Travel Medicine and Infectious Disease最新文献

{"title":"Prognosis and mortality risk in elderly patients with dengue virus infection: Excess fatality and the urgent need for revising current WHO criteria for elderly patients","authors":"Min-Jia Jeng ,&nbsp;Nan-Yao Lee ,&nbsp;Ing-Kit Lee ,&nbsp;Yi-Chun Chen ,&nbsp;Wen-Chi Huang ,&nbsp;Jui-Chi Hsu ,&nbsp;Chien-Hsiang Tai ,&nbsp;Hao-Min Lan","doi":"10.1016/j.tmaid.2025.102855","DOIUrl":"10.1016/j.tmaid.2025.102855","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) reports a rising global incidence of dengue and severe outcomes among the elderly. This study investigates the differences in dengue characteristics between elderly and non-elderly patients and identifies mortality risk factors among elderly dengue patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of adults (≥20 years) with dengue virus (DENV) infection at two medical centers from 2002 to 2018. Participants were divided into non-elderly (20–64 years) and elderly (≥65 years) groups.</div></div><div><h3>Results</h3><div>A total of 1274 patients with laboratory-confirmed dengue were included in the study, of whom 373 (29.3 %) were classified as elderly. The majority of patients (67.5 %) were infected with DENV-2. In the overall cohort, age ≥65 years was identified as an independent predictor of mortality. Compared with non-elderly patients, elderly individuals exhibited significantly lower frequencies of classical dengue symptoms (e.g., fever, myalgia, bone pain, rash), but experienced higher rates of severe dengue, longer hospital stays, and more frequent complications, including acute kidney injury, severe hepatitis, bacteremia, pneumonia, and acute respiratory failure. The mortality rate was significantly higher among elderly patients (18 %) compared to non-elderly patients (2.7 %). Multivariate analysis among the elderly subgroup identified altered consciousness and pleural effusion at presentation, along with the development of acute kidney injury, severe hepatitis, and pneumonia during hospitalization, as independent predictors of mortality.</div></div><div><h3>Conclusions</h3><div>The current WHO criteria may be insufficient for the timely identification of dengue in the elderly population. Excess mortality in this group underscores the urgent need for updated guidelines. Neurological symptoms, pleural effusion at presentation, and organ impairment during hospitalization are key predictors of mortality in elderly dengue patients.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102855"},"PeriodicalIF":6.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous leishmaniasis presenting as dactylitis and paronychia in an immunocompetent individual: Case report of a rare condition from Tuscany region, Italy","authors":"Roberta Maria Antonello ,&nbsp;Anna Barbiero ,&nbsp;Michele Spinicci ,&nbsp;Costanza Fiorelli ,&nbsp;Alessandro Bartoloni ,&nbsp;Lorenzo Zammarchi","doi":"10.1016/j.tmaid.2025.102851","DOIUrl":"10.1016/j.tmaid.2025.102851","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102851"},"PeriodicalIF":6.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting norovirus cases on cruise ships to support outbreak management on board","authors":"Andrea Bizzotto ,&nbsp;Alfredo De Bellis ,&nbsp;Valentina Marziano ,&nbsp;Varvara A. Mouchtouri ,&nbsp;Leonidas Kourentis ,&nbsp;Lemonia Anagnostopoulos ,&nbsp;Christos Hadjichristodoulou ,&nbsp;Stefano Merler ,&nbsp;Giorgio Guzzetta","doi":"10.1016/j.tmaid.2025.102850","DOIUrl":"10.1016/j.tmaid.2025.102850","url":null,"abstract":"<div><h3>Background</h3><div>Norovirus outbreaks on cruise ships are a significant threat to the cruising industry. Mathematical models have the potential to leverage routinely collected syndromic surveillance data on board to provide insight into outbreak evolution.</div></div><div><h3>Methods</h3><div>We used historical data from seven norovirus outbreaks occurred in 2011–2013, totalling 359 diagnosed cases, to assess the performance of automated forecasts in real-time. We compared the performance of a set of alternative models on three endpoints (the number of cases by symptom onset time, by diagnosis date, and the total number of cases until the end of the cruise), using the logarithmic score (logS), the ranked probability score (RPS), and the 95 % coverage.