Tropical Medicine and Infectious Disease最新文献

{"title":"Schistosomiasis and Soil Transmitted Helminthiasis Among School Age Children: Impact of 3-5 Annual Rounds of Mass Drug Administration in Ekiti State, Southwest Nigeria.","authors":"Solomon Monday Jacob, Jan-Carel Diehl, Gleb Vdovine, Temitope Agbana, Samuel Popoola, Satyajith Jujjavarapu, David Bell, Akande Oladimeji Ajayi, Joseph O Fadare, Adebowale F Akinwumi, Saheed Animashaun, Francisca Olamiju, Moses Oluwaseun Aderogba, Louise Makau-Barasa","doi":"10.3390/tropicalmed10040085","DOIUrl":"https://doi.org/10.3390/tropicalmed10040085","url":null,"abstract":"<p><p><b>Background:</b> Schistosomiasis (SCH) and soil transmitted helminthiasis (STH) have been targeted for elimination as a public health problem (EPHP) within the World Health Organization (WHO)'s Roadmap for Neglected Tropical Diseases (NTDs) 2021-2030. One of the global strategies for the control and elimination of these diseases is the mass administration of praziquantel and albendazole/mebendazole without prior individual diagnosis. To measure the progress towards the 2030 target, we conducted an assessment to determine the impact of the 3-5 rounds of annual mass drug administration among school age children in Ekiti State. Such scientific insights into the impact of these treatments will facilitate improved planning and targeting of resources towards reaching the last mile. <b>Methodology</b>: This assessment was conducted in 16 local government areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in 166 primary and junior secondary schools across 166 wards of the State. Urine and stool samples were collected from 7670 pupils of ages 5 to 14 years, following standard laboratory procedures. Urine membrane filtration techniques were used for urine preparation while the Kato-Katz technique was used for stool preparation. A novel AiDx digital microscope was used to examine the presence of any ova in the prepared specimen. Parasite ova in urine were reported as the number of ova/10 mL of urine, and were categorized as light infection (˂50 ova/10 mL of urine) or heavy infection (>50 ova/10 mL of urine) while ova of parasites in stool samples were reported as eggs per gram of stool (EPG) and categorized into light, moderate and heavy infection. <b>Results</b>: Overall, 0.76% (0.56-0.95) at 95% CI of the 7670 respondents were infected with <i>Schistosomia haematobium</i>. No <i>Schistosoma mansoni</i> infection was recorded in the study. Similarly, 3.9% (3.43-4.29) at 95% CI were infected with STHs. The overall prevalence of schistosomiasis had significantly reduced from 8.2% in 2008 to 0.8%, while the overall prevalence of STHs significantly reduced from 30.9% to 3.9% with <i>Ascaris lumbricoides</i> being the dominant species of STH. In the 16 LGAs assessed, Ekiti West had the highest <i>S. haematobium</i> prevalence of 4.26%. Ise/Orun and Oye ranked second and third with a prevalence of 3.48% and 2.40% respectively, while all other LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45% while Emure and Ikole Local Governments had the lowest prevalence of 0.31% and 0.38%, respectively. There was no significant difference in the prevalence of schistosomiasis between male (0.76%) and female (0.75%) as <i>p</i> ≥ 0.05. Similarly, the difference in prevalence for STH among males (3.95%) was not significantly different from their female counterparts (3.77%), <i>p</i> ≥ 0.05. <b>Conclusions:</b> Based on the WHO guidelines, this study demonstrated that only t","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016909","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 Review of the Efficacy, Safety, and Feasibility of Rifamycin-Based Post-Exposure Chemoprophylaxis for Leprosy.","authors":"Patrick O Campbell, Nicholas M Douglas, Stephen T Chambers","doi":"10.3390/tropicalmed10040084","DOIUrl":"https://doi.org/10.3390/tropicalmed10040084","url":null,"abstract":"<p><p>In 2021, the World Health Organization (WHO) recommended scaling up leprosy prevention activities, including chemoprophylaxis, as one of the pillars of their 'Towards Zero Leprosy' strategy. This recommendation was primarily based on a 57% overall reduction in leprosy incidence among contacts who received chemoprophylaxis in the COLEP study conducted in Bangladesh. Since this landmark study, further research on the efficacy, feasibility, and implementation of leprosy chemoprophylaxis has been conducted. Additionally, concerns have been raised regarding the strength of evidence supporting the overall benefit of chemoprophylaxis and the potential for propagation of drug resistance in <i>M. leprae</i> strains. This literature review presents the current evidence for the efficacy and safety of rifamycin-based chemoprophylaxis