GERMS最新文献

{"title":"The presence of exotoxin genes and biofilm production in carbapenem-resistant <i>Pseudomonas aeruginosa</i> clinical isolates.","authors":"Amany Gamal Thabit, Magda Nasser Sediek, Mona Sallam Embarek Mohamed","doi":"10.18683/germs.2025.1452","DOIUrl":"10.18683/germs.2025.1452","url":null,"abstract":"<p><strong>Introduction: </strong><i>Pseudomonas aeruginosa</i> produces many exotoxins which are essential for the bacterial pathogenesis. The aim of this study was to identify <i>Pseudomonas aeruginosa</i> from clinical specimens, detect the sensitivity pattern, biofilm production, and the frequency of exogenes.</p><p><strong>Methods: </strong><i>Pseudomonas aeruginosa</i> clinical isolates were identified by conventional and genotypic methods. Antibiotic susceptibility patterns and biofilm production were performed. Molecular detection of exotoxin genes <i>exoS</i>, <i>exoT</i>, <i>exoU</i>, and <i>exoY</i> in <i>Pseudomonas aeruginosa</i> isolates was performed by PCR.</p><p><strong>Results: </strong>Seventy-five <i>Pseudomonas aeruginosa</i> were identified in 400 clinical specimens. Sixty-six (88%) isolates were carbapenem-resistant. A total of 25 (33.3%) isolates were extensively drug resistant, 18 (24%) were multidrug resistant, and 11 (14.7%) were pandrug resistant. Sixty-three (84%) isolates were biofilm producers. Biofilm formation was detected in 56 (85%) of carbapenem-resistant isolates. Totally, 70 (93.3%) isolates carried <i>exoS</i>, 68 (90.7%) carried <i>exoY</i>, 65 (86.7%) carried <i>exoT</i>, and 28 (37.3%) carried <i>exoU</i>. Exogenes were highly expressed in carbapenem-resistant isolates. Coexistence of more than one gene was detected in nearly all isolates.</p><p><strong>Conclusions: </strong><i>Pseudomonas aeruginosa</i> clinical isolates were resistant to many anti-pseudomonal antibiotics. Most of isolates were biofilm-producers. The genes <i>exoT</i>, <i>exoS</i> and <i>exoY</i> were identified in almost all <i>P. aeruginosa</i> strains and are considered an inevitable component of <i>P. aeruginosa</i> virulence.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 1","pages":"26-36"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875826","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":"<i>Mycoplasma pneumoniae</i> and <i>Chlamydia pneumoniae</i> community-acquired pneumonia in young adults from a family medicine practice.","authors":"Ana-Maria Slănină, Adorata Elena Coman, Antoneta-Dacia Petroaie, Carmen Liliana Barbacariu, Otilia Novac, Elena Popa, Mihaela Manole, Agnes Iacinta Bacuşcă, Adriana Cosmescu","doi":"10.18683/germs.2025.1455","DOIUrl":"10.18683/germs.2025.1455","url":null,"abstract":"<p><strong>Introduction: </strong>A major area of pathology in primary care practice is represented by respiratory infections, from common colds to severe lower respiratory tract illness. Our aim was to evaluate the incidence of <i>Mycoplasma pneumoniae</i> and <i>Chlamydia pneumoniae</i> pneumonia among the patients with suspected atypical pneumonia from a family medicine urban setting in Iaşi, Romania, to study serological retrospective diagnosis, the therapeutic outcome and the modified immunologic parameters in a subgroup of patients.</p><p><strong>Methods: </strong>We enrolled 93 patients with suspected atypical community-acquired pneumonia (CAP); enzyme-linked immunosorbent assay (ELISA) testing for <i>Mycoplasma pneumoniae</i> and <i>Chlamydia pneumoniae</i> was performed, both immunoglobulins M and G being determined. Considering the systemic inflammation associated to atypical germs infections, in a subgroup of 13 patients, with positive results for <i>Mycoplasma</i> and <i>Chlamydia pneumoniae</i>, interleukin 5, interleukin 8, tumor necrosis factor α and interferon γ levels were determined, using chemiluminescence method (EI-CLA).</p><p><strong>Results: </strong>Positive IgM serology for atypical germs was recorded in 25.8% of patients. <i>Mycoplasma pneumoniae</i> infection was confirmed in 10.8% of patients, <i>Chlamydia pneumoniae</i> infection in 6.5% of patients, and co-infection (both <i>Mycoplasma pneumoniae</i> and <i>Chlamydia pneumoniae</i>) in 8.6% of patients. A number of 41 patients (44.0%) presented chronic cough/bronchial hyperreactivity despite the treatment. Modified values were recorded for all immunological parameters tested, confirming the role in chronic airway inflammation.</p><p><strong>Conclusions: </strong><i>Mycoplasma</i> and <i>Chlamydia pneumoniae</i> CAP, frequent among young adults, is successfully treated with macrolides, still, the residual symptoms and the modified immunologic parameters need further studies regarding chronic inflammation.