GERMS最新文献

{"title":"Variety of <i>Clostridioides difficile</i> Ribotypes in CDI Patients in Las Vegas, NV.","authors":"Amber Consul, Mohamad Mubder, Samrawit Misiker, Shadaba Asad, Kimberly D Leuthner, Chia-Dan Kang, Yassin Shams Eldien Naga, Chad L Cross, Ernesto Abel-Santos","doi":"10.3390/germs16010002","DOIUrl":"https://doi.org/10.3390/germs16010002","url":null,"abstract":"<p><strong>Objective: </strong>Although Las Vegas is a major tourist hub, it is not among the counties that are under CDC surveillance for <i>Clostridioides difficile</i> infection (CDI), a major nosocomial infection. To determine the distribution of <i>C. difficile</i> ribotypes in the Las Vegas area, we collected stool samples from CDI-positive patients at the University Medical Center (UMC).</p><p><strong>Methods: </strong>We included adult patients diagnosed with CDI and provided informed consent. <i>C. difficile</i> was isolated from the stool samples and ribotyped. Demographic information was also obtained and analyzed. All information was compared to the surveillance data from the CDC.</p><p><strong>Results: </strong>We identified more frequently in male patients than in the CDC data. Less than half of the patients used antibiotics prior to the infection. We observed several comorbidities in our patient sample pool, with cardiovascular disease and diabetes being the most prevalent comorbidities. Hypervirulent <i>C. difficile</i> strain 027 was the most prevalent ribotype. Except for two samples of ribotype 076, all other samples represented unique singlet ribotypes. Four of these ribotypes (160, 302, 363, and 813) have not been explicitly reported in humans.</p><p><strong>Conclusions: </strong>Due to the unique environment created by the tourism industry in Las Vegas, this population is exposed to national and international visitors. This study shows the pre-COVID landscape of <i>C. difficile</i> ribotypes in Las Vegas and offers valuable insights into the varieties of <i>C. difficile</i> that are currently infecting this community.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"16 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785150","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":"Doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/ TDF) treatment in people living with HIV: A single-center real-world experience from Belgrade, Serbia.","authors":"Marko Markovic, Jovan Ranin, Aleksa Despotovic, Ivan Rajkovic, Jovana Ranin, Milan Tanasijevic, Nikola Mitrovic, Natasa Nikolic, Ivana Milosevic, Ivana Gmizic","doi":"10.18683/germs.2025.1469","DOIUrl":"10.18683/germs.2025.1469","url":null,"abstract":"<p><strong>Introduction: </strong>Doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) is recommended for both ART initiation and switch in virologically suppressed patients. We report early real-world outcomes after DOR/3TC/TDF introduction in Belgrade, Serbia.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study at the Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, including all adults who initiated or switched to DOR/3TC/TDF between May 2024 and April 2025. Demographics, comorbidities, prior ART, adverse events, and laboratory data (CD4, HIV-1 RNA, triglycerides, total and LDL cholesterol) were abstracted from electronic records.</p><p><strong>Results: </strong>Of 260 participants, 75 were treatment-naïve and 185 switched regimens; median follow-up was 7 months (IQR: 1-11 months). In naïve patients, CD4 counts increased (458.2±312.0 to 580.7±262.8 cells/μL; p=0.007) and viral load fell to undetectable in 82.8% (24/29; p=0.002). In switch patients, CD4 counts remained stable (665.0±317.5 to 660.5±268.0; p=0.891) and suppression was maintained, with rates of undetectable viral load rising from 83.2% to 93.1% (p=0.013). No significant short-term changes were observed in triglycerides, total cholesterol, or LDL. No virological failures occurred; one discontinuation due to rash was recorded.</p><p><strong>Conclusions: </strong>In routine care in Belgrade, once-daily DOR/3TC/TDF was well tolerated and effective: naïve patients achieved rapid suppression with CD4 gains, and switch patients maintained high rates of undetectable viral load without adverse lipid shifts. These findings support DOR/3TC/TDF as a practical option in the Serbian setting.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"216-220"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661930","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":"One-year surveillance of last-resort antimicrobial resistance patterns in carbapenemase-producing <i>Klebsiella pneumoniae</i> strains isolated in a Romanian tertiary care hospital: a prospective study.","authors":"Mihai Octavian Dan, Dragoş Florea, Alexandru Rafila, Mihai Turcitu, Dan Florin Turcitu, Daniela Tălăpan","doi":"10.18683/germs.2025.1468","DOIUrl":"10.18683/germs.2025.1468","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance is a significant public health issue worldwide, associated with limited treatment options and with major consequences for healthcare systems. Our study aims to assess rates and patterns of resistance to five last-resort antimicrobials in a cohort of carbapenemase-producing <i>Klebsiella pneumoniae</i> strains, isolated over a one-year interval. Additionally, we have tested two potentially synergistic combinations for in vitro efficacy.