Epidemics最新文献

{"title":"Forecasting SARS-CoV-2 epidemic dynamic in Poland with the pDyn agent-based model","authors":"Karol Niedzielewski ,&nbsp;Rafał P. Bartczuk ,&nbsp;Natalia Bielczyk ,&nbsp;Dominik Bogucki ,&nbsp;Filip Dreger ,&nbsp;Grzegorz Dudziuk ,&nbsp;Łukasz Górski ,&nbsp;Magdalena Gruziel-Słomka ,&nbsp;Jędrzej Haman ,&nbsp;Artur Kaczorek ,&nbsp;Jan Kisielewski ,&nbsp;Bartosz Krupa ,&nbsp;Antoni Moszyński ,&nbsp;Jędrzej M. Nowosielski ,&nbsp;Maciej Radwan ,&nbsp;Marcin Semeniuk ,&nbsp;Urszula Tymoszuk ,&nbsp;Jakub Zieliński ,&nbsp;Franciszek Rakowski","doi":"10.1016/j.epidem.2024.100801","DOIUrl":"10.1016/j.epidem.2024.100801","url":null,"abstract":"<div><div>We employ pDyn (derived from “pandemics dynamics”), an agent-based epidemiological model, to forecast the fourth wave of the SARS-CoV-2 epidemic, primarily driven by the Delta variant, in Polish society. The model captures spatiotemporal dynamics of the epidemic spread, predicting disease-related states based on pathogen properties and behavioral factors. We assess pDyn’s validity, encompassing pathogen variant succession, immunization level, and the proportion of vaccinated among confirmed cases. We evaluate its predictive capacity for pandemic dynamics, including wave peak timing, magnitude, and duration for confirmed cases, hospitalizations, ICU admissions, and deaths, nationally and regionally in Poland. Validation involves comparing pDyn’s estimates with real-world data (excluding data used for calibration) to evaluate whether pDyn accurately reproduced the epidemic dynamics up to the simulation time. To assess the accuracy of pDyn’s predictions, we compared simulation results with real-world data acquired after the simulation date. The findings affirm pDyn’s accuracy in forecasting and enhancing our understanding of epidemic mechanisms.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100801"},"PeriodicalIF":3.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing spatial distribution of wastewater-based epidemiology to advance health equity","authors":"Maria L. Daza-Torres ,&nbsp;J. Cricelio Montesinos-López ,&nbsp;César Herrera ,&nbsp;Yury E. García ,&nbsp;Colleen C. Naughton ,&nbsp;Heather N. Bischel ,&nbsp;Miriam Nuño","doi":"10.1016/j.epidem.2024.100804","DOIUrl":"10.1016/j.epidem.2024.100804","url":null,"abstract":"<div><div>In 2022, the US Centers for Disease Control and Prevention commissioned the National Academies of Sciences, Engineering, and Medicine to assess the role of community-level wastewater-based epidemiology (WBE) beyond COVID-19. WBE is recognized as a promising mechanism for promptly identifying infectious diseases, including COVID-19 and other novel pathogens. An important conclusion from this initiative is the critical importance of maintaining equity and expanding access to fully realize the benefits of wastewater surveillance for marginalized communities. To address this need, we propose an optimization framework that strategically allocates wastewater monitoring resources at the wastewater treatment plant (WWTP) level, ensuring more effective and equitable distribution of surveillance efforts to serve underserved populations.</div><div>The purpose of the framework is to obtain a balanced spatial distribution, inclusive population coverage, and efficient representation of disadvantaged groups in the allocation of resources for WBE. Furthermore, the framework concentrates on areas with high population density and gives priority to vulnerable regions, as well as identifying signals that display significant variations from other monitored sources. The optimization objective is to maximize a weighted combination of these critical factors. This problem is formulated as an integer optimization problem and solved using simulated annealing. We evaluate various scenarios, considering different weighting factors, to optimize the allocation of WWTPs with monitoring systems. This optimization framework provides an opportunity to enhance WBE by providing customized monitoring strategies created to address specific priorities and situations, thus enhancing the decision-making processes in public health responses.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100804"},"PeriodicalIF":3.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building in-house capabilities in health agencies and outsourcing to academia or industry: Considerations for effective infectious disease modelling.","authors":"Rachael Pung, Adam J Kucharski","doi":"10.1016/j.epidem.2024.100802","DOIUrl":"https://doi.org/10.1016/j.epidem.2024.100802","url":null,"abstract":"<p><p>Infectious disease models provide a systematic way to estimate crucial features of epidemic dynamics and explore different transmission and control scenarios. Given the importance of model-based analysis in managing public health crises, there has been an increase in post-pandemic creation of both academia-driven modelling centres, hubs and consortiums and government-driven public health agencies with in-house modelling units or teams. However, in the past, the delineation of roles and responsibilities between government- and academia-led modelling groups has often been unclear. Who should perform which tasks and when? This ambiguity can increase the risk of duplicated work or unaddressed gaps in analysis. It also raises questions about the sustainability of modelling capacity for addressing routine operational analytical needs while also developing new approaches that can be tailored for emergencies. In the sections below, we discuss factors that could inform decisions about where to locate infectious disease modelling activity. Rather than giving a fixed set of rules, we outlined key considerations and trade-offs that could be taken into account to enable academic and government modelling activities to complement each other effectively, which can in turn be refined as new public health crises emerge in future.