"Trends of Chlamydia trachomatis Infections in STI Clinic at a Tertiary Care Hospital in North India.","authors":"Chandana Acharya, Arya Babu, Somesh Gupta, Benu Dhawan","doi":"10.1097/OLQ.0000000000002366","DOIUrl":"10.1097/OLQ.0000000000002366","url":null,"abstract":"","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"e86"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043746","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":"Assessing Partner Management and Counseling in Prenatal Care of Women Diagnosed With Sexually Transmitted Infections.","authors":"Likhita Nandigam, Sara Vincent, Julie Gutierrez, Han-Yang Chen, Alison Goulding Mustoe, Irene Stafford","doi":"10.1097/OLQ.0000000000002381","DOIUrl":"10.1097/OLQ.0000000000002381","url":null,"abstract":"<p><strong>Background: </strong>Testing for sexually transmitted infections (STIs) is a routine component of prenatal care. Treating partners is challenging and the inconsistency contributes to maternal reinfection and neonatal morbidity. This study evaluated documentation of partner treatment among pregnant women diagnosed with different STIs.</p><p><strong>Methods: </strong>This retrospective cohort study included pregnant women who received care at 2 safety-net hospitals in Harris County, TX, between 2019 and 2022. Electronic health records were reviewed for documented partner treatment among patients with chlamydia, gonorrhea, coinfection of both chlamydia and gonorrhea, hepatitis B infection (HBV), or syphilis during pregnancy. Patients with chlamydia and gonorrhea are typically offered expedited partner therapy by physicians, whereas the local health department coordinates partner treatment of HBV and syphilis. Gaps in hospital and health department records were supplemented through brief patient interviews. Multivariable Poisson regression models with robust error variance examined associations between STI and physician counseling on partner treatment, adjusting for age, race and ethnicity, marital status, preferred language, and substance use. Adjusted relative risk with 95% confidence intervals were calculated. P <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among 369 eligible patients, physician documentation of partner treatment was highest for patients with chlamydia only (54%), followed by gonorrhea only (46%), syphilis (43%), and lowest for HBV (1%). Documented barriers to partner treatment included lack of partner contact (gonorrhea only 75%, chlamydia only 43%, syphilis 34%) and partner refusal (HBV 43%). Physician counseling on partner treatment was documented for ≥80% of patients with STIs except HBV (56%, adjusted relative risk = 0.68, compared to chlamydia only, 95% confidence interval: 0.51-0.91). Sufficient prenatal care was associated with higher partner treatment for chlamydia only (67% vs. 45%, P = 0.023).</p><p><strong>Conclusions: </strong>Partner treatment and physician counseling vary by STI. Physician reliance on public health-managed partner treatment may hinder completion and sustain high rates of STIs during pregnancy.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"769-774"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303151","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":"Peripheral Positions and Reachability of Casual Sexual Partners in Egocentric Networks Among Sexual and Gender Minorities.","authors":"Guozheng Yang, Ian Dale, Carol Golin, Feng-Chang Lin, Meagan Zarwell, Ann M Dennis","doi":"10.1097/OLQ.0000000000002365","DOIUrl":"10.1097/OLQ.0000000000002365","url":null,"abstract":"<p><strong>Background: </strong>Casual sexual partners (CSP) involve non-monogamous partnerships, limited personal disclosure, and sexual behaviors that could facilitate HIV transmission. Their peripheral positions in social networks may limit intervention reach but also create unique bridging opportunities for prevention efforts.</p><p><strong>Methods: </strong>Egocentric network data were collected from sexual and gender minority participants (egos) in Charlotte, North Carolina from 2023 to 2025. We compared CSPs' demographic characteristics and structural positions in networks with those of other social contacts (alters), including established sexual partners (ESPs), and non-sexual alters (NSAs). Factors associated with connectivity between NSAs and sexual partners were examined using dyadic and triadic analyses.</p><p><strong>Results: </strong>Having CSPs was associated with having HIV, larger networks, and more sexual partnerships. Both casual and established sexual partners provided limited social support to egos and occupied peripheral positions with reduced reachability within egocentric networks. NSAs connected to CSPs showed lower racial homophily with their egos compared with those connected to established partners but were more likely to provide physical or health support. NSAs who were: socially closer to egos (adjusted odds ratio [aOR] = 6.13, 95% confidence interval [CI], 1.26-62.24); not family members (aOR = 0.02, 95% CI, 0.00-0.45); and living within 5 miles (aOR = 6.92, 95% CI, 1.22-55.53) were more likely to know egos' CSPs. In sensitivity analysis that defined longer-standing sexual partners as CSPs, our main findings persisted.