Marta Santos Bravo, Nicolas Plault, Sonsoles Sánchez-Palomino, Cristina Rodríguez, Mireia Navarro Gabriel, María Mar Mosquera, Francesc Fernández Avilés, María Suarez-Lledó, Montserrat Rovira, Marta Bodro, Asunción Moreno, Laura Linares, Frederic Cofan, Carla Berengua, Cristina Esteva, Elisa Cordero, Pilar Martin-Davila, Maitane Aranzamendi, Ana Belén Pérez Jiménez, Elisa Vidal, Nuria Fernández Sabé, Oscar Len, Sebastien Hantz, Sophie Alain, María Ángeles Marcos
{"title":"Genotypic and Phenotypic Study of Antiviral Resistance Mutations in Refractory Cytomegalovirus Infection.","authors":"Marta Santos Bravo, Nicolas Plault, Sonsoles Sánchez-Palomino, Cristina Rodríguez, Mireia Navarro Gabriel, María Mar Mosquera, Francesc Fernández Avilés, María Suarez-Lledó, Montserrat Rovira, Marta Bodro, Asunción Moreno, Laura Linares, Frederic Cofan, Carla Berengua, Cristina Esteva, Elisa Cordero, Pilar Martin-Davila, Maitane Aranzamendi, Ana Belén Pérez Jiménez, Elisa Vidal, Nuria Fernández Sabé, Oscar Len, Sebastien Hantz, Sophie Alain, María Ángeles Marcos","doi":"10.1093/infdis/jiac349","DOIUrl":"https://doi.org/10.1093/infdis/jiac349","url":null,"abstract":"<p><strong>Background: </strong>This study describes the genotypic and phenotypic characterization of novel human cytomegalovirus (HCMV) genetic variants of a cohort of 94 clinically resistant HCMV patients.</p><p><strong>Methods and results: </strong>Antiviral-resistant mutations were detected in the UL97, UL54, and UL56 target genes of 25 of 94 (26.6%) patients. The genotype-phenotype correlation study resolved the status of 5 uncharacterized UL54 deoxyribonucleic acid polymerase (G441S, A543V, F460S, R512C, A928T) and 2 UL56 terminase (F345L, P800L) mutations found in clinical isolates. A928T conferred high, triple resistance to ganciclovir, foscarnet, and cidofovir, and A543V had 10-fold reduced susceptibility to cidofovir. Viral growth assays showed G441S, A543V, F345L, and P800L impaired viral growth capacities compared with wild-type AD169 HCMV. Three-dimensional modeling predicted A543V and A928T phenotypes but not R512C, reinforcing the need for individual characterization of mutations by recombinant phenotyping.</p><p><strong>Conclusions: </strong>Extending mutation databases is crucial to optimize treatments and to improve the assessment of patients with resistant/refractory HCMV infection.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1528-1536"},"PeriodicalIF":6.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40433709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omid Rezahosseini, Mie Sylow Liljendahl, Nikolai Loft, Dina Leth Møller, Zitta Barrella Harboe, Mads Kirchheiner Rasmussen, Kawa Khaled Ajgeiy, Alexander Egeberg, Lone Skov, Susanne Dam Nielsen
{"title":"Incidence, Risk Factors, and Consequences of Human Alphaherpesvirus Infections in Patients With Psoriasis Who Initiate Methotrexate or Biologic Agents.","authors":"Omid Rezahosseini, Mie Sylow Liljendahl, Nikolai Loft, Dina Leth Møller, Zitta Barrella Harboe, Mads Kirchheiner Rasmussen, Kawa Khaled Ajgeiy, Alexander Egeberg, Lone Skov, Susanne Dam Nielsen","doi":"10.1093/infdis/jiac367","DOIUrl":"https://doi.org/10.1093/infdis/jiac367","url":null,"abstract":"<p><strong>Background: </strong>Immunosuppressive agents may increase the risk of infections with human alphaherpesviruses.</p><p><strong>Methods: </strong>We included all adult patients with moderate to severe psoriasis who initiated methotrexate (MTX) or biologic agents in a retrospective cohort study. An episode of alphaherpesviruses infection was defined as filling a prescription for systemic acyclovir, valacyclovir, or famciclovir. Using nationwide registries, we determined the incidence, risk factors, 180-day hospital contacts, and 30-day mortality following infection.</p><p><strong>Results: </strong>We included 7294 patients; 4978 (68%) received MTX, and 2316 (32%) biologic agents. The incidence rates (95% confidence intervals) of alphaherpesviruses were 23 (20-27), 26 (19-35), 17 (11-27), and 6.7 (1.3-21) per 1000 person-years of follow-up in patients on MTX, tumor necrosis factor alpha (TNF-α) inhibitors, interleukin 12/23 (IL-12/23) inhibitors, and interleukin 17 (IL-17) inhibitors, respectively. Males had an unadjusted hazard ratio (HR) of 0.47 (P < .001) for alphaherpesvirus infection. Patients on IL-17 inhibitors had an adjusted HR of 0.24 (P = .048) compared to TNF-α inhibitors. Within 180 days after infection, 13%, 7.5%, and <0.5% of patients on MTX, TNF-α inhibitors, and IL-12/23 or IL-17 inhibitors, respectively, had hospital contacts, and the 30-day mortality for all groups was <0.5%.