{"title":"The abattoir condemnation of meat because of parasitic infection, and its economic importance: results of a retrospective study in north-eastern Iran.","authors":"H Borji, S Parandeh","doi":"10.1179/136485910X12851868780261","DOIUrl":"https://doi.org/10.1179/136485910X12851868780261","url":null,"abstract":"<p><p>In nine districts in the north of Khorasan province, in north-eastern Iran, a 5-year retrospective study was carried out to determine the prevalences, in livestock slaughtered in abattoirs, of the parasitic infections responsible for the condemnation of the animals' carcasses and viscera (and the economic importance of such infections in terms of lost meat and offal). Between 20 March 2005 and 19 March 2010, 436,620 animals (45,360 cattle, 275,439 sheep, 115,674 goats and 147 camels) were slaughtered in the study area and the livers of 30,207 (6.9%), the lungs of 23,259 (5.3%) and the carcasses of 1072 (0.2%) of these animals were condemned. Almost all (92.4%) of the condemned livers, most (68.9%) of the condemned lungs but only 10.8% of the condemned carcasses were rejected because of parasitic infection. The parasitic lesions observed in the condemned livers were attributed to Echinococcus granulosus, Fasciola hepatica and/or Dicrocoelium dendriticum (cattle, sheep and goats) or entirely to E. granulosus (camels). All the parasitic lesions observed in the condemned lungs (which also came from cattle, sheep, goats and camels) were attributed to E. granulosus. Sarcocystis cysts and/or Taenia cysticerci were found in ovine muscle while only Taenia cysticerci were detected in bovine muscle (no parasitic lesions were observed in the muscles of the goats and camels). Parasites were responsible for 80.8% of the condemned organs or carcasses, and the value of the food lost because of parasite-related condemnation (based on market prices in 2010) was estimated to be U.S.$421,826 (U.S.$47,980 for cattle, U.S.$316,344.0 for sheep, U.S.$57,372 for goats and U.S.$130 for camels). The parasites contributing most to the condemnation of otherwise marketable organs and muscles were E. granulosus (52.2%) and D. dendriticum flukes (29.5%). These parasites clearly remain too common and cause considerable economic loss in Khorasan and, presumably, other areas of Iran.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"641-7"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868780261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524474","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}
P R Moore, C C Jansen, G C Graham, I L Smith, S B Craig
{"title":"Emerging tropical diseases in Australia. Part 3. Australian bat lyssavirus.","authors":"P R Moore, C C Jansen, G C Graham, I L Smith, S B Craig","doi":"10.1179/136485910X12851868779948","DOIUrl":"https://doi.org/10.1179/136485910X12851868779948","url":null,"abstract":"<p><p>Since its discovery in a juvenile black flying fox (Pteropus alecto) in 1996, Australian bat lyssavirus (ABLV) has become the cause of a potentially important emerging disease for health authorities in Australia, with two human deaths (one in 1996 and one in 1998) attributed to the virus in the north-eastern state of Queensland. In Australia, the virus has been isolated from all four species of flying fox found on the mainland (i.e. P. alecto, P. scapulatus, P. poliocephalus and P. conspicillatus) as well as a single species of insectivorous bat (Saccolaimus flaviventris). Australian bat lyssavirus belongs to the Lyssavirus genus and is closely related, genetically, to the type strain of Rabies virus (RABV). Clinically, patients infected with ABLV have displayed the 'classical' symptoms of rabies and a similar disease course. This similarity has led to the belief that the infection and dissemination of ABLV in the body follows the same pathways as those followed by RABV. Following the two ABLV-related deaths in Queensland, protocols based on the World Health Organization's guidelines for RABV prophylaxis were implemented and, presumably in consequence, no human infection with ABLV has been recorded since 1998. ABLV will, however, probably always have an important part to play in the health of Australians as the density of the human population in Australia and, consequently, the level of interaction between humans and flying foxes increase.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"613-21"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868779948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524472","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}
A F van den Hurk, S B Craig, S M Tulsiani, C C Jansen
