Tropical Medicine & International Health最新文献

{"title":"Community Health Workers' Multiple Understandings of Schistosomiasis Transmission Pathways: Exploring Contextual Factors in Côte d'Ivoire, Kenya and Uganda.","authors":"Dianne Verhoeven, Lisa Sophie Reigl, Alice Sereti Sinkeet, Mary Maghanga, Alexise Djouquou Gnahore, Bi Tra Jamal Sehi, Suzanne Lobohon Lavry, Andrea Buhl, Marie Frese, Jennifer Burrill, Eveline Hürlimann, Peter Steinmann, Nora Monnier, Ashley Preston, Janet Masaku, Matthias Richter, Mary Amuyunzu Nyamongo, Alain Toh, Stella Neema, Isabelle L Lange, Andrea S Winkler","doi":"10.1111/tmi.70195","DOIUrl":"10.1111/tmi.70195","url":null,"abstract":"<p><strong>Objective: </strong>Schistosomiasis remains a public health concern in sub-Saharan Africa, affecting over 250 million people. In endemic settings, schistosomiasis transmission is not always understood exclusively in biomedical terms. Community health workers (CHWs) contribute to schistosomiasis control through mass drug administration and health education, yet limited evidence exists on how they understand schistosomiasis transmission. This study explores how CHWs in Côte d'Ivoire, Kenya and Uganda explain schistosomiasis transmission and how these explanations relate to wider disease and training contexts.</p><p><strong>Methods: </strong>This paper draws on the CHW component of a larger mixed-methods study conducted in Côte d'Ivoire, Kenya and Uganda, with multiple respondent groups. We present findings from interviews and focus group discussions with CHWs. Data were analysed thematically, at both semantic (descriptive) and latent (interpretive) level, employing Kleinman's framework of explanatory models and Good's work on semantic networks to support interpretation.</p><p><strong>Results: </strong>CHWs expressed multiple understandings of schistosomiasis transmission. Most described schistosomiasis transmission in biomedical terms, often emphasising skin contact with contaminated water. Others combined biomedical terms with locally circulating ideas about disease transmission, linking infection to drinking unsafe water, stepping on faeces, flies or other diseases such as trachoma or diarrhoeal illnesses. These understandings emerged in relation to a complex disease landscape in which signs, symptoms and perceived transmission routes overlapped. They were also situated within uneven training experiences, including irregular refresher sessions, variable access to schistosomiasis-specific training and training focused mainly on treatment campaign logistics.</p><p><strong>Conclusion: </strong>CHWs' varying understandings of schistosomiasis reflect not only individual knowledge but also the broader disease landscape and training contexts in which they work. Strengthening schistosomiasis communication therefore requires attention to how CHWs interpret, adapt and combine disease-specific information with other sources of knowledge, and to how training can better prepare them to navigate similarities and differences between disease-specific messages in everyday practice.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1453-1464"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362548","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":"Balancing Simplicity and Diagnostic Robustness: Critical Appraisal of the Korat-Scrub Typhus Score for Acute Undifferentiated Febrile Illness.","authors":"Thirunavukkarasu Arun Babu, Dinesh Kumar Narayanasamy","doi":"10.1111/tmi.70182","DOIUrl":"10.1111/tmi.70182","url":null,"abstract":"","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1505-1506"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of ABO Blood Group and Severe Plasmodium falciparum Malaria: An Updated Meta-Analysis and Trial Sequential Analysis.","authors":"Shovit Ranjan, Madhavi Dubey, Sharda Sharma, Sweety Rani Behera, Sanjaya Meher, Aditya K Panda","doi":"10.1111/tmi.70186","DOIUrl":"10.1111/tmi.70186","url":null,"abstract":"<p><strong>Background: </strong>Plasmodium falciparum malaria remains a major cause of morbidity and mortality in endemic regions, with outcomes influenced by host genetic factors. The ABO blood group system has been linked to clinical severity, though findings differ regarding blood groups and severe malaria susceptibility. This analysis aims to synthesise evidence on ABO blood group's role in severe P. falciparum malaria (SM) through meta-analysis and trial sequential analysis.</p><p><strong>Materials and methods: </strong>A search was conducted across PubMed, Scopus, Embase, Web of Science and Science Direct databases on August 31, 2025, to identify case-control studies reporting ABO blood groups in SM and uncomplicated malaria (UM). All Statistical analysis was performed with CMAv4.