{"title":"[Comparison of PVL-producing MRSA Showing POT Type 106-77-113 and POT Type 106-255-121 Detected in Materials Derived from Patients with Skin Infections].","authors":"Hitoshi Miyamoto, Shinobu Murakami, Minami Tamaki, Miyako Iyoda, Ayame Hyodo, Hisamichi Tauchi, Yasunori Takasuka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) strains showing POT type 106-77-113 have been associated with USA300. Additionally, many strains produce Panton-Valentine Leukocidin (PVL). Until 2018, 106-77-113 was the most dominant POT-type PVL-producing bacteria isolated in our hospital; however, in 2018, one strain with POT type 106-255-121 was isolated, and thereafter, since 2019, an increasing trend towards isolation of this strain has been observed. In this study, we compared two PVL-producing strains detected in skin infections-derived materials from outpatients during the three-year period between 2019 and 2021 through genetic analysis using next-generation sequencers. Eight, each of POT types 106-77-113 (POT-A) and 106-255-121 (POT-B), strains were included in this study, and PVL productivity, drug susceptibility, multi-locus sequencing typing (MLST), and resistance genes and virulence genes were detected. Both the groups shared the same MLST profile (3-3-1-1-4-4-3), but a single nucleotide mutation of <i>ARCC</i> was detected in POT-B type strain, which was determined to be similar to ST 8 of POT-A and POT-B type strains. Only POT-B type strains harbored <i>aac(6')</i>-<i>aph(2″)</i> and <i>erm(A)</i> genes, consistent with the results of drug susceptibility tests. All the strains were resistant to GM and CAM and were positive to D-zone test. On the other hand, the POT-A strains were sensitive to GM, and 7 of 8 strains were sensitive to CLDM and MINO. However, one POT-A type strain was found to harbor <i>erm(C)</i>, <i>tet(K)</i>, and <i>tet(M)</i> genes and was resistant to CAM, CLDM, and MINO. Both groups of isolates harbored 17 genes including ACME, lukF-PV, and LukS-PV, and no difference in pathogenicity was observed. In our hospital, one strain of POT type 106-255-121 was isolated for the first time in 2018, and the number of isolates of this type has been increasing since then. The present study confirms that POT type 106-255-121 strains have the same virulence as POT type 106-77-113 strains have and have also acquired a drug resistance gene.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"32 1","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10522365","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}
{"title":"[Comparative Study of Rapid Antigen Test Reagents for Group A <i>Streptococcus</i> spp.]","authors":"Eisuke Nakano, Shinobu Koyama, Megumi Imai, Yoshimi Machida, Takefumi Sakanoue, Tsuyoshi Nakahara, Yuji Yaguchi, Kiyoko Tamai, Kiyofumi Ohkusu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We compared rapid antigen detection kits widely used for the rapid diagnosis of group A streptococcal pharyngitis, evaluating their minimum detection sensitivity and operability in five levels. Five kits based on the immunochromatographic method were used: ImunoAce Strep A (Tauns), ImunoAce Strep A Neo (Tauns), Quick Navi-StrepA2 (Denka), Quick Vue Dipstick Strep A (SB Bioscience) and RapidTesta Strep A (SEKISUI MEDICAL). Thirteen strains were tested: 10 clinical isolates of <i>Streptococcus pyogenes</i>, 2 strains of <i>Streptococcus dysgalactiae</i> subsp. <i>equisimilis</i> (SDSE), and <i>S. pyogenes</i> ATCC 19615. All kits had the same or higher minimum detection sensitivity than previously reported. ImunoAce StrepA Neo had the highest detection sensitivity and the best overall evaluation among the group A streptococcal rapid antigen detection kits used in this study. The detection sensitivity of SDSE with group A polysaccharide antigen was comparable to that of <i>S. pyogenes</i>. Although culture tests are necessary to confirm the causative organism, SDSE may present with clinical symptoms similar to those of <i>S. pyogenes</i>, and detection with a rapid antigen detection kit may be of therapeutic value.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"32 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435926","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}
