Tropical Medicine and Infectious Disease最新文献

{"title":"Epidemiological Dynamics and Trends of Dengue Outbreaks in Sao Tome and Principe: A Comprehensive Retrospective Analysis (2022-2024).","authors":"Sousa Lazaro, Vilfrido Santana Gil, Ivando Carvalho Viegas de Ceita, Isaulina Neto Viegas Barreto, Eula Carvalho Batista Sousa Maquengo, Andreza Batista de Sousa, Bakissy da Costa Pina, Tieble Traore, Alimuddin Zumla, John Otokoye Otshudiema","doi":"10.3390/tropicalmed10020034","DOIUrl":"10.3390/tropicalmed10020034","url":null,"abstract":"<p><strong>Background: </strong>Dengue has emerged as a significant public health concern in Sao Tome and Principe, with the first documented outbreak occurring between 2022 and 2024. This study examined the epidemiological patterns, environmental determinants, and demographic characteristics of dengue transmission during this period.</p><p><strong>Methods: </strong>We conducted a comprehensive retrospective analysis of laboratory-confirmed dengue cases using national surveillance data, clinical records, and environmental monitoring data. Statistical analyses included demographic profiling, temporal trend assessment, and environmental correlation studies using multiple regression modeling.</p><p><strong>Results: </strong>Among 1264 laboratory-confirmed cases, we observed distinct age-specific vulnerability patterns, with the highest incidence rate in the 70-79 age group (829.6 per 100,000) despite most cases occurring in younger adults. Rainfall emerged as the strongest predictor of dengue transmission (r = 0.96, <i>p</i> < 0.001), explaining 92% of case variance in the regression model. Case distribution showed marked temporal variation, with 91.9% of cases reported in 2022, coinciding with exceptional rainfall (3205 mm). The overall case fatality rate was 0.71% (95% CI: 0.33-1.35), with significant quarterly variations. Geographical analysis revealed concentration in the Água Grande district (68.2% of cases).</p><p><strong>Conclusions: </strong>This first comprehensive analysis of dengue in Sao Tome and Principe demonstrates the crucial role of rainfall in disease transmission and reveals important age-specific vulnerability patterns. These findings provide an evidence base for developing targeted interventions, particularly during high-rainfall periods, and suggest the need for age-stratified clinical protocols in similar island settings.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493479","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":"Molecular Detection of <i>Mycobacterium leprae</i> and the Process of Infection and Illness in Contacts of Leprosy Patients: A Systematic Review.","authors":"Sarah Lamas Vidal, Lavínia Cássia Ferreira Batista, Daniele Dos Santos Lages, Bruna Eduarda Bortolomai, Isabela de Caux Bueno, Eyleen Nabyla Alvarenga Niitsuma, Nathan Guilherme de Oliveira, Ida Maria Foschiani Dias Baptista, Francisco Carlos Félix Lana","doi":"10.3390/tropicalmed10020032","DOIUrl":"10.3390/tropicalmed10020032","url":null,"abstract":"<p><p>Various techniques have been used for the molecular identification of <i>Mycobacterium leprae</i> (<i>M. leprae</i>). The aim of this review was to identify the relationship between the molecular presence of <i>M. leprae</i> and the process of infection and/or illness of contact of leprosy cases. A systematic review was carried out by searching the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane Library, Embase, Scopus, Web of Science and the Latin American and Caribbean Health Sciences Literature (LILACS) databases in January 2024. The studies were selected by two pairs of reviewers. Observational cross-sectional, case-control and cohort studies were included. A descriptive synthesis of the results by category was carried out. A total of 443 studies were identified, and 36 were included in the review. Twelve molecular targets were tested to identify the presence of the bacillus. A relationship was established between the identification of <i>M. leprae</i> DNA and factors related to the index case, housing characteristics, living conditions, epidemiology and anti-PGL-1 serology. None of the studies identified evaluated the molecular viability of <i>M. leprae</i> among contacts. The detection of <i>M. leprae</i> DNA alone does not necessarily predict the development of infection or clinical illness among contacts.