</p><p><strong>Results: </strong>Twenty-three studies comprising 3553 SM and 6112 UM cases were analysed. Results showed higher SM risk in blood groups A (OR:1.98; p = 0.00), B (OR:1.87; p = 0.00), AB (OR:1.91; p = 0.00) and non-O (OR:1.88; p = 0.00) versus group O. These associations were confirmed in African and South Asian populations, while Melanesians showed different patterns. Non-O groups showed increased risk in adults and children. Group A was linked to severe malarial anaemia (OR:1.75, p = 0.004), while group B showed protective effects (OR:0.75, p = 0.00). SM patients had lower haemoglobin (MD = -2.23; p = 0.00), with parasite density showing no correlation with severity. TSA confirmed evidence linking ABO groups with SM and haemoglobin levels.</p><p><strong>Conclusion: </strong>This meta-analysis and TSA confirm non-O blood groups as a susceptible factor for SM across ethnicities and ages. While ABO blood group is an inexpensive and widely available genetic marker, its clinical utility should be viewed as complementary rather than deterministic. However, at present, evidence does not support population-wide screening solely for malaria risk prediction. These findings improve understanding of host genetic susceptibility and may inform future research into targeted risk stratification.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1297-1314"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Algorithm Accuracy to Diagnostic Accountability: A FIELD-AI Pathway for Resource-Limited Settings.","authors":"Diksha Ranaut, Rajesh Prasad Jayaswal","doi":"10.1111/tmi.70236","DOIUrl":"https://doi.org/10.1111/tmi.70236","url":null,"abstract":"","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albendazole Treatment of Alveolar Echinococcosis in a Trial Based on a Cross Sectional Ultrasound Study in Kyrgyzstan.","authors":"G Minbaeva, U Tukeshov, S Aetbiev, J Usubaleava, G Abduldaeva, G Jumashava, B Müllhaupt, A Deibel, P A Kronenberg, P Deplazes, P R Torgerson","doi":"10.1111/tmi.70230","DOIUrl":"https://doi.org/10.1111/tmi.70230","url":null,"abstract":"<p><strong>Background: </strong>Human alveolar echinococcosis (AE) is a potentially fatal parasitic disease. In the low-resource country of Kyrgyzstan, it is essential to develop protocols to manage the large number of AE cases being diagnosed.</p><p><strong>Methods: </strong>A randomised trial was undertaken to explore the hypothesis that subjects with small AE lesions, detected by ultrasound, a wait and see approach could be adopted. Alternatively, subjects could be managed by albendazole and avoid invasive surgical treatment. One group of subjects with small P1N0M0 lesions was treated with albendazole. A second group remained untreated. A third group, with larger lesions, was either treated with albendazole or referred for surgical intervention. Patients were monitored for up to 2.5 years by ultrasound every 3-4 months. Subjects in the wait and watch group were switched to albendazole treatment if their lesions progressed. The study was registered at clinicaltrials.com. Registration number NCT07182305.</p><p><strong>Results: </strong>Of the 97 subjects initially assigned to the wait and watch group, 22 had signs of lesion progression and were placed on albendazole therapy. Subjects on continuous albendazole therapy demonstrated a reduction in the mean lesion size during the course of the study.</p><p><strong>Conclusion: </strong>In hyperendemic areas of AE, wait and see for small lesions or combined with albendazole therapy is a realistic approach to the management of AE cases. Frequent follow up with imaging every 3-4 months is essential to monitor any disease progression.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral Hepatitis A, B and C in Roraima, Brazilian Amazon: Epidemiological and Serological Profile, 2012-2023.","authors":"Jamilla Karla Corrêa Reis, Katrini Guidolini Martinelli, Flávia Freitas de Oliveira Bonfim, Cícera Raquel Feitosa, Bianca Jorge Sequeira, Livia Melo Villar, Vanessa Salete de Paula","doi":"10.1111/tmi.70224","DOIUrl":"https://doi.org/10.1111/tmi.70224","url":null,"abstract":"<p><strong>Introduction: </strong>Viral hepatitis remains a major global public health challenge, with heterogeneous epidemiological patterns across geographic and socioeconomic contexts. In the Brazilian Amazon, evidence remains limited, particularly regarding long-term trends. This study analyzed the epidemiological and serological profiles of viral hepatitis cases in Roraima, Brazil, from 2012 to 2023.</p><p><strong>Methods: </strong>A descriptive epidemiological study was conducted using secondary data from confirmed cases of viral hepatitis reported to the Notifiable Diseases Information System (SINAN) in Roraima between 2012 and 2023. Sociodemographic, epidemiological, clinical, and serological variables were analysed using descriptive statistics. Detection rates were calculated per 100,000 inhabitants.</p><p><strong>Results: </strong>A total of 5416 confirmed cases were identified. Hepatitis B was the predominant aetiology throughout the study period, ranging from 57.2% to 86.5% of cases, followed by hepatitis A (10.3%) and hepatitis C (9.6%). Hepatitis C cases increased over time, reaching more than 30% of notifications in 2021-2023, while hepatitis A declined markedly after 2019. Serological markers showed high frequencies of total anti-HBc and reactive anti-HCV results.