Venereology (Basel, Switzerland)最新文献

{"title":"Screening for HPV-Related Oropharyngeal Cancer in Gay and Bisexual Men: Acceptability and Predicting Possible Use of \"Oral Selfies\" by Smartphone as a Secondary Prevention Approach.","authors":"Michael W Ross, Sarah L Bennis, Niles Zoschke, Brian R Simon Rosser, Cyndee L Stull, Alan G Nyitray, Samir S Khariwala, Mark Nichols, Charlene Flash, Michael Wilkerson","doi":"10.3390/venereology2040016","DOIUrl":"10.3390/venereology2040016","url":null,"abstract":"<p><p>Oropharyngeal cancers (OPCa) caused by HPV have emerged as one of the leading causes of malignancies caused by HPV infection. They are also significantly more likely to occur in males and in people with a history of oral sex with multiple partners. Gay and bisexual men are disproportionately affected by HPV-positive oropharyngeal cancers. We studied 1699 gay and bisexual men on 2 major dating sites in the US to assess their knowledge about HPV-related OPCa, attitudes toward screening for it, beliefs about oropharyngeal cancer screening based on the Health Belief Model, and attitudes toward possible screening approaches for OPCa. Knowledge on a 12-item scale was low, with a median of 5 items correct: 72% knew of the benefits of HPV vaccination. Significant predictors of needing OPCa screening included perception of risk for OPCa, seeing it as severe, having lower barriers, fewer reasons to avoid screening, higher knowledge, and being HPV vaccinated were significant predictors, explaining half the total variance. Most participants would accept routine, virtual/online doctor or dental appointments, and over half would accept an in-person screening. Nearly two-thirds stated that they would accept getting checked for OPCa if they could do self-screening at home, and half were prepared to use an online screening tool or app, where they could take an \"oral selfie\" and send it to a healthcare provider for examination. One-third stated that they would trust the results of a home screening completed by themselves and posted to a website equally as cancer screening completed online by a healthcare provider. Data indicate that despite low OPCA knowledge levels, the risk of HPV-associated OPCa was known. Being at personal risk and having knowledge of disease severity had 70% of the sample thinking about, or preparing to get, screening. Self-screening by a smartphone \"oral selfie\" transmitted to a screening website was acceptable to many gay and bisexual men, and online screening by a doctor or dentist was acceptable to most. OPCa screening in this population using electronic technology, together with the increasing incidence of HPV-associated OPCa in gay and bisexual men, brings together an opportunity to detect OPCa early.</p>","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"2 4","pages":"180-193"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186516","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}

{"title":"Racial Disparities Associated with Increased Burden of Sexually Transmitted Infections in North Carolina, Southeastern United States","authors":"Peter D. Ahiawodzi, Cydney Nicholson, Briana Williams, Dorothea K. Thompson","doi":"10.3390/venereology2040015","DOIUrl":"https://doi.org/10.3390/venereology2040015","url":null,"abstract":"Sexually transmitted infections (STIs) constitute a major public health issue in the United States. North Carolina (NC) in the southeastern U.S. ranks among the highest in STI incidence. We aimed to describe the incidence rates and identify potential risk factors of STIs in NC. The STI data reported by the NC Department of Health and Human Services for 2018 were compiled for chlamydia, gonorrhea, syphilis, and HIV infections for all 100 NC counties. Linear regression modeling was used to assess the association of STIs with predefined county-level variables. The mean STI incidence rates per 100,000 persons were highest for chlamydia (592.43 ± 30.02), followed by gonorrhea (212.06 ± 13.75), HIV (12.66 ± 0.947), and syphilis (3.33 ± 0.439). For chlamydia, higher risk was significantly associated with income (β = −0.008, SE = 0.003; p = 0.006), education (some college; β = 10.02, SE = 3.15, p = 0.002), race (Black; β = 12.17, SE = 1.57, p < 0.0001), and number of truck stops (β = 20.20, SE = 6.75, p = 0.004). The same variables, except for education, were associated with higher gonorrhea risk. Only race (being Black) was significantly associated with higher syphilis risk. Racial disparities in STI burden were significant, with race (being Black) constituting a risk factor for all four STIs. Interventions targeted to identified risk factors may help to reduce the STI burden in NC.