</p><p><strong>Conclusions: </strong>Future interventions could consider integrating key NSAs into peer-led strategies to enhance HIV/STI prevention, as their connections within egocentric networks may help facilitate engagement with sexual partners.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"665-672"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043765","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":"Doxycycline Postexposure Prophylaxis May Dramatically Reduce Syphilis Among Gay, Bisexual, and Other Men Who Have Sex With Men: A Modeling Study.","authors":"Patrick A Clay, David A Jackson, Laura H Bachmann, Ian H Spicknall","doi":"10.1097/OLQ.0000000000002371","DOIUrl":"10.1097/OLQ.0000000000002371","url":null,"abstract":"<p><strong>Background: </strong>Syphilis cases in the United States have surged over the past decade, and cases are highest among gay, bisexual, and other men who have sex with men (GBMSM). The Centers for Disease Control and Prevention recommends doxycycline postexposure prophylaxis (doxy PEP) for GBMSM recently diagnosed with bacterial sexually transmitted infections to mitigate this burden. Potential drawbacks include increased antimicrobial resistance and microbiome disruption. Here, we estimate doxy PEP coverage levels required to eliminate sustained community transmission among GBMSM while balancing the drawbacks of doxy PEP.</p><p><strong>Methods: </strong>We fit a modified susceptible-infectious-susceptible model of syphilis transmission among GBMSM to syphilis case counts by sex-of-sex-partner. We simulated a range of doxy PEP coverage and adherence levels among GBMSM linked to human immunodeficiency virus treatment and prevention over a 10-year period. We tracked syphilis prevalence and incident cases among GBMSM with and without healthcare access.</p><p><strong>Results: </strong>With a lower bound efficacy estimate (41%) and 10% doxy PEP utilization (coverage × adherence) among GBMSM linked to human immunodeficiency virus treatment and prevention, we estimated a 24% (interquartile range: 17%-30%) reduction in annual syphilis cases among GBMSM over the next 10 years. Under upper-bound efficacy estimates (97%) and 50% utilization, we estimated a 99% (interquartile range: 88%-100%) reduction in annual syphilis cases among GBMSM over the next 10 years. Our model shows that if subpopulations of GBMSM have reduced access to healthcare, then the elimination of sustained community transmission is unlikely over the next decade.</p><p><strong>Conclusions: </strong>Doxy PEP may dramatically reduce syphilis incidence among GBMSM, but barriers to healthcare may impede the elimination of sustained community transmission of syphilis.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"703-711"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303157","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":"Correlates of Sexually Transmitted Infection Positivity and Implementation of Point-of-Care Sexually Transmitted Infection Testing at a Mobile Clinic for Women Who Inject Drugs in Seattle, WA.","authors":"Abigail G Fessler, Maria A Corcorran, Lauren R Violette, Kenneth A Tapia, Thomas S Fitzpatrick, Stacey Jones, Elizabeth J Austin, Sara N Glick, Emily C Williams, Shireesha Dhanireddy, Jenell Stewart","doi":"10.1097/OLQ.0000000000002360","DOIUrl":"10.1097/OLQ.0000000000002360","url":null,"abstract":"<p><strong>Background: </strong>Women who inject drugs (WWID) face complex barriers to engagement in sexual healthcare. We used point-of-care (POC) testing to assess sexually transmitted infection (STI) prevalence, correlates, and treatment delivery, as well as testing acceptability and feasibility, at a mobile clinic for WWID in Seattle, Washington.</p><p><strong>Methods: </strong>We implemented a mobile clinic offering substance use and sexual health services for women ≥18 years with a history of injecting drugs and negative or unknown HIV status. We offered POC testing for trichomonas, syphilis, chlamydia, gonorrhea, and HIV at enrollment, 3 months, and 6 months. Participant surveys assessed demographics, behaviors, and acceptability of POC testing. Provider surveys assessed the feasibility of care delivery. We used bivariate analysis to identify correlates of STI positivity.</p><p><strong>Results: </strong>Among 50 WWID enrolled, 73% were unstably housed, and 56% reported a previous STI. In the preceding 3 months, 34% reported transactional sex, and 38% had ≥2 sexual partners. During the study period, 26% of women tested positive for trichomonas, 4% for syphilis, 3% each for chlamydia and gonorrhea, and 0% for HIV. Same-day treatment was provided in 94% of cases. STI positivity was associated with ≥2 sexual partners (odds ratio: 5.8, P = 0.02) and transactional sex (odds ratio: 4.8, P = 0.02). POC testing was acceptable, and 84% preferred it over traditional methods. Staff encountered challenges with POC logistics and competing participant priorities.</p><p><strong>Conclusions: </strong>STI prevalence, particularly trichomonas, was high among WWID, but low-barrier POC STI testing services were acceptable and feasible, leading to same-day STI treatment in most cases.