Travel Medicine and Infectious Disease最新文献

{"title":"Ready for takeoff? exploring United States health care providers’ pretravel consultation priorities, gaps, barriers, and opportunities","authors":"Katherine A. Reifler ,&nbsp;Swati S. Sharma ,&nbsp;Nicholas A. Bergren ,&nbsp;Elizabeth D. Barnett ,&nbsp;Lin H. Chen ,&nbsp;Jeffery A. Goad ,&nbsp;William B. Macleod ,&nbsp;Laura Kogelman ,&nbsp;Davidson H. Hamer","doi":"10.1016/j.tmaid.2025.102911","DOIUrl":"10.1016/j.tmaid.2025.102911","url":null,"abstract":"<div><div>Pretravel consultation by healthcare providers (HCPs) with travel medicine expertise can mitigate travel-related health risks. This analysis aimed to understand US-based HCPs' pretravel consultation educational gaps, priorities, barriers, and opportunities. An electronic survey was conducted May–June 2024, using a convenience sample of HCPs identified through the Med Learning Group and travel specialists from the International Society of Travel Medicine and American Society of Tropical Medicine and Hygiene. In total, 205 HCPs completed the survey, including physicians (50 %), nurse practitioners (19 %), nurses (12 %), pharmacists (11 %), physician associates (7 %). Most (66 %) provided pretravel consultations and only 21 % held formal travel medicine certification. HCPs not providing pretravel consultation were less comfortable with traveler's diarrhea self-treatment, malaria chemoprophylaxis, altitude illness prevention, yellow fever, Japanese encephalitis, rabies, and typhoid vaccination management. The most desired topics for education were travel vaccinations (94, 46 %), travel medicine insurance (89, 43 %), and altitude illness prevention (86, 42 %). Major barriers to providing pretravel consultation were lack of clarity about reimbursement (110, 54 %), lack of insurance coverage (89, 43 %), and inability to stock travel vaccines (73, 36 %). Top interventions suggested to increase access to and awareness of pretravel consultation included primary care physician education and community outreach. Most HCPs were interested in pretravel educational opportunities, but comfort varied by experience and certification, highlighting need for targeted training, especially for primary care providers. Top barriers were insurance coverage for pretravel consultation and access to travel vaccines, underscoring critical gaps in the US healthcare system.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102911"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204483","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":"ZIeKA monitor study: travel-related arbovirus infections among Dutch travellers, 2018–2020","authors":"Chiara de Bellegarde de Saint Lary ,&nbsp;Marieke L.A. de Hoog ,&nbsp;Lotte Jonker ,&nbsp;Johan Reimerink ,&nbsp;Renée A.H. van Schaijk ,&nbsp;Leo G. Visser ,&nbsp;Susan Hahné ,&nbsp;Patricia C.J.L. Bruijning-Verhagen","doi":"10.1016/j.tmaid.2025.102921","DOIUrl":"10.1016/j.tmaid.2025.102921","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to estimate the incidence of arbovirus infections among Dutch travellers and subsequent potential risk of importation.</div></div><div><h3>Methods</h3><div>For this prospective, fully remote study, Dutch travellers visiting arbovirus endemic countries between August 2018 to March 2020 were recruited through (social) media and travel-clinics. Interested travellers could register online. Participants completed questionnaires and kept a daily symptom log during travel using a custom-made study app. Travellers reporting symptoms suggestive of arbovirus infection were invited to self-collect a dry-blood spot sample (DBS) upon return. In a sub-cohort of participants, post-travel DBS were also collected if asymptomatic. Participants mailed the DBS to the laboratory to be tested by PCR for ZIKV, DENV and CHIKV, along with IgG and IgM antibody testing.</div></div><div><h3>Results</h3><div>Of 1222 subjects registering online, 737 (60.3 %) completed the baseline questionnaire and ≥60 % of symptom diaries and were included in the analysis. Arbovirus-like symptoms were reported by 73 participants (9.9 %). A post-travel DBS was obtained from 67 symptomatic and 154 asymptomatic travellers. None were RT-PCR positive for ZIKV, DENV or CHIKV. Two symptomatic travellers were IgM positive indicating probable recent arbovirus infection. An additional ten cases were IgG positive/IgM negative suggesting possible previous arbovirus exposure. The estimated incidence proportion and rate of travel-related arbovirus infection were 2.7–16.3/1000 trips and 3.9–23.4/1000 person-months, respectively.</div></div><div><h3>Conclusion</h3><div>While a small proportion of travellers to arbovirus endemic areas have evidence of recent infection, the risk of arbovirus importation by returning travellers appears low as viraemia was not detected in any participant upon return.