Journal of Infectious Diseases最新文献

{"title":"FGF8 Protects Against Polymicrobial Sepsis by Enhancing the Host's Anti-infective Immunity.","authors":"Kai Chen, Yanting Ruan, Wenjing Ma, Xiaoyan Yu, Ying Hu, Yue Li, Hong Tang, Xuemei Zhang, Yibing Yin, Dapeng Chen, Zhixin Song","doi":"10.1093/infdis/jiae559","DOIUrl":"10.1093/infdis/jiae559","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is characterized by a life-threatening syndrome caused by an unbalanced host response to infection. Fibroblast growth factor 8 (FGF8) has been newly identified to play important roles in inflammation and innate immunity, but its role in host response to sepsis is undefined.</p><p><strong>Methods: </strong>A cecal ligation and puncture (CLP)-induced mouse sepsis model was established to evaluate the immunomodulatory function of FGF8 during sepsis. The underlying molecular mechanisms were elucidated by cell models using relevant molecular biology experiments. The clinical value of FGF8 in the adjuvant diagnosis of sepsis was evaluated using clinical samples.</p><p><strong>Results: </strong>FGF8 protein concentrations were elevated in CLP-induced septic mice compared to controls. In vivo, FGF8 blockade using anti-FGF8 antibody significantly increased mortality and bacterial burden and was paralleled by significantly aggravated tissue injury after CLP. Therapeutic administration of recombinant FGF8 (rFGF8) improved the bacterial clearance and mortality of septic mice in a FGFR1-dependent manner. In vitro, FGF8 directly enhanced bacterial phagocytosis and killing of macrophages by enhancing the phosphorylation of the ERK1/2 signaling pathway, which could be abrogated with the ERK1/2 pathway inhibitor U0126. Clinically, serum FGF8 levels in both adult and pediatric patients with sepsis in an intensive care unit were significantly higher than those in healthy controls.</p><p><strong>Conclusions: </strong>These results present a previously unrecognized role of FGF8 in improving survival of sepsis by enhancing host immune defense. Therefore, targeting FGF8 may provide new strategies for the diagnosis and immunotherapy of sepsis.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e659-e670"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Late-Rainy Season Indoor Residual Spraying on Holoendemic Malaria Transmission: A Cohort Study in Northern Zambia.","authors":"Anne C Martin, Mike Chaponda, Mbanga Muleba, James Lupiya, Mary E Gebhardt, Sophie Berube, Timothy Shields, Amy Wesolowski, Tamaki Kobayashi, Douglas E Norris, Daniel E Impoinvil, Brian Chirwa, Reuben Zulu, Paul Psychas, Matthew Ippolito, William J Moss","doi":"10.1093/infdis/jiae609","DOIUrl":"10.1093/infdis/jiae609","url":null,"abstract":"<p><strong>Background: </strong>Indoor residual spraying (IRS) is a malaria control strategy implemented before the rainy season. Nchelenge District, Zambia, is a holoendemic setting where IRS has been conducted since 2008 with little impact on malaria incidence or parasite prevalence. Pre-rainy season IRS may not reduce the post-rainy season peak abundance of the major vector Anopheles funestus.</p><p><strong>Methods: </strong>A controlled, pretest-posttest, prospective cohort study assessed the impact of late-rainy season IRS on malaria prevalence, incidence, hazard, and vector abundance. A total of 382 individuals were enrolled across 4 household clusters, of which 2 were sprayed in April 2022 toward the end of the rainy season. Monthly household and individual surveys and indoor overnight vector collections were conducted through August 2022. Multivariate regression and time-to-event analyses estimated the impact of IRS on outcomes measured by rapid diagnostic tests, microscopy, and quantitative polymerase chain reaction.</p><p><strong>Results: </strong>Among participants, 72% tested positive by rapid diagnostic test at least once, and incidence by microscopy was 3.4 infections per person-year. Residing in a household in a sprayed area was associated with a 52% reduction in infection hazard (hazards ratio, 0.48; 95% CI, .29-.78) but not with changes in incidence, prevalence, or vector abundance. The study-wide entomologic inoculation rate was 34 infectious bites per person per year.</p><p><strong>Conclusions: </strong>Monthly tracking of incidence and prevalence did not demonstrate meaningful changes in holoendemic transmission intensity. However, hazard of infection, which provides greater power for detecting changes in transmission, demonstrated that late-rainy season IRS reduced malaria risk.