American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Community-Based Delivery and Administration of Sars-CoV-2 Antigen Rapid Diagnostic Tests: An Operational Research Study in Marketplaces in Malawi and Zambia.","authors":"Fiona Gambanga, Lindiwe Nchimunya, Joseph Makondesa, Chancy Chavula, Namwaka Mulenga, Tamara Mwenifumbo, Francis Chitanda, Jonathan Mtaula, Yucheng Tsai, Joseph Bitilinyu-Bangoh, Andrews Gunda, Aaron Shibemba, Powell Choonga, Shaukat Khan, Trevor Peter","doi":"10.4269/ajtmh.23-0785","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0785","url":null,"abstract":"<p><p>To expand access to testing beyond public health facilities and to strengthen surveillance efforts for COVID-19, community testing using COVID-19 antigen-based rapid diagnostic tests (Ag-RDTs) was identified as a major area of focus in Malawi and Zambia. This research aimed to gather evidence on the feasibility and acceptability of community testing in marketplaces. A cross-sectional study with a mixed-methods design was conducted in marketplaces in Malawi and Zambia to understand operational considerations for the implementation of Ag-RDTs for SARS-CoV-2 in a community setting. Programmatic data were collected prospectively as individuals were tested from June to September 2022. COVID-19 testing was done using Abbott Panbio nasal swab test kits. Semi-qualitative questionnaires were administered to individuals who tested, healthcare workers, and site-based personnel. Data were collected electronically via the SurveyCTO platform and analyzed using STATA. In Malawi, 2,348 participants were tested, and in Zambia, 1,723 people were tested for COVID-19. In Zambia, participants were 46% female, with a median age of 28 years, whereas in Malawi, participants were 69% female, with a median age of 37 years. In Malawi, 78 positive cases were reported (3.3% positivity rate), and in Zambia 10 positive cases were reported (0.5% positivity rate). In Zambia, 99% of 300 participants and in Malawi, 92% of 1,158 testers found the market testing experience and sample collection acceptable. Community testing is a feasible and acceptable intervention to increase testing access in Malawi and Zambia, especially when coupled with community awareness campaigns and mobilization.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Clinical Severity of Trachomatous Inflammation and Chlamydia trachomatis Bacterial Load.","authors":"Louisa Lu, Ali Fauci, Quintin R Richardson, Hamidah Mahmud, John M Nesemann, Solomon Aragie, Dagnachew Hailu, Adane Dagnew, Ambahun Chernet, Zerihun Tadesse, Taye Zeru, Isabel J B Thompson, Dionna M Wittberg, Scott D Nash, Thomas M Lietman, Jeremy D Keenan","doi":"10.4269/ajtmh.24-0319","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0319","url":null,"abstract":"<p><p>The purpose of this study was to investigate the correlation between bacterial load of Chlamydia trachomatis as measured from quantitative polymerase chain reaction (qPCR) and the relative clinical severity of trachomatous inflammation. Individuals with trachoma from rural communities in Ethiopia had photographs taken as well as swabs obtained of the upper tarsal conjunctivas. Conjunctival swabs were processed with PCR assay, which provided quantitative results of ocular chlamydial load. A series of 125 conjunctival photographs were ranked from least to most severe according to clinical severity for follicular and papillary conjunctivitis. Higher intensity rankings of trachomatous inflammation were associated with higher chlamydial load for both follicular inflammation (Spearman's ρ = 0.43; P <0.001) and papillary inflammation (Spearman's ρ = 0.50; P <0.001). Rankings of trachomatous inflammation may be a clinically meaningful indicator of trachoma.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strongyloides Hyperinfection Syndrome and Disseminated Disease with Negative Serology.","authors":"Ashton D Hall, Divya Salibindla, Keith M Luckett","doi":"10.4269/ajtmh.24-0460","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0460","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonlactational Mastitis in Western Brazilian Amazon Mastitis Cases.","authors":"Michel de Araujo Tavares, Marcelo Cordeiro Dos Santos, Vinicius da Silva Monteiro, Ryan Antônio de Lucena Almeida, Hilka Flávia Barra do Espirito Santos Alves Pereira, Simone Ferreira de Castro Botileiro, Victor Costa Morais Oliveira, Marcus Vinícius Guimarães de Lacerda, René Aloisio da Costa Vieira","doi":"10.4269/ajtmh.23-0461","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0461","url":null,"abstract":"<p><p>Chronic mastitis varies in etiology between its lactational and