</p><p><strong>Methods: </strong>This prospective observational study evaluated <i>Klebsiella pneumoniae</i> strains with diminished carbapenem susceptibility from patients admitted to the National Institute for Infectious Diseases \"Prof. Dr. Matei Balş\" in Bucharest between August 2023 and July 2024. Strains presenting a minimum inhibitory concentration to meropenem of >0.125 μg/mL underwent phenotypic enzyme production testing, followed by synergistic testing to identify antimicrobial salvage therapy options. A subset of these strains was analysed for the detection of plasmid-mediated resistance genes, using a custom workflow for DNA extraction and amplification/detection.</p><p><strong>Results: </strong>A total of 139 non-duplicate strains were isolated, with 129 (92.8%) being carbapenemase producers. These 129 strains were phenotypically diverse: 29 (22.5%) were NDM, 12 (9.3%) OXA-48 type, 8 (6.2%) KPC, while most of them (62.0%) were double carbapenemase producers: 79 (61.2%) NDM and OXA-48-type, and one strain was NDM and KPC. Forty-six strains were resistant to cefiderocol (35.7%), 108 (83.7%) to ceftazidime/avibactam, 127 (98.4%) to ceftolozane/tazobactam, 116 (90.0%) to imipenem/relebactam and 127 (98.4%) to aztreonam. The association of aztreonam with ceftazidime/avibactam demonstrated a synergistic effect in 127 (98.5%) strains, while aztreonam with imipenem/relebactam was efficient in vitro against 103 (79.8%) strains.</p><p><strong>Conclusions: </strong>Antimicrobial resistance remains a concerning phenomenon among Enterobacterales, especially when considering the increasing resistance rates even against salvage therapy antimicrobials.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"209-215"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662283","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":"Evolving insights into viral hepatitis: Advances, evidence, and expert perspectives from the ESCMID Study Group for Viral Hepatitis (ESGVH) - Part 2: hepatitis B, C, and delta.","authors":"Oana Săndulescu, Mojca Matičič, Federico Garcia, Marianne Alanko Blomé, Mario U Mondelli, William Irving, Snjezana Zidovec-Lepej, Anders Widell, Gülşen Özkaya Şahin","doi":"10.18683/germs.2025.1473","DOIUrl":"10.18683/germs.2025.1473","url":null,"abstract":"<p><p>Hepatitis B virus (HBV), hepatitis delta virus (HDV), and hepatitis C virus (HCV) remain leading drivers of chronic viral hepatitis, cirrhosis, hepatocellular carcinoma, and liver-related mortality. This ESCMID Study Group for Viral Hepatitis (ESGVH) narrative review summarizes recent advances and expert perspectives in the field. For HBV, emerging biomarkers such as quantitative HBs antigen, HBV RNA, and hepatitis B core-related antigen offer opportunities to refine monitoring and to individualize treatment. HDV epidemiology is evolving, and is being increasingly studied; in parallel, the approval of bulevirtide represents a major breakthrough in therapy, with further agents in the HDV pipeline. For HCV, direct-acting antivirals provide curative therapy and have made elimination a realistic goal, while identifying remaining gaps in diagnosis, linkage-to-care, and equitable access offers clear opportunities to accelerate progress. Together, these advances bring the goal of a hepatitis-free future closer than ever.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"263-273"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662264","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 literature review of influenza chemoprophylaxis and treatment in children.","authors":"Ioana Luca, Elena Diana Andone, Ioana Arbanas, Laura Bleotu, Oana Falup Pecurariu","doi":"10.18683/germs.2025.1471","DOIUrl":"10.18683/germs.2025.1471","url":null,"abstract":"<p><p>Influenza remains a common cause of hospitalization among children, bringing substantial morbidity and mortality rates. Despite its soaring prevalence, a significant gap in therapeutic interventions persists, especially for the pediatric population. We present a literature review detailing clinical trials or case reports published in the last six years (since 2019) that discuss the prevention or treatment of influenza in children. We used search engines such as PubMed or Cochrane Library. All studies/case reports are written in English, and all the clinical trials are finished. In Europe, oseltamivir, zanamivir, and baloxavir marboxil are recommended for the treatment or prophylaxis of influenza in adults and children, while the Food and Drug Administration added intravenous peramivir to the list of anti-influenza drugs. Oseltamivir remains the first line of treatment and chemoprophylaxis. However, there are still discussions related to the duration of prophylaxis, with shorter periods of administration being explored, or the most efficient treatment dosage program (whether it is the conventional dosage of 3 mg/kg/dose for children <40 kg or 75 mg for adults, twice daily, compared to a double dosage administration program). When faced with an old disease, it is essential to constantly assess the efficacy of conventional molecules and dosages, along with new antivirals or complementary medication.