</p><p><strong>Conclusions: </strong>The incidence and risk of alphaherpesvirus infections were comparable between patients on MTX and TNF-α inhibitors, whereas use of IL-17 inhibitors was associated with a lower risk.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1510-1518"},"PeriodicalIF":6.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33463848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eduard Grebe, Elaine A Yu, Marjorie D Bravo, Alex Welte, Roberta L Bruhn, Mars Stone, Valerie Green, Phillip C Williamson, Leora R Feldstein, Jefferson M Jones, Michael P Busch, Brian Custer
{"title":"Coronavirus Disease 2019 Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the United States Before the Delta- and Omicron-Associated Surges: A Retrospective Cohort Study of Repeat Blood Donors.","authors":"Eduard Grebe, Elaine A Yu, Marjorie D Bravo, Alex Welte, Roberta L Bruhn, Mars Stone, Valerie Green, Phillip C Williamson, Leora R Feldstein, Jefferson M Jones, Michael P Busch, Brian Custer","doi":"10.1093/infdis/jiac318","DOIUrl":"https://doi.org/10.1093/infdis/jiac318","url":null,"abstract":"<p><strong>Background: </strong>To inform public health policy, it is critical to monitor coronavirus disease 2019 vaccine effectiveness (VE), including against acquiring infection.</p><p><strong>Methods: </strong>We estimated VE using self-reported vaccination in a retrospective cohort of repeat blood donors who donated during the first half of 2021, and we demonstrated a viable approach for monitoring VE via serological surveillance.</p><p><strong>Results: </strong>Using Poisson regression, we estimated an overall VE of 88.8% (95% confidence interval, 86.2-91.1), adjusted for demographic covariates and variable baseline risk.</p><p><strong>Conclusions: </strong>The time since first reporting vaccination, age, race and/or ethnicity, region, and calendar time were statistically significant predictors of incident infection.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1556-1561"},"PeriodicalIF":6.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384661/pdf/jiac318.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40666681","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}
Bingyi Yang, Irene O L Wong, Jingyi Xiao, Tim K Tsang, Qiuyan Liao, Benjamin J Cowling
{"title":"Effectiveness of CoronaVac and BNT162b2 Vaccines Against Severe Acute Respiratory Syndrome Coronavirus 2 Omicron BA.2 Infections in Hong Kong.","authors":"Bingyi Yang, Irene O L Wong, Jingyi Xiao, Tim K Tsang, Qiuyan Liao, Benjamin J Cowling","doi":"10.1093/infdis/jiac360","DOIUrl":"https://doi.org/10.1093/infdis/jiac360","url":null,"abstract":"<p><p>There is limited evidence on vaccine effectiveness against asymptomatic or mild Omicron infections. We estimated that recent third doses of messenger RNA or inactivated vaccines reduced the risk of self-reported infection by 52% (95% confidence interval, 17%-73%) among randomly sampled adults during the Omicron BA.2-dominated surge in Hong Kong.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1382-1384"},"PeriodicalIF":6.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9494330/pdf/jiac360.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40344659","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}
James N Moy, Mark Anderson, Xiaoying Shen, Jia Fu, Michael Stec, Amy Gosha, Dina Naquiallah, Jennifer Kinslow, David C Montefiori, Gavin Cloherty, Alan Landay
{"title":"Neutralizing Antibody Activity to Severe Acute Respiratory Syndrome Coronavirus 2 Delta (B.1.617.2) and Omicron (B.1.1.529) After 1 or 2 Doses of BNT162b2 Vaccine in Infection-Naive and Previously Infected Individuals.","authors":"James N Moy, Mark Anderson, Xiaoying Shen, Jia Fu, Michael Stec, Amy Gosha, Dina Naquiallah, Jennifer Kinslow, David C Montefiori, Gavin Cloherty, Alan Landay","doi":"10.1093/infdis/jiac261","DOIUrl":"https://doi.org/10.1093/infdis/jiac261","url":null,"abstract":"<p><p>Previous reports demonstrated that severe acute respiratory syndrome coronavirus (SARS-CoV-2) binding immunoglobulin G levels did not increase significantly between the first and second doses of the BNT162b2 vaccine in previously infected individuals. We tested neutralizing antibodies (nAbs) against SARS-CoV-2 Delta and Omicron variants after the first and second doses of this vaccine in infection-naive and previously infected individuals. Delta, but not Omicron, nAb titers significantly increased from the first to the second dose in both groups of individuals. Importantly, we found that Omicron nAb titers were much lower than Delta nAb titers and that even after 2 doses of vaccine, 17 of 29 individuals in the infection-naive group and 2 of 27 in the previously infected group did not have detectable Omicron nAb titers. Infection history alone did not adequately predict whether a second dose resulted in adequate nAb. For future variants of concern, the discussion on the optimal number of vaccine doses should be based on studies testing for nAb against the specific variant.