nonlactational forms and can be challenging to diagnose. This study aimed to assess the epidemiological profile and diverse etiologies of nonlactational mastitis in Amazonas, Brazil, focusing on distinguishing between tuberculous mastitis (TM) and idiopathic granulomatous mastitis (IGM). This is a retrospective and prospective study that was carried out at the mastitis outpatient clinic of Fundação de Medicina Tropical Doutor Heitor Vieira Dourado from 2013 to 2021 and evaluated epidemiological data, imaging, and laboratory tests. Descriptive statistics were performed. In this retrospective and prospective analysis, 124 medical records were initially considered, with 12 excluded for various reasons. The remaining 112 cases underwent thorough evaluation through epidemiological data, imaging, and laboratory tests, by employing descriptive statistics for analysis. The pathology revealed a predominant prevalence of IGM (64.3%), followed by various forms of mastitis, including confirmed TM (4.5%), presumable TM (8.9%), and others. Our findings indicate that IGM, though a rare cause of breast masses and abscesses, accounts for a significant portion of mastitis cases. Histopathological studies were essential for diagnosis, with ultrasound being the primary imaging tool. This study is one of the largest Brazilian series on nonlactational mastitis, highlighting the condition's complexity and diverse manifestations in the Amazon region.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application of Culturomics to Explore African Skin Microbiota.","authors":"Codou Ndiaye, Hubert Bassene, Maxime Descartes Mbogning Fonkou, Florence Fenollar, Jean Christophe Lagier, Didier Raoult, Cheikh Sokhna","doi":"10.4269/ajtmh.23-0165","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0165","url":null,"abstract":"<p><p>Over the past 12 years, culturomics, a high-throughput culture method, has been developed, considerably widening the repertoire of known cultured bacteria. An exhaustive database, including a list of microbes isolated by culture from human skin, was recently established by performing a review of the literature. The aim of the present study was to use the culturomics approach to explore the African skin microbiota. Skin swabs from the palms of human hands were collected between January and December 2016 from healthy subjects from the villages of Dielmo and Ndiop in rural Senegal. Three culture media were selected for the isolation of bacteria in aerobic conditions. Bacterial colonies were subjected to matrix-assisted laser desorption ionization-time of flight mass spectroscopy and the 16 S rRNA gene was sequenced for unidentified colonies. A total of 176 bacterial species were isolated. This increased the repertoire of bacterial species on the skin by 14.0%, by adding 71 bacteria, including seven new species. The culturomics approach characterizing microbial diversity has significantly changed our view of the skin microbiota, raising many important questions about the host-microorganism relationship and its relevance to skin diseases. In particular, the difference between the palm microbiota of these African populations (composed mainly of the genera Staphylococcus, Arthrobacter, Bacillus, and Microbacterium) and that of Western populations, whose main genera are Staphylococcus, Propionibacterium, Micrococcus, Corynebacterium, Enhydrobacter, and Streptococcus. This study demonstrates the need to continue to explore the skin microbiome using the culturomics approach.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serologic Evidence for Early SARS-CoV-2 Circulation in Lima, Peru, 2020.","authors":"Andres Moreira-Soto, Maria Paquita García, Gloria Arotinco-Garayar, Dana Figueroa-Romero, Nancy Merino-Sarmiento, Adolfo Marcelo-Ñique, Edward Málaga-Trillo, César Cabezas Sanchez, Jan Felix Drexler","doi":"10.4269/ajtmh.24-0260","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0260","url":null,"abstract":"<p><p>During early 2021, Peru had the highest COVID-19-associated per-capita mortality rate. Socioeconomic inequality, insufficiently prepared healthcare, and surveillance systems are factors explaining the mortality rate, which can be severely worsened by early undetected SARS-CoV-2 circulation. We tested 1,441 individuals with fever sampled during August 2019-May 2021, several months before the first SARS-CoV-2 seroprevalence study available so far in Lima, Peru, for SARS-CoV-2-specific antibodies. The testing algorithm included a chemiluminescence immunoassay and surrogate virus neutralization test. Early positive samples (N = 24) from January-March 2020 were further tested using a plaque-reduction neutralization