Transactions of The Royal Society of Tropical Medicine and Hygiene最新文献

{"title":"First report of Culex flavivirus and its association with Wolbachia in Culex quinquefasciatus from Puducherry, India.","authors":"Indranil Haldar, Waseema Arif, Panneer Devaraju, Krishan Kumar Sihag, Srikanth Srirama, Vijayakumar Balakrishnan, Pushpa Srinivasan, Amala Ramasamy, Manju Rahi","doi":"10.1093/trstmh/trag047","DOIUrl":"10.1093/trstmh/trag047","url":null,"abstract":"<p><strong>Background: </strong>Symbiotic insect-specific viruses, such as Culex flavivirus (CxFV), are increasingly recognized for their ability to modulate arboviral replication in mosquitoes. However, the prevalence of CxFV in Culex quinquefasciatus mosquitoes from Puducherry, India-a region previously endemic for filariasis-and its interaction with the endosymbiotic bacterium Wolbachia pipientis, remain unexplored.</p><p><strong>Methods: </strong>Culex quinquefasciatus mosquitoes were collected from villages in and around Puducherry. A total of 150 pools were screened for CxFV by PCR targeting the NS-5 gene and the amplicons were sequenced. Further, 100 individual mosquitoes were tested for both CxFV and the relative density of Wolbachia.</p><p><strong>Results: </strong>The study identified a CxFV prevalence of 3.73% (95% CI 2.27-5.46) among the mosquito pools by Bayesian estimation approach. Phylogenetic analysis classified the circulating strain as genotype 2 of CxFV. The median relative density of Wolbachia was observed to be 0.170 (IQR 0.009-0.683) in CxFV-positive mosquitoes and 0.132 (IQR 0.021-0.570) in CxFV-negative mosquitoes, with no statistically significant difference between the two groups.</p><p><strong>Conclusions: </strong>Thus, with the first report on the circulation of CxFV-infected mosquitoes in Puducherry, the study highlights a probable lack of association between the relative density of Wolbachia and CxFV.</p><p><strong>Accession numbers: </strong>The raw sequence reads have been deposited in GenBank (https://www.ncbi.nlm.nih.gov/nuccore/) with the following accession numbers: PQ586414, PQ586415, PQ586416, PQ586417, PQ586418, PQ586419, PQ586420, PQ586421, PQ586422, PQ586423.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"851-861"},"PeriodicalIF":1.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782072","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":"Diagnostics and the 100-day mission: why preparedness cannot wait.","authors":"Caitlin R Thompson, Emily R Adams, Tom E Fletcher","doi":"10.1093/trstmh/trag052","DOIUrl":"10.1093/trstmh/trag052","url":null,"abstract":"<p><p>The 2025 International Panel for Pandemic Surveillance Report and the G7 100-day mission emphasise rapid deployment of diagnostics, but preparatory infrastructure is vital to achieve this goal. Drawing on lateral flow development and haemorrhagic fever case studies, we highlight the requirement for pre-established diagnostic building blocks, including monoclonal antibodies, antigens, biological reference materials and regulatory pathways. Persistent funding imbalances and inequitable global investment threaten timely outbreak response. Sustained preparedness investment, strengthened biobanking and equitable access frameworks will ensure that diagnostics can be delivered within meaningful response timelines.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"898-900"},"PeriodicalIF":1.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820650","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":"Science-policy translation for Lassa fever control in West Africa: a qualitative synthesis of regional evidence.","authors":"Virgil Kuassi Lokossou, Aishat Bukola Usman, Issiaka Sombie, Oluomachukwu Omeje, Chukwuma David Umeokonkwo, Lionel Sogbossi, Ermel Johson, Bayode Romeo Adegbite, Kpatcha Tchamdja, Yves Mongbo, Harvey de Hardt-Kaffils, Oliver Manigart, Oyeronke Oyebanji, Katrin Ramsauer, Chimezie Anueyiagu, Adama Ndir, Chijioke Kaduru, Ifeoma Ezenyi, Elsie Ilori, Vivianne Ihekweazu, Chimezie Anyakora, Kemi Agaboye, Asari Ndem, Lambert Boton, Namoudou Keita, Placido Cardoso, Nadège Hounkpe, Franck Ale, Achille Batonon, Landry Boya, Cletus Adohinzin, Felix Agbla, Hadijatou Janneh, Melchior Athanase Aïssi","doi":"10.1093/trstmh/trag048","DOIUrl":"10.1093/trstmh/trag048","url":null,"abstract":"<p><strong>Background: </strong>Lassa fever remains a major public health threat in West Africa, requiring coordinated scientific, policy, and financing responses. Regional scientific convenings are increasingly used to connect research evidence with policy action, yet their contribution to epidemic preparedness is not well documented.</p><p><strong>Methods: </strong>We conducted a qualitative health systems and policy analysis of the 2nd ECOWAS Lassa Fever International Conference (ELFIC 2025) in Abidjan, Côte d'Ivoire. Data sources comprised 302 scientific abstracts, plenary and ministerial session records, and the official Ministerial Joint Communiqué. Using the conference's six thematic pillars as a deductive framework, we conducted a thematic content analysis and synthesized findings into four domains: scientific advances; surveillance and laboratory systems; policy and financing insights; and cross-cutting lessons for regional preparedness.