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 1","pages":"64-70"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875910","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":"Extending mental health support to the survivors of Ebola virus disease by overcoming challenges.","authors":"Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate","doi":"10.18683/germs.2025.1458","DOIUrl":"10.18683/germs.2025.1458","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 1","pages":"83-87"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875823","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":"Acute <i>Chlamydia pneumoniae</i> infection in a child, complicated by retrobulbar optic neuritis.","authors":"Gheorghiţă Jugulete, Bianca Borcoş, Mădălina Maria Merişescu","doi":"10.18683/germs.2025.1457","DOIUrl":"10.18683/germs.2025.1457","url":null,"abstract":"<p><strong>Introduction: </strong>This case highlights a rare and significant complication of <i>Chlamydia pneumoniae</i> infection: optic neuritis (ON). Acute <i>Chlamydia pneumoniae</i> infection in children typically presents with respiratory tract symptoms and may occasionally lead to complications or sequelae. ON is a condition most commonly associated with viral infections or other demyelinating diseases.</p><p><strong>Case report: </strong>The patient, a 10-year-old girl, initially presented with the typical systemic symptoms of <i>Chlamydia pneumoniae</i> infection, including fever, chills, and headache, in addition to an atypical symptom-chromatic deficit, or visual disturbances. This prompted further investigation into potential neurological complications, ultimately leading to a diagnosis of ON. The case underscores the importance of a comprehensive diagnostic workup, including serological testing (IgM ELISA) and PCR analysis of nasopharyngeal specimens, to confirm the underlying infection. Additionally, imaging studies (CT, MRI) and consultations with specialists in neurology and ophthalmology were critical for excluding other potential causes and assessing the extent of complications. The rapid and favorable response to treatment highlights the importance of early diagnosis and appropriate management.</p><p><strong>Conclusions: </strong>Although ON is a rare complication of <i>Chlamydia pneumoniae</i> infection, it should be considered in pediatric patients with unexplained visual symptoms, particularly when the clinical course does not improve or worsens despite treatment for the primary infection. This case further emphasizes the importance of interdisciplinary collaboration in managing complex cases and the need for vigilant monitoring of potential neurological complications in children with respiratory infections.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 1","pages":"77-82"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875912","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":"Bibliometric analysis of highly pathogenic avian influenza research globally from 2003 to 2023.","authors":"Clement Meseko, Uwem Okon Edet, Okoroiwu Henshaw, Nicodemus Mkpuma, Kayode Abraham Olawuyi, Charles Archibong","doi":"10.18683/germs.2025.1451","DOIUrl":"10.18683/germs.2025.1451","url":null,"abstract":"<p><strong>Introduction: </strong>Despite decades of research on highly pathogenic avian influenza, especially H5N1, an understanding of the impact of research outputs on policy, the impact of funding and policies, collaboration between authors, and other bibliometric measurable indices is elusive.</p><p><strong>Methods: </strong>H5N1 research data were retrieved from the PubMed database using \"H5N1\", \"highly pathogenic\", and \"influenza\" as keywords, and combined with the Boolean operator, \"OR\". The evaluated growth pattern of H5N1 research was analysed using Microsoft Excel, while the VOS viewer window version 1.6.15 was utilized in analyzing the keywords, authors' inputs, and collaborations amongst research institutes/universities involved in H5N1 research.</p><p><strong>Results: </strong>A total of 8,411 articles published within 2003 and 2023 were retrieved. The trend of the published articles indicates that 2003 to 2004 had the lowest number of articles, while the highest were observed for 2009 and 2010. Since then, there has been a gradual decline. The most dominant article type was original research article (89.80%), followed by reviews with 7.54%. The most productive countries were Japan, the United States of America, China, and Egypt in Africa. The top 15 authors accounted for 12.40% of the total published data. Keywords analysis revealed the emergence of newer keywords such as H5N8, wild birds, mammals, and Nigeria; however, as expected, influenza virus avian H5N1 subtype was the dominant keyword. Research institutes with backgrounds in agriculture and veterinary medicine dominated the top 15 organizations involved in H5N1 research.