in preventing clinical disease, and the feasibility of implementing chemoprophylaxis programmes. Post-exposure prophylaxis (PEP) has a reported efficacy of 45-80%, depending on the degree of case contact, the classification of the index case, the selected chemoprophylaxis regimen, the geographical setting, childhood BCG coverage and the implementation approach. As an intervention, it appears to be feasible, cost-effective, and acceptable to patients, contacts, and healthcare staff, with minimal harm. Implementation strategies need to be tailored to specific epidemiological and sociocultural settings for maximal benefit. Further research is required to optimise PEP regimens and strategies in various epidemiological settings and to assess the impact of these programmes on the susceptibility profile of local <i>M. leprae</i> strains.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 4","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12030903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999838","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":"Antimicrobial Resistance and Its Impact on Food Safety Determinants Along the Beef Value Chain in Sub-Saharan Africa-A Scoping Review.","authors":"Godfrey Musuka, Jairus Machakwa, Oscar Mano, Patrick Gad Iradukunda, Pierre Gashema, Enos Moyo, Amon Nsengimana, Shepherd Manhokwe, Tapiwa Dhliwayo, Tafadzwa Dzinamarira","doi":"10.3390/tropicalmed10030082","DOIUrl":"10.3390/tropicalmed10030082","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) poses a significant threat to human, animal, and public health, particularly in Sub-Saharan Africa (SSA), where the beef sector is vital to food security and livelihoods. We conducted a scoping review to explore the determinants and impacts of AMR within the beef value chain in SSA, highlighting the challenges and progress in mitigating AMR risks in livestock production. This review identifies key factors contributing to AMR, including the overuse and misuse of antimicrobials, inadequate veterinary oversight, and weak regulatory frameworks. These practices are prevalent across various stages of the beef value chain, from farm to slaughterhouse, and are exacerbated by informal markets and insufficient infrastructure. Our findings also highlight the role of environmental factors, such as contamination of feed, water, and manure, in the spread of resistant pathogens. Additionally, gaps in AMR surveillance, education, and enforcement limit effective control measures in the region. While efforts to combat AMR have gained momentum in some countries, including the development of national action plans and surveillance systems, substantial challenges remain. These include poor adherence to antimicrobial guidelines, insufficient veterinary training, and the lack of integration between sectors. There is a need for targeted research to better understand antimicrobial misuse, socio-economic drivers, and the environmental pathways of AMR, as well as the need for stronger regulatory frameworks and cross-border cooperation. Addressing these challenges will be essential to safeguarding food safety, public health, and the sustainability of the beef industry in SSA.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731670","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":"Clinical Characteristics of Nontuberculous Mycobacterial Positivity Occurring During Multidrug-Resistant Tuberculosis Treatment: A Retrospective Study.","authors":"Min Wang, Muhammad Tahir Khan, Zilong Yang, Zhiyu Feng, Hong Zhang, Yuan Yuan, Di Wu, Zeying Chen, Haobin Kuang, Shouyong Tan","doi":"10.3390/tropicalmed10030083","DOIUrl":"10.3390/tropicalmed10030083","url":null,"abstract":"<p><p>The clinical characteristics of multidrug-resistant tuberculosis (MDR-TB) patients with concurrent nontuberculous mycobacterial (NTM) infection present significant challenges to treatment. This study investigated the clinical characteristics of MDR-TB patients with concurrent NTM infection during treatment. A retrospective cohort study was conducted to collect the clinical data of MDR-TB patients who initiated treatment between January 2020 and December 2022. A total of 389 patients were analyzed, among which 111 patients who were lost to follow-up and 56 patients who missed etiological examination of tuberculosis during the visit period were excluded. A total of 222 patients with complete data were included in this study. The species identification method primarily employed molecular biology techniques, specifically the DNA microarray method and/or MPB64 antigen detection using the colloidal gold method. Patients whose sputum or bronchoalveolar lavage fluid cultures were positive and who were identified at least once as having NTM or as MPB64 