</p><p><strong>Results: </strong>Progress was noted in diagnostics, therapeutics, vaccine development, decentralized laboratory capacity, genomic surveillance, and digital reporting. Persistent gaps remain at sub-national and community levels, in surveillance coverage, workforce capacity, and operational readiness. A major outcome was the Ministerial Joint Communiqué endorsing regional co-financing for Lassa fever vaccine development.</p><p><strong>Conclusion: </strong>ELFIC 2025 demonstrates the role of regional scientific platforms in aligning evidence with policy commitments. Sustained impact will require institutionalized coordination, strengthened accountability, and targeted investments in frontline capacity.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"879-885"},"PeriodicalIF":1.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820722","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":"Rapid diagnostic test-based algorithms for Chagas disease diagnosis: a cost-utility and budget impact analysis in Colombia.","authors":"Mario J Olivera","doi":"10.1093/trstmh/trag050","DOIUrl":"10.1093/trstmh/trag050","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease remains underdiagnosed in endemic countries due to reliance on centralized laboratory-based algorithms. Rapid diagnostic tests (RDTs) may simplify diagnostic processes and expand access to decentralized testing, but uncertainty remains regarding their performance across heterogeneous settings and long-term economic value. This study evaluated the cost-utility and budget impact of RDT-based diagnostic strategies in Colombia.</p><p><strong>Methods: </strong>A cost-utility analysis was conducted from the Colombian health system perspective using a hybrid decision tree-Markov model. Three diagnostic strategies were compared: serial RDT with ELISA resolution, hybrid RDT-ELISA and the conventional ELISA algorithm with indirect immunofluorescence assay resolution. Lifetime costs and quality-adjusted life years (QALYs) were estimated. The model incorporated loss to follow-up between steps. Scenario analyses explored correlated test performance and earlier diagnosis among women of reproductive age. A 5-year budget impact analysis was conducted.</p><p><strong>Results: </strong>Lifetime costs were US$319.27, US$266.03 and US$252.74, with corresponding QALYs of 12.30, 12.34 and 12.35 for the conventional, hybrid and serial RDT strategies, respectively. Both RDT-based strategies were economically dominant.</p><p><strong>Conclusions: </strong>RDT-based algorithms may improve access to diagnosis and reduce program costs. Improving completion of the diagnostic process may be a key driver of effectiveness and economic value.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"840-850"},"PeriodicalIF":1.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782172","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":"Strengthening lymphatic filariasis elimination programmes with molecular xenomonitoring: critical utility and unmet operational needs.","authors":"Sivagnaname Narayanasamy, Yuvarajan Sivagnaname","doi":"10.1093/trstmh/trag041","DOIUrl":"10.1093/trstmh/trag041","url":null,"abstract":"<p><p>Molecular xenomonitoring (MX)-the detection of filarial DNA in mosquito vectors-has become an important component of post- mass drug administration surveillance within the Global Programme to Eliminate Lymphatic Filariasis (GPELF). MX offers non-invasive, high-sensitivity detection of residual or recrudescent Wuchereria bancrofti transmission, particularly where human microfilaraemia and antigenemia surveys have limited power. However, the current operational model relies heavily on gravid-trap-based sampling, which captures a physiologically narrow, behaviourally biased subset of mosquitoes, often dominated by zoophagic Culex quinquefasciatus. This restricts interpretation and programme decision-making. We propose a restructured MX approach focused on representative multi-physiological sampling, routine blood-meal profiling, stage-specific molecular assays and harmonized analytical frameworks. With these refinements, MX can evolve into an actionable transmission-intelligence platform vital for sustaining lymphatic filariasis elimination in the endgame phase.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":"895-897"},"PeriodicalIF":1.