Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Endogenous reactivation cases identified by whole genome sequencing of Mycobacterium tuberculosis: Exploration of possible causes in Latvian tuberculosis patients","authors":"","doi":"10.1016/j.jctube.2024.100493","DOIUrl":"10.1016/j.jctube.2024.100493","url":null,"abstract":"<div><h3>Background</h3><div>The recurrence of tuberculosis (TB) continues to place a significant burden on patients and TB programs worldwide. Repeated TB episodes can develop either due to endogenous reactivation of previously treated TB or exogenous reinfection with a distinct strain of <em>Mycobacterium tuberculosis</em> (Mtb). Determining the precise cause of the recurrent TB episodes and identifying reasons for endogenous reactivation of previously successfully treated patients is crucial for introducing effective TB control measures.</div></div><div><h3>Methods</h3><div>Here, we aimed to provide a retrospective individual analysis of the clinical data of pulmonary TB patients with assumed endogenous infection reactivation based on WGS results to identify the reasons for reactivation. Patient medical files were reviewed to describe the provoking factors for endogenous reactivation.</div></div><div><h3>Results</h3><div>In total, 25 patients with assumed endogenous TB reactivation were included in the study group, and 30 patients with one TB episode during the study period were included in the control group. There were no statistically significant differences identified between studied patient groups in patients age (t₍₅₃₎ = −1.53, p = 0.13), body mass index (t₍₅₃₎ = 0.82, p = 0.42), area of residency (χ²_(1;55) = 0.015, p = 0.9), employment status (χ²_{(1;55) =} 0.076, p = 0.78) and presence of comorbidities (χ²_(1;55) = 3.67, p = 0.78). Study group patients had statistically significantly more frequently positive sputum smear microscopy results (χ²_(1;55) = 8.72, p = 0.0031), longer time to sputum smear (t₍₃₁₎ = −2.2, p = 0.036) and sputum culture conversion (W ₍₅₅₎ = 198.5, p = 0.0029). Smoking was statistically significantly (χ²_(1;55) = 5.77, p = 0.016) more frequently represented among study group patients. The median treatment duration for drug susceptible TB was 6 months in both in the control group (IQR 6–6) and among study group patients (IQR 6–7.75). The median treatment duration for multidrug-resistant TB was 20 months (IQR 17–23) in the control group and 19 months (IQR 16–19) in the study group patients.</div></div><div><h3>Conclusion</h3><div>Positive SSM for acid-fast bacteria, delayed time to sputum smear and sputum culture conversion, smoking, and incomplete therapy in the study group patients with multidrug-resistant TB should be considered as potential reasons for reactivation in recurrent TB patient group in our study.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bovine tuberculosis reactor cattle in Southwest Ethiopia: Risk factors for bovine tuberculosis","authors":"","doi":"10.1016/j.jctube.2024.100492","DOIUrl":"10.1016/j.jctube.2024.100492","url":null,"abstract":"<div><div>Bovine tuberculosis, caused by <em>Mycobacterium bovis</em>, is a chronic zoonotic disease that persists in Ethiopia despite global control efforts, impacting public health and the economy. However, little is known about the epidemiology of bovine tuberculosis in Southwest Ethiopia. This study aims to assess the prevalence of bovine tuberculosis and identify associated risk factors in dairy cattle. A cross-sectional study was conducted from October 2022 to October 2023 in four districts in the Sheka, Bench-Sheko, and Keffa zones. A multistage sampling approach was employed, resulting in the selection of 1,152 cattle from various herds. Tuberculin skin testing was performed to detect bovine tuberculosis, and data on potential risk factors were collected through questionnaires. Logistic regression models were used to analyze the association between bovine tuberculosis and various risk factors. The overall prevalence of bovine tuberculosis was 4.95% at the cow level and 22.19% at the herd level in the study areas. Significant herd-level risk factors for bovine tuberculosis included lowland areas, larger herd sizes, and the introducing new animals. At the cow level, risk factors included age, breed, body condition, herd size, introduction of new animals, and management system. The study reveals a high prevalence of bovine tuberculosis in dairy cattle in Southwest Ethiopia, identifying key risk factors. Effective control requires targeted interventions, such as improved management practices, enhanced farmer awareness, and a better understanding of and guidance on bovine tuberculosis strategies in Ethiopia. Future research should isolate and characterize <em>M. bovis</em> in the study areas.