</div></div><div><h3>Results</h3><div>We found that the best forecasting performance was given by a model that includes both superspreading and the effect of case isolation. This model had in most cases a better score than that of a baseline model assuming constant incidence; this happened in 59–70 % of data points when assessed using the logS and 53–57 % with the RPS (depending on the considered endpoint). The best model also had the highest coverage over all endpoints. Its added value was especially evident for longer forecasting horizons, with an improvement in performance for up to 78 % of data points, both according to the logS and the RPS.</div></div><div><h3>Conclusions</h3><div>Simple mathematical models integrating key mechanisms of norovirus transmission can help predict the number of cases on board. This knowledge can be automatized in syndromic surveillance systems to support decision making for the management of outbreaks.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102850"},"PeriodicalIF":6.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leishmaniasis in Syria – A call for action of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) Study Groups for Infections in Travellers and Migrants (ESGITM) and for Clinical Parasitology (ESGCP)","authors":"Aula Abbara ,&nbsp;Marta González-Sanz ,&nbsp;Ayla AlKharrat ,&nbsp;Mohamad Khalife ,&nbsp;Yasir Elferruh ,&nbsp;Naser Almhawish ,&nbsp;Salam Abbara ,&nbsp;Sana Marroush ,&nbsp;Clare Shortall ,&nbsp;Shamsa Hussein Ahmed ,&nbsp;Abdulaziz Alhazmi ,&nbsp;Miriam J. Alvarez-Martinez ,&nbsp;Muhammad Asaduzzaman ,&nbsp;Asma Al Balushi ,&nbsp;Ana Paula Barboza ,&nbsp;Hanne Brekke ,&nbsp;Paola Di Carlo ,&nbsp;Antonio Cascio ,&nbsp;Peter Chiodini ,&nbsp;Agnese Colpani ,&nbsp;Alfonso J. Rodriguez-Morales","doi":"10.1016/j.tmaid.2025.102849","DOIUrl":"10.1016/j.tmaid.2025.102849","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102849"},"PeriodicalIF":6.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomic next-generation sequencing enhances the diagnosis of Q fever: A retrospective observational study","authors":"Lingxiao Sun ,&nbsp;Yuyao Yin ,&nbsp;Yifan Guo,&nbsp;Hongbin Chen,&nbsp;Hui Wang","doi":"10.1016/j.tmaid.2025.102845","DOIUrl":"10.1016/j.tmaid.2025.102845","url":null,"abstract":"<div><h3>Background</h3><div>Q fever, a global zoonosis, poses a significant challenge for public health due to its varied and nonspecific clinical presentations, making diagnosis difficult. Metagenomic next-generation sequencing (mNGS) is a potential tool for diagnosing Q fever.</div></div><div><h3>Methods</h3><div>This retrospective observational study was conducted on patients with Q fever admitted to Peking University People's Hospital, from May 2023 to November 2024. mNGS was performed using the patient's peripheral blood, and the qPCR of <em>Coxiella burnetii</em> was also adopted. Subsequently, the clinical data of patients diagnosed with Q fever were systematically evaluated.</div></div><div><h3>Results</h3><div>Twelve peripheral blood samples of 12 patients were detected <em>Coxiella burnetii</em> positive by mNGS. Most patients were male (10, 83.33 %). Fever (12, 100 %), muscle soreness (8, 66.7 %), and headache (4, 33.3 %) were the most common clinical manifestations. Specific qPCR of <em>Coxiella burnetii</em> was detected positive in 8 patients. Chronic Q fever was diagnosed in two patients, who had aortic valve replacement, and their immunological markers, like anti-nuclear were elevated. Once the diagnosis was clear, proper antibiotics were used, and all patients were discharged in better health.</div></div><div><h3>Conclusion</h3><div>Metagenomic next-generation sequencing enhances the diagnosis of Q fever, especially for patients displaying atypical and various clinical symptoms and having unclear epidemiological data or histories of antibiotic use.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102845"},"PeriodicalIF":6.3,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox knowledge, risk perception, attitudes and willingness to vaccinate in Colombia's LGBTIQ+ communities: Online survey (CoSex)","authors":"Cándida Diaz-Brochero ,&nbsp;Miguel Barriga ,&nbsp;John Fredy Ramirez ,&nbsp;David Santiago Quevedo ,&nbsp;Geraldine Gomez ,&nbsp;Juliana Mateus ,&nbsp;Natalia Nino-Machado ,&nbsp;Juliana Cuervo-Rojas ,&nbsp;Zulma M. Cucunubá","doi":"10.1016/j.tmaid.2025.102848","DOIUrl":"10.1016/j.tmaid.2025.102848","url":null,"abstract":"<div><h3>Background</h3><div>In the 2022-23 global clade IIb mpox outbreak, Colombia was the sixth country with the most reported cases globally and the second in Latin America after Brazil. LGTBIQ + communities, especially those with extensive sexual networks, were particularly affected.</div></div><div><h3>Objective</h3><div>We aim to characterize the knowledge, risk perceptions, attitudes, and willingness to implement preventive measures against mpox among LGBTIQ + communities in Colombia.