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782158","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":"Staying ahead of the curve: a decade of a sustainable public-private synergy for TB elimination in Haryana, India.","authors":"Bornali Datta, Alistair Story, Pinky Goyal, Ashish Kumar Prakash, David Ford, Jaya Prasad Tripathy, Elliott Rogers, Rajesh Raju, Rakesh Sehl, Simi Kapoor, Suman Vishwakarma, Tarun Yadav, Jaswant Singh Punia, Keshav Sharma, Anand Jaiswal, Andrew Hayward, Randeep Guleria, Naresh Trehan","doi":"10.1093/trstmh/trag088","DOIUrl":"https://doi.org/10.1093/trstmh/trag088","url":null,"abstract":"<p><p>Achieving the goal of tuberculosis (TB) elimination in India requires innovative approaches. The TB-Free Haryana Mission is a decade-long public-private partnership (PPP) between the government of Haryana state and Medanta - The Medicity, a tertiary corporate hospital designed to strengthen TB case detection and care, particularly among underserved populations. Launched in 2014 as a pilot in Rewari district, the initiative scaled statewide by 2019 using a mobile diagnostic model that integrated digital chest X-ray screening, sputum microscopy and rapid molecular testing. Over time, point-of-care molecular diagnostics and AI-assisted chest X-ray interpretation were incorporated to enable same-day diagnosis and treatment initiation. Over 10 years, the Mission performed >62 000 chest X-rays, achieving an overall high diagnostic yield (5.3%) and extending access to quality diagnostics in remote rural settings. The approach improved detection of smear-negative TB, reduced delays between diagnosis and treatment and remained operationally effective even during the COVID-19 pandemic. Long-term sustainability was supported through shared funding, continuous technological upgrades, strong monitoring systems, community engagement and alignment with national TB policies. This experience demonstrates that a technology-enabled, domestically funded PPP model can effectively bridge diagnostic gaps and is scalable for replication to accelerate TB elimination efforts in India.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621425","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":"Efficacy of artemisinin derivatives and kelch13 mutations in Plasmodium falciparum: a systematic review and meta-analysis.","authors":"Özlem Ulusan Bağcı, Atilla Halil Elhan, Gülay Aral Akarsu","doi":"10.1093/trstmh/trag086","DOIUrl":"https://doi.org/10.1093/trstmh/trag086","url":null,"abstract":"<p><p>Artemisinin-based combination therapies (ACTs) remain the cornerstone of treatment for uncomplicated Plasmodium falciparum malaria; however, the spread of artemisinin resistance linked to kelch13 (pfk13) mutations poses a major global concern. This study aimed to systematically evaluate ACT efficacy in parallel with the global distribution of pfk13 mutations and to explore the relationship between molecular markers and clinical outcomes. A systematic review and meta-analysis were conducted using PubMed, Web of Science, and Scopus. Studies reporting 28-day adequate clinical and parasitological response (ACPR) following ACTs and assessing pfk13 mutations were included. Thirty studies from Asia, Africa, and the Americas were analyzed. ACTs maintained high efficacy, with pooled ACPR rates exceeding 95% and no significant regional differences (P = .99). By contrast, pfk13 mutation prevalence was significantly higher in Asia (P = .001). Notably, high treatment success rates were maintained despite the increasing prevalence of pfk13 mutations, indicating that the relationship between molecular resistance markers and clinical outcomes remains complex and may be modulated by partner-drug efficacy, host immunity, and local transmission dynamics. While ACTs remain highly effective, the marked geographical variation and persistence of resistance-associated mutations underscore the need for integrated molecular surveillance and therapeutic efficacy monitoring.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621456","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":"Integrated serological, entomological, and environmental assessment of Chagas disease in a post-control area of Argentina.","authors":"Diego Mendicino, Romina Chiaraviglio, Anabel Furon, María Del Pilar Lopez-Ureta, Alejandra Roman-Miyasato, Marcelo Nepote, María Soledad Lopez","doi":"10.1093/trstmh/trag084","DOIUrl":"https://doi.org/10.1093/trstmh/trag084","url":null,"abstract":"<p><strong>Objectives: </strong>Chagas disease remains a public health concern in environmentally transitional regions of the Gran Chaco. Assessing the current eco-epidemiological situation is essential to evaluate vector-control strategies and identify residual transmission risks.</p><p><strong>Methods: </strong>An entomological and serological survey was conducted in Huanqueros District (Santa Fe, Argentina). A total of 208 participants (153 urban and 55 rural) were screened for Chagas disease, while 58 dwellings were inspected for triatomine infestation. Sociodemographic and environmental risk factors were analyzed using prevalence ratios and bivariate analysis.</p><p><strong>Results: </strong>Overall seroprevalence was 7.69%. Prevalence was significantly higher among adults (>18 years, 22.73%) than among children (<18 years, 0.70%; P < .05). The infestation rate was 10.34%, with Triatoma infestans detected mainly in peridomestic and rural environments. No Trypanosoma cruzi-infected vectors were found. Household characteristics, including precarious wall materials and overcrowding, were not associated with seropositivity.