</p><p><strong>Conclusions: </strong>Hepatitis B remains the main etiological agent of viral hepatitis in Roraima, predominantly identified in its chronic phase. The increase in hepatitis C and the decline of hepatitis A highlight the impact of expanded diagnosis and vaccination strategies. Strengthening epidemiological surveillance and improving data quality are essential to guide effective public health interventions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Screening for Communicable and Non-Communicable Diseases Multimorbidity in Low- and Middle-Income Countries: A Scoping Review.","authors":"Evans Duah, Nyeleti Chauke, Smangaliso Morerwa, Kuhlula Maluleke, Gabrielle Thompson, George Obeng Adjei, Paramjit Gill, Tivani Mashamba-Thompson","doi":"10.1111/tmi.70233","DOIUrl":"https://doi.org/10.1111/tmi.70233","url":null,"abstract":"<p><p>Multimorbidity is a growing public health challenge in low- and middle-income countries (LMICs), where resource-limited and fragmented health systems impede coordinated disease detection and management. Integrated screening offers a promising strategy to improve early detection of communicable and non-communicable diseases. We mapped the current evidence on integrated screening in LMICs, examining models, strategies, diseases, diagnostic tools and contextual factors that affect implementation and sustainability. A comprehensive search was conducted using the following electronic databases: PubMed, Scopus, Web of Science, ProQuest and EBSCOhost following the PRISMA-ScR guidelines. Two independent reviewers screened and extracted data, with a third reviewer resolving any discrepancies. The methodological quality of the study was appraised using the Mixed Methods Appraisal Tool (MMAT, Version 2018). Results were synthesized thematically and presented narratively. Out of 5380 studies screened, 17 were included, spanning 2012-2025 across 12 countries (13 conducted in Africa, 3 in South Asia and 1 in Latin America). They assessed communicable and non-communicable conditions, including HIV, TB, diabetes, hypertension and cardiovascular disease. Integrated screening was delivered via facility-based, mobile, community and community health worker-led models across primary healthcare and community settings. Five themes emerged: implementation in community and healthcare facilities; role of point-of-care diagnostics; health system preparedness and workflow alignment; staffing and workforce support; and factors influencing sustainability. Integrated multimorbidity screening in LMICs is feasible and improves detection, diagnosis and care when supported by trained staff, task shifting, community health workers and point-of-care diagnostics. Sustainable scale-up needs national alignment, funding and resource mobilization for equitable access.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Equity Analysis of the Prevalence, Costs and Coping Mechanisms of Informal Payments in the Utilisation of Healthcare Services in Nigeria.","authors":"Obinna Onwujekwe, Ifunanya Agu, Uche Ezema, Chukwudi Nwokolo, Blake Angell, Iheomimichineke Ojiakor, Martin McKee, Pamela Ogbozor, Muktar Gadanya, Eleanor Hutchinson, Dina Balabanova","doi":"10.1111/tmi.70234","DOIUrl":"https://doi.org/10.1111/tmi.70234","url":null,"abstract":"<p><strong>Background: </strong>Informal payments in healthcare facilities increase the cost of services, negatively impacting access and utilisation, particularly for poor and vulnerable populations. However, those affected may adopt various coping strategies to alleviate the financial burden. This paper presents evidence on the costs and coping mechanisms used by different population groups in response to informal payments in healthcare facilities in Nigeria.</p><p><strong>Methods: </strong>The study was conducted in the states of Enugu and Kano, located in the southeast and northwest regions of Nigeria, respectively. We collected data from 1659 randomly selected households using a pre-tested interviewer-administered questionnaire. We collected data on reported unapproved payments for healthcare services, amounts paid and coping strategies adopted by respondents. We explored the prevalence and drivers of making informal payments, the amounts paid and the coping mechanisms among different population groups. Concentration indices (CI) were used to examine socio-economic status (SES) inequities in payments, dividing SES into quintiles (poorest, poor, average, rich, most well-off).</p><p><strong>Results: </strong>The prevalence of informal payments was high, especially payments for drugs (77.7%), consultations (54.3%), medical consumables (54.0%) and diagnosis (53.4%). Among the coping mechanisms used were household income (63.9%), help from family members (46.1%) and help from someone/organisation/ (22.3%). Wealthiest households were most likely to make informal payments (28.0%), spending the largest sums (₦941,220, €550). However, poor households had the highest average expenditure on informal payments (₦8579.71, €5).