{"title":"Comparison of Microorganism Detection, Time to Positivity, and Time-Dependent Shift in Viable Bacterial Count from VersaTREK and BacT/ALERT 3D Blood Culture Systems.","authors":"Akihiro Nakamura, Osamu Ueda, Noriyuki Abe, Masashi Shimada, Mikio Kamioka, Masaru Komatsu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rapid positive blood culture reporting allows early and appropriate treatment of severe infections to improve patient prognosis. This study evaluated performance of the VersaTREK system with gas pressure detection and tornado stirring method and the conventional BacT/ALERT 3D system. Time to positivity (TTP) of simulated blood cultures without whole blood using 17 ATCC strains was faster with VersaTREK than BacT/ALERT 3D, averaging 6.3 h in aerobic bottles and 12.7 hours in anaerobic bottles. In simulated blood cultures with whole blood using 53 clinical isolates, on average, VersaTREK was faster in aerobic bottles by 6.5 h but slower in anaerobic bottles by 3.8 h. Fifty of 53 simulated blood cultures with whole blood (94%) showed fastest TTP with VersaTREK. TTP of VersaTREK for anaerobic bacteria <i>Bacteroides fragilis</i> and <i>Clostridium perfringens</i>, <i>Helicobacter cinaedi</i>, and <i>Candida glabrata</i> was fast, and viable bacteria numbers in bottles using the Miles and Misra method increased quickly.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"32 1","pages":"23-35"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430308","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}
{"title":"Rapid Detection of Carbapenemase-producing Genes by Multiplex Real-Time PCR with Melting Curve Analysis using a BD MAX™ Open System.","authors":"Akihiro Nakamura, Kaichi Ohta, Masaru Komatsu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recently, the global spread of carbapenemase-producing Enterobacterales has become a concern, and rapid detection methods are required. We have developed a rapid and inexpensive multiplex real-time PCR with melting curve analysis using the BD MAX™ system and evaluated it. We used 31 carbapenemase-producing Gram-negative bacteria (<i>bla</i><sub>IMP</sub> group, 12; <i>bla</i><sub>GES</sub> group, 6; <i>bla</i><sub>NDM</sub> group, 5; <i>bla</i><sub>VIM</sub> group, 3; <i>bla</i><sub>KPC</sub> group, 3; <i>bla</i><sub>OXA-48</sub>-like group, 1 strain; and <i>bla</i><sub>IMP</sub> group + <i>bla</i><sub>GES</sub>, 1 strain), 10 AmpC-producing Gram-negative bacteria, and 10 ESBLproducing Gram-negative bacteria. A BD MAX™ open platform system was used. Carbapenemase-positive and carbapenemase-negative strains were correctly identified 30 of 31 (excluding a <i>bla</i><sub>IMP</sub> group and <i>bla</i><sub>GES</sub> group co-coding strain) and all 20 of 20 isolates, respectively. Melting temperature (Tm) values of the various genes were as follows: <i>bla</i><sub>IMP</sub> group, 81.2±0.5°C; <i>bla</i><sub>VIM</sub> group, 91.8±0.4°C; <i>bla</i><sub>NDM</sub> group, 85.4±0.3°C; <i>bla</i><sub>GES</sub> group, 90.5±0.3°C; <i>bla</i><sub>KPC</sub> group, 94.1±0.5°C; and <i>bla</i><sub>OXA-48</sub>-like group, 82.1°C. Identification of the various genotypes was possible from the Tm values. However, only a peak derived from the <i>bla</i><sub>GES</sub> group could be detected in the strains producing both <i>bla</i><sub>IMP</sub> group and <i>bla</i><sub>GES</sub> group simultaneously, suggesting that only the genotype with the highest expression level could be captured in cases of simultaneous production. In the carbapenemase-negative strains, no obvious peaks were observed in the 20 AmpC and 20 ESBL-producing Gram-negative bacteria, and even when Tm values were detected, the dF/dT values were low and easily differentiated. This method appears to be very useful as a rapid and inexpensive test that can provide detection in about 2 hours.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"32 1","pages":"13-21"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435927","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}
{"title":"Correlation of Strain Classification with IR Biotyper and Molecular Epidemiological Method of <i>Pseudomonas aeruginosa</i>.","authors":"Megumi Oho, Zenzo Nagasawa, Yumiko Funashima, Osamu Ueda, Shinya Watamabe, Longzhu Cui, Hiroshi Miyamoto, Eisaburo Sueoka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>From 2018, IR Biotyper (IRBT; Bruker Daltonik GmbH, Germany) based on the Fourier transform infrared spectrophotometer has begun to be introduced as a new strain classification method in the field of clinical microbiological examination. We compared it with molecular epidemiology method to evaluate the usefulness of strain classification by IRBT.