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"1020-1030"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Surrogate Enzyme-Linked Immunosorbent Assay to Select High-Titer Human Convalescent Plasma for Treating Immunocompromised Patients Infected With Severe Acute Respiratory Syndrome Coronavirus 2 Variants of Concern.","authors":"Victoria Dolange, Stefan Slamanig, Adam Abdeljawad, Tsoi Ying Lai, Nicholas Lemus, Gagandeep Singh, Juan Manuel Carreño, Anass Abbad, Komal Srivastava, Viviana Simon, Jaiprasath Sachithanandham, Andrew Pekosz, David Sullivan, Florian Krammer, Weina Sun, Peter Palese, Irene González-Domínguez","doi":"10.1093/infdis/jiae645","DOIUrl":"10.1093/infdis/jiae645","url":null,"abstract":"<p><strong>Background: </strong>The emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants challenges the treatment of immunocompromised patients against coronavirus disease 2019 (COVID-19). High-titer COVID-19 convalescent plasma (CCP) remains one of the few available therapeutics for these patients. We have revisited the selection of CCP samples and evaluated their efficacy against the Omicron XBB.1.5 variant, the dominant strain in 2023.</p><p><strong>Methods: </strong>A surrogate enzyme-linked immunoassay was reviewed to select CCP samples that ensure a protective level of neutralizing antibodies as the main correlate of protection. Antibody titers were analyzed in 500 serum samples from a population-based serosurvey at Mount Sinai Hospital in early 2023, and the results were validated with CCP samples (collected in 2020-2023) using an immunosuppressed mouse model.</p><p><strong>Results: </strong>Using logistic regression modeling, we have redefined high-titer CCP against the new variant in the postpandemic era, where over 97% of the population has natural or vaccine-induced antibodies against earlier SARS-CoV-2 strains. Treatment of immunocompromised mice with two doses (100 μL/dose) of CCP plasma via intraperitoneal injection reduced lung viral titers by 46-fold 3 days post-XBB.1.5 infection.</p><p><strong>Conclusions: </strong>These findings will guide future efforts in selecting high-titer CCP for emerging SARS-CoV-2 variants.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e723-e733"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Live Attenuated Measles Virus in the Respiratory Tract Following Subcutaneous Measles-Mumps-Rubella Vaccination.","authors":"Timothy A Watkins, Jacqueline K Brockhurst, Gregory Germain, Diane E Griffin, Ellen F Foxman","doi":"10.1093/infdis/jiae537","DOIUrl":"10.1093/infdis/jiae537","url":null,"abstract":"<p><p>The live attenuated measles vaccine is extremely effective in preventing measles and induces mucosal immunity in the respiratory tract; however, the mechanism is not known. We show that live attenuated measles virus (LAMV) RNA is frequently detected in the respiratory tract 7-21 days after subcutaneous measles-mumps-rubella (MMR) vaccination in healthy children (n = 5/20) and macaques (n = 6/8). Replicating LAMV was isolated from the lungs of 2 macaques, with no evidence of transmission to unvaccinated individuals. These observations suggest that LAMV in the respiratory tract may play a role in the development of robust mucosal immunity following MMR vaccination.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"1089-1093"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomics Should Inform Appropriate Analysis of Taxonomy and Pathogenesis of Rickettsia.","authors":"J Stephen Dumler, David H Walker","doi":"10.1093/infdis/jiae513","DOIUrl":"10.1093/infdis/jiae513","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"827-829"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479487","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":"Effectiveness of mRNA COVID-19 Vaccines and Hybrid Immunity in Preventing SARS-CoV-2 Infection and Symptomatic COVID-19 Among Adults in the United States.","authors":"Leora R Feldstein, Jasmine Ruffin, Ryan E Wiegand, Craig B Borkowf, Jade James-Gist, Tara M Babu, Melissa Briggs-Hagen, James Chappell, Helen Y Chu, Janet A Englund, Jennifer L Kuntz, Adam S Lauring, Natalie Lo, Marco Carone, Christina Lockwood, Emily T Martin, Claire M Midgley, Arnold S Monto, Allison L Naleway, Tara Ogilvie, Sharon Saydah, Mark A Schmidt, Jonathan E Schmitz, Ning Smith, Ine Sohn, Lea Starita, H Keipp Talbot, Ana A Weil, Carlos G Grijalva","doi":"10.1093/infdis/jiaf007","DOIUrl":"10.1093/infdis/jiaf007","url":null,"abstract":"<p><strong>Background: </strong>Understanding protection against SARS-CoV-2 infection by vaccine and hybrid immunity is important for informing public health strategies as new variants emerge.