test (PRNT) and avidity test against the SARS-CoV-2 spike and nucleoprotein. None of the early samples were PRNT-confirmed, in contrast to 81.8% (18/22) of a subsample from April 2020 onward (Fisher exact test; P <0.0001). Therefore, we excluded non-PRNT-confirmed samples from subsequent analyses. The SARS-CoV-2 antibody detection rate was 0.9% in mid-April 2020 (1/104; 95% CI: 0.1-5.8%), suggesting viral circulation in early-middle March 2020, consistent with the first molecular detection of SARS-CoV-2 in Peru on March 2020. Mean avidity increase of 62-77% to 81-94% from all PRNT-confirmed SARS-CoV-2-positive samples during early 2020 were consistent with onset of SARS-CoV-2 circulation during late February/March 2020. Early circulation was also confirmed in a susceptible, exposed, infected, and recovered mathematical model that calculated an effective reproduction number >1 during February-March 2020. Early introduction of SARS-CoV-2 thus contributed to the high COVID-19 mortality rate in Peru. Emphasizing the role of diagnostic confirmation in understanding the pandemic's trajectory, this study highlights the importance of early detection and accurate testing in managing infectious disease outbreaks.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing Priorities for Epilepsy Care and Electroencephalogram Use in Low-Resource Settings.","authors":"Alexander Andrews, Yamikani Chimalizeni, Dana Harrar, Emmie Mbale, Kondwani Kawaza, Tesfaye Zelleke, Maiden D Wadson, John Barber, Jessica Chikwana, Ugur Erickson, Alice M Liomba, Douglas G Postels","doi":"10.4269/ajtmh.24-0392","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0392","url":null,"abstract":"<p><p>We convened an electroencephalography and epilepsy think tank in Blantyre, Malawi, bringing together American pediatric neurologist clinical researchers and Malawian clinicians. We worked with the aim of improving care for children with seizures and epilepsy in southern Malawi. By sharing and discussing ideas, six United States-based researchers and six Malawian end users developed consensus for directions of both current and future clinical research activities. Compared with our previous use of informal one-to-one discussions to generate research ideas, we found the structured think tank useful for generating ideas and better establishing links between clinical researchers and those who will eventually use the results of their work. We hope that these new interactions will lead to a self-sustaining environment integrating clinical care and research, leading to improvements in brain health for the children of Malawi and integrating technology in the places where it will be most clinically useful.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonparametric Testing of Body Mass Index as a Predictor of Severe Noma: Assessing Potential Association.","authors":"Heron G Gebretsadik","doi":"10.4269/ajtmh.24-0274","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0274","url":null,"abstract":"<p><p>Noma, a devastating facial disease, primarily affects impoverished populations in low- and middle-income countries, often leading to severe disfigurement or fatality if untreated. Studies suggest malnutrition is a significant risk factor for noma, yet the association between body mass index (BMI) in kilograms per square meter and tissue damage severity remains underexplored. This study aimed to investigate the relationship between BMI and tissue damage severity among noma cases in Ethiopia. A retrospective analysis of medical records from Facing Africa's database covering noma cases treated between 2007 and 2019 was conducted. A standardized data collection template recorded demographic and clinical data, including patient demographics, BMI, and tissue damage severity levels. JASP statistical software was used for analysis. Analysis of 228 noma cases revealed a mean BMI of 17.8 kg/m2, ranging from 11.5 to 28.3 kg/m2. Females exhibited a higher mean BMI (18.3 kg/m2) than males (16.9 kg/m2). Differences in BMI distributions between major (67) and minor (30) tissue damage categories were observed, with \"minor\" cases having a slightly higher mean BMI. The study found a statistically significant association between BMI and tissue damage severity (P = 0.03), indicating that tissue damage due to noma worsened as BMI decreased. Nonparametric tests confirmed this association's significance. This study highlights low BMI as a predictor of severe noma. Public health interventions should focus on malnutrition to reduce noma severity and psychosocial and functional morbidity and improve outcomes. However, additional factors influencing the progression of noma and the severity of associated tissue damage require further investigation.