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1407-1411"},"PeriodicalIF":6.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278194/pdf/jiac261.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40403660","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}
Maria R Farcet, Michael Karbiener, Julia Schwaiger, Reinhard Ilk, Thomas R Kreil
{"title":"Rapidly Increasing Severe Acute Respiratory Syndrome Coronavirus 2 Neutralization by Intravenous Immunoglobulins Produced From Plasma Collected During the 2020 Pandemic.","authors":"Maria R Farcet, Michael Karbiener, Julia Schwaiger, Reinhard Ilk, Thomas R Kreil","doi":"10.1093/infdis/jiab142","DOIUrl":"https://doi.org/10.1093/infdis/jiab142","url":null,"abstract":"<p><p>Immunoglobulin lots (N = 176) released since March 2020 were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibodies, with first positive results for September 2020 lots (mean, 1.7 IU/mL; 46% of lots positive). From there, values steadily increased, in correlation with the cumulative coronavirus disease 2019 (COVID-19) incidence, to reach a mean of 31.2 IU/mL and 93% of lots positive by January 2021. Extrapolating the correlation, immunoglobulins could reach an anti-SARS-CoV-2 potency of approximately 345 IU/mL by July 2021. At that stage, prophylactic immunoglobulin treatment for primary/secondary immunodeficiency could contain similar doses of anti-SARS-CoV-2 as convalescent plasma that is used for treatment of COVID-19.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1357-1361"},"PeriodicalIF":6.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/infdis/jiab142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25483508","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}
Rabia Johnson, Noluxabiso Mangwana, Jyoti R Sharma, Christo J F Muller, Kholofelo Malemela, Funanani Mashau, Stephanie Dias, Pritika Ramharack, Craig Kinnear, Brigitte Glanzmann, Amsha Viraragavan, Johan Louw, Swastika Surujlal-Naicker, Sizwe Nkambule, Candice Webster, Mongezi Mdhluli, Glenda Gray, Angela Mathee, Wolfgang Preiser, Alvera Vorster, Shareefa Dalvie, Renee Street
{"title":"Delineating the Spread and Prevalence of SARS-CoV-2 Omicron Sublineages (BA.1-BA.5) and Deltacron Using Wastewater in the Western Cape, South Africa.","authors":"Rabia Johnson, Noluxabiso Mangwana, Jyoti R Sharma, Christo J F Muller, Kholofelo Malemela, Funanani Mashau, Stephanie Dias, Pritika Ramharack, Craig Kinnear, Brigitte Glanzmann, Amsha Viraragavan, Johan Louw, Swastika Surujlal-Naicker, Sizwe Nkambule, Candice Webster, Mongezi Mdhluli, Glenda Gray, Angela Mathee, Wolfgang Preiser, Alvera Vorster, Shareefa Dalvie, Renee Street","doi":"10.1093/infdis/jiac356","DOIUrl":"https://doi.org/10.1093/infdis/jiac356","url":null,"abstract":"<p><p>This study was one of the first to detect Omicron sublineages BA.4 and BA.5 in wastewater from South Africa. Spearman rank correlation analysis confirmed a strong positive correlation between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA in wastewater samples and clinical cases (r = 0.7749, P < .0001). SARS-CoV-2 viral load detected in wastewater, resulting from the Delta-driven third wave, was significantly higher than during the Omicron-driven fourth wave. Whole-genome sequencing confirmed presence of Omicron lineage defining mutations in wastewater with the first occurrence reported 23 November 2021 (BA.1 predominant). The variant spread rapidly, with prevalence of Omicron-positive wastewater samples rising to >80% by 10 January 2022 with BA.2 as the predominant sublineage by 10 March 2022, whilst on 18 April 2022 BA.4 and BA.5 were detected in selected wastewater sites. These findings demonstrate the value of wastewater-based epidemiology to monitor the spatiotemporal spread and potential origin of new Omicron sublineages.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1418-1427"},"PeriodicalIF":6.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/80/jiac356.PMC9574669.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33438210","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}