negative were included in this study. Imaging data, comorbidities, pre-treatment infection, and nutritional indicators were analyzed during treatment. Among the 222 MDR-TB patients, no concurrent NTM cases were identified at the beginning of treatment. However, 19 cases (8.56%) were presumed to be NTM-positive during treatment, which appeared during anti-tuberculosis treatment from 2 to 12 months, averaging 6 (3, 12) months. Thirteen patients were only tested for MPB64, with five having two negative MPB64 tests. The symptoms of NTM-positive patients varied, and imaging findings were similar to those of MDR-TB but did not worsen. The emergence of presumed NTM-positive cases (8.56%) among MDR-TB patients during treatment highlights the need for monitoring, as symptoms and imaging findings may mimic MDR-TB without worsening. Early and repeated testing, including methods beyond MPB64, may be useful for more accurate diagnosis and tailored management.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731695","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":"Microbial Infections and Antimicrobial Use in Neonates and Infants.","authors":"Chryssoula Tzialla","doi":"10.3390/tropicalmed10030080","DOIUrl":"10.3390/tropicalmed10030080","url":null,"abstract":"<p><p>Infectious diseases in infants are a major cause of morbidity and mortality during the first 28 days of life, accounting for approximately 33% of neonatal deaths and 50% of deaths in children under the age of five [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731780","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":"Alterations and Dynamics of Major Meningitis Etiological Agents During and Post-COVID-19 Pandemic: A Systematic Review.","authors":"Luís Arthur Brasil Gadelha Farias, Larissa Santos Weyne, Lenifer Siqueira Landim, Pablo Eliack Linhares de Holanda, Aliniana da Silva Santos, Luciano Pamplona de Góes Cavalcanti, Lourrany Borges Costa, Antonio Gutierry Neves Dantas de Melo, Melissa Soares Medeiros, Evelyne Santana Girão, Tânia Mara Silva Coelho, Lauro Vieira Perdigão Neto","doi":"10.3390/tropicalmed10030081","DOIUrl":"10.3390/tropicalmed10030081","url":null,"abstract":"<p><p>The transmission dynamics of many pathogens were altered during the coronavirus disease 2019 (COVID-19) pandemic. Several factors, including control measures and social distancing, have influenced the circulation and epidemiology of major etiological agents of meningitis during this period. This review examined trends in the primary etiologic agents of meningitis during and after the COVID-19 pandemic. A comprehensive literature search was conducted using the MEDLINE, Embase, LILACS, and SciELO databases for studies published between 2020 and 2024. The data were summarized descriptively and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-eight studies are included in this review. Bacterial and viral meningitis pathogens exhibited significant epidemiological shifts during the pandemic. A marked decline in infections caused by the enteroviruses, <i>Neisseria meningitidis</i>, <i>Streptococcus pneumoniae</i>, and <i>Haemophilus influenzae</i> was observed from 2020 to 2021 in the northern and southern hemispheres during the pandemic. Post-pandemic, meningitis cases increased, with a resurgence in various countries. Despite the heterogeneity of the studies, the evidence indicates that the COVID-19 pandemic significantly affected the epidemiology of meningitis-causing microorganisms during and after the pandemic. Understanding these epidemiological shifts and dynamics is crucial for defining the control measures, vaccination strategies, and public health policies in the post-COVID-19 era.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731669","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":"Treatment Adherence and Outcomes in Patients with Tuberculosis Treated with Telemedicine: A Scoping Review.","authors":"Kikelomo Sabainah Olowoyo, Deborah Tolulope Esan, Paul Olowoyo, Babatunji Emmanuel Oyinloye, Israel Opeyemi Fawole, Segun Aderibigbe, Mary Opeyemi Adigun, David Bamidele Olawade, Theophilus Olaide Esan, Benedict Tolulope Adeyanju","doi":"10.3390/tropicalmed10030078","DOIUrl":"10.3390/tropicalmed10030078","url":null,"abstract":"<p><p>Patient non-adherence to drug usage is a major barrier to treating tuberculosis (TB). Telemedicine has shown promise in treatment monitoring and evaluation. This paper aims to explore scientific evidence of telemedicine application in TB treatment to promote widespread adoption in areas that are remote or have poor road networks from health facilities. Articles published from 2010 to 2023 on the adherence and outcomes in pulmonary tuberculosis with the use of telemedicine were reviewed. A scoping review of the studies was conducted by two authors independently, following the PRISMA guidelines to identify relevant articles. Telemedicine interventions have shown improvements in medication adherence, treatment completion, cure rates, and smear conversion among TB patients. The available evidence supports the beneficial effect of telemedicine in improving treatment adherence and outcomes in patients with pulmonary tuberculosis. However, the effect and outcomes varied across studies, indicating the need for further research and standardization of telemedicine interventions.