</p>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":" ","pages":"100802"},"PeriodicalIF":3.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct and indirect effects of hepatitis B vaccination in four low- and middle-income countries","authors":"Margaret J. de Villiers ,&nbsp;Edward de Villiers ,&nbsp;Shevanthi Nayagam ,&nbsp;Timothy B. Hallett","doi":"10.1016/j.epidem.2024.100798","DOIUrl":"10.1016/j.epidem.2024.100798","url":null,"abstract":"<div><div>Population-level vaccination effects of the hepatitis B vaccine were investigated in four low- and middle-income countries with different levels of vertical and horizontal transmission. Indirect vaccination effects constitute a large proportion of overall vaccination effects of the vaccination programmes in all four countries (over 70% by 2030 in all four countries). However, countries with higher levels of vertical transmission benefit less from indirect vaccination effects from the infant hepatitis B vaccine series during the first decades of the vaccination programme, making the birth dose vaccine more important in these countries. Vaccination, even at levels that do not fully control transmission, has a great effect on the development of disease as it also increases the average age of infection, thereby causing a decrease in the number of chronic infections relative to the number of acute infections.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100798"},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling plausible scenarios for the Omicron SARS-CoV-2 variant from early-stage surveillance","authors":"Christopher J. Banks ,&nbsp;Ewan Colman ,&nbsp;Anthony J. Wood ,&nbsp;Thomas Doherty ,&nbsp;Rowland R. Kao","doi":"10.1016/j.epidem.2024.100800","DOIUrl":"10.1016/j.epidem.2024.100800","url":null,"abstract":"<div><div>We used a spatially explicit agent-based model of SARS-CoV-2 transmission combined with spatially fine-grained COVID-19 observation data from Public Health Scotland to investigate the initial rise of the Omicron (BA.1) variant of concern. We evaluated plausible scenarios for transmission rate advantage and vaccine immune escape relative to the Delta variant based on the data that would have been available at that time. We also explored possible outcomes of different levels of imposed non-pharmaceutical intervention. The initial results of these scenarios were used to inform the Scottish Government in the early outbreak stages of the Omicron variant.</div><div>Using the model with parameters fit over the Delta variant epidemic, some initial assumptions about Omicron transmission rate advantage and vaccine escape, and a simple growth rate fitting procedure, we were able to capture the initial outbreak dynamics for Omicron. We found that the modelled dynamics hold up to retrospective scrutiny. The modelled imposition of extra non-pharmaceutical interventions planned by the Scottish Government at the time would likely have little effect in light of the transmission rate advantage held by the Omicron variant and the fact that the planned interventions would have occurred too late in the outbreak’s trajectory. Finally, we found that any assumptions made about the projected distribution of vaccines in the model population had little bearing on the outcome, in terms of outbreak size and timing. Instead, it was the landscape of prior immunity that was most important.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100800"},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating pathogen spread using structured coalescent and birth–death models: A quantitative comparison","authors":"Sophie Seidel,&nbsp;Tanja Stadler ,&nbsp;Timothy G. Vaughan","doi":"10.1016/j.epidem.2024.100795","DOIUrl":"10.1016/j.epidem.2024.100795","url":null,"abstract":"<div><div>Elucidating disease spread between subpopulations is crucial in guiding effective disease control efforts. Genomic epidemiology and phylodynamics have emerged as key principles to estimate such spread from pathogen phylogenies derived from molecular data. Two well-established structured phylodynamic methodologies – based on the coalescent and the birth–death model – are frequently employed to estimate viral spread between populations. Nonetheless, these methodologies operate under distinct assumptions whose impact on the accuracy of migration rate inference is yet to be thoroughly investigated.