</p><p><strong>Conclusions: </strong>The low prevalence in children and absence of infected vectors support the sustained interruption of vector-borne transmission, with current infections reflecting past exposure. These findings support transitioning from insecticide-centered control to surveillance-based strategies integrating community participation, environmental management, and continuous entomological monitoring, particularly given concerns about insecticide resistance associated with repeated spraying.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621386","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":"Healthcare professionals' knowledge and preparedness for snakebite envenomation in Morocco: a cross-sectional study.","authors":"El Houssain Marouani, Hassan Alahyane, Fatima Menssouri, Fatima Zahra Naanaa, Bilal El-Mansoury, Adnane Hakem, Abdessamad Mouhssine, Moulay Abdelmounaim El Hidan, Brahim El Houate, Omar El Hiba, Abdelaati El Khiat","doi":"10.1093/trstmh/trag083","DOIUrl":"https://doi.org/10.1093/trstmh/trag083","url":null,"abstract":"<p><strong>Background: </strong>Snakebites are a major global public health problem and remain a significant concern in Morocco, particularly in rural areas where access to healthcare is limited and medical resources are often insufficient. They are an important cause of morbidity and mortality. Prompt and appropriate first aid, followed by adequate clinical management, is essential to reduce adverse outcomes. This study aimed to assess healthcare professionals' knowledge, attitudes and preparedness regarding the diagnosis and management of snakebite envenomation (SBE) in the Ouarzazate region of Morocco.</p><p><strong>Methods: </strong>A descriptive cross-sectional study with an analytical component was conducted among 151 healthcare professionals working in the province of Ouarzazate. Data were collected using a structured questionnaire composed of 22 items.</p><p><strong>Results: </strong>The most represented age group was 20-30 y and most participants had 5-10 y of professional experience. Regarding knowledge level, 66.23% demonstrated a moderate level, 29.14% a low level and 4.63% a good level. Additionally, 46% had received basic training in snakebite management, while 92.72% had never received continuing education. A significant association was found between knowledge level and both training and professional speciality (p<0.05).</p><p><strong>Conclusions: </strong>Important gaps in knowledge and training were identified. Integrating snakebite management into undergraduate curricula and strengthening continuing education are essential to improve care quality and reduce morbidity and mortality.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607938","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":"Urban heat island intensity and chikungunya incidence: a multi-city time-series analysis in Brazil.","authors":"Zhilin Wu, Hailun Pi, Jingxiao Shang, Wenzeng Zhang","doi":"10.1093/trstmh/trag080","DOIUrl":"https://doi.org/10.1093/trstmh/trag080","url":null,"abstract":"<p><strong>Objectives: </strong>Urban heat islands (UHIs) produce  2°C-8°C in urban cores excesses, accelerating Aedes aegypti development and shortening chikungunya virus (CHIKV) extrinsic incubation, yet UHI intensity's (UHII) independent contribution to CHIKV transmission remanins unquantified.</p><p><strong>Methods: </strong>We conducted an ecological time-series analysis of five Brazilian cities (2015-24; n = 563 city-months) . Monthly UHII was derived from MODIS land surface temperature (urban-core minus peri-urban) via Google Earth Engine; CHIKV incidence came from InfoDengue. Lag-specific (0-3 months) Poisson generalized linear models were adjusted for  temperature, humidity, and seasonality. Given severe overdispersion, quasi-Poisson and negative-binomial models were the preferred sensitivity analyses.</p><p><strong>Results: </strong>Across 261 353 cases, each 1°C UHII increase was associated with higher lag-1 incidence in subtropical Rio de Janeiro (RR = 2.857, 95% CI 2.799-2.915) and Salvador (RR = 1.168, 1.156-1.179; both P < .001). Brasília showed inverse associations (lags 0-3), Fortaleza (highest burden, 133 371 cases) a mixed lag pattern, and São Paulo minimal effects despite the highest UHII. Incidence peaked in April-May.</p><p><strong>Conclusions: </strong>UHII-CHIKV associations were heterogeneous; city-specific thermal context should inform integrating satellite-derived heat metrics into arboviral surveillance, as several associations attenuated or lost statistical significance under overdispersion-robust models and were sensitive to individual epidemic years.</p>","PeriodicalId":23218,"journal":{"name":"Transactions of The Royal Society of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550570","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}