Travel Medicine and Infectious Disease最新文献

{"title":"IRIS in a person living with HIV due to disseminated Mycobacterium simiae infection possibly acquired after a remote travel history to Thailand","authors":"Mazin Barry ,&nbsp;Rakan Alotaibi ,&nbsp;Mohammed Bahatheg ,&nbsp;Khalifa Binkhamis","doi":"10.1016/j.tmaid.2025.102935","DOIUrl":"10.1016/j.tmaid.2025.102935","url":null,"abstract":"<div><div>We report a case of a man living with HIV with a baseline CD4 count of 7 cells/μl, who initially presented with vision loss due to CMV retinitis and cervical lymphadenopathy. Upon initiating antiretroviral therapy, his lymph node swelling increased, and a biopsy culture grew <em>Mycobacterium simiae.</em> The patient had a remote history of travel to Thailand, where he had frequent close encounters with monkeys. Primates may harbour non-tuberculous mycobacteria (NTM), and zoonotic transmission from monkeys to humans is feasible. Despite antimicrobial therapy, his condition worsened with increased lymph node swelling and abscess formation, which required surgical drainage, and he was determined to have developed immune reconstitution inflammatory syndrome (IRIS). Corticosteroid therapy was started, which showed a quick clinical response.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102935"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145463115","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":"Detection of circulating mosquito-borne arboviruses in Brazil using travellers as sentinels","authors":"Laura Vavassori ,&nbsp;Silvan Hälg ,&nbsp;Nadja Hedrich ,&nbsp;Duschinka Guedes ,&nbsp;Marcelo S. Paiva ,&nbsp;Christian Beuret ,&nbsp;Ulf Blanke ,&nbsp;Andreas Neumayr ,&nbsp;Pie Müller","doi":"10.1016/j.tmaid.2025.102936","DOIUrl":"10.1016/j.tmaid.2025.102936","url":null,"abstract":"<div><div>Travellers visiting countries endemic for arboviral diseases may introduce arboviruses to new areas where competent vectors are already present, potentially leading to disease outbreaks in populations that have not previously been exposed. To assess exposure risks for travellers and identify which arboviruses they might import, we explored the use of international travellers to collect mosquito saliva samples at their travel destinations to map locally circulating arboviruses. We recruited 73 travellers from Switzerland visiting Brazil between August 2018 and June 2019 and provided each of them with five kits to collect viral RNA on Flinders Technology Association cards. We have chosen Brazil as a study area for a proof of concept for reasons of convenience, as this is a popular travel destination. We asked the travellers to place the kits at their destinations and use a smartphone app to track their locations. We received 155 kits back and screened the cards for arboviral RNA using reverse transcriptase PCR with consecutive sequencing of amplicons from positive samples. Due to RNA degradation during an extended storage period, 129 cards produced no positive signal. In contrast, among 26 cards that could be processed shortly after receipt, seven were positive for dengue virus serotype 4 and three for West Nile virus lineage 2 (WNV-2). To our knowledge, this is the first time WNV-2 has been reported from Brazil. Our ‘citizen science’ approach has the potential to contribute to arbovirus surveillance, extending the geographic range of sampling – particularly in regions lacking an arbovirus surveillance programme.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102936"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530843","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":"The Italian network for severe malaria treatment (NOMAL): epidemiology, clinical presentation, management and outcomes in a non-endemic setting","authors":"Tommaso Ascoli Bartoli ,&nbsp;Angela Corpolongo ,&nbsp;Alessandra D'Abramo ,&nbsp;Andrea Angheben ,&nbsp;Giulia Bertoli ,&nbsp;Katleen de Gaetano Donati ,&nbsp;Roberto Cauda ,&nbsp;Spinello Antinori ,&nbsp;Luciano Attard ,&nbsp;Giordano Madeddu ,&nbsp;Lina Rachele Tomasoni ,&nbsp;Carlo Pallotto ,&nbsp;Antonella Vulcano ,&nbsp;Gaetano Maffongelli ,&nbsp;Lorenzo Zammarchi ,&nbsp;Gabriella d'Ettorre ,&nbsp;Assunta Navarra ,&nbsp;Enrico Girardi ,&nbsp;Umberto D'Alessandro ,&nbsp;Emanuele Nicastri","doi":"10.1016/j.tmaid.2025.102919","DOIUrl":"10.1016/j.tmaid.2025.102919","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102919"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370449","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":"Probable scrub typhus-like infection in Colombia: seroconversion and serological reactivity to Orientia spp. among patients with acute undifferentiated febrile illness in Villeta municipality","authors":"Carlos Ramiro Silva-Ramos ,&nbsp;Nicole L. Mendell ,&nbsp;Patricia A. Crocquet-Valdes ,&nbsp;Peter C. Melby ,&nbsp;Patricia V. Aguilar ,&nbsp;Miguel M. Cabada ,&nbsp;Marylin Hidalgo ,&nbsp;David H. Walker","doi":"10.1016/j.tmaid.2025.102937","DOIUrl":"10.1016/j.tmaid.2025.102937","url":null,"abstract":"<div><h3>Background</h3><div>Scrub typhus, caused by <em>Orientia</em> spp., is a mite-borne disease historically restricted to the Asia-Pacific region. Autochthonous cases have been confirmed in southern Chile, while serological evidence has been reported in Peru, Honduras and Colombia, suggesting wider distribution in Latin America. Identifying recent exposure among febrile patients is essential to evaluate its role in acute undifferentiated febrile illness (AUFI) etiology.</div></div><div><h3>Aim</h3><div>To assess the possible implication of <em>Orientia</em> infection as a cause of AUFI in Villeta, Colombia.</div></div><div><h3>Methods</h3><div>Between September and December 2021, patients with AUFI were recruited. Whole-blood samples were tested for <em>Orientia</em> DNA by real-time PCR targeting the 16S rRNA gene. Acute and convalescent serum samples were analyzed for IgG antibodies by IFA and ELISA, with paired samples titration to assess seroconversion. Reactive sera were further confirmed by Western blot.</div></div><div><h3>Results</h3><div>Forty-one acute whole-blood samples were tested by qPCR; no <em>Orientia</em> DNA was detected. Serology identified antibodies in 27 % (11/41) of patients: six positive by ELISA, two by IFA, and three by both methods. Based on paired sera, eight cases (20 %) were classified as recent infections, including cases of seroconversion, and three (7 %) as previous exposures. Western blot confirmed specific reactivity against <em>Orientia</em> antigens in all positive samples.</div></div><div><h3>Conclusions</h3><div>This study provides serological evidence of <em>Orientia</em> circulation among febrile patients in Villeta, Colombia, including clear cases of seroconversion. Western blot validated reactivity against immunodominant proteins. Findings suggest a local scrub typhus–like illness and highlight the need for pathogen isolation and genetic characterization to clarify its contribution to AUFI.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102937"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517081","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":"Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women: Systematic review and meta-analysis of clinical trials","authors":"Ammar Elgadi ,&nbsp;Tibyan Noorallah ,&nbsp;Egbal Abdelazim ,&nbsp;Sara Altraifi ,&nbsp;Hajir Altraifi ,&nbsp;Ammar Elhaj ,&nbsp;Walaa Elnaiem ,&nbsp;Lina Hemmeda","doi":"10.1016/j.tmaid.2025.102908","DOIUrl":"10.1016/j.tmaid.2025.102908","url":null,"abstract":"<div><h3>Background</h3><div>The WHO recommended the use of intermittent preventive treatment (IPT) regimens for malaria in HIV-positive pregnant women living in endemic areas to prevent malaria-related perinatal complications. However, the high drug resistance rates make the effectiveness of the various available options questionable.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted according to the PRISMA guidelines and registered in Prospero (ID: CRD42024579942). PubMed, Scopus, and Cochrane libraries were searched in June 2024 for relevant studies. Randomized clinical trials reporting the use of ITP for malaria in HIV-infected pregnant women were included. The incidence of peripheral malaria diagnosis was our primary extracted outcome. RevMan 5.3 was used for meta-analysis.</div></div><div><h3>Results</h3><div>Thirteen clinical trials with 5226 HIV-positive pregnant patients were included. ITP showed 55 % lower odds of malaria during pregnancy or at delivery (OR = 0.45, 95 % CI: 0.36, 0.56, P ≤ 0.001), with IPTp-DP (Dihydroartemisinin-Piperaquine) being the most effective regimen. However, despite reducing the odds of placental malaria by 48 % (OR = 0.52, 95 % CI: 0.39, 0.70, P ≤ 0.001), ITP showed no significant effect on low birth weight, fetal loss, stillbirth, or preterm labor. Furthermore, IPT reduces the odds of maternal anemia by 18 % (OR = 0.82, 95 % CI: 0.69, 0.97, P = 0.03).</div></div><div><h3>Conclusion</h3><div>IPT was shown to be effective in reducing malaria-related maternal complications, including malaria during pregnancy, at delivery, or placental and maternal anemia. However, it showed no effective impact on adverse birth outcomes. Further research may be necessary to explore birth-related outcomes.