Farshad Guirakhoo, Shixia Wang, Chang Yi Wang, Hui Kai Kuo, Wen Jiun Peng, Hope Liu, Lixia Wang, Marina Johnson, Adam Hunt, Mei Mei Hu, Thomas P Monath, Alexander Rumyantsev, David Goldblatt
{"title":"High Neutralizing Antibody Levels Against Severe Acute Respiratory Syndrome Coronavirus 2 Omicron BA.1 and BA.2 After UB-612 Vaccine Booster.","authors":"Farshad Guirakhoo, Shixia Wang, Chang Yi Wang, Hui Kai Kuo, Wen Jiun Peng, Hope Liu, Lixia Wang, Marina Johnson, Adam Hunt, Mei Mei Hu, Thomas P Monath, Alexander Rumyantsev, David Goldblatt","doi":"10.1093/infdis/jiac241","DOIUrl":"https://doi.org/10.1093/infdis/jiac241","url":null,"abstract":"<p><p>The highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has caused high rates of breakthrough infections in those previously vaccinated with ancestral strain coronavirus disease 2019 (COVID-19) vaccines. Here, we demonstrate that a booster dose of UB-612 vaccine candidate delivered 7-9 months after primary vaccination increased neutralizing antibody levels by 131-, 61-, and 49-fold against ancestral SARS-CoV-2 and the Omicron BA.1 and BA.2 variants, respectively. Based on the receptor-binding domain protein binding antibody responses, the UB-612 third-dose booster may lead to an estimated approximately 95% efficacy against symptomatic COVID-19 caused by the ancestral strain. Our results support UB-612 as a potential potent booster against current and emerging SARS-CoV-2 variants.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1401-1406"},"PeriodicalIF":6.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/48/jiac241.PMC9278180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40070564","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}
Jessica E Manning, Sophana Chea, Daniel M Parker, Jennifer A Bohl, Sreyngim Lay, Allyson Mateja, Somnang Man, Sreynik Nhek, Aiyana Ponce, Sokunthea Sreng, Dara Kong, Soun Kimsan, Claudio Meneses, Michael P Fay, Seila Suon, Rekol Huy, Chanthap Lon, Rithea Leang, Fabiano Oliveira
{"title":"Development of Inapparent Dengue Associated With Increased Antibody Levels to Aedes aegypti Salivary Proteins: A Longitudinal Dengue Cohort in Cambodia.","authors":"Jessica E Manning, Sophana Chea, Daniel M Parker, Jennifer A Bohl, Sreyngim Lay, Allyson Mateja, Somnang Man, Sreynik Nhek, Aiyana Ponce, Sokunthea Sreng, Dara Kong, Soun Kimsan, Claudio Meneses, Michael P Fay, Seila Suon, Rekol Huy, Chanthap Lon, Rithea Leang, Fabiano Oliveira","doi":"10.1093/infdis/jiab541","DOIUrl":"https://doi.org/10.1093/infdis/jiab541","url":null,"abstract":"<p><strong>Background: </strong>We established the first prospective cohort to understand how infection with dengue virus is influenced by vector-specific determinants such as humoral immunity to Aedes aegypti salivary proteins.</p><p><strong>Methods: </strong>Children aged 2-9 years were enrolled in the PAGODAS (Pediatric Assessment Group of Dengue and Aedes Saliva) cohort with informed consent by their guardians. Children were followed semi-annually for antibodies to dengue and to proteins in Ae. aegypti salivary gland homogenate using enzyme-linked immunosorbent assays and dengue-specific neutralization titers. Children presented with fever at any time for dengue testing.</p><p><strong>Results: </strong>From 13 July to 30 August 2018, we enrolled 771 children. At baseline, 22% (173/770) had evidence of neutralizing antibodies to 1 or more dengue serotypes. By April 2020, 51 children had symptomatic dengue while 148 dengue-naive children had inapparent dengue defined by neutralization assays. In a multivariate model, individuals with higher antibodies to Ae. aegypti salivary proteins were 1.5 times more likely to have dengue infection (hazard ratio [HR], 1.47 [95% confidence interval {CI}, 1.05-2.06]; P = .02), particularly individuals with inapparent dengue (HR, 1.64 [95% CI, 1.12-2.41]; P = .01).</p><p><strong>Conclusions: </strong>High levels of seropositivity to Ae. aegypti salivary proteins are associated with future development of dengue infection, primarily inapparent, in dengue-naive Cambodian children.</p><p><strong>Clinical trials registration: </strong>NCT03534245.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"1327-1337"},"PeriodicalIF":6.4,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574658/pdf/jiab541.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39680672","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}