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"78 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135271486","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":"Seroprevalence of Human Cytomegalovirus Infection among HIV Patients in Edo State, Southern Nigeria","authors":"Ifueko Mercy Moses-Otutu, Nosawema Franklyn Ojo, Ogochukwu Janet Nzoputam, Chimezie Igwegbe Nzoputam","doi":"10.3390/venereology2040014","DOIUrl":"https://doi.org/10.3390/venereology2040014","url":null,"abstract":"Background: Human cytomegalovirus (HCMV) is an important pathogen in immunocompromised individuals where it causes end organ diseases leading to increased morbidity and mortality. The aim of this study was to determine the prevalence of HCMV infection and its associated risk factors among HIV patients in Edo State, Nigeria. Methods: A total of 150 HIV patients consisting of 80 males and 70 females were enrolled for this study. About 4 mL of venous blood was aseptically collected from each participant by venipuncture and was centrifuged to obtain serum. The serum was screened by ELISA for HCMV IgG and IgM antibodies. Results: The results obtained were analyzed using SPSS version 20 for data analysis. An overall prevalence of 32.7% for HCMV IgM antibodies was recorded among the HIV patients. Males had a higher prevalence of 55.1% HCMV IgM antibodies than their female counterparts with 44.9% HCMV IgM antibodies. HCMV was more prevalent among the age group <19 years (51.0%), followed by the age group 20–39 years (30.6%), while the age groups >60 years, and 40–59 years recorded a prevalence of 12.2% and 6.1%, respectively. Conclusions: The co-occurrence of HCMV IgG and IgM antibodies, religion and location significantly influenced the acquisition of HCMV infection among HIV patients. Integrating HIV prevention by spreading awareness and early diagnosis of HCMV is key to reducing complications from these viral infections in HIV disease patients.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"192 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136102276","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":"Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions","authors":"James Oluwagbamigbe Fajemiroye, Andre Luis Elias Moreira, Célia Regina Malveste Ito, Elson Alves Costa, Rafaella Misael Queiroz, Ogbu John Ihayi, Caroline Vitória Moreira, Rafael Fernandes Costa, Claudia Carneiro Teixeira, Miguel Júnior Sordi Bortolini, Osmar Nascimento Silva","doi":"10.3390/venereology2040013","DOIUrl":"https://doi.org/10.3390/venereology2040013","url":null,"abstract":"In recent years, the global resurgence of syphilis has posed significant challenges to public health. This sexually transmitted infection, caused by the bacterium Treponema pallidum, can have severe consequences if left untreated, including neurological and cardiovascular complications. Diagnosing syphilis is complex due to its diverse clinical presentations, necessitating a multifaceted approach, including serological, molecular, and direct techniques such as dark-field microscopy. Penicillin remains the primary and effective treatment, but emerging macrolide-resistant strains have spurred investigations into alternative antibiotics. Syphilis vaccine development faces unique hurdles, yet promising strategies are under investigation. Targeted prevention strategies focus on high-risk populations such as men who have sex with men, pregnant women, and individuals with multiple sexual partners. The integration of syphilis services into primary healthcare enhances accessibility, early detection, and treatment. Innovative point-of-care diagnostics offer rapid, sensitive testing, while ongoing vaccine research holds the potential for long-term prevention. Addressing the global burden of syphilis requires a multifaceted approach, encompassing immunological advancements, innovative diagnostics, targeted prevention, and primary healthcare integration. Collaborative efforts between governments, healthcare systems, researchers, and communities are essential to effectively combat syphilis, striving toward a syphilis-free future that promotes better sexual health and overall well-being.