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493806","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":"Transcriptome Analysis of <i>Culex pipiens quinquefasciatus</i> Larvae Exposed to a Semi-Lethal Dose of Vermistatin.","authors":"Junhui Chen, Zhiyong Xu, Feiying Yang, Jian Yang, Wendong Kuang, Jianghuai Li, Yaqi Wang, Liang Jin","doi":"10.3390/tropicalmed10020031","DOIUrl":"10.3390/tropicalmed10020031","url":null,"abstract":"<p><p><i>Culex pipiens quinquefasciatus</i> is a notorious vector transmitting severe diseases such as Zika virus and West Nile virus to humans worldwide. Vermistatin is a type of funicon-like compound and was first isolated from <i>Penicillin vermiculatum</i> in the 1970s. Vermistatin has shown promising activity against <i>Cx. p. quinquefasciatus</i> larvae in our previous research. Here, we conducted a transcriptomic analysis of <i>Cx. p. quinquefasciatus</i> larvae treated with a median lethal concentration of 28.13 mg/L vermistatin. Differential expression analysis identified 1055 vermistatin-responsive genes, with 477 downregulated and 578 upregulated. Gene Ontology annotation and enrichment analysis revealed the metabolic process to be the most significantly affected biological process, the membrane to be the most significantly affected cellular component, and catalytic activity to be the most significantly affected molecular function. Kyoto Encyclopedia of Genes and Genomes pathway analysis classified the differential expression genes into six major categories, with metabolism and organismal systems being the most enriched. Fifty-five pathways were significantly enriched, with the hematopoietic cell lineage, renin-angiotensin system, cholesterol metabolism, and peroxisome proliferator-activated receptor signaling pathways among the top altered pathways. Furthermore, 32 potential detoxification-related genes were differentially expressed, with 3 cytochrome P450s, 2 ABC transporters, and 1 UGT induced by vermistatin. This study provides insights into the molecular mechanisms of vermistatin's action against <i>Cx. p. quinquefasciatus</i> larvae, highlighting potential targets for novel mosquito control strategies.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493837","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":"Schistosomiasis in the Philippines: A Comprehensive Review of Epidemiology and Current Control.","authors":"Emmanuel John Tabilin, Darren J Gray, Mario A Jiz, Mary Lorraine Mationg, Marianette Inobaya, Eleonor Avenido-Cervantes, Megumi Sato, Marcello Otake Sato, Yasuhito Sako, Yi Mu, Hong You, Matthew Kelly, Pengfei Cai, Catherine A Gordon","doi":"10.3390/tropicalmed10020029","DOIUrl":"10.3390/tropicalmed10020029","url":null,"abstract":"<p><p><i>Schistosomiasis japonica</i> is an infectious parasitic disease caused by infection with the blood fluke <i>Schistosoma japonicum</i>, which is endemic in China, small pockets of Indonesia, and the Philippines. Of the three countries, the prevalence of infection is the highest in the Philippines, despite decades of mass drug administration (MDA). As a zoonosis with 46 potential mammalian definitive hosts and a snail intermediate host, the control and eventual elimination of <i>S. japonicum</i> requires management of these animal hosts in addition to new interventions for the human hosts, including health education and water, sanitation, and hygiene (WASH) infrastructure. In this review we examine the status and epidemiology of <i>S. japonicum</i> in the Philippines with an overview of the current control program there and what needs to be accomplished in the future to control and eliminate this disease in the country.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493779","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":"A Retrospective Study of Clinical Biomarkers of Severe Dengue in a Tertiary Hospital in Johor Bahru, Malaysia.","authors":"Si Yin Kok, Ruth Elizabeth Abraham, Shareen Nisha Jauhar Ali, Wei Xuan Tuang, Edmund Liang Chai Ong","doi":"10.3390/tropicalmed10020030","DOIUrl":"10.3390/tropicalmed10020030","url":null,"abstract":"<p><p>Management of severe dengue remains a clinical challenge. This retrospective study evaluated clinical features and laboratory biomarkers associated with severe dengue at Hospital Sultanah Aminah Johor Bahru from 1 January 2022 to 31 March 2023. Records of 99 patients, categorized into ICU (51) and non-ICU (48) groups, were identified and analyzed using SPSS version 28.0. Sociodemographic details, clinical features and laboratory biomarkers were collected. Patients aged 50 and older, those with obesity, and those with pre-existing comorbidities were significantly more likely to be admitted to the ICU. The four most common warning signs in both cohorts were lethargy/restlessness/confusion, abdominal pain, persistent vomiting, and diarrhea. Fever, or history of fever, and thrombocytopenia were the two most common severe dengue criteria present in both cohorts. ICU patients exhibited more signs of plasma leakage and abnormal laboratory findings, including normal white cell count, hypoalbuminemia, hyperbilirubinemia, and elevated creatine kinase. In contrast, leukopenia and normal albumin, bilirubin, and creatine kinase levels were more common in non-ICU patients. Hyponatremia and raised lactate dehydrogenase were seen in both groups. This study highlighted key differences and similarities in clinical features and laboratory biomarkers between ICU and non-ICU patients, emphasizing the need for further research to develop a comprehensive risk assessment tool for predicting severe dengue that resulted in ICU admission.