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapidly growing knowledge of Mycobacterium smegmatis: A case series and review of antimicrobial susceptibility patterns","authors":"","doi":"10.1016/j.jctube.2024.100489","DOIUrl":"10.1016/j.jctube.2024.100489","url":null,"abstract":"<div><div><em>Mycobacterium smegmatis</em> is a rapidly growing nontuberculous mycobacterium that is rarely isolated from clinical specimens and is frequently considered to be a contaminant. We conducted a retrospective review of mycobacterial cultures positive for <em>M. smegmatis</em> from 1998 to 2023 at our institution to evaluate the clinical significance of recovering this mycobacterium. Antimicrobial susceptibility patterns were also determined. Twenty-two <em>M. smegmatis</em> isolates were identified from 17 patients, 12 of whom met criteria for clinical chart review. <em>M. smegmatis</em> was deemed a cause of infection in 5/5 isolates from skin or soft tissue, 3/3 from bone, 1/1 from blood, and 0/3 from respiratory specimens. All cases thought to be significant were treated with at least 2 active agents for periods varying from 2 weeks up to 8 months. 18 isolates had antimicrobial susceptibility testing performed and all were susceptible to doxycycline, imipenem, linezolid, moxifloxacin, trimethoprim/sulfamethoxazole, and tobramycin while all isolates were resistant to clarithromycin. When recovered in culture, the presence of <em>M. smegmatis</em> should be correlated with clinical presentation as it may represent a true infection.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A predictive score for early in-patient tuberculosis mortality: A case-control study","authors":"","doi":"10.1016/j.jctube.2024.100487","DOIUrl":"10.1016/j.jctube.2024.100487","url":null,"abstract":"<div><h3>Introduction</h3><div>In-hospital mortality rates for tuberculosis (TB) patients are high within the first seven days of admission. This study sought to identify predictors of early inpatient mortality and assess the performance of a predictive score for early mortality in a Ugandan tertiary hospital.</div></div><div><h3>Materials and methods</h3><div>A case-control study was conducted at Kiruddu National Referral Hospital in Kampala, Uganda. Cases included patients admitted with TB who died within seven days of admission, while controls survived beyond this period. Logistic regression was utilized to identify early mortality predictors. The performance of an adapted predictive score (<strong>PROS</strong> score) was evaluated, assigning scores based on the following criteria: <strong>P</strong>ulse rate &gt;100 beats/min (1 point), <strong>R</strong>espiratory rate &gt;20 breaths/min (2 points), <strong>O</strong>xygen saturation &lt;92 % (4 points), and <strong>S</strong>ystolic blood pressure &lt;90 mmHg (2 points).</div></div><div><h3>Results</h3><div>Of 602 hospitalized TB patients, 187 (31.0 %) died during admission. Among these, 78 (41.7 %) died within seven days. Wasting (adjusted odds ratio [aOR] = 5.76, 95 % confidence interval [CI] 2.12–15.63, p = 0.001) and respiratory rate &gt;20 breaths/min (aOR = 2.89, 95 % CI 1.19–7.00, p = 0.019) predicted early mortality. PROS score of ≥1 demonstrated a sensitivity of 87.8 % and negative predictive value of 90.0 %. The ultimate TB treatment success rate of all hospitalized patients (n = 599) was 47.4 % with 275 (45.9 %) dying during TB treatment.</div></div><div><h3>Conclusion</h3><div>Early and long term mortality rates among hospitalized TB patients are high. Wasting and tachypnea predict early inpatient mortality. The PROS score could be useful in ruling out low-risk patients in low-resource settings.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of tuberculosis-Specific antigens Ag85B, ESAT-6 and CFP10 in pulmonary tuberculosis","authors":"","doi":"10.1016/j.jctube.2024.100486","DOIUrl":"10.1016/j.jctube.2024.100486","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the diagnostic value of tuberculosis-secreted Ag85B, ESAT-6 and CFP10 in pulmonary tuberculosis.</div></div><div><h3>Method</h3><div>Immunohistochemical (IHC) and acid-fast staining were performed, the detection efficiency of the two methods were analysed with chi-square test.