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135462908","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":"Pangenome Analysis Reveals a High Degree of Genetic Diversity in Gardnerella vaginalis: An In Silico Approach","authors":"Andrei Giacchetto Felice, Eduarda Guimarães Sousa, Fabiana Vieira Dominici, Vasco Ariston de Carvalho Azevedo, Siomar de Castro Soares","doi":"10.3390/venereology2040012","DOIUrl":"https://doi.org/10.3390/venereology2040012","url":null,"abstract":"The genus Gardnerella comprises Gram-variable, anaerobic, hemolytic, and non-motile bacilli, with four known species, where Gardnerella vaginalis is the main species responsible for bacterial vaginosis (BV). However, quantifying this species is challenging due to a lack of data and underreporting. Despite its significance, particularly for women, and the availability of several genomes in online databases, genomic analyses and studies on effective treatments still lack details. This study aimed to conduct bioinformatic analyses focused on pangenomics to investigate the complete gene repertoire of the species. Genomes of the bacterium available in online databases were used for comparative genomics, genomic plasticity, gene synteny, and pangenome prediction analyses. The results revealed considerable genome variability, indicating a highly diverse pangenome. The low number of genes in the core genome and similarity analysis confirmed this variability. Three pathogenicity islands, two resistance islands, and nine genomic islands were identified, suggesting horizontal gene transfer events during evolution. These findings underscore the need for sequencing new G. vaginalis genomes to better comprehend its variability and adaptation patterns.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344441","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":"Going Off-Script: Dilemmas in the Evaluation and Treatment of Syphilis in Four Patients","authors":"Benjamin Silverberg, Chad Sethman, Jonathan Williamson, Mary Craft, Melinda Sharon, Amie M. Ashcraft","doi":"10.3390/venereology2030011","DOIUrl":"https://doi.org/10.3390/venereology2030011","url":null,"abstract":"Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Currently, rates of infection are increasing across all populations worldwide, with disproportionate impact on men who have sex with men, adolescents, and young adults. Syphilis is well-known for its variability in disease progression and clinical presentation, which complicates prompt and accurate diagnosis. Acute care settings have become the frontline in the battle against this syphilis surge, and providers must be prepared to recognize syphilis presentation, initiate appropriate testing, and establish contact tracing for individuals who may have been exposed. The purpose of this manuscript is to serve as a teaching tool for syphilis diagnosis and treatment, and we present four cases that showcase the risks and variable clinical presentation, discussing the challenges involved in managing each case. The authors then summarize key learning points related to diagnosis, treatment, and follow-up.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135879116","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":"“I Use Strawberry Flavoured Condoms during My Periods”: Safe Sex Practices and STI Screening Behaviours among Female Sex Workers in Gulu City, Uganda","authors":"F. Bongomin, Winnie Kibone, Pebalo Francis Pebolo, Fiona Gladys Laker, J. Okot, F. Kaducu, Grace Madraa, C. Loum, S. Awor, Agnes Napyo, D. Musoke, S. Ouma","doi":"10.3390/venereology2030010","DOIUrl":"https://doi.org/10.3390/venereology2030010","url":null,"abstract":"Background: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging health-risk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility, empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized population.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43284936","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":"Efficacy of a Multi-Level Pilot Intervention (“Harmony”) to Reduce Discrimination Faced by Men Who Have Sex with Men and Transgender Women in Public Hospitals in India: Findings from a Pre- and Post-Test Quasi-Experimental Trial among Healthcare Workers","authors":"Venkatesan Chakrapani, S. Nair, S. Subramaniam, K. Ranade, Biji Mohan, Ruban Nelson, Sajeesh T. Sivaraman, M. Shunmugam, J. Kaur, S. Rawat, Theranirajan Ethirajan, Chinmoyee Das, Shobini Rajan, A. Puri, Bhawani Singh Kushwaha, Bhawna Rao, Utpal Das, V. Verma, Neha Kapoor","doi":"10.3390/venereology2030009","DOIUrl":"https://doi.org/10.3390/venereology2030009","url":null,"abstract":"Reducing the stigma and discrimination faced by men who have sex with men (MSM) and transgender women (TGW) in healthcare settings is key to improving health outcomes. Using a one-group pre- and post-test design, we tested the efficacy of a theory-informed, multi-level