</div></div><div><h3>Methods</h3><div>This was an anonymized, cross-sectional, observational study based on a population-based online questionnaire using a participatory approach.</div></div><div><h3>Results</h3><div>Among the 784 participants from 66 municipalities, 49.1 % were aged 18–29 years, and 89.3 % were male and assigned at birth. A total of 73.9 % identified as homosexual, whereas 14.9 % reported never using condoms. Casual sexual partners were reported by 45.4 % of the participants in the past year (median: 3; range: 1–100), and 29.3 % engaged in group sex during the same period (median: 4; range: 2–100). Temporary behavioral changes to reduce mpox risk, such as limiting sexual partners and increasing condom use, were reported by 24.1 % of the participants. Suspected or confirmed mpox infection was reported by 4 % of the participants, with 77.4 % attributing potential exposure to sexual contact. Notably, 89.5 % expressed a willingness to receive mpox vaccination if it was offered.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate the importance of academic and social communities' cross-collaboration to understand the impact of mpox infection in this population and as a basis for planning epidemic responses to future mpox outbreaks in Colombia and Latin America.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102848"},"PeriodicalIF":6.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Chagas disease in Latin-American pregnant women and their newborns: A prospective observational, multicenter study in Milan, Italy","authors":"Federico Sabaini ,&nbsp;Andrea Giacomelli ,&nbsp;Beatrice Tassis ,&nbsp;Mariagrazia Ierardi ,&nbsp;Anna Maria Marconi ,&nbsp;Andrea Ronchi ,&nbsp;Irene Cetin ,&nbsp;Lea Testa ,&nbsp;Valeria Savasi ,&nbsp;Elisa Fabbri ,&nbsp;Giulia Alabiso ,&nbsp;Greta Nova ,&nbsp;Michele Vignali ,&nbsp;Nikita Alfieri ,&nbsp;Vania Giacomet ,&nbsp;Martina Beltrami ,&nbsp;Giacomo Casalini ,&nbsp;Margherita Longo ,&nbsp;Silvia Grosso ,&nbsp;Romualdo Grande ,&nbsp;Spinello Antinori","doi":"10.1016/j.tmaid.2025.102846","DOIUrl":"10.1016/j.tmaid.2025.102846","url":null,"abstract":"<div><h3>Objectives</h3><div>Chagas Disease (CD), caused by <em>Trypanosoma cruzi</em>, is endemic in Latin America (LA). However, due to migration, it is now present globally. We aimed to evaluate the prevalence of CD among LA pregnant women in Milan, Italy, and the incidence of <em>T. cruzi</em> transmission to their newborns.</div></div><div><h3>Methods</h3><div>A prospective multicenter observational study was conducted in five different Obstetrics and Gynecology outpatient clinics in Milan, Italy between September 2019 and October 2024. Pregnant women from endemic areas for CD were tested by means of two serological tests directed against <em>T. cruzi</em> antigens. Newborns from positive <em>T. cruzi</em> mothers were screened for <em>T. cruzi</em> infection at birth and at 1, 3 and 9 months.</div></div><div><h3>Results</h3><div>339 women underwent screening for <em>T. cruzi</em> infection with a median age of 33 years [IQR 28–37 years]. Most of them came from Peru (38.3 %), followed by El Salvador (20.6 %) and Ecuador (19.5 %). Six of them tested positive for <em>T. cruzi</em>, accounting for an estimated prevalence of 1.77 % (95 % CI 0.37 %–3.17 %). Two of the affected women were from Bolivia, and the remaining from El Salvador, Brazil, Ecuador and Peru. All 6 children had a negative PCR for <em>T. cruzi</em> infection, and their serology turned negative within the first year of life.</div></div><div><h3>Conclusions</h3><div>The seroprevalence of <em>T. cruzi</em> infection among LA pregnant women in Milan is significant, underscoring the potential occurrence of congenital CD in a non-endemic area like Italy. Raising awareness of this neglected tropical disease among LA women, midwives and gynecologists is crucial.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102846"},"PeriodicalIF":6.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New World screwworm (Cochliomyia hominivorax) infestation in a returned traveller from Costa Rica","authors":"Amna Majeed ,&nbsp;George Ho ,&nbsp;Antoine Corbeil ,&nbsp;Isaac I. Bogoch","doi":"10.1016/j.tmaid.2025.102843","DOIUrl":"10.1016/j.tmaid.2025.102843","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102843"},"PeriodicalIF":6.