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493931","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":"Innovations in TB Screening and Preventive Therapy Services for PLHIV in Yogyakarta City, Indonesia.","authors":"Dani Catrianiningsih, Guardian Yoki Sanjaya, Geoff Chan, Betty Weri Yolanda Nababan, Rina Triasih, Desthi Diah Intani, Endang Sri Rahayu","doi":"10.3390/tropicalmed10010028","DOIUrl":"10.3390/tropicalmed10010028","url":null,"abstract":"<p><p>Tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) has been recommended by Indonesia's National TB Program since 2014 but has seen limited implementation. This study describes TB screening and TPT initiation from 2019 to 2022 among eight healthcare facilities supported by the Zero TB Yogyakarta (ZTB) project. ZTB assigned a dedicated nurse to assist with active TB screening among PLHIV and recommended the immediate initiation of TPT as an innovation implemented. Data were obtained from the national HIV program reporting system, routinely reported by ART clinics from 2019 to 2022. We conducted a descriptive analysis, comparing the pre-intervention and intervention periods. During the intervention, there was a significant increase in PLHIV visits to healthcare facilities where TPT eligibility was assessed. At health centers, TB screening coverage for PLHIV decreased toward the end of the baseline period but recovered during the intervention. The number of PLHIV starting TPT also rose during the intervention. While the direct impact of ZTB is difficult to measure, the changes observed indicate progress in integrating TB/HIV services and enhancing TB prevention among PLHIV. Ongoing support, training, and supervision of healthcare facilities are crucial for improving TB screening and TPT provision.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033889","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":"Estimation and Characterization of Dengue Serotypes in Patients Presenting with Dengue Fever at Makkah Hospitals.","authors":"Sami Melebari, Abdul Hafiz, Hatim A Natto, Mohamed Osman Elamin, Naif A Jalal, Ashwaq Hakim, Safiah Rushan, Othman Fallatah, Kamal Alzabeedi, Feras Malibari, Hutaf Mashat, Aisha Alsaadi, Amani Alhakam, Anoud Hadidi, Ghazi Saad Alkhaldi, Ahmed Alkhyami, Ali Alqarni, Abdulaziz Alzahrani, Mohammed Alghamdi, Abdullah Siddiqi, Abdullah Alasmari, Rowaida Bakri, Saleh Alqahtani, Juman M Al-Bajaly, Asim Khogeer","doi":"10.3390/tropicalmed10010027","DOIUrl":"10.3390/tropicalmed10010027","url":null,"abstract":"<p><p>Dengue fever is caused by four common serotypes of the dengue virus (DENV-1, DENV-2, DENV-3, and DENV-4). Patients infected with one serotype may develop lifelong serotype-specific protective immunity. However, they remain susceptible to reinfection with the other serotypes, often increasing the risk of severe forms of dengue. This cross-sectional study investigates the prevalence of the four dengue serotypes in patients who presented with dengue fever at Makkah hospitals between April 2023 and May 2024. Data were collected from the medical records of the Regional Laboratory in Makkah, Saudi Arabia. The 238 positive dengue samples included 185 samples (77.73%) from male patients. The average age of the patients was 37.65 years (SD = 15.05). Dengue type 2 was the most common serotype, followed by type 1, type 3, and type 4. Most of the dengue patients were Saudi nationals, followed by Egyptians. There were 11 dengue-positive samples that were not diagnosed with any of the four dengue serotypes. Since Makkah receives numerous international travelers, these samples might contain novel dengue serotypes circulating in different parts of the world. This study underscores the need for the continuous monitoring of dengue serotypes to predict potential outbreaks and mitigate the risk of severe dengue in susceptible populations.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033975","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":"Risk of Colonization with Multidrug-Resistant Gram-Negative Bacteria Among Travellers and Migrants: A Narrative Review.","authors":"Diogo Mendes Pedro, Daniela Santos, Maria Meneses, Fátima Gonçalves, Gonçalo Jantarada Domingos, Cátia Caneiras","doi":"10.3390/tropicalmed10010026","DOIUrl":"10.3390/tropicalmed10010026","url":null,"abstract":"<p><p>Globalization in the 21st century has posed several challenges. In particular, the spread of multidrug-resistant bacterial strains, especially Gram-negative bacteria, which are prevalent in certain regions of the world, is one of the most critical issues. This raises concerns about the risks associated with the booming tourism industry and migratory flows. In fact, even transient colonization with multidrug-resistant strains can present significant challenges to individual, family, and public health. Understanding the epidemiology and mechanisms of resistance, associated risk factors and prevention policies is therefore essential to ensure that strategies are in place to limit the global spread of high-risk bacterial clones and thereby protect public health.