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"242-253"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661654","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":"Innovative approaches in RSV prevention: The expanding role of monoclonal antibodies in protection for all infants.","authors":"Florin-Dumitru Mihălţan, Ruxandra Ulmeanu, Roxana-Maria Nemeş, Sorin Petrea, Anca Streinu-Cercel, Oana Săndulescu","doi":"10.18683/germs.2025.1475","DOIUrl":"10.18683/germs.2025.1475","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"279-282"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662231","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":"Consensus statement: updated recommendations for the interdisciplinary management of people living with HIV in Romania.","authors":"Oana Săndulescu, Anca Streinu-Cercel, Mariana Mărdărescu, Cristiana Oprea, Maria Dorobanţu, Gener Ismail, Aura Diana Reghina, Odette Chirilă, Adrian Streinu-Cercel","doi":"10.18683/germs.2025.1470","DOIUrl":"10.18683/germs.2025.1470","url":null,"abstract":"<p><p>Owing to significant advances in HIV treatment and the resultant increase in life expectancy, the number of aging individuals living with HIV and associated comorbidities continues to rise. Consequently, the management of people living with HIV is no longer solely the responsibility of infectious disease or HIV specialists, but requires an integrated and multidisciplinary approach that addresses the prevention, as well as the monitoring and treatment needs of associated conditions. The care of people living with HIV in Romania is largely aligned with international guidelines, particularly those of the European AIDS Clinical Society (EACS). However, guideline implementation requires adaptation to local clinical realities and collaboration across medical specialties. In response to this need, a team of experts in infectious diseases, cardiology, nephrology, diabetes, metabolic disorders, and clinical psychology, convened to develop a national consensus for the interdisciplinary management of people living with HIV. The consensus provides clear and practical recommendations addressed to both infectious disease specialists and healthcare providers from other specialties involved in the care of people living with HIV. Its goal is to offer a unified, up-to-date, and applicable framework to support patient-centered care, facilitate interdisciplinary collaboration, and contribute to improving the quality of life of people living with HIV in Romania.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"221-241"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661984","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":"Multidrug-resistant <i>Acinetobacter baumannii</i> meningitis and cerebellar abscess: case report and therapeutic considerations.","authors":"Maria-Elena Vodarici, Nicola-Maria Militaru, Lucia Zekra, Nicoleta Chipăilă, Oana-Elena Ioniţă, Andra-Elena Petcu, Roxana-Carmen Cernat, Bogdan Florentin Niţu, Simona Claudia Cambrea, Irina-Magdalena Dumitru","doi":"10.18683/germs.2025.1474","DOIUrl":"10.18683/germs.2025.1474","url":null,"abstract":"<p><strong>Introduction: </strong>Brain abscess is defined as a suppurative collection resulting from hematogenous dissemination as an extension from otorhinolaryngologic infectious foci, or secondary to cranial trauma and neurosurgical procedures. Its evolution follows four histopathological stages, the most severe complication being intraventricular rupture, which is associated with extremely high mortality. Central nervous system infections caused by multidrug-resistant (MDR/XDR) <i>Acinetobacter baumannii</i> are rare but severe, significantly limiting therapeutic options due to the reduced penetration of the blood-brain barrier by active antimicrobial agents.</p><p><strong>Case report: </strong>We report the case of a 48-year-old patient with a history of hemorrhagic stroke treated surgically, who was admitted for fever, severe headache, and vomiting. On admission, lumbar puncture confirmed bacterial meningitis, with isolation of <i>A. baumannii</i> susceptible only to colistin. Brain magnetic resonance imaging revealed a postoperative cerebellar abscess. Initial empirical therapy consisted of meropenem and vancomycin, subsequently adjusted according to the susceptibility profile to cefiderocol, intravenous and intrathecal colistin, combined with ampicillin/sulbactam and minocycline. The clinical course was favorable with regard to meningitis, with partial regression of the cerebellar abscess. Follow-up lumbar punctures were sterile, and the patient's neurological condition stabilized, allowing avoidance of neurosurgical drainage.