pilot intervention (“Harmony”) among 98 healthcare workers (HCWs) to reduce sexual orientation and gender identity (SOGI)-related stigma and discrimination faced by MSM and TGW in two public hospitals. The intervention contained group-level (a half-day workshop) and individual-level (four videos) components. Using multi-level modelling, we compared knowledge, attitudes, and comfort level among HCWs across three timepoints: pre-intervention, post-intervention, and follow-up (2 months after the intervention). Client surveys were conducted among 400 MSM/TGW (two independent samples of 200 MSM/TGW) attending the intervention hospitals, before the intervention among HCWs and three months after the intervention. Generalised estimating equations assessed service users’ satisfaction with hospital services, discrimination experiences, and positive interactions with HCWs. Significant changes were observed in primary outcomes: 30% increase in positive attitude scores (incidence rate ratio (IRR) = 1.30, 95% CI 1.13–1.49) and 23% increase in the proportion of HCWs reporting being comfortable in providing care to MSM/TGW (IRR = 1.23, 95% CI 0.03–1.68). Similarly, there was a significant improvement in secondary outcomes (scores): support for non-discriminatory hospital policies (IRR = 1.08, 95% CI 1.004–1.15), the importance of asking SOGI questions in clinical history (IRR = 1.17, 95% CI 1.06–1.29), and perceived self-efficacy in providing clinical care (IRR = 1.13, 95% CI 1.01–1.27). Service users’ data provided corroborative evidence for intervention efficacy: e.g., 14% increase in the proportion of MSM reporting overall satisfaction with hospital services and 6% and 15% increase in the scores of positive interactions with HCWs in the combined sample of MSM/TGW and TGW, respectively. The Harmony intervention showed preliminary evidence for improving positive attitudes, comfort level, and understanding of the healthcare issues of MSM/TGW among HCWs, warranting large-scale implementation research.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47928587","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":"Modulatory Effect of Human Immunodeficiency Virus on Circulating p53, miR-21, and miR-125b: Any Diagnostic Implication?","authors":"Jude Ogechukwu Okoye, A. Ngokere, C. C. Onyenekwe, O. Omotuyi, S. Ogenyi, C. M. Obi, S. Fasogbon","doi":"10.3390/venereology2030008","DOIUrl":"https://doi.org/10.3390/venereology2030008","url":null,"abstract":"Identifying immunocompromised women who are at risk of developing cervical cancer remains a challenge for clinicians. In an effort to identify the role of HIV in cervical carcinogenesis, this study evaluated the levels of normally downregulated oncomirs (miR-21, miR-146a, miR-155, miR-182, and miR-200c) and normally upregulated tumor suppressors (miR-let-7b, miR-125b, miR-143, miR-145, and p53 expression) associated with cervical cancer in the serum of women living with HIV (HIV+) and without HIV (HIV. Method: This case-control study included 173 women; confirmed HIV+ (n = 103) and HIV− (n = 70). Serum levels of miRNAs and p53 were determined using reverse transcriptase PCR. t-test and Pearson’s correlation analyses were carried out on the generated data. Result: A higher level of miR-21 was observed among HIV+ women compared with their HIV− counterpart (p = 0.028), whereas lower levels of miR-125, and p53 gene were observed among HIV+ women compared with HIV− women at p = 0.050 and 0.049, respectively. Significant direct relationships were observed between miR-21 and other oncomirs (p < 0.05) among HIV+ women. Conclusion: This study revealed that HIV contributes to cervical carcinogenesis by modulating circulating levels of miR-21, p53, and miR-125b. It suggests that these biomarkers could be used to identify at high risk for developing cervical cancer.","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48841459","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":"The Emerging Threat of Antimicrobial-Resistant Sexually Transmitted Infections: Epidemiology, Management and Detection","authors":"Karan Varshney","doi":"10.3390/venereology2020007","DOIUrl":"https://doi.org/10.3390/venereology2020007","url":null,"abstract":"Antimicrobial resistance (AMR) has become one of the most pressing public health crises, with sexually transmitted infections (STIs) of all types rapidly becoming resistant to treatments [...]","PeriodicalId":75296,"journal":{"name":"Venereology (Basel, Switzerland)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41941303","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}