</p><p><strong>Conclusions: </strong>Our findings suggest that research aimed at developing therapeutics and vaccines, as well as continuous surveillance in high-risk areas is urgently needed. Furthermore, the findings provide baseline data for all the stakeholders involved in H5N1 research, which could inform future research, funding, and policies.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 1","pages":"11-25"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875822","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":"Rare cutaneous fungal infection due to <i>Nigrograna chromolaenae</i> in a heart transplant recipient.","authors":"Maud Foissac, Lucas Balloy, Guillaume Wartel, Anne-Gaёlle Leroy, Marie-Pierre Moiton","doi":"10.18683/germs.2025.1456","DOIUrl":"10.18683/germs.2025.1456","url":null,"abstract":"<p><strong>Introduction: </strong>Solid organ transplant recipients are particularly prone to infections, and many germs can be involved, including opportunistic pathogens. Regarding catheter-related infections however, the number of causative microorganisms is most often limited to germs of the skin flora, rare enterobacteria and <i>Pseudomonas aeruginosa</i>.</p><p><strong>Case report: </strong>We present here a case of venous catheter-related cutaneous infection in a man with immunosuppression, which was surprisingly caused by a rare environmental fungus, named <i>Nigrograna chromolaenae.</i> The therapeutic strategy combining posaconazole and removal surgery appears to have been effective, with no relapse more than 2 months after surgery.</p><p><strong>Conclusions: </strong>Due to advances in molecular biology techniques, it is possible that infections with <i>Nigrograna</i> spp. will be increasingly described. At the moment the reported cases are few in number, and the treatment is not yet standardized, which is why we thought this new case could support the literature about these opportunistic pathogens.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"15 1","pages":"71-76"},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875825","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":"Attitudes and acceptance of COVID-19 vaccination among Serbian medical students.","authors":"Katarina Maksimovic, Sandra Šipetić-Grujičić, Jelena Ilić Živojinović, Milena Tomanić, Isidora Vujčić","doi":"10.18683/germs.2024.1449","DOIUrl":"https://doi.org/10.18683/germs.2024.1449","url":null,"abstract":"","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"14 4","pages":"402-405"},"PeriodicalIF":1.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029541","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":"Segmenting attitudes toward vaccination - behavioral insights into influenza vaccination refusal in Romania.","authors":"Gheorghe Gindrovel Dumitra, Sandra Adalgiza Alexiu, Dorica Sănduţu, Cosmina Berbecel, Monica Curelea, Cristina Vasilica Barbu, Anca Deleanu, Adrian Grom, Maria Lup, Ioana Budiu, Mădălina Vesa, Roxana Surugiu, Anca Lăcătuş, Adina Turcu-Stiolica","doi":"10.18683/germs.2024.1446","DOIUrl":"https://doi.org/10.18683/germs.2024.1446","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccine hesitancy remains a significant public health challenge, particularly in rural populations where geographic and socioeconomic barriers exacerbate the issue. This study aimed to examine the factors influencing vaccine hesitancy, focusing on influenza vaccinations in rural and urban communities in Romania.</p><p><strong>Methods: </strong>The study was conducted between October 4 and October 30, 2024, across 16 family medicine practices, including seven in rural and nine in urban areas from Romania. A 13-item vaccine hesitancy questionnaire, assessing factors such as fear of adverse effects, distrust in vaccines, and perceived necessity included 272 responses. Latent Class Analysis (LCA) was used to identify distinct subgroups of hesitancy, while Chi-square and odds ratio analyses assessed geographic differences. We performed logistic regression for the most observed root attitudes on influenza vaccination refusal.</p><p><strong>Results: </strong>Rural residents were significantly more likely to refuse influenza vaccination compared to urban residents. The LCA revealed three distinct latent classes, characterized by varying levels of agreement with key hesitancy items. Class 1 demonstrated low hesitancy, Class 2 exhibited high hesitancy driven by beliefs in natural immunity and perceived lack of necessity, and Class 3 showed intermediate hesitancy, influenced by distrust in vaccines and past negative experiences. Among the key significant triggers underlying vaccine refusal were fear of adverse effects, parental status, chronic diseases, and previous vaccination experiences, while factors such as age and gender showed limited impact.