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102908"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092562","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":"Clinical, therapeutic, and stigma-related challenges in leprosy and the emerging role of apremilast in managing leprosy reactions","authors":"Diego Gayoso Cantero ,&nbsp;Pablo Fernández-González ,&nbsp;Sandra Chamorro-Tojeiro ,&nbsp;Carmen Quereda ,&nbsp;Marta Tato ,&nbsp;Emilio Berna-Rico ,&nbsp;Jorge Naharro-Rodríguez ,&nbsp;Jose A. Perez-Molina","doi":"10.1016/j.tmaid.2025.102918","DOIUrl":"10.1016/j.tmaid.2025.102918","url":null,"abstract":"<div><div>Leprosy is a chronic granulomatous infection caused by <em>Mycobacterium leprae</em> (or <em>M. lepromatosis</em>) that targets macrophages and Schwann cells. The resulting neuropathy and skin lesions can lead to lifelong deformities and disabilities. Despite being poorly transmissible and readily treatable, leprosy remains a neglected disease. Management is hampered by delayed diagnosis, multidrug resistance, recalcitrant leprosy reactions, and entrenched social stigma. We report a case of imported multidrug-resistant borderline lepromatous leprosy that progressed with recurrent, steroid-dependent erythema nodosum leprosum (ENL). The patient experienced multiple toxicities secondary to the medications used for treating leprosy and managing ENL. Disease was controlled through a clofazimine–clarithromycin–minocycline regimen combined with the phosphodiesterase-4 inhibitor apremilast, enabling complete withdrawal of corticosteroids and thalidomide while maintaining sustained clinical and microbiological remission. We examine the key clinical challenges in managing this patient and summarise current evidence, including a literature review on apremilast as treatment for refractory leprosy reactions.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102918"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303714","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":"Screening for Trypanosoma cruzi in patients living with the human immunodeficiency virus (PWH) in the Peruvian Amazon","authors":"Silvia Otero-Rodriguez ,&nbsp;Martin Casapia-Morales ,&nbsp;Lilia-Lorena Pinedo-Ramirez ,&nbsp;Esperanza Merino ,&nbsp;Eva H. Clark ,&nbsp;José-Manuel Ramos-Rincón","doi":"10.1016/j.tmaid.2025.102927","DOIUrl":"10.1016/j.tmaid.2025.102927","url":null,"abstract":"<div><h3>Introduction</h3><div>Chagas disease (CD) - <em>Trypanosoma cruzi</em> infection - in people living with HIV (PWH), particularly those with advanced CD4 T cell depletion, can lead to severe syndromes affecting the central nervous system and the heart.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study to screen for CD among PWH in Iquitos, Peru, between October 2023 and May 2024, with the objective of understanding the frequency of infection in this population. Adults with confirmed HIV attending outpatient services at two regional hospitals were enrolled. Two ELISA tests (lysate and recombinant) were used, and discordant results were adjudicated by indirect chemiluminescence immunoassay (CLIA).</div></div><div><h3>Result</h3><div>Of 534 PWH, the median age was 41 years (IQR 32–49), 66.1 % were male, the median current CD4⁺ count was 443/μL, and 75.8 % had an undetectable viral load. Two discordant serologic results were resolved with a negative CLIA, resulting in no confirmed CD cases.</div></div><div><h3>Conclusion</h3><div>The prevalence of <em>T. cruzi</em> infection is likely very low in urban and peri-urban areas of Iquitos. <em>Continued epidemiological surveillance is essential to monitor potential changes over time.</em></div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102927"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410147","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":"Travel-associated carbapenemase-producing Enterobacterales: Epidemiology and risk factors in a Finnish cohort","authors":"Mikael Kajova ,&nbsp;Tamim Khawaja ,&nbsp;Katariina Kainulainen ,&nbsp;Anu Kantele","doi":"10.1016/j.tmaid.2025.102926","DOIUrl":"10.1016/j.tmaid.2025.102926","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing Enterobacterales (CPE) are increasing worldwide, with strains associated with difficult-to-treat infections. We previously reported that international travel is a major source of CPE acquisition in the Helsinki region, Finland. To clarify the extent of importation, we investigated the epidemiology and associated risk factors of foreign-acquired CPEs.</div></div><div><h3>Methods</h3><div>We revisited two earlier cohorts. Cohort A (n = 187 after a one-year extension) comprised patients from 2010 through 2024 presumed to have acquired CPE abroad; CPE types were categorized by travel region. Cohort B included 3029 patients screened for CPE from 2010 through 2019 within 12 months after hospitalization abroad. Multivariable analysis identified factors that predispose to colonization.