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102921"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287010","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":"Temporal and spatial dynamics of dengue fever in mainland China from 2004 to 2020 and the impact of COVID-19 public health interventions","authors":"Zhiqun Lei ,&nbsp;Zhixin Lei ,&nbsp;Qi Wang","doi":"10.1016/j.tmaid.2025.102938","DOIUrl":"10.1016/j.tmaid.2025.102938","url":null,"abstract":"<div><h3>Background</h3><div>Dengue fever (DF), a mosquito-borne viral disease, presents critical public health issues worldwide, especially in tropical and subtropical areas. This study analyzed temporal and spatial patterns of DF in mainland China from 2004 to 2020 and evaluated the association between COVID-19-related public health interventions and DF incidence.</div></div><div><h3>Methods</h3><div>The dataset was sourced from China's Public Health Science Data Center. Joinpoint regression identified changes in incidence and mortality rates. Local Indicators of Spatial Association identified high-incidence clusters. To forecast DF incidence rates, time series models were employed, including Seasonal Autoregressive Integrated Moving Average (SARIMA), Exponential Smoothing (ETS), and Bayesian Structural Time Series (BSTS). Model performance was evaluated by RMSE, MASE, and SMAPE. Counterfactual forecasts for 2020 (assuming no COVID-19 public interventions) were generated to quantify reductions in DF incidence.</div></div><div><h3>Results</h3><div>Between January 2004 and December 2020, a total of 94,725 DF cases and 13 related fatalities were documented in China. The incidence showed multi-stage trends with joinpoints in 2011 and 2014 and phase-specific APCs of −3.07 % (95 % CI −73.07 to 53.87) for 2004–2011, +301.54 % (38.41–697.77) for 2011–2014, and −25.60 % (−78.89 to 18.10) for 2014–2020. High-incidence clusters were in Guangdong, Guangxi, Fujian, Zhejiang, and Hainan. Global Moran's I was 0.0298 (P = 0.62), indicating no significant global spatial autocorrelation, but Local Moran's I identified significant high–high clusters in Fujian, Jiangxi, Guangdong, and Guangxi. Age-specific analysis showed the highest incidence rates in the 15–64 age group. On the national test set, ETS performed best (RMSE = 0.81, MASE = 0.82, SMAPE = 0.71), while province-specific optimal models varied. Observed 2020 incidence was 96.5 % lower than counterfactual predictions overall, with Guangdong and Guangxi showing reductions of 99.5 % and 49.3 %, respectively.</div></div><div><h3>Conclusions</h3><div>DF incidence in mainland China exhibited significant temporal and spatial variations from 2004 to 2020, with high-risk areas mainly in the south. The multi-model forecasting framework yields robust, interpretable province-level predictions and reveals a substantial 2020 decline associated with COVID-19–related public interventions.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102938"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524152","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":"Immune profiling and prognosis implications in severe fever with thrombocytopenia syndrome with and without hemophagocytic lymphohistiocytosis","authors":"Siyu Zou ,&nbsp;Ting Wang ,&nbsp;Danning Xu ,&nbsp;Wei Wei ,&nbsp;Yun Wang ,&nbsp;Ming Huang ,&nbsp;Shiji Wu ,&nbsp;Feng Wang ,&nbsp;Hongyan Hou","doi":"10.1016/j.tmaid.2025.102940","DOIUrl":"10.1016/j.tmaid.2025.102940","url":null,"abstract":"<div><h3>Objective</h3><div>Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease with high mortality, particularly when complicated by hemophagocytic lymphohistiocytosis (HLH). This study aimed to characterize the immunological and clinical features of SFTS patients with and without HLH, and to determine the impact of HLH on disease severity and prognosis.</div></div><div><h3>Method</h3><div>A total of 233 patients with laboratory-confirmed SFTS were enrolled, including 112 who developed HLH during hospitalization (SFTS-HLH group) and 121 with SFTS alone. Clinical, laboratory and immunological parameters were analyzed. Immune cell subsets, activation/exhaustion markers, proliferation and cytotoxicity were assessed using flow cytometry. Prognostic factors for 28-day mortality were identified using Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>SFTS-HLH patients exhibited more severe clinical manifestations, higher mortality, greater organ dysfunction and more frequency co-infections than the SFTS group. Immunologically, SFTS-HLH patients exhibited more profound lymphopenia, upregulation of exhaustion markers (PD-1, Tim-3, CD39), impaired CD8⁺ T cell cytotoxicity, and reduced NK cell proliferation compared with SFTS and HC groups. These abnormalities were more pronounced in non-survivors than in survivors. SFTSV RNA viral load was significantly higher in SFTS-HLH patients and correlated positively with proinflammatory cytokines and organ injury markers. Multivariate Cox analysis identified SFTS-HLH (HR = 2.942, 95 % CI: 1.277–6.775) and high viral load (HR = 1.636, 95 % CI: 1.239–2.159) as independent predictors of 28-day mortality.