</p><p><strong>Conclusions: </strong>Vaccine hesitancy persists as a complex, multidimensional issue, with rural populations disproportionately affected. Targeted, context-specific interventions addressing key drivers such as distorted risk perception, fear of adverse effects and distrust in vaccines are critical for improving vaccination rates These findings underscore the importance of tailored public health strategies to promote equitable vaccine uptake.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"14 4","pages":"362-374"},"PeriodicalIF":1.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002247","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":"The influence of farnesol and tyrosol on <i>Candida</i> spp. virulence traits.","authors":"Cristina Nicoleta Ciurea, Anca Delia Mare, Mihai Mareş, Felicia Toma, Irina-Bianca Kosovski, Anca Cighir, Adrian Man","doi":"10.18683/germs.2024.1444","DOIUrl":"https://doi.org/10.18683/germs.2024.1444","url":null,"abstract":"<p><strong>Introduction: </strong>Intercellular communication helps regulate the cell density and the virulence traits in yeasts and bacteria. The study aims to identify the effects of quorum sensing molecules (QSMs) like farnesol and tyrosol on <i>Candida</i> spp. virulence traits.</p><p><strong>Methods: </strong>The effects of farnesol and tyrosol were studied on the growth rate of <i>Candida albicans</i>, <i>Candida parapsilosis</i>, <i>Candida krusei</i>, <i>Candida auris,</i> and <i>Candida guilliermondii</i> at different time points, on a 48 hours incubation period. The growth rate was assessed spectrophotometrically. The biofilm formation abilities of <i>Candida</i> spp. were assessed by crystal violet staining technique. Moreover, the expression of <i>C. albicans</i> virulence genes (<i>ALS3</i>, <i>HSP70</i>, <i>SAP2</i>) was analyzed as a response to 100 μM farnesol and tyrosol, by RT-PCR.</p><p><strong>Results: </strong>Generally, farnesol was found to inhibit the growth rate and biofilm formation mostly in non-<i>albicans</i> species, while tyrosol exerted a non-consistent response on the different <i>Candida</i> species. The expression of <i>ALS3</i> and <i>HSP70</i> in <i>C. albicans</i> was upregulated by the QSMs.</p><p><strong>Conclusions: </strong>Both farnesol and tyrosol are involved in the regulation of <i>Candida</i> spp. virulence mechanisms, dependent on the used concentration and exposure time and in a species-dependent manner.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"14 4","pages":"344-351"},"PeriodicalIF":1.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988735","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":"The infectious disease burden among war related internally displaced people in the Lviv region of Ukraine.","authors":"Marta Vasylyev, Hanne Lamberink, Ivanna Svyst, Oksana Khlypnyach, Oleksandra Sluzhynska, Maryana Sluzhynska, Iryna Shtoiko, Oleksandra Hrushynska, Dmytro Demianenko, Casper Rokx","doi":"10.18683/germs.2024.1443","DOIUrl":"https://doi.org/10.18683/germs.2024.1443","url":null,"abstract":"<p><strong>Introduction: </strong>Armed conflicts exacerbate the spread of infectious diseases. We assessed the impact of the 2022 armed conflict in Ukraine on common sexually, bloodborne, and respiratory-transmitted infectious diseases in internally displaced people (IDP) in Ukraine.</p><p><strong>Methods: </strong>A cross-sectional study (#aware.id) was conducted in Lviv, Ukraine, from 3 May 2023 to 24 June 2024, including IDP seeking care for HIV, hepatitis B and C, COVID-19, tuberculosis, and sexually transmitted infections. After medical screening to evaluate disease risk, we used rapid point-of-care tests followed by confirmatory standard of care testing. The main endpoints were the infectious disease case positivity rate in IDP compared to a local at-risk population, the association with war related risk factors including shelter use and experienced violence, and linkage to care.</p><p><strong>Results: </strong>Among 695 enrolled participants (250 IDP and 445 locals), the median age was 37 years (IQR 30-45) and 58.7% were women. Both groups disclosed a high HIV and viral hepatitis disease risk. Among IDP, rates of HIV (4.8% in IDP vs. 7.1% in local at-risk population), hepatitis C (33.9% vs. 40.0%) and syphilis (4.7% vs. 2.7%) were comparable with the local at-risk controls (all p>0.05), while the hepatitis B rate was lower in IDP (6.3% vs. 26.9%, p<0.01). COVID-19, tuberculosis, chlamydia, and gonorrhea were infrequent and comparable (all p>0.05). Despite higher war-related risk factors, we found no clear association with infectious disease burden in IDP disclosing these factors. All those diagnosed were linked to care within 4 weeks.</p><p><strong>Conclusions: </strong>The undiagnosed infectious disease burden in IDP was high and comparable to a high-risk local population.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"14 4","pages":"322-343"},"PeriodicalIF":1.7,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032318","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}