</div><div>In this manuscript, we present a simulation study, contrasting the inferential outcomes of the structured coalescent model with constant population size and the multitype birth–death model with a constant rate. We explore this comparison across a range of migration rates in endemic diseases and epidemic outbreaks. The results of the epidemic outbreak analysis revealed that the birth–death model exhibits a superior ability to retrieve accurate migration rates compared to the coalescent model, regardless of the actual migration rate. Thus, to estimate accurate migration rates, the population dynamics have to be accounted for. On the other hand, for the endemic disease scenario, our investigation demonstrates that both models produce comparable coverage and accuracy of the migration rates, with the coalescent model generating more precise estimates. Regardless of the specific scenario, both models similarly estimated the source location of the disease.</div><div>This research offers tangible modelling advice for infectious disease analysts, suggesting the use of either model for endemic diseases. For epidemic outbreaks, or scenarios with varying population size, structured phylodynamic models relying on the Kingman coalescent with constant population size should be avoided as they can lead to inaccurate estimates of the migration rate. Instead, coalescent models accounting for varying population size or birth–death models should be favoured. Importantly, our study emphasises the value of directly capturing exponential growth dynamics which could be a useful enhancement for structured coalescent models.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100795"},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the impact of prevalence-dependent adaptive behavior on COVID-19 transmission: A modeling case study in Maryland","authors":"Alexander Tulchinsky ,&nbsp;Gary Lin ,&nbsp;Alisa Hamilton ,&nbsp;Nodar Kipshidze ,&nbsp;Eili Klein","doi":"10.1016/j.epidem.2024.100799","DOIUrl":"10.1016/j.epidem.2024.100799","url":null,"abstract":"<div><div>The COVID-19 pandemic highlighted the need for robust epidemic forecasts, projecting health burden over short- and medium-term time horizons. Many COVID-19 forecasting models incorporate information on infection transmission, disease progression, and the effects of interventions, but few combine information on how individuals change their behavior based on altruism, fear, risk perception, or personal economic circumstances. Moreover, early models of COVID-19 produced under- and over-estimates, failing to consider the complexity of human responses to disease threat and prevention measures. In this study, we modeled adaptive behavior during the first year of the COVID-19 pandemic in Maryland, USA. The adapted compartmental model incorporates time-varying transmissibility informed on data of environmental factors (e.g., absolute humidity) and behavioral factors (aggregate mobility and perceived risk). We show that humidity and mobility alone did little to explain transmissibility after the first 100 days. Including adaptive behavior in the form of perceived risk as a function of hospitalizations more effectively explained inferred transmissibility and improved out-of-sample fit, demonstrating the model’s potential in real-time forecasting. These results demonstrate the importance of incorporating endogenous behavior in models, particularly during a pandemic, to produce more accurate projections, which could lead to more impactful and efficient decision making and resource allocation.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100799"},"PeriodicalIF":3.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 control measures on respiratory syncytial virus and hand-foot-and-mouth disease transmission in Hong Kong and South Korea","authors":"Yiu Chung Lau ,&nbsp;Sukhyun Ryu ,&nbsp;Zhanwei Du ,&nbsp;Lin Wang ,&nbsp;Peng Wu ,&nbsp;Eric H.Y. Lau ,&nbsp;Benjamin J. Cowling ,&nbsp;Sheikh Taslim Ali","doi":"10.1016/j.epidem.2024.100797","DOIUrl":"10.1016/j.epidem.2024.100797","url":null,"abstract":"<div><div>The public health and social measures (PHSMs) for mitigation/control of COVID-19 pandemic influenced the transmission dynamics of many other infectious diseases, including respiratory syncytial virus (RSV) infection, and hand, foot and mouth disease (HFMD) and their disease-burden. This study aimed to infer the transmission dynamics of these respiratory viruses and assess the impact of COVID-19 PHSMs on their community activity. We developed a compartmental framework to infer the transmission dynamics of RSV and HFMD in Hong Kong and South Korea from January 2014 to May 2024. We assessed the impact of PHSMs by comparing the change in virus transmissibility, reproduction number and population susceptibility before, during, and after the COVID-19 pandemic period. A significant reduction in RSV and HFMD activity was observed starting in January 2020, with a resurgence since late 2021. Transmissibility of both diseases decreased by 46 % - 95 % during the lull, while population susceptibility was estimated to increase by maximum of 19 %. On relaxation of the PHSMs, the transmissibility were recovered up to 70 % in Hong Kong and nearly 100 % in South Korea in 2023 with significant epidemics for these viruses. Strict implementation of COVID-19 PHSMs led to low RSV and HFMD activity, but the absence of community infection resulted in reductions in population immunity, and slightly larger epidemics when these diseases re-emerged following the COVID-19 pandemic.