</div></div><div><h3>Results</h3><div>Acid-fast staining demonstrated a sensitivity of (18/69, 26.09%) and a specificity of 100%. IHC staining for Ag85B, ESAT-6 and CFP10 was positive in all 18 cases with positive acid-fast staining and additionally positive in 25,36 and 30 cases, respectively, that were acid-fast-negative. The sensitivities of IHC staining for Ag85B, ESAT-6 and CFP10 were 62.32%, 78.26% and69.57%, respectively, while their specificities were 86.57%, 85.07% and 91.04%, respectively. Joint antigen analysis revealed that simultaneous positivity for two or three of Ag85B, ESAT-6 and CFP10 increased specificity (95.52% to 100%) but decreased sensitivity (49.28% to 62.31%). The presence of any one of the three antigens elevated sensitivity (81.16% to 88.41%) but lowered specificity (68.66% to 77.61%). Specificity reached 100% for concurrent positivity of all three antigens, while a sensitivity of 88.41% was observed for positivity of any one antigen.</div></div><div><h3>Conclusions</h3><div>Ag85B, ESAT-6, and CFP10 exhibits greater sensitivity in pulmonary tuberculosis and combined antigen testing enhances the diagnostic accuracy.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variants in the N-acetyltranferase 2 gene, acetylator phenotypes and their association with tuberculosis: Findings in Peruvian patients","authors":"","doi":"10.1016/j.jctube.2024.100485","DOIUrl":"10.1016/j.jctube.2024.100485","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) is a highly prevalent chronic infectious disease in developing countries, with Peru being one of the most affected countries in the world. The variants of the <em>N</em>-acetyltransferase 2 (<em>NAT2</em>) gene are related to xenobiotic metabolism and have potential usefulness in TB studies.</div></div><div><h3>Aim</h3><div>To determine whether <em>NAT2</em> gene variants and acetylator phenotypes are associated with active TB in Peruvian patients.</div></div><div><h3>Methods</h3><div>This study included cases (patients with TB) and controls (population-based data). First, DNA isolation and the rs1799929, rs1799930, and rs1799931 variants of the <em>NAT2</em> gene were identified using sequencing methods. Subsequently, the acetylator phenotypes, namely slow (SA), intermediate (IA), and rapid acetylation (RA), were also analyzed.</div></div><div><h3>Results</h3><div>The comparison of the frequencies of the rs1799931 variant in the cases and controls revealed significant differences. Risk factors were found for both the A allele (p = 0.00; odds ratio [OR] = 3.04, 95 % confidence interval [CI]: 1.88–4.9) and AG genotype (p = 0.00; OR = 5.94, 95 % CI: 3.17–11.09). In addition, the non-rapid acetylator phenotype (SA + IA) was also found to be a risk factor (p = 0.016; OR = 3.16, 95 % CI: 1.29–7.72).</div></div><div><h3>Conclusion</h3><div>The A allele, GA heterozygous genotype of the rs1799931 variant of the NAT2 gene, and SA + IA acetylator phenotype showed an association with increased risk for the development of TB. In addition to xenobiotic metabolism, other metabolic and immunological functions of <em>NAT2</em> have also been postulated to confer susceptibility to TB in the Peruvian population owing to its characteristic high Native American component.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycobacterium tuberculosis evolution from monoresistance to pre-extensive drug resistance during a prolonged household outbreak","authors":"","doi":"10.1016/j.jctube.2024.100482","DOIUrl":"10.1016/j.jctube.2024.100482","url":null,"abstract":"<div><div>Whole genome sequencing (WGS) is sensitive tool for the analysis of tuberculosis transmission and drug-resistance. We used WGS to analyze the <em>Mycobacterium tuberculosis</em> evolution from isoniazid monoresistance to MDR/preXDR during a prolonged household outbreak. The outbreak started with a isoniazid resistant strain (katG S315T mutation) and evolve in two cases to pre-XDR phenotype (with mutations in katG, rpoB, embB, pncA and gyrA genes). Based on WGS data and epidemiological interview we proposed a possible chain of transmission an evolution of the strains.</div><div>Similar intra-patient and inter-patient acquisition of variability was observed, making difficult to distinguish reinfection or reactivation. Analysis of WGS data together with epidemiological clinical history are discussed in order to distinguish between prolonged infections or transition from latency to reactivation. Classical interview and clinical history taking should be consider to fully understanding WGS data. With a still low incidence of TB cases, Uruguay could use universal WGS of all isolates to reduce time of diagnosis, detect outbreaks and perform public actions to reduce TB incidence.