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Hygiene Protocols and Doxycycline Therapy in Ameliorating Lymphatic Filariasis Morbidity in an Endemic Area Post-Interruption of Disease Transmission in Ghana.","authors":"Linda Batsa Debrah, Ute Klarmann-Schulz, Jubin Osei-Mensah, Janina M Kuehlwein, Yusif Mubarik, Jennifer Nadal, Nana Kwame Ayisi-Boateng, Arcangelo Ricchiuto, Vera Serwaa Opoku, Sarah M Sullivan, Derrick Adu Mensah, John Horton, Abu Abudu Rahamani, Philip J Budge, Stephen Gbedema, Patricia Jebett Korir, John Opoku, Kenneth Pfarr, Derrick Boateng Kontoh, Angelika Kellings, Charles Gyasi, Michael Agyemang Obeng, Barbara Gruetzmacher, Fatima Amponsah Fordjour, Inge Kroidl, Sacha Horn, Eunice Kyaakyile Kuutiero, Caroline Wauschkuhn, Abdallah Ngenya, Charles Mackenzie, Samuel Wanji, Akili Kalinga, Eric A Ottesen, Achim Hoerauf, Alexander Yaw Debrah","doi":"10.4269/ajtmh.24-0313","DOIUrl":"10.4269/ajtmh.24-0313","url":null,"abstract":"<p><p>Filarial lymphedema (LE) remains a significant global problem despite the progress made toward elimination of lymphatic filariasis (LF). In Ghana, the main approach to LF is preventive chemotherapy, but this has minimal impact on individuals who have already developed LE. In 2018-2020, a 24-month randomized, double-blind, placebo-controlled trial was conducted to evaluate the efficacy of stringent hygiene measures using the Essential Package of Care with or without additional administration of doxycycline (DOX) to improve filarial leg LE. This study enrolled 356 participants with LE stages 1-3 from two districts in the Upper East Region of Ghana. In addition to regular training on appropriate care for their affected legs, participants were randomized to receive 6 weeks of either 200 mg/day DOX (n = 117), 100 mg/day DOX (n = 120), or matching placebo (n = 119). Participants were seen every 2 months, with clinical measurements done at 6, 12, 18, and 24 months to assess the status of affected legs. There was a trend toward later appearance of acute attacks after DOX, but surprisingly, DOX showed no effect on LE stage progression. In all groups, leg LE improvement was more common (DOX 200 mg: n = 23 [20%]; DOX 100 mg: n = 23 [19.5%]; placebo: n = 32 [27.4%]) than LE worsening (DOX 200 mg: n = 2 [1.7%]; DOX 100 mg: n = 3 [2.5%]; placebo: n = 2 [1.7%]). Overall, these data show a strong benefit from adherence to a strict hygiene protocol, with some added potential benefit for DOX in preventing acute attacks.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and Clinical Features of Visceral Leishmaniasis in Chad: A Prospective Cross-Sectional Survey.","authors":"Demba Kodindo Israël, Cheick Amadou Coulibaly, Vourchakbé Joël, Betrand Fesuh Nono, Gonnonta Vincent, Shaden Kamhawi, Seydou Doumbia","doi":"10.4269/ajtmh.23-0033","DOIUrl":"10.4269/ajtmh.23-0033","url":null,"abstract":"<p><p>Visceral leishmaniasis (VL), caused by the protozoan Leishmania donovani complex, is endemic in many parts of the world. Little known in Chad, VL has been recently documented from previously nonendemic areas. We report an epidemiological investigation of VL in the Léré district hospital in southwestern Chad. After informed consent, 40 VL patients were enrolled in the study. Diagnosis made using the formalin serological test was confirmed by polymerase chain reaction on blood samples. Clinical parameters were obtained from the physician or nurse caregiver, and from patients. Of a total of 40 serology positive patients, L. donovani DNA was found in 33 (82.5%), with 55% being male patients. The most affected age groups were 15-29 (47.5%) and 0-14 (32.5%) years. Fever, weight loss, and pallor were frequent symptoms. Notably, splenomegaly and hepatomegaly were uncommon clinical signs. Common comorbidities included malaria (25%) and hepatitis B (15%), followed by gastric ulcer (10%) and tuberculosis (7.5%). These comorbidities were concurrent with VL and were diagnosed microscopically in blood and serum for malaria and tuberculosis, respectively, and by the rapid diagnostic test using serum for hepatitis B and gastric ulcer. Thirty-five percent of cases were treated with meglumine antimoniate, and three patients (7.5%), all with comorbidities, died. Sixty percent of patients lived close to the main town. Our data demonstrate that VL is endemic in the health district of Léré. Improving health education regarding L. donovani infection in endemic areas of Chad and providing training of health workers on early detection and management of VL are needed to help save lives.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}