Ticks and Tick-borne Diseases最新文献

{"title":"Dermacentor ticks and their human pathogens in various ecosystems of eastern France","authors":"C. Barthel ,&nbsp;J. Stynen ,&nbsp;M. Grau ,&nbsp;M-L. Poulle ,&nbsp;P. Bauda ,&nbsp;N. Boulanger","doi":"10.1016/j.ttbdis.2025.102520","DOIUrl":"10.1016/j.ttbdis.2025.102520","url":null,"abstract":"<div><div><em>Dermacentor</em> is Europe’s second most important tick genus. It comprises two species: <em>Dermacentor reticulatus</em>, which has a more northerly range, and <em>Dermacentor marginatus</em>, which is typically found in Mediterranean regions. In France, especially in the east, the presence of <em>Dermacentor</em> remains understudied. Leveraging projects on <em>Ixodes ricinus</em>, we identified high-risk ecosystems for <em>Dermacentor</em> ticks. Both species were present, but <em>D. reticulatus</em> was dominant (96.3 %), always coexisting with <em>Ixodes</em>, at densities reaching 30.3 questing adults/100 m² in Bas-Rhin. This species was found to thrive in wet meadows, alluvial forests, and lakes, where wild boars (<em>Sus scrofa</em>) are common. Among domestic animals, dogs and horses were the preferred hosts. Regarding human pathogens, we focused on the circulation of rickettsiae responsible for tick-borne lymphadenopathy. Acarological risk varied by region, with <em>Rickettsia raoultii</em> being the most prevalent bacterial species in all the departments, whereas <em>Rickettsia slovaca</em> was rarer and present only in 2 Bas-Rhin nature reserves. At the peak of tick activity, up to 18.7 % of <em>Dermacentor</em> adult ticks carried <em>R. raoultii</em>. In the studied region, <em>D. reticulatus</em> is the only known vector of these potentially pathogenic microorganisms.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102520"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental factors determining the survival of winter ticks (Dermacentor albipictus) at different life stages in Québec, Canada","authors":"Morgane Le Goff ,&nbsp;Christian Dussault ,&nbsp;Julien H. Richard ,&nbsp;Steeve D. Côté","doi":"10.1016/j.ttbdis.2025.102519","DOIUrl":"10.1016/j.ttbdis.2025.102519","url":null,"abstract":"<div><div>Ticks are responsible for large economic losses because of their impact on livestock and wildlife. In recent years, winter ticks (<em>Dermacentor albipictus)</em> have caused mass mortalities in moose (<em>alces</em>) populations of North America, leading to host mortality due to severe blood loss. During their off-host stages (i.e. egg and larvae), winter ticks are particularly vulnerable to mortality because of potential exposure to stressful abiotic conditions that could dehydrate eggs or freeze larvae. We conducted a field experiment in Québec, Canada, to better understand larval questing behaviour and assess the ability of unfed larvae to survive over the winter to the following fall. In the laboratory, we tested the tolerance of eggs to different saturation deficits reflected by combinations of temperature and humidity and evaluated the tolerance of larvae to sub-freezing temperatures. We found that unfed winter tick larvae did not survive until a second fall regardless of habitat types (open, closed or sheltered from the snow) and thus could not quest for a host for two consecutive years. However, unfed larvae withstood short-term exposure to low sub-freezing temperatures, potentially prolonging their questing period and increasing the likelihood of moose infestations. Egg survival varied among saturation deficits, but survival tended to be higher at 30 °C and lower at 22 °C regardless of the saturation deficit. Overall, we found that the free stages of winter ticks are highly tolerant of extreme conditions, reinforcing the concern that winter ticks represent for moose populations.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102519"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An official South African species checklist from the National Tick Collection of South Africa (Gertrud Theiler Tick Museum)","authors":"Ronel Pienaar ,&nbsp;Dikeledi Matloa ,&nbsp;Ben J. Mans","doi":"10.1016/j.ttbdis.2025.102510","DOIUrl":"10.1016/j.ttbdis.2025.102510","url":null,"abstract":"<div><div>Ticks play a crucial role in ecosystem dynamics and disease transmission, necessitating accurate species identification for epidemiological and ecological research. South Africa, despite occupying only 0.82 % of the world's land area, harbors approximately 11 % of global tick species richness. This study provides an updated, authoritative checklist of South African tick species curated by the National Tick Collection of South Africa (NTCSA), housed at the Agricultural Research Council – Onderstepoort Veterinary Research (ARC<img>OVR). Previous lists for South Africa presented outdated taxonomic classifications and incomplete data on taxonomic taxa. The NTCSA checklist aims to correct inaccuracies, incorporating the most recent literature, molecular systematics, and expert curation. A total of 110 tick species across three families (Ixodidae, Argasidae, Nuttalliellidae) are documented, with corrections to genera classifications and species distributions indicated. This list serves as a reference for researchers, veterinarians, and policymakers involved in tick diversity, vector control, and conservation efforts. Continuous updates integrating morphological and molecular assessments will further enhance our understanding of tick diversity and distribution in South Africa. The wide extralimital distribution of various species extend the taxonomic observations to the African continent, while the general taxonomic observations presented summarize our understanding of tick taxonomy at global level.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102510"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhipicephalus microplus voraxin-alpha contains B-cell epitopes that reduce ticks’ biological fitness in immunized cattle","authors":"Daniel Gustavo López-Díaz ,&nbsp;María Martina Esperanza Pérez-Soria ,&nbsp;José Rodrigo Morales-García ,&nbsp;Rafael Jiménez-Ocampo ,&nbsp;Gabriela Aguilar-Tipacamú ,&nbsp;Massaro W. Ueti ,&nbsp;Juan Mosqueda","doi":"10.1016/j.ttbdis.2025.102516","DOIUrl":"10.1016/j.ttbdis.2025.102516","url":null,"abstract":"<div><div><em>Rhipicephalus microplus</em> ticks are a serious pest of cattle in tropical and subtropical regions, mainly due to the losses they cause by reducing meat and milk production, as well as causing hide damage, in addition to their role as vectors of babesiosis and anaplasmosis. Integrated tick control must include the use of anti-tick vaccines to reduce tick populations and mitigate the ecological impact associated with the extensive use of acaricides. To develop improved vaccines, evaluation of new tick antigens is essential. Voraxin, mainly described as a testes-derived protein, is transferred from males to females during copulation, and it is crucial for stimulating engorgement in female ticks and for the development of their organs. In this study, <em>R. microplus</em> voraxin-alpha (voraxin-α) was amplified and sequenced, four peptides with predicted B-cell epitopes were designed and their immunogenic properties were evaluated. Each peptide was mixed with a commercial adjuvant and inoculated into two cattle from a tick-free region to corroborate if they were truly immunogenic. The antibody responses to each peptide were assessed using indirect ELISA. Two peptides were immunogenic and were selected for further testing involving immunization and experimental infestation with 10,000 larvae and two cattle per evaluated peptide. Immunization with peptide 3 reduced tick survival in 17 %, oviposition in 14 % and egg hatching in 22 %, while peptide 4 impaired oviposition in 18 % and egg hatching in 18 %. No effect on weight was observed. In conclusion, ticks fed on cattle producing specific antibodies against voraxin-α B-cell epitopes, have a reduced survival, oviposition and fertility, which are important biological parameters, related to tick fitness. Vaccine trials are required to evaluate this antigen as a vaccine candidate against <em>R. microplus</em>.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102516"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and diversity of Borrelia spp. in questing ticks from urban green spaces in Lithuania","authors":"Justina Snegiriovaitė,&nbsp;Indrė Lipatova,&nbsp;Miglė Razgūnaitė,&nbsp;Algimantas Paulauskas,&nbsp;Jana Radzijevskaja","doi":"10.1016/j.ttbdis.2025.102512","DOIUrl":"10.1016/j.ttbdis.2025.102512","url":null,"abstract":"<div><div>Lithuania is a highly endemic area for Lyme borreliosis (LB), and <em>Ixodes ricinus</em>, the primary vector of <em>Borrelia burgdorferi</em> sensu lato (s.l.) in Europe, is widespread throughout the country. While previous studies conducted in Lithuania have examined the prevalence of <em>B. burgdorferi</em> s.l. in natural habitats, comprehensive data on the distribution of ticks and their infection with tick-borne pathogens in urban areas remain largely unknown. This study aimed to assess the risk of LB by analyzing tick abundance and the prevalence of <em>Borrelia</em> spp. in ticks collected from urban green spaces across ten Lithuanian counties. A total of 3628 ticks were collected, comprising two species: <em>I. ricinus</em> (<em>n</em> = 3599) and <em>Dermacentor reticulatus</em> (<em>n</em> = 29). Ticks were found in 43 out of 52 investigated locations. Molecular analyses