</p><p><strong>Methods: </strong>We analyzed data from 3 cohort studies spanning 1 September 2022 to 31 July 2023 to estimate COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 infection and symptomatic COVID-19 among adults with and without prior infection in the United States. Participants collected weekly nasal swabs irrespective of symptoms, participated in annual blood draws, and completed periodic surveys, which included vaccination status and infection history. Swabs were tested molecularly for SARS-CoV-2. VE was estimated by Cox proportional hazards models for the hazard ratios of infections, adjusting for covariates. VE was calculated considering prior infection and recency of vaccination.</p><p><strong>Results: </strong>Among 3344 adults, the adjusted VE of a bivalent vaccine against infection was 37.2% (95% CI, 12.3%-55.7%) within 7 to 59 days of vaccination and 21.1% (95% CI, -0.5% to 37.1%) within 60 to 179 days of vaccination when compared with participants who were unvaccinated or had received an original monovalent vaccine dose ≥180 days prior. Overall, the adjusted VE of a bivalent vaccine against infection, in conjunction with prior infection, was 62.2% (95% CI, 46.0%-74.5%) within 7 to 179 days of vaccination and 39.4% (95% CI, 12.5%-61.6%) at ≥180 days when compared with naive participants who were unvaccinated or had received a monovalent vaccine dose ≥180 days prior.</p><p><strong>Conclusions: </strong>Adults with prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e743-e753"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological Responses to Target Streptococcus pyogenes Vaccine Antigens in Patients With Proven Invasive β-Hemolytic Streptococcal Infections.","authors":"Kristyn Langworthy, Michael Taggart, Rosemary Smith, Avram Levy, Daniel R Knight, Siong Hui, Alma Fulurija, Michael Morici, Edward Raby, Laurens Manning","doi":"10.1093/infdis/jiae496","DOIUrl":"10.1093/infdis/jiae496","url":null,"abstract":"<p><strong>Background: </strong>Rising incidence of invasive β-hemolytic streptococcal (iBHS) infections has prompted consideration of vaccination as a preventative strategy for at-risk populations. The benefits of a vaccine targeting Lancefield group A (Streptococcus pyogenes; Strep A) would increase if cross-species immunity against Lancefield groups C/G (Streptococcus dysgalactiae subspecies equisimilis; SDSE) and B (Streptococcus agalactiae; GBS) was demonstrated.</p><p><strong>Methods: </strong>A prospective, observational study of adult patients with iBHS infections due to Strep A, SDSE, or GBS. Antibody responses to 6 Strep A candidate antigens were assayed on acute and convalescent sera. A serological response was defined as an increase of >0.2 log10 arbitrary units/mL (AU/mL).</p><p><strong>Results: </strong>Sixty-seven participants were enrolled. Thirty-three participants were included in the final analysis (12, 11, and 10 with Strep A, SDSE, and GBS, respectively). The median serological response for participants with Strep A was significant for all tested antigens (median >0.2 log10 difference between acute and convalescent samples; P < .05 for all). Those with SDSE had comparable and significant median responses to streptolysin-O (0.65 log10 AU/mL; interquartile range [IQR], 0.36-1.67; P = .004), S. pyogenes adhesion and division protein (0.68 log10 AU/mL; IQR, 0.36-1.63; P = .005), and C5a peptidase (ScpA; 0.30 log10 AU/mL; IQR, 0.23-1.06; P = .004). GBS responses were limited to ScpA only (0.34 log10 AU/mL; IQR, 0.08-0.52; P = .05).</p><p><strong>Conclusions: </strong>Patients with invasive Strep A infection mount robust antibody responses to 6 non-M protein vaccine candidate antigens. Similar significant responses to C5a peptidase in those with invasive SDSE and GBS infection highlight the importance of further research into cross-species protection and immunological correlates of vaccine efficacy.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"913-920"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394841","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":"Risk Stratification of Metabolic Risk Factors and Statin Use Associated With Liver and Nonliver Outcomes in Chronic Hepatitis B.","authors":"Xinrong Zhang, Vy H Nguyen, Leslie Yeeman Kam, Scott D Barnett, Linda Henry, Ramsey Cheung, Mindie H Nguyen","doi":"10.1093/infdis/jiae522","DOIUrl":"10.1093/infdis/jiae522","url":null,"abstract":"<p><strong>Background: </strong>We investigated the association of metabolic risk factors (MRFs) and statin use with liver and nonliver outcomes in a nationwide cohort of patients with chronic hepatitis B (CHB) in the United States.