</div></div><div><h3>Conclusion</h3><div>SFTS complicated by HLH is characterized by immune dysregulation, high viral burden, and increased mortality. Early recognition of HLH and immune-virological surveillance may aid risk stratification and improve patient outcomes.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102940"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514251","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":"Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre","authors":"Jinghao Nicholas Ngiam ,&nbsp;Matthew Chung Yi Koh ,&nbsp;Brenda Mae Alferez Salada ,&nbsp;Dale Fisher ,&nbsp;Sophia Archuleta ,&nbsp;Jolene Ee Ling Oon","doi":"10.1016/j.tmaid.2025.102882","DOIUrl":"10.1016/j.tmaid.2025.102882","url":null,"abstract":"<div><h3>Background</h3><div>Dengue fever places a substantial burden on healthcare systems in endemic areas. Traditional inpatient management places strain on hospital capacity during seasonal surges. This study evaluates an expanded nurse-led Dengue Outpatient Management (DOM) program at a tertiary centre in Singapore.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted from January 2023 to August 2024. DOM inclusion criteria were broadened to include older adults and patients with comorbidities, if clinically stable. Patients received physician evaluation, a nurse-led symptom-based assessment and vital signs monitoring.</div></div><div><h3>Results</h3><div>There were 167 patients managed in DOM in the study period. The model saved an average of 3.3 bed-days per patient, amounting to approximately 231 bed-days saved in 2023.</div></div><div><h3>Conclusion</h3><div>This expanded nurse-led outpatient dengue management model demonstrates safety, feasibility, and resource efficiency. With structured patient selection and monitoring protocols, DOM significantly reduces hospital bed occupancy while offering a scalable solution for dengue-endemic regions<strong>.</strong></div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102882"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754396","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":"Plasmodium vivax microgametes in a Colombian malaria case: A diagnostic challenge","authors":"Diego Andrés Rodríguez Lugo ,&nbsp;Jorge A. Morcillo Muñoz ,&nbsp;Leidy J. Medina-Lozano ,&nbsp;Álvaro A. Faccini-Martínez","doi":"10.1016/j.tmaid.2025.102895","DOIUrl":"10.1016/j.tmaid.2025.102895","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102895"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903939","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":"Biodiversity of malaria ecosystems, challenges for control: When human diversity is forgotten","authors":"Florence Fouque ,&nbsp;Konstantina Boutsika","doi":"10.1016/j.tmaid.2025.102887","DOIUrl":"10.1016/j.tmaid.2025.102887","url":null,"abstract":"<div><div>Malaria has been affecting human beings since ever through a great biodiversity of transmission contexts, and only recently this vector-borne parasitic disease was controlled and eliminated due to the progress in the knowledge of the pathogens, the mosquito vectors and the transmission cycles, but also technological advances in diagnostic, prevention and control tools targeting both the parasite and the vector.</div><div>Within the past 150 years malaria was eliminated from all temperate countries of the northern hemisphere, and this success triggered the belief that human malaria could be eradicated with simple tools such as environmental management, impregnated nets and treatments. But this did not happen, and a resurgence of malaria burden started about 50 years ago, affecting mostly sub-Saharan Africa. Consequently, a strong worldwide mobilization after the 2000s was followed by a new decline of malaria incidence and a strong decline in malaria mortality, but the diversity of the transmission contexts did not allow the continuation of declined incidence. Further, this situation was concomitant with a great upsurge on mobility of human populations due to different reasons. Malaria control is now at crossroads where access to health is the main driver of the disease. Reaching the hard to reach and mobile populations will be essential to continue the progress on malaria control.