detected <em>B. burgdorferi</em> s.l. in 22.89 % of <em>I. ricinus</em> and 3.45 % of <em>D. reticulatus</em> specimens, while <em>Borrelia miyamotoi</em> was found in 3.97 % of <em>I. ricinus</em> and 3.45 % of <em>D. reticulatus</em>. Five species from <em>B. burgdorferi</em> s.l. complex were identified: <em>B. afzelii, B. garinii, B. burgdorferi</em> s.s., <em>B. lusitaniae</em>, and <em>B. valaisiana</em>. Co-infections with different <em>Borrelia</em> spp. were observed in 0.72 % of <em>I. ricinus</em> ticks. <em>Borrelia-</em>infected ticks were detected at 38 of 43 locations (88.37 %), with the prevalence of infection ranging from 3.70 % to 41.53 %. These findings indicate that urban green spaces in Lithuania provide suitable habitats for ticks, with varying risks of human-tick contact and tick-borne infections, underscoring the potential public health risk of LB in Lithuanian cities. Further evaluation of tick distribution and the prevalence of <em>Borrelia</em> spp. is necessary to monitor how climate change and urbanization affect pathogen circulation and infection risk.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102512"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A full-length 16S survey using Nanopore sequencing to uncover the bacterial microbiome in Ixodes ricinus ticks from a single UK woodland, collected across three springs (2019-2021)","authors":"Mia L. White ,&nbsp;Jack M. Crook ,&nbsp;Kayleigh M. Hansford ,&nbsp;Daniel P. Carter ,&nbsp;Michael J. Elmore ,&nbsp;Colin Johnston ,&nbsp;Sara Gandy ,&nbsp;Kuiama Lewandowski ,&nbsp;Alexander Vaux ,&nbsp;Karen L. Osman ,&nbsp;Richard Vipond ,&nbsp;Jolyon M. Medlock ,&nbsp;Edward J Feil ,&nbsp;Steven T. Pullan","doi":"10.1016/j.ttbdis.2025.102506","DOIUrl":"10.1016/j.ttbdis.2025.102506","url":null,"abstract":"<div><div><em>Ixodes ricinus</em> is a key vector of several bacterial pathogens, including <em>Borrelia</em> and <em>Rickettsia</em> species. To assess bacterial prevalence and diversity, we characterised the microbiome of ticks collected from a single UK woodland, comparing different woodland types, life stages (adult male, female, and nymph), and sampling years (spring 2019–2021). Unlike previous studies that target short regions of the <em>16S rRNA</em> gene, we used Nanopore sequencing to generate full-length 16S reads, allowing for higher taxonomic resolution. Our results showed significant microbiome differences across life stages, but not by woodland type or year. <em>Rickettsia</em> was the most abundant taxon, with prevalence varying by life stage and year. <em>Borrelia</em> was present in all life stages but absent in 2021 samples. <em>Anaplasma</em> abundance varied significantly by year and life stage, peaking in nymphs from Pine woodland. <em>Bartonella</em> was found across all woodland types, with the highest abundance in nymphs from Oak-dominated areas.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102506"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should we consider tularemia in travelers returning from North Africa?","authors":"Souheil Zayet ,&nbsp;Isabelle Pelloux ,&nbsp;Max Maurin ,&nbsp;Vincent Gendrin ,&nbsp;Jean-Baptiste Vuillemenot ,&nbsp;Pauline Granier ,&nbsp;Julie Plantin ,&nbsp;Thierry Spicarolen ,&nbsp;Timothée Klopfenstein","doi":"10.1016/j.ttbdis.2025.102511","DOIUrl":"10.1016/j.ttbdis.2025.102511","url":null,"abstract":"<div><div>We report a rare case of cervical lymphadenopathy tularemia from North Africa in a French immunocompromised traveler returning from Egypt after participating in an outdoor travel involving dromedary camels. The timeline and clinical course support tularemia as a cause of infection in this patient. The diagnosis was confirmed by serology and polymerase chain reaction methods. A concurrent Epstein-Barr virus-infectious mononucleosis complicated the diagnosis of tularemia. Treatment was successful after surgical procedures in addition to two different antimicrobial regimens: doxycycline followed by fluoroquinolones.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102511"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative distribution and population genetics of bisexual and parthenogenetic Asian longhorned tick (Haemaphysalis longicornis) in the Republic of Korea","authors":"Jiseok Kim ,&nbsp;Donghun Kim","doi":"10.1016/j.ttbdis.2025.102507","DOIUrl":"10.1016/j.ttbdis.2025.102507","url":null,"abstract":"<div><div>The Asian longhorned tick (<em>Haemaphysalis longicornis</em>) is an ectoparasite that transmits several pathogens, including severe fever with thrombocytopenia syndrome virus, to humans and animals. Wild populations of <em>H. longicornis</em> are maintained by both bisexual and asexual reproductive strategies. This