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033898","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":"The Global Challenge of <i>Campylobacter</i>: Antimicrobial Resistance and Emerging Intervention Strategies.","authors":"Zubeiru Bukari, Toyin Emmanuel, Jude Woodward, Richard Ferguson, Martha Ezughara, Nikhil Darga, Bruno Silvester Lopes","doi":"10.3390/tropicalmed10010025","DOIUrl":"10.3390/tropicalmed10010025","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) in <i>Campylobacter</i> species, particularly <i>C. jejuni</i> and <i>C. coli</i>, poses a significant public health threat. These bacteria, which are commonly found in livestock, poultry, companion animals, and wildlife, are the leading causes of foodborne illnesses, often transmitted through contaminated poultry. Extensive exposure to antibiotics in human and veterinary medicine creates selection pressure, driving resistance through mechanisms such as point mutations, horizontal gene transfer, and efflux pumps. Resistance to fluoroquinolones, macrolides, and tetracyclines complicates treatment and increases the risk of severe infections. Drug-resistant <i>Campylobacter</i> is transmitted to humans via contaminated food, water, and direct contact with animals, highlighting its zoonotic potential. Addressing this challenge requires effective interventions. Pre-harvest strategies like biosecurity and immune-based methods reduce bacterial loads on farms, while post-harvest measures, including carcass decontamination and freezing, limit contamination. Emerging approaches, such as bacteriocins and natural antimicrobials, offer chemical-free alternatives. Integrated, multidisciplinary interventions across the food chain are essential to mitigate AMR transmission and enhance food safety. Sustainable agricultural practices, antimicrobial stewardship, and innovative solutions are critical to curbing <i>Campylobacter</i> resistance and protecting global public health. Our review examines the dynamics of antimicrobial resistance in <i>Campylobacter</i> and presents current strategies to mitigate <i>Campylobacter</i>-related AMR, offering valuable insights for antimicrobial control in the poultry industry.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11768457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033931","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":"Biological and Social Predictors of HIV-1 RNA Viral Suppression in ART Treated PWLH in Sub-Saharan Africa.","authors":"Sindhuri Gandla, Raja Nakka, Ruhul Ali Khan, Eliezer Bose, Musie Ghebremichael","doi":"10.3390/tropicalmed10010024","DOIUrl":"10.3390/tropicalmed10010024","url":null,"abstract":"<p><p>HIV remains a significant health issue, especially in sub-Saharan Africa. There are 39 million people living with HIV (PLWH) globally. Treatment with ART improves patient outcomes by suppressing the HIV RNA viral load. However, not all patients treated with ART suppress the HIV RNA viral load. This research paper explores the potential predictors of VL suppression in ART-treated PLWH. We used retrospective data from the 4820 ART-treated participants enrolled through population-based surveys conducted in Zambia and Malawi. We applied several machine learning (ML) classifiers and used the top classifiers to identify the predictors of VL suppression. The age of participants ranged from 15 to 64 years, with a majority being females. The predictive performance of the various ML classifiers ranged from 64% to 92%. In our data from both countries, the logistic classifier was among the top classifiers and was as follows: Malawi (AUC = 0.9255) and Zambia (AUC = 0.8095). Thus, logistic regression was used to identify the predictors of viral suppression. Our findings indicated that besides ART treatment status, older age, higher CD4 T-cell count, and longer duration of ART were identified as significant predictors of viral suppression. Though not statistically significant, ART initiation 12 months or more before the survey, urban residence, and wealth index were also associated with VL suppression. Our findings indicate that HIV prevention programs in the region should integrate education on early ART initiation and adherence in PLWH.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11768424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033640","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}