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study","authors":"","doi":"10.1016/j.jctube.2024.100481","DOIUrl":"10.1016/j.jctube.2024.100481","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a significant cause of mortality globally, with India accounting for 27% of the estimated number of people with TB. Multidrug-resistant TB (MDR-TB) and isoniazid (INH) resistance pose additional challenges to effective treatment. We aimed to describe treatment outcomes of INH mono-resistant TB patients under programmatic conditions in Mumbai, India.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted at Shatabdi Hospital in Mumbai between 2019–2021.We described the clinical and demographic characteristics, treatment outcomes, and risk factors for unfavourable outcomes among patients with INH mono-resistant TB treated with rifampicin, ethambutol, pyrazinamide, and levofloxacin (LfxREZ) for a duration of 6 months.</div></div><div><h3>Results</h3><div>Among 3105 patients with drug-resistant TB initiated on treatment, 217 (7 %) had INH mono-resistant TB. Of these, 54 % (117/217) were female, with a median age of 26 years (interquartile range: 20–40). The majority (88 %; 191/217) presented with pulmonary TB, and most (87 %; 188/217) had favourable treatment outcomes, including treatment completion (52 %; 112/217) and cure (35 %; 76/217). Unfavourable outcomes, including treatment failure (2.3 %; 5/217), loss to follow-up (9.2 %; 20/217), or death (1.8 %; 4/217), were observed in 13 % (29/217) of patients. A total of ten (5 %) patients experienced at least one non-severe adverse drug reaction. Factors associated with unfavourable outcomes included severe thinness (p = 0.019) and male gender (p = 0.012).</div></div><div><h3>Conclusion</h3><div>Treating INH mono-resistant patients with LfxREZ resulted in satisfactory outcomes and low toxicity. It is important to rule out drug resistance to INH while determining the treatment regimen.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of nontuberculous mycobacteria in the Finger Lakes region of New York","authors":"","doi":"10.1016/j.jctube.2024.100483","DOIUrl":"10.1016/j.jctube.2024.100483","url":null,"abstract":"<div><div>Clinical-epidemiologic data for all nontuberculous mycobacteria isolated in the 9 County Finger Lakes region of NY from 226 patients between 04/01/2018–03/31/2020 were retrospectively analyzed. Only 51% of patients meeting diagnostic criteria were treated, while 25% not meeting diagnostic criteria were also treated, indicating important knowledge gaps and research opportunities.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)","authors":"","doi":"10.1016/j.jctube.2024.100480","DOIUrl":"10.1016/j.jctube.2024.100480","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventions. This study aims to analyse the trends in the TB burden in South Asia from 1990 to 2021 and project future TB incidence rates up to 2031.</div></div><div><h3>Methods</h3><div>This study utilized data from the Global Burden of Disease (GBD) 2021 results to analyse trends in age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) rates (ASDR) associated with TB in South Asia from 1990 to 2021. Joinpoint regression analysis was employed to identify significant trends, whereas ARIMA models were used to project future TB incidence rates up to 2031.</div></div><div><h3>Results</h3><div>This study revealed significant declines in the ASIR, ASPR, ASDR, and ASMR related to TB in South Asia over the past three decades. Prominent reductions were found in Bangladesh and Bhutan, whereas India, Pakistan, and Nepal continue to bear the highest TB burdens. The ARIMA model projections indicate a continued decline in TB incidence across the region, although the extent of the decline varies by country, with less favourable trends observed in Nepal and Pakistan. The analysis also highlights tobacco use, high fasting plasma glucose, and high body mass index as significant risk factors contributing to the TB burden.</div></div><div><h3>Conclusions</h3><div>Substantial progress has been made in reducing the TB burden in South Asia; however, sustained and intensified efforts are needed, particularly in countries with inconsistent progress. These findings emphasize the need for targeted interventions to meet the WHO End TB Strategy (WETS) targets by 2035. Continuous monitoring and adaptive strategies will be crucial in maintaining and accelerating progress toward TB elimination in South Asia.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}