</p><p><strong>Conclusions: </strong>Meningitis and brain abscess caused by MDR <i>A. baumannii</i> represent rare clinical entities with potentially severe outcomes. Intrathecal administration of colistin, in combination with systemic multidrug therapy, proved decisive in controlling the infection. An interdisciplinary approach and individualized antimicrobial regimens are essential to achieving a favorable prognosis in such complex cases.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"274-279"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662220","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":"Evolving insights into viral hepatitis: Advances, evidence, and expert perspectives from the ESCMID Study Group for Viral Hepatitis (ESGVH) - Part 1: hepatitis A, E, and herpesvirus-associated liver diseas.","authors":"Oana Săndulescu, Mojca Matičič, Federico Garcia, Marianne Alanko Blomé, Mario U Mondelli, William Irving, Snjezana Zidovec-Lepej, Anders Widell, Gülşen Özkaya Şahin","doi":"10.18683/germs.2025.1472","DOIUrl":"10.18683/germs.2025.1472","url":null,"abstract":"<p><p>Viral hepatitis remains a global health concern, with growing recognition of the impact of hepatitis A virus (HAV), hepatitis E virus (HEV), and herpesvirus-associated hepatitis, particularly in vulnerable groups. This narrative review from the ESCMID Study Group for Viral Hepatitis (ESGVH) summarizes recent advances and expert perspectives. For HAV, insights into viral evolution, epidemiology, and risk groups underline the preventable nature of severe disease. HEV is increasingly recognized as both a hepatotropic and a systemic pathogen, with expanding knowledge on natural and vaccine-induced immunity. Herpesvirus-associated hepatitis, while rare, poses significant challenges, especially in patients with immunosuppression or during pregnancy, where early suspicion and empirical antiviral therapy can be lifesaving. Collectively, these evolving insights highlight the importance of strengthened diagnostics, targeted prevention, and tailored management strategies to mitigate the burden of these underappreciated but clinically significant causes of viral hepatitis.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 3","pages":"254-262"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12642957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662097","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":"Human papillomavirus knowledge, vaccination status, and barriers to vaccination in an urban transgender clinic population.","authors":"Hannah Sinks, Caitlin Waters, Alejandro Alvarez, Gary L Goldberg, David W Rosenthal, Elizabeth O Schmidt","doi":"10.18683/germs.2025.1463","DOIUrl":"10.18683/germs.2025.1463","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to better understand patient-reported human papillomavirus (HPV) vaccination rates and barriers to vaccination among transgender patients receiving care at a gender-affirming clinic in urban New York.</p><p><strong>Methods: </strong>All patients with arrived appointments at the Center for Transgender Care at Northwell Health from January 1, 2020 through July 14, 2021, aged 14 and up, were invited to participate. Participants were sent an online consent form followed by a survey that assessed HPV knowledge, personal vaccination history, and reasons for or against vaccination. Data were collected in RedCap and analyzed using descriptive and basic inferential statistics. We received 79 completed consent forms and 70 completed surveys.</p><p><strong>Results: </strong>At least 68 of the 70 participants identified as transgender or gender diverse. Only 61.4% (43/70) of participants reported ever being offered the HPV vaccine and 55.7% (39/70) reported ever receiving at least one dose. Common reasons in favor of vaccination included doctor recommendation and decreasing cancer risk. Common reasons mentioned against HPV vaccination included sexual inactivity, concern over side effects, and assumption of low-risk HPV status. Of unvaccinated participants, 58.1% (18/31) reported they were more likely to get vaccinated after completing the survey.</p><p><strong>Conclusions: </strong>The HPV vaccination rate in this study was higher than the rates seen in previous studies involving sexual and gender minority participants. Provider recommendation was found to be important in promoting vaccination.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 2","pages":"127-143"},"PeriodicalIF":1.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065763","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}