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102887"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370986","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":"Genetic characterization of enteric protozoan microorganisms in newly arrived migrants in Italy and correlation with the gut microbiome layout","authors":"Marianna Marangi ,&nbsp;Giorgia Palladino ,&nbsp;Felice Valzano ,&nbsp;Daniel Scicchitano ,&nbsp;Silvia Turroni ,&nbsp;Simone Rampelli ,&nbsp;Marco Candela ,&nbsp;Fabio Arena","doi":"10.1016/j.tmaid.2025.102901","DOIUrl":"10.1016/j.tmaid.2025.102901","url":null,"abstract":"<div><div>The prevalence of the enteric protozoan microorganisms, its genetic characterization as well as its associated gut microbiome has been molecularly and 16S metagenomic characterized in a cohort of newly arrived migrants in Italy from African countries over the period 2022–2024. Out of 199 individuals, 92 (46.2%) were found to be carrier of protozoan microorganisms with a higher prevalence of <em>Blastocystis</em> sp. (15.5%), followed by <em>Giardia duodenalis</em> (12.6%), <em>Dientamoeba fragilis</em> (7.5%), <em>Cryptosporidium parvum</em> (6.5%), and <em>Entamoeba histolytica</em> (4%). Subtypes ST1, ST2 and ST3 were genetically characterized for <em>Blastocystis</em> sp., assemblages A and B for <em>G. duodenalis</em>, subtypes families IIa and IIc for <em>C. parvum</em> and genotype 1 for <em>D. fragilis</em>. High prevalence of <em>Butyrivibrio</em>, <em>Lachnospiraceae UGC 10</em> and <em>Paraprevotella</em>, were identified in the protozoan non-carrier individual group. This work shed lights on the circulation of enteric protozoan microorganisms in apparently healthy migrants from African countries and the potential relationship with the host-microbiome composition. Moreover, these results give an overview of the importance of microbiological surveys among migrants and asylum seekers arriving to hosting countries in order to evaluate the reliable risk of several microorganisms introduction though migration. Ultimately, further investigation of interplays between the intestinal microbiota and protozoan microorganisms will provide new approaches in the diagnosis and treatment of intestinal infections.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102901"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041330","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":"Assessing yellow fever and arboviral risks during the 2025 jubilee in Rome: A mass gathering and global mobility perspective","authors":"Giancarlo Ceccarelli ,&nbsp;Francesco Branda ,&nbsp;Fabio Scarpa ,&nbsp;Marta Giovanetti ,&nbsp;Massimo Ciccozzi","doi":"10.1016/j.tmaid.2025.102884","DOIUrl":"10.1016/j.tmaid.2025.102884","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102884"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722903","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":"Assessing scalability factors of a malaria intervention using Malakit and target drug administration among hard-to-reach populations: An original approach focusing on key stakeholders – implementers and decision-makers – in the Guiana shield","authors":"Carlotta Carboni ,&nbsp;Alice Sanna ,&nbsp;Yann Lambert ,&nbsp;Lorraine Plessis ,&nbsp;Teddy Bardon ,&nbsp;Antoine Adenis ,&nbsp;Mathieu Nacher ,&nbsp;Stephen Vreden ,&nbsp;Martha Suárez-Mutis ,&nbsp;Maylis Douine","doi":"10.1016/j.tmaid.2025.102847","DOIUrl":"10.1016/j.tmaid.2025.102847","url":null,"abstract":"<div><h3>Introduction</h3><div>The Guiana Shield faces significant malaria challenges due to a mobile, hard-to-reach population involved in goldmining. Interventions like Malakit (self-testing and self-treatment kits), Targeted Drug Administration against <em>P. vivax</em>, or their combination, aim to combat malaria. These community-based interventions, evaluated in Brazil, French Guiana, and Suriname, show promising results and potential for scale-up. The research aimed to assess the scalability of these interventions by identifying and mapping stakeholders and doing a SWOT analysis for scale-up.</div></div><div><h3>Methods</h3><div>This pre-planning assessment, conducted from June 2023 to March 2024, involved a collaborative, participatory approach. The process included working sessions with the resource team, semi-structured interviews with stakeholders, and participant observation during formal meetings with stakeholders and the resource team. Field notes have been taken and deductive qualitative analysis has been made using the ExpandNet/WHO Framework. Data was used to design Mendelow's Matrix and SWOT analysis.</div></div><div><h3>Results</h3><div>Stakeholders were categorized into implementers, decision-makers, beneficiaries, and partners. Mendelow's matrix and SWOT analysis highlighted strengths like Malakit's effectiveness, while weaknesses included data gaps and regulatory challenges. Opportunities for scaling up were linked to malaria elimination initiatives in Brazil, French Guiana, and Suriname, while funding and regulatory issues posed threats.</div></div><div><h3>Discussion and conclusion</h3><div>Stakeholder analysis is crucial in scaling up public health interventions, identifying key contributors and challenges. Financial and regulatory barriers can hinder scalability, but political and epidemiological factors offer opportunities. Effective collaboration across countries, engaging stakeholders, and advocating for evidence-based decisions are essential for malaria elimination in Brazil, French Guiana, and Suriname.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"67 ","pages":"Article 102847"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370969","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}