{"title":"Emerging tropical diseases in Australia. Part 4. Mosquitoborne diseases.","authors":"A F van den Hurk, S B Craig, S M Tulsiani, C C Jansen","doi":"10.1179/136485910X12851868779984","DOIUrl":"https://doi.org/10.1179/136485910X12851868779984","url":null,"abstract":"<p><p>Mosquito-borne diseases continue to be a serious public-health concern in Australia. Endemic alphaviruses (including Ross River and Barmah Forest viruses) account for the majority of the arboviral notifications, while some flaviviruses (Murray Valley encephalitis, Japanese encephalitis and Kunjin viruses) cause occasional outbreaks of encephalitis. Dengue epidemics are increasing in frequency in northern Queensland, with the largest outbreak in 50 years occurring during the 2008-2009 wet season. Of great concern are the threats posed by the importation of exotic arboviruses, such as West Nile, chikungunya and Rift Valley fever viruses, the introduction of exotic vectors, and the potential range expansion of key Australian vectors. Environmental and anthropogenic influences provide additional uncertainty regarding the future impact of mosquito-borne pathogens in Australia. This review discusses the trends, threats and challenges that face the management of mosquito-borne disease in Australia. Topical mosquito-borne pathogens of biosecurity and public-health concern, and the potential impacts of environmental and global trends, are discussed. Finally, a short overview of the public-health response capability in Australia is provided.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"623-40"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868779984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524473","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}
B Matthys, B G Koudou, E K N'Goran, P Vounatsou, L Gosoniu, M Koné, G Gissé, J Utzinger
{"title":"Spatial dispersion and characterisation of mosquito breeding habitats in urban vegetable-production areas of Abidjan, Côte d'Ivoire.","authors":"B Matthys, B G Koudou, E K N'Goran, P Vounatsou, L Gosoniu, M Koné, G Gissé, J Utzinger","doi":"10.1179/136485910X12851868780108","DOIUrl":"https://doi.org/10.1179/136485910X12851868780108","url":null,"abstract":"<p><p>Although urban agriculture (UA) in the developing world may enhance nutrition and local economies, it may also lead to higher densities of mosquito breeding sites and, consequently, to increased transmission of malarial parasites. If targeted interventions against malaria vectors are to be successful in urban areas, the habitats that support Anopheles breeding need to be identified and detected. Mosquito breeding sites have recently been characterised, and the factors associated with productive Anopheles habitats identified, in market gardens of Abidjan, Côte d'Ivoire. Two surveys were conducted in seven vegetable-production areas, one towards the end of the rainy season and one during the dry season. A standardized methodology was used for habitat characterisation and the detection of Anopheles larvae and mosquito pupae. Overall, 454 and 559 potential mosquito-breeding sites were recorded in the rainy-season and dry-season surveys, respectively. In the rainy season, Anopheles larvae and mosquito pupae were found in 29.7% and 5.5% of the potential breeding sites, respectively, whereas the corresponding percentages in the dry season were 24.3% and 8.6%. The potential breeding sites in an agricultural zone on the periphery of Abidjan were those least likely to be positive for Anopheles larvae and mosquito pupae whereas 'agricultural trenches' between seedbeds were the sites most likely to be positive. In a spatially-explicit Bayesian multivariate logistic-regression model, although one out of every five such wells was also found to harbour Anopheles larvae, irrigation wells were found to be the least productive habitats, of those sampled, for pupae. In the study area, simple and cost-effective strategies of larval control should be targeted at agricultural trenches, ideally with the active involvement of local stakeholders (i.e. urban farmers and urban agricultural extension services).</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"649-66"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868780108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524475","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}
A K Dalal, U Dalal, R Singal, R Kaur, M Jayant, A K Attri
{"title":"Tuberculosis of the spleen with pleural effusion: a rare but important clinical entity.","authors":"A K Dalal, U Dalal, R Singal, R Kaur, M Jayant, A K Attri","doi":"10.1179/136485910X12851868780180","DOIUrl":"https://doi.org/10.1179/136485910X12851868780180","url":null,"abstract":"Among cases of extra-pulmonary tuberculosis, splenic tuberculosis is exceptionally rare, poorly described in the available literature, and more usually encountered in miliary tuberculosis than as an isolated presenting feature (Bastounis et al., 1999). Only 16 (0.01%) of the 9205 cases of tuberculosis recently investigated by Dixit et al. (2010), in the Indian state of Rajasthan, had splenic tuberculosis. In autopsy-based studies, tubercular splenic abscesses have only been found in 0.14%– 0.7% of tuberculosis cases (Jain et al., 2008). An Indian patient with such an abscess is described below.","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"675-8"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868780180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524478","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}