</div></div><div><h3>Results</h3><div>Among patients hospitalized abroad (Cohort B), CPE rates were particularly high for South Asia (14.6 %) and North Africa (13.7 %). Across the 24 individual countries with data, the highest CPE colonization risks were observed for Egypt (20.8 %) and India (16.4 %). In addition to destination, independent risk factors included antibiotic use, travel type, short interval between discharge from a foreign hospital and screening (within one week or one month) and male sex. For South/Southeast Asia and sub-Saharan Africa, over 70 % of CPE carriers (Cohort A) had metallo-β-lactamase-producing Enterobacterales, predominantly NDM, whereas OXA-48–like enzymes predominated in North Africa and the Middle East.</div></div><div><h3>Conclusions</h3><div>Hospitalization in high-prevalence countries and antibiotic use emerged as key risk factors for CPE acquisition. Regional variation was evident: OXA-48–like enzymes dominated among CPEs linked to the Middle East and North Africa, whereas NDM was prevalent elsewhere in Eurasia and Africa.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102926"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347506","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":"Dengue incidence, mortality, and case-fatality in Brazil: spatial patterns, socioeconomic contrasts, and serotype impact","authors":"Patricia Marques Moralejo Bermudi ,&nbsp;Raquel Gardini Sanches Palasio ,&nbsp;Monica Pirani ,&nbsp;Lidia Maria Reis Santana ,&nbsp;Gerson Laurindo Barbosa ,&nbsp;Marta Blangiardo ,&nbsp;Francisco Chiaravalloti-Neto","doi":"10.1016/j.tmaid.2025.102934","DOIUrl":"10.1016/j.tmaid.2025.102934","url":null,"abstract":"<div><h3>Background</h3><div>Despite its burden, dengue remains neglected, with few studies comparing its incidence, mortality, case-fatality, and key variables such as socioeconomic factors, healthcare access, and serotype distribution.</div></div><div><h3>Methods</h3><div>This ecological study analyzed dengue cases and deaths (2014–2024) in intermediate regions of Brazil. Covariates included illiteracy rate, hospital bed availability, serotype distribution, and private healthcare coverage. High- and low-risk spatial clusters were identified using the SaTScan Poisson model. Statistical analysis assessed significant covariate differences between risk groups.</div></div><div><h3>Results</h3><div>High-incidence clusters were found in areas with lower illiteracy rates, whereas high-case fatality clusters were found in areas with higher illiteracy rates. DENV-2 was associated with high-risk case-fatality areas; in contrast, DENV-1 showed the opposite pattern, appearing to be more common but associated with lower severity.</div></div><div><h3>Conclusions</h3><div>These findings provide a basis for generating hypotheses for future modeling studies on these associations.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102934"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477010","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":"Rhino-orbital conidiobolomycosis in non-endemic Settings. A diagnostic and therapeutic challenge","authors":"Romain Gueneau ,&nbsp;Lei Tanaka ,&nbsp;Pierre Reimbold ,&nbsp;Julien Harroche ,&nbsp;Cécile Nabet ,&nbsp;Stéphane Jauréguiberry","doi":"10.1016/j.tmaid.2025.102931","DOIUrl":"10.1016/j.tmaid.2025.102931","url":null,"abstract":"<div><div>Conidiobolomycosis is a rare tropical mycosis that is often difficult to diagnose and treat.</div></div><div><h3>Method</h3><div>We describe here an imported case that highlights these issues.</div></div><div><h3>Results</h3><div>A 24-year-old HIV positive patient was diagnosed and treated for a conidiobolomycosis due to <em>Conidiobolus coronatus.</em> Imaging showed extensive facial invasion. Biopsy and fungal culture confirmed conidiobolomycosis, resistant to standard antifungals. Initial therapy with liposomal amphotericin B and itraconazole failed due to drug interactions. After adjusting treatment and performing surgery, the patient's condition improved. Despite high MICs, clinical response was favorable. He completed 14 months of itraconazole without recurrence four months post-treatment. Serial beta-D-glucan assays showed promise as a reliable biomarker for therapeutic monitoring.</div></div><div><h3>Conclusion</h3><div>This case highlights the complex medicosurgical management of a rare imported tropical mycosis, the diagnostic aspects of conidiobolomycosis, and the promising potential benefit of beta-D-glucan for the management and follow-up of this severe tropical deep-sited mycosis.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102931"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507562","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}