</p><p><strong>Method: </strong>Homology of strain classification with molecular epidemiology method (Multilocus Sequencing Typing; MLST and PCR-based ORF Typing; POT) for 48 strains of <i>Pseudomonas aeruginosa</i> with different detection times from multiple institutions to evaluate the accuracy of IRBT was compared.</p><p><strong>Results: </strong>IRBT used \"KBM\" SCD agar medium for preculture and was classified into 12 types when classified by Cut-off value 0.181, 8 types by MLST, and 13 types by POT. In the Adjusted Wallace between IRBT and molecular epidemiology method, MLST was 0.458 (95% CI; 0.295 to 0.620) and POT was 0.330 (95% CI; 0.135 to 0.525), indicating a discrepancy in strain classification.</p><p><strong>Conclusion: </strong>No correlation was found between IRBT and the classification results by the molecular epidemiology method. In the molecular epidemiology method, strains are classified by matching only specific gene regions, but IRBT irradiates a sample with an infrared laser and classifies the strains according to the difference in absorption spectrum according to the molecular structure, so the measurement principle is different. When classifying strains by IRBT, it is desirable to grasp the clinical information of the detected strains and to target multiple strains isolated at the same facility at the same time.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"31 1","pages":"29-40"},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39788965","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}
{"title":"[Evaluation of Screening Performance and Detection Time of Carbapenemase-Producing <i>Enterobacterales</i> Using RAISUS S4 in a Antimicrobial Sensitivity Test].","authors":"Yumiko Funashima, Hiroki Hanaiwa, Taeko Narita, Zenzo Nagasawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rapid detection of carbapenemase-producing <i>Enterobacterales</i> (CPE) is important in infection control, since it transmits plasmids carrying resistance genes. Here, we evaluated the rapid detection of CPE using the fully automated antimicrobial susceptability testing system \"RAISUS S4\". Sixty-two CPE strains including carbapenem-resistant <i>Enterobacterales</i> and 100 carbapenemase-non-producing <i>Enterobacterales</i> strains were used. RAISUS S4 was performed using both 18 hr and rapid methods. The sensitivity of CPE detection and decision time were evaluated using Meropenem results. The results showed that the sensitivity for CPE detection was 100% for both methods, with specificity of 97% for the 18 hr method and 95% for the rapid method. The mean CPE detection time for the 18 hr method was 7.2 hrs and 8.8 hrs for the rapid method. The mean MIC determination time of the 18 hr method for all 162 strains was 17.2 hrs and 8.8 hrs for the rapid method. In addition, we analyzed the absorbance values of the 18 hr method. Checking the growth curve at a drug concentration of 0.125 µg/ml and determining it to be positive when its absorbance reached 0.8 Abs, CPE could be detected in an average of 5.8 hrs with in sensitivity of 100% and specificity of 92%. The 18 hr method of RAISUS S4 allowed rapid detection of CPE, and the rapid method allowed earlier MIC determination, including sensitive isolates. These results suggest that RAISUS S4 can detect CPE rapidly without missing CPE by routine test even in Japan where the frequency of CPE isolation is low.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"31 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787028","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}
{"title":"Clinical Utility of BD<sup>TM</sup> mCCDA ClearHT Agar Medium for <i>Campylobacter jejuni</i>.","authors":"Mitsunori Kaneda, Kumiko Takesue, Keisuke Mori, Kiyoshi Kamiyama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><i>Campylobacter</i> spp. has been the leading cause of bacterial food poisoning in Japan since 2000. The predominant <i>Campylobacter</i> spp. testing method employs selective medium to isolate <i>Campylobacter</i> spp. In the present study, we evaluated the <i>Campylobacter</i>-isolating capacity and clinical utility of BD<sup>TM</sup> mCCDA Clear-HT, an agar medium containing a chromogenic substrate, on 230 diarrhea stool samples. After 48 hours incubation, 50 samples (21.7%) were positive with BD<sup>TM</sup> mCCDA Clear-HT, while 61 samples (26.5%) were positive using modified Skirrow agar medium. In this study, BD<sup>TM</sup> mCCDA Clear-HT had a lower detection rate of <i>Campylobacter jejuni</i> more than Vitalmedia modified Skirrow agar medium.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"31 1","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787029","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}