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients with CHB using the MarketScan Databases (January 2007-December 2021). Incidence of liver and nonliver outcomes (cardiovascular disease, chronic kidney disease, and extrahepatic cancer) was analyzed. MRFs included diabetes mellitus (DM), hypertension, hyperlipidemia, and obesity.</p><p><strong>Results: </strong>The study included 52 277 patients with CHB, and 1:1 propensity score matching yielded 16 696 pairs of matched patients with and without MRFs for analysis. When compared with those without MRFs, patients with DM and all 3 other MRFs had the highest adjusted hazard ratio (95% CI) for any liver outcome at 2.08 (1.22-3.52), followed by 12.98 (7.73-21.80) for cardiovascular disease, 9.25 (5.46-15.66) for chronic kidney disease, and 2.01 (1.00-4.04) for extrahepatic cancer. Increased metabolic burden was associated with liver and nonliver outcomes except for comparison between patients without MRFs and those with MRFs but no DM (P > .2 for all liver outcomes). Among lower metabolic burden (≤2 MRFs), statin use was associated with a 15% lower risk of any liver outcomes, 35% reduced risk of HCC, and 15% lower risk of cirrhosis but not among those with higher metabolic burden (≥3 MRFs).</p><p><strong>Conclusions: </strong>Higher metabolic burden was associated with a greater risk for liver and nonliver complications in patients with CHB, with DM having the highest impact among other MRFs. Statin use was associated with a reduced risk of liver outcomes among lower metabolic burden.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"1079-1088"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814817","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":"Epigenetic Changes in Cerebrospinal Fluid and Blood of People With Neurosyphilis.","authors":"Darius Mostaghimi, Sameet Mehta, Jennifer Yoon, Priya Kosana, Christina M Marra, Michael J Corley, Shelli F Farhadian","doi":"10.1093/infdis/jiae476","DOIUrl":"10.1093/infdis/jiae476","url":null,"abstract":"<p><p>Epigenetic changes within immune cells may contribute to neuroinflammation during bacterial infection, but their role in neurosyphilis (NS) pathogenesis and response has not yet been established. We longitudinally analyzed DNA methylation and RNA expression in cerebrospinal fluid (CSF) cells and peripheral blood mononuclear cells (PBMCs) from 11 participants with laboratory-confirmed NS (CSF Venereal Disease Research Laboratory test positive) and 11 matched controls with syphilis without NS (non-NS). DNA methylation profiles from CSF and PBMCs of participants with NS significantly differed from those of participants with non-NS. Some genes associated with these differentially methylated sites had corresponding RNA expression changes in the CSF (111/1097 [10.1%]), and included genes involved in B cell activation and insulin-response pathways. Despite antibiotic treatment, approximately 80% of CSF methylation changes associated with NS persisted, suggesting that epigenetic scars accompanying NS may persistently affect immunity following infection. Future studies must examine whether these sequelae are clinically meaningful.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"883-893"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Immunization.","authors":"Hye-Kyung Cho, Collrane Frivold, Helen Y Chu","doi":"10.1093/infdis/jiae509","DOIUrl":"10.1093/infdis/jiae509","url":null,"abstract":"<p><p>Pregnant individuals and infants are at risk from vaccine-preventable diseases like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza. Maternal vaccination during pregnancy can protect both the mother and child. Recent progress in developing these vaccines is notable, but vaccine hesitancy and the exclusion of pregnant individuals from clinical trials limit their use. Maternal immunization safeguards mothers from severe illness and adverse pregnancy outcomes while providing infants with antibodies through the placenta and breast milk. Inactivated vaccines are generally effective and safe during pregnancy. Limited safety and efficacy data due to exclusion from trials hinder vaccine uptake; however, vaccines like tetanus-diphtheria-acellular pertussis (Tdap), influenza, and SARS-CoV-2 have proven effective, and are recommended vaccines during pregnancy. New vaccines for group B Streptococcus (GBS) and cytomegalovirus are in development, with the GBS vaccine being the most advanced. Combating vaccine hesitancy through strong health care provider recommendations is vital to enhance uptake and protect pregnant individuals and their infants.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"830-836"},"PeriodicalIF":5.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479488","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}