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100797"},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of HIV self-testing on HIV incidence and awareness of status among men who have sex with men in the United States: Insights from a novel compartmental model","authors":"Alex Viguerie ,&nbsp;Chaitra Gopalappa ,&nbsp;Cynthia M. Lyles ,&nbsp;Paul G. Farnham","doi":"10.1016/j.epidem.2024.100796","DOIUrl":"10.1016/j.epidem.2024.100796","url":null,"abstract":"<div><h3>Background</h3><div>The OraQuick In-Home HIV self-test represents a fast, inexpensive, and convenient method for users to assess their HIV status. If integrated thoughtfully into existing testing practices, accompanied by efficient pathways to formal diagnosis, self-testing could enhance both HIV awareness and reduce HIV incidence. However, currently available self-tests are less sensitive, particularly for recent infection, when compared to gold-standard laboratory tests. It is important to understand the impact if some portion of standard testing is replaced by self-tests. We used a compartmental model to evaluate the effects of self-testing in diverse scenarios among gay, bisexual and other men who have sex with men (MSM) in the United States for the period 2020–2030, and to understand which scenarios maximize the advantages of self-testing.</div></div><div><h3>Methods</h3><div>We introduced a novel 4-compartment model for HIV self-testing. We employed the model under different screening rates, self-test proportions, and delays to diagnosis for those identified through self-tests to determine the potential effects of self-testing on HIV incidence and awareness of status when applied to the US MSM population. We studied scenarios in which self-tests supplement laboratory-based tests, with no replacement, and scenarios in which some replacement occurs. We also examined how future improvements in self-test sensitivity may affect our results.</div></div><div><h3>Results</h3><div>When HIV self-tests are supplemental rather than substitutes for laboratory-based testing, self-testing can decrease HIV incidence among MSM in the US by up to 10 % and increase awareness of status among MSM from 85 % to 91 % over a 10-year period, provided linkage to care and formal diagnosis occur promptly following a positive self-test (90 days or less). As self-tests replace a higher percentage laboratory-based testing algorithms, increases in overall testing rates were necessary to ensure reductions in HIV incidence. However, such needed increases were relatively small (under 10 % for prompt engagement in care and moderate levels of replacement). Improvements in self-test sensitivity and/or decreases in the detection period may further reduce any necessary increases in overall testing by up to 40 %.</div></div><div><h3>Conclusions</h3><div>If properly utilized, self-testing can provide significant long-term reductions to HIV incidence and improve awareness of HIV status. Ensuring that self-testing increases overall testing and that formal diagnosis and engagement in care occur promptly following a positive self-test are necessary to maximize the benefits of self-testing. Future improvements in self-test sensitivity and reductions in the detection period would further reduce HIV incidence and the potential risks associated with replacing laboratory tests with self-tests.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100796"},"PeriodicalIF":3.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wastewater-based epidemiology for COVID-19 surveillance and beyond: A survey","authors":"Chen Chen ,&nbsp;Yunfan Wang ,&nbsp;Gursharn Kaur ,&nbsp;Aniruddha Adiga ,&nbsp;Baltazar Espinoza ,&nbsp;Srinivasan Venkatramanan ,&nbsp;Andrew Warren ,&nbsp;Bryan Lewis ,&nbsp;Justin Crow ,&nbsp;Rekha Singh ,&nbsp;Alexandra Lorentz ,&nbsp;Denise Toney ,&nbsp;Madhav Marathe","doi":"10.1016/j.epidem.2024.100793","DOIUrl":"10.1016/j.epidem.2024.100793","url":null,"abstract":"<div><div>The pandemic of COVID-19 has imposed tremendous pressure on public health systems and social economic ecosystems over the past years. To alleviate its social impact, it is important to proactively track the prevalence of COVID-19 within communities. The traditional way to estimate the disease prevalence is to estimate from reported clinical test data or surveys. However, the coverage of clinical tests is often limited and the tests can be labor-intensive, requires reliable and timely results, and consistent diagnostic and reporting criteria. Recent studies revealed that patients who are diagnosed with COVID-19 often undergo fecal shedding of SARS-CoV-2 virus into wastewater, which makes wastewater-based epidemiology for COVID-19 surveillance a promising approach to complement traditional clinical testing. In this paper, we survey the existing literature regarding wastewater-based epidemiology for COVID-19 surveillance and summarize the current advances in the area. Specifically, we have covered the key aspects of wastewater sampling, sample testing, and presented a comprehensive and organized summary of wastewater data analytical methods. Finally, we provide the open challenges on current wastewater-based COVID-19 surveillance studies, aiming to encourage new ideas to advance the development of effective wastewater-based surveillance systems for general infectious diseases.</div></div>","PeriodicalId":49206,"journal":{"name":"Epidemics","volume":"49 ","pages":"Article 100793"},"PeriodicalIF":3.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}