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"733-739"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043788","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":"Patterns of Sexually Transmitted Infection-Related Testing and Diagnosis by Places of Service, MarketScan Commercial Claims Data, 2023-2024.","authors":"Chirag G Patel, Brian Emerson, Guoyu Tao","doi":"10.1097/OLQ.0000000000002419","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002419","url":null,"abstract":"<p><strong>Background: </strong>Understanding where people receive care for sexually transmitted infections (STI) is essential for optimizing STI service delivery.</p><p><strong>Methods: </strong>Based on the date of service, the first encounter with STI testing or diagnosis for each patient aged ≥15 years was identified using MarketScan commercial claims data from 2023-2024. We identified chlamydia, gonorrhea and syphilis testing using Current Procedural Terminology codes (CPT) and diagnoses using International Classification of Diseases (ICD-10) codes. Encounters were classified as diagnosis encounters if they included an STI diagnosis, and as testing encounters if they included STI testing only. We appropriately identified place-of-service using an encounter-ordering approach, especially tracing laboratory claims to their origin.</p><p><strong>Results: </strong>A total of 2,964,733 STI-related encounters (98.6% for testing, 1.4% for diagnoses) were identified, including 82.7% for chlamydia (CT), 81.3% for gonorrhea (GC), and 50.0% for syphilis (TP). Among the encounters, office encounters accounted for the highest proportion (82.1%), followed by independent laboratories (12.2%) and emergency room (ER)/urgent care (UC)/acute care (AC) clinics (4.8%). Based on demographic characteristics, encounters were more frequent among people aged 30-34 years old (17.9%), women (74.5%) and people living in the South region (47.4%).</p><p><strong>Conclusions: </strong>The predominance of STI testing-coded encounters indicates that most identified claims involved STI testing rather than diagnosis coding. However, claims data cannot distinguish routine screening from diagnostic testing and finding reflect encounter-based observations of claims, rather than inferring adherence to screening guidelines. Maintaining access to offices, independent laboratories, and ER/UC/AC clinics remains important for appropriate STI care.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064289","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":"Chlamydia and Gonorrhea Prevalence in Women Entering the North Carolina Department of Adult Corrections, 2013-2019.","authors":"Mary D Carmody, Mia B Hodges, Brooke W Bullington, Anna B Cope, Andrea K Knittel","doi":"10.1097/OLQ.0000000000002418","DOIUrl":"10.1097/OLQ.0000000000002418","url":null,"abstract":"<p><p>Chlamydia and gonorrhea prevalence was higher among women entering North Carolina prisons in 2019 compared to 2013, reflecting broader statewide trends. Annual screening rates varied between 41%-73%, suggesting missed opportunities. Standardized screening protocols are needed to improve carceral health data to inform statewide sexually transmitted infection surveillance efforts.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064266","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":"Screening for Sexually Transmitted Infections during pregnancy: Is healthcare meeting expectations?","authors":"Uttara Seshu, Mahmoud Azqul, Edeanya Agbese, Kathryn Risher, Douglas L Leslie, Casey N Pinto","doi":"10.1097/OLQ.0000000000002412","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002412","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted infections (STIs) during pregnancy contribute to adverse maternal and neonatal outcomes. Guidelines from the U.S. Centers for Disease Control and Prevention (CDC), and American College of Obstetricians and Gynecologists (ACOG), recommend routine screening for syphilis, HIV, chlamydia, gonorrhea, and risk-based screening for trichomoniasis for pregnant women. We assessed pre-COVID-19 prenatal STI screening patterns among privately insured pregnant persons in the United States to assess whether practice aligns with guidelines.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive analysis of pregnancies among persons aged 15-44 years captured in the Merative MarketScan® commercial claims database from 2016-2019. Pregnancies were identified using ICD-10, CPT-4, and HCPCS codes and classified by delivery type. Screening coverage was summarized overall and by pregnancy outcome, age group, and metropolitan statistical area.</p><p><strong>Results: </strong>Among 917,859 pregnancies, overall screening coverage was highest for syphilis (90.5 %), followed by HIV (82.4%), chlamydia (80.4%), and gonorrhea (79.5%), while trichomoniasis screening was substantially lower (22.4%). Screening was lowest among pregnancies ending in spontaneous abortion and declined with increasing maternal age for chlamydia, gonorrhea, and trichomoniasis. Urban rural differences were small, with slightly higher screening in urban areas.</p><p><strong>Conclusions: </strong>We provide a pre-COVID-19 baseline for prenatal STI screening among privately insured pregnant persons. STI screening adherence was high, but further progress is needed to mitigate STIs' costly but preventable health outcomes.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025938","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}