study examined the geographical distribution and genetic differentiation of bisexual and parthenogenetic <em>H. longicornis</em> populations collected from 12 cities across the Republic of Korea: Chuncheon (CC), Sokcho (SC), Samcheok (SCH), Ganghwa (GH), Sangju (SJ), Ulsan (US), Jinju (JNJ), Boryeong (BR), Gochang (GC), Jindo (JD), Jeju (JJ), and Seogwipo (SG). Based on 16S ribosomal DNA sequence analysis, parthenogenetic and bisexual individuals were found to coexist at varying proportions depending on the region. Parthenogenetic individuals were more dominant in the northeastern regions (CC, US, SJ, SC, GH, and SCH), while bisexual individuals were more abundant in the southwestern regions (SG, BR, JD, JJ, GC, and JNJ). Population genetic analysis based on concatenated mitochondrial cytochrome c oxidase subunit I (COI) and cytochrome B (CytB) genes revealed that the genetic structure of female ticks was primarily influenced by their reproductive strategy (bisexual or parthenogenetic), rather than by geographic origin. Demographic analysis detected evidence of population expansion in both northeastern (CC, SC, and SCH) and southwestern (JD and SG) regions. These findings enhance the understanding of <em>H. longicornis</em> population dynamics in the Republic of Korea.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102507"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data","authors":"Gordon Brestrich ,&nbsp;Madiha Shafquat ,&nbsp;Frederick J. Angulo ,&nbsp;Alexander Davidson ,&nbsp;Ye Tan ,&nbsp;Kate Halsby ,&nbsp;Julie Davis ,&nbsp;Jennifer C Moïsi ,&nbsp;James H. Stark","doi":"10.1016/j.ttbdis.2025.102509","DOIUrl":"10.1016/j.ttbdis.2025.102509","url":null,"abstract":"<div><div>Lyme borreliosis (LB) is the most common tick-borne disease in Europe and can manifest as localized erythema migrans (EM) or further disseminate into Lyme neuroborreliosis (LNB), Lyme arthritis (LA) or other manifestations. However, public health surveillance in Denmark and Ireland only captures LNB, while published LB data for Sweden only includes LNB. To enhance the understanding of LB disease burden in these countries, this study aimed to estimate LB incidence by clinical manifestation using the ratio of each manifestation to LNB. These ratios were derived using random effects meta-analysis of published data from other European countries. We estimated the ratios for EM/LNB, LA/LNB and other manifestations/LNB to be 42.8 (95 % confidence interval [CI]: 36.4–50.4), 0.9 (95 % CI: 0.7–1.0), and 0.8 (95 % CI; 0.4–1.4), respectively. Applying these ratios to the LNB incidence resulted in an estimated overall LB incidence of 151.5 cases per 100,000 population per year (PPY) in Denmark, 285.2 per 100,000 PPY in Sweden and 9.5 per 100,000 PPY in Ireland. These correspond to &gt;36,000 LB cases per year compared to approximately 800 LNB cases reported in these three countries. Furthermore, the estimated incidence of disseminated manifestations was 8.7 and 16.4 per 100,000 PPY in Denmark and Sweden, respectively. These estimates across LB manifestations highlight the LB health burden on the national healthcare systems. Future studies that directly estimate the incidence of medically-attended LB from healthcare registries, claims data or administrative medical records may help validate these estimates.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102509"},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First report of the taiga tick Ixodes persulcatus in Norway","authors":"Andrea Cotes-Perdomo ,&nbsp;Arnulf Soleng ,&nbsp;Kristian Alfsnes ,&nbsp;Åshild Andreassen","doi":"10.1016/j.ttbdis.2025.102508","DOIUrl":"10.1016/j.ttbdis.2025.102508","url":null,"abstract":"<div><div>The distribution range of the taiga tick, <em>Ixodes persulcatus</em>, has increased in the last decade in Northern Europe. We performed samplings at nine locations in Nordland County, east and northeast of Brønnøysund, south of the Arctic Circle in July 2023. Four of 62 ticks collected were identified as <em>I. persulcatus</em> (one female, two males and one nymph), the remaining were identified as <em>Ixodes ricinus</em> (9 females, 2 males and 47 nymphs). This is the first report of <em>I. persulcatus</em> in Norway. Given the importance of <em>I. persulcatus</em> as vector of <em>Borrelia burgdorferi</em> sensu lato and more pathogenic subtypes of the tick-borne encephalitis virus, more research should be done focusing on its distribution, ecology and associated pathogens in Norway.</div></div>","PeriodicalId":49320,"journal":{"name":"Ticks and Tick-borne Diseases","volume":"16 4","pages":"Article 102508"},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144469975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}