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polish travellers on the move: A study of knowledge of travel health and associated practices among polish travellers abroad","authors":"Anna Bogacka ,&nbsp;Agnieszka Wroczyńska ,&nbsp;Maciej Grzybek","doi":"10.1016/j.tmaid.2025.102842","DOIUrl":"10.1016/j.tmaid.2025.102842","url":null,"abstract":"<div><h3>Background</h3><div>Post-pandemic travel has surged, with 1.3 billion journeys recorded worldwide in 2023, reflecting a growing interest in tropical destinations despite the associated health risks. Access to travel health information has improved, yet adherence to preventive measures remains limited due to misinformation, insufficient pre-travel consultations, and concerns about malaria prophylaxis. Based on data from a three-year survey, this study examines the attitudes of Polish travellers to vaccinations, malaria prophylaxis, and COVID-19-related measures.</div></div><div><h3>Methods</h3><div>Surveys conducted during travel festivals from 2021 to 2023 targeted adult participants. A questionnaire designed by experts in travel medicine addressed the demographics, travel behaviours, and health-related practices. Statistical analyses, including chi-squared tests and logistic regression, explored the impact of demographic factors on behaviours, using Python for data analysis.</div></div><div><h3>Results</h3><div>Among 644 participants (mean age 32; 48 % male), 49.5 % reported pre-travel vaccination and 281 intended to use malaria chemoprophylaxis. Gender significantly influenced vaccination status and travel to Africa. The most cited malaria prevention methods were repellents and mosquito nets. Illnesses were reported by 317 participants, with travellers' diarrhoea (185 cases) most common, particularly in Turkey, Egypt, and India. Forty-eight individuals required medical consultations.</div></div><div><h3>Conclusions</h3><div>Education and pre-travel counseling enhance adherence to preventive measures, yet many travellers fail to follow recommendations. Malaria remains the most common travel-imported disease in the EU/EEA, with 4856 cases in 2021. The Capability, Opportunity, and Motivation Behavior (COM-B) model highlights the importance of addressing these factors to improve compliance with preventive behaviours.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102842"},"PeriodicalIF":6.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operational challenges and lessons learned from conducting febrile surveillance in a long-term randomized dengue vaccine trial in Latin America and Asia-Pacific.","authors":"Harald Pfaar, Eduardo López-Medina, Ian Escudero, Yanee Hutagalung, Nicholas Roubinis, Seloni Thakrar, Charissa Fay Corazon Borja-Tabora, Vianney Tricou, Suely Tuboi","doi":"10.1016/j.tmaid.2025.102840","DOIUrl":"https://doi.org/10.1016/j.tmaid.2025.102840","url":null,"abstract":"<p><strong>Background: </strong>In trials, dengue vaccine efficacy evaluation relies on participants presenting with febrile illness/clinically suspected dengue contacting the study site for sample collection and clinical assessment within a short timeframe. Here, we present key considerations to maintain high compliance with the febrile surveillance procedures in a trial that assessed TAK-003 efficacy.</p><p><strong>Methods: </strong>DEN-301 (NCT02747927) is a randomized phase 3 trial in children/adolescents from eight dengue-endemic countries in Latin America (LATAM) and Asia-Pacific (APAC). Febrile surveillance consisted of weekly contact with the participant to identify cases of fever (≥38°C; two of three consecutive days). Blood samples were collected for molecular testing, preferably ≤5 days of fever onset, together with thorough clinical assessment by the investigators. The data are presented descriptively.</p><p><strong>Results: </strong>Of the 20,071 (LATAM, 11,080; APAC, 8991) participants who received TAK-003/placebo, 18,260 (91.0%) completed 4.5 years of follow-up. The overall incidence of febrile illness was 30 (LATAM, 26.0; APAC, 35.1) cases per 100 person-years. The rate samples collected during the acute phase was 98.1%. The overall rate of samples collected after 5 days of fever onset (missed/out-of-window) was 6% (LATAM, 10%; APAC, 2%). A trend toward reduced missed/out-of-window samples was observed after implementing measures, such as transportation, engagement, and healthcare aid tailored per study site in 2017, which appeared to increase during the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>The design of the febrile surveillance protocol ensured high compliance in the trial. Maintaining engagement and access to healthcare beyond the protocol was important in improving febrile case evaluation ≤5 days of fever onset.</p>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":" ","pages":"102840"},"PeriodicalIF":6.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}