{"title":"[A Case of Fungalemia that Detected the <i>Mucor circinelloides</i> by Versa TREK].","authors":"Taeko Narita, Yumiko Funashima, Osamu Ueda, Zenzo Nagasawa, Tsukuru Umemura, Takashi Yaguchi, Katsuhiko Kamei, Futoshi Kawaura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Man in his 80s. In March 20XX, the level of consciousness decreased at the admission facility, and he was transported as an emergency case. He was diagnosed as aspiration pneumonia, septic shock due to cholecystitis, and DIC, and was hospitalized for medical treatment. During the course of hospitalization, aspiration pneumonia continued to improve and worsen, but in January 20XX+3, a fever of 38.7°C occurred, and <i>Mucor circinelloides</i> was detected in the blood culture collected at this time. In sputum 7 days before the blood culture was submitted, an image of suspicious zygomycosis was confirmed by Gram stain, so the patient was diagnosed with <i>Mucor</i> disease and started administration of amphotericin B. After that, the condition was temporarily stable, but due to recurrence of aspiration pneumonia and renal damage, he died 19 days after the start of amphotericin B administration. It is difficult to detect <i>Mucor</i> spp. in blood culture, however in this case, it was detected by the blood culture device; Versa TREK (Thermo Fisher Scientific K.K. Tokyo, Japan).</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"31 1","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787030","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}
{"title":"[Evaluation of Accuracy and Availability of the Antimicrobial Resistance Testing by the Direct Disc Methods Using AmpC/ESBL Differential Discs in the Samples in Which <i>Enterobacterales</i> are Detected in Blood Culture].","authors":"Kenta Yamaguchi, Shun Taguchi, Mayo Katsuki, Yukari Sano, Takayuki Hirano, Michio Yasunami, Mami Fukuoka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The emergence and dissemination of drug-resistant Gram-negative bacilli have been recognized as a serious health concern in worldwide. The isolation rates of Extended-Spectrum β-lactamases (ESBL) and AmpC β-lactamases (AmpC) producing gram negative rods are increasing in our hospital. In the present study, we evaluate the availability of the antimicrobial resistance testing by the direct disc methods using AmpC/ESBL differential discs. One hundred and ten strains of <i>Enterobacterales</i> were isolated during the observation period, of which 19 strains (17%) were ESBL-positive and 6 strains (5%) were AmpC-positive. The positive and negative coincidence rate between direct disc methods and standard disc methods were 100%. We conclude that the direct disc method is a useful and rapid detection method for ESBL and AmpC from blood culture samples.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"31 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787027","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}
{"title":"Clinical Utility of Pourmedia ViGBS Agar Medium for Group B <i>Streptococcus</i> Screening.","authors":"Mitsunori Kaneda, Kumiko Takesue, Keisuke Mori, Kiyoshi Kamiyama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Group B <i>Streptococcus</i> (hereinafter GBS) is the main pathogen in neonatal sepsis and meningitis, accounting for approximately one quarter of the cases. 1) Prevention of infection is therefore crucial. The GBS carriage testing of pregnant women is necessary to prevent infections. In this study, we examined the clinical utility of Pourmedia ViGBS agar medium (Eiken Chemical Co., Ltd.) in GBS screening, using a total of 197 vaginal and urine samples. Of these samples, 32 (16.2%) tested GBS positive with Pourmedia ViGBS agar medium, and 29 (14.7%) tested GBS positive with Nissui separated plate sheep blood agar/Drigalski agar medium (Nissui Pharmaceutical Co., Ltd.). These results indicate the usefulness of Pourmedia ViGBS agar medium as a GBS screening selective agar medium.</p>","PeriodicalId":74740,"journal":{"name":"Rinsho Biseibutsu Jinsoku Shindan Kenkyukai shi = JARMAM : Journal of the Association for Rapid Method and Automation in Microbiology","volume":"30 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38845937","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}