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731804","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 High Burden of Infectious Tuberculosis Cases Among Older Children and Young Adolescents of the Female Gender in Ethiopia.","authors":"Zewdu Dememew, Atakilt Deribew, Amtatachew Zegeye, Taye Janfa, Teshager Kegne, Yohannes Alemayehu, Asfawosen Gebreyohannes, Sidhartha Deka, Pedro Suarez, Daniel Datiko, Dan Schwarz","doi":"10.3390/tropicalmed10030079","DOIUrl":"10.3390/tropicalmed10030079","url":null,"abstract":"<p><p>The study was conducted in all regions of Ethiopia, except Tigray. It describes types of Tuberculosis (TB) based on gender, age, region, HIV status, and geographic setting in Ethiopia. It is a cross-sectional study that utilized the Ministry of Health's District Health Information System-based reporting to analyze all types of TB from July 2022 to March 2024. In total, 290,450 TB cases were detected: 42.6% (123,871) were female, 9.4% (27,160) were children (under 15 years of age), and 14.5% (42,228) were adolescents (10-19 years of age). About 48% (20,185) of adolescent TB cases were bacteriologically confirmed, of which 47.5% were females. Compared to children <5 years, the male-to-female ratio is 26% higher among older children (5-9 years of age) (Adjusted Odds Ratio (AOR): 1.26, 95% Confidence Interval (CI): 0.51-2.01)) and 53% higher among adolescents (AOR: 1.53, 95% CI 0.87-2.18). In short, about half of TB cases are infectious among older children and young adolescents of the female gender in Ethiopia. TB among these age categories may be addressed through the integration of TB services with reproductive health services and youth-friendly and pediatric clinics.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731667","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":"Neglected Tropical Diseases Remain a Considerable Public Health Challenge in West Africa.","authors":"Andrew Ramsay, Edward Mberu Kamau","doi":"10.3390/tropicalmed10030077","DOIUrl":"10.3390/tropicalmed10030077","url":null,"abstract":"<p><p>Neglected tropical diseases (NTDs) form a category of diverse, mainly infectious, diseases that are prevalent in tropical and subtropical countries [...].</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731860","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":"Dog-Mediated Rabies Surveillance in Nigeria (2014-2023): Investigating Seasonality and Spatial Clustering.","authors":"Rebecca D Williams, Mahbod Entezami, Ruth Alafiatayo, Olaniran Alabi, Daniel L Horton, Emma Taylor, Rachel Tidman, Columba T Vakuru, Taiwo Olasoju, Abel B Ekiri, Joaquin M Prada","doi":"10.3390/tropicalmed10030076","DOIUrl":"10.3390/tropicalmed10030076","url":null,"abstract":"<p><p>Rabies is an important zoonotic disease responsible for 59,000 human deaths worldwide each year. More than a third of these deaths occur in Africa. The first step in controlling rabies is establishing the burden of disease through data analysis and investigating regional risk to help prioritise resources. Here, we evaluated the surveillance data collected over the last decade in Nigeria (2014-2023). A spatio-temporal model was developed using the NIMBLE (1.2.1) package in R to assess outbreak risk. Our analysis found a high risk of canine rabies outbreaks in Plateau state and its surrounding states, as well as increased trends of outbreaks from July to September. The high number of reported canine rabies outbreaks in the North Central region could be due to cross-border transmission or improved reporting in the area. However, this could be confounded by potential reporting bias, with 8 out of 37 states (21.6%) never reporting a single outbreak in the period studied. Improving surveillance efforts will highlight states and regions in need of prioritisation for vaccinations and post-exposure prophylaxis. Using a One Health approach will likely help improve reporting, such as through integrated bite-case management, creating a more sustainable solution for the epidemiology of rabies in Nigeria in the future.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731850","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}