</p><p><strong>Conclusion: </strong>Informal payments are widespread in Nigeria's healthcare system, contributing to increased costs and inequities in access to healthcare services. This underscores the urgent need for systemic reforms to combat corruption in healthcare facilities. Eliminating informal payments is essential for improving equity and ensuring that the health system can deliver services at a low cost. Transparent service pricing, regular audits and robust oversight mechanisms are recommended to detect and prevent informal payments.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine TB Surveillance as a Diagnostic Tool: Subnational Care Cascade Gaps in East Nusa Tenggara, Indonesia.","authors":"Kori Limbong, Nursalam, Erika Martining Wardani, Violin Irene Ninef, Aemilianus Mau","doi":"10.1111/tmi.70227","DOIUrl":"https://doi.org/10.1111/tmi.70227","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) control remains challenging in decentralised health systems, where subnational variation may be obscured by aggregate programme indicators.</p><p><strong>Objectives: </strong>To assess district-level variation in the TB care cascade using routine TB surveillance data in East Nusa Tenggara, Indonesia, and develop a composite TB Programme Performance Index (TPPI) for subnational benchmarking.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of aggregated 2025 TB surveillance data (SITB) covering all 22 districts. The cascade comprised presumptive TB identification, diagnostic evaluation, notification and treatment enrolment. A TPPI was constructed using four equally weighted indicators. Sensitivity analyses assessed ranking stability under alternative weighting schemes.</p><p><strong>Results: </strong>Among 87,547 presumptive TB cases, 82,281 (94.0%) completed diagnostic evaluation, yielding 10,318 notified cases. Treatment enrolment among notified cases was 93.2% (9622/10,318). Substantial district-level variation was observed: diagnostic evaluation completion ranged from 76.7% in West Sumba to 98.7% in Central Sumba; notification yield ranged from 4.7% in East Flores to 34.1% in West Sumba; and treatment enrolment ranged from 82.0% in Belu to 98.6% in Malaka. TPPI scores ranged from 42.8 in South Central Timor to 80.6 in Malaka. Rankings remained stable across weighting schemes (Spearman's ρ = 0.93-0.96).</p><p><strong>Conclusions: </strong>Routine TB surveillance revealed substantial subnational variation, particularly in diagnostic and notification indicators, while treatment enrolment among notified cases was high. Early cascade differences may reflect both underlying TB burden and health-system performance. District-level cascade analysis can inform targeted TB programme planning.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Drug Resistance, Drug Resistance Conferring Mutations and Genomic DNA Methylation Revealed in Mycobacterium tuberculosis From South Africa.","authors":"Unarine Matodzi, Awelani Mutshembele, Eric Mensah, Dillon Muzondiwa, Ndivhuho A Makhado, Oleg N Reva","doi":"10.1111/tmi.70228","DOIUrl":"https://doi.org/10.1111/tmi.70228","url":null,"abstract":"<p><p>Tuberculosis remains a major public health threat globally, with drug-resistant strains undermining treatment efficacy. We analyzed 126 Mycobacterium tuberculosis (M. tuberculosis) isolates with diverse drug resistance spectra and selected 35 for whole genome sequencing (WGS) using Illumina NextSeq, SMRT PacBio Onso and SMRT PacBio Revio sequencing platforms. The study aimed to characterize drug resistance profiles, compare short- and long-read sequencing performance, identify lineages among South African isolates, detect known drug resistance mutations and their lineage-specific patterns, and utilize long-read SMRT platforms for epigenetic profiling. Multiple drug resistance mutations were identified, some lineage-specific, and notably, East-African-Indian (EAI) Lineage 1 isolates often considered less pathogenic, showed significant potential for multidrug-resistance development, including higher fluoroquinolone resistance as compared to other lineages. Three DNA motifs with methylated adenines, namely CACGCaG, CtCCaG and GaTNNNNRtAC, were detected, with methylation patterns varying by lineage and strain due to mutations in the corresponding methyltransferases (MTases). A particularly notable finding was the stable maintenance of a genetic heterogeneity in the mamB MTase, performing methylation at CACGCaG motifs. These results highlight the combined role of genetic and epigenetic variation in M. tuberculosis adaptive evolution and underscore the value of integrating long-read sequencing into TB surveillance and research.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}