M A Adeleke, C F Mafiana, S O Sam-Wobo, O P Akinwale, G O Olatunde, S M Sanfo, A Adjami, L Toè
{"title":"Molecular characterisation of the Simulium damnosum complex (Diptera: Simuliidae) found along the Osun River system, in south-western Nigeria.","authors":"M A Adeleke, C F Mafiana, S O Sam-Wobo, O P Akinwale, G O Olatunde, S M Sanfo, A Adjami, L Toè","doi":"10.1179/136485910X12851868780225","DOIUrl":"https://doi.org/10.1179/136485910X12851868780225","url":null,"abstract":"Simulium damnosum s.l. are the only known vectors of Onchocerca volvulus in West Africa (Toè et al., 1997). At least nine sibling species of S. damnosum s.l. exist in this region and these siblings have varying vectorial capacities in the different ecozones (Wilson and Post, 1994). The savannadwelling group (S. damnosum s.s. and S. sirbanum) transmits the blinding, savanna strain of O. volvulus and the forest-dwelling group (S. squamosum and S. yahense) transmits the non-blinding, forest strain of the parasite (Tang et al., 1995). The members of the transition-zone-dwelling group (S. sanctipauli, S. leonense and S. soubrense) are commonly found in areas where the two strains of O. volvulus co-exist (Tang et al., 1995). Most of the classification of the S. damnosum s.l. in West Africa has been based on larval cytotaxonomy (Ibeh et al., 2006). The available cytotaxonomic techniques can only be applied to seventh-instar larvae and cannot be used to identify the adult flies that are involved in transmission. Adult S. damnosum s.l. have been investigated using iso-enzyme analysis (Thomson et al., 1990), morphotaxonomy (Garms and Zillman, 1984; Wilson et al., 1993), morphometrics (Garms et al., 1982; Wilson et al., 1993) and molecular techniques based on the amplification of the internal transcribed spacers (ITS) of the flies’ nuclear ribosomal DNA (Brockhouse et al., 1993). Unfortunately, each of these methods could only differentiate two or three of the sibling species, leaving the problem of adult identification unresolved. More recently, however, the amplification of the 16S ribosomal RNA and NADH dehydrogenase subunit 4 (ND4) mitochondrial genes has been found useful, and the electrophoretic migration of heteroduplex formations of these sequences has been used to distinguish at least six of the siblings that serve as the main vectors in the areas formerly covered by the Onchocerciasis Control Programme (OCP) in West Africa (Tang et al., 1995; Higazi et al., 2000). A heteroduplex assay has recently been employed to investigate the sibling composition of the biting adults of S. damnosum s.l. to be found along the Osun River, in south– western Nigeria. This river lies (at 8u209– 6u309N, 5u109–3u259E) in the forest zone of Nigeria, outside of the ‘OCP area’. Between February 2008 and January 2009, adult S. damnosum s.l. were collected every fortnight, as they landed on human volunteers at three catching points along the river (at Eleja, Ogbere and Budepo), and then morphologically classified into forest or savanna flies (Kurtak et al., 1981; Wilson et al., 1993). Fifty flies were randomly selected from the collections made during each of the three seasonal peaks (April–June, July–September and October–March; Mayr, 1969). The DNA in each selected fly was extracted using a commercial kit (DNeasyH blood and tissue kit; QIAGEN, Hilden, Germany) and then run in a PCR designed to amplify ND4 sequences (Tang et al., 1995). The denaturation and renaturation o","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"679-83"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868780225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524479","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":"Granulomatous abscess of the ulnar nerve in a case of paucibacillary leprosy given multidrug therapy.","authors":"R K Singh","doi":"10.1179/136485910X12851868780063","DOIUrl":"https://doi.org/10.1179/136485910X12851868780063","url":null,"abstract":"Although leprosy is a granulomatous disease that is potentially treatable with the multidrug therapy (MDT) currently recommended by the World Health Organization (WHO), a few ‘borderline tuberculoid’ cases harbour Mycobacterium leprae in their nerves for many years after they have received such treatment and become clinically inactive (Chaudhuri et al., 1998). Pure neuritic leprosy is most frequently found in India and Nepal, where it accounts for 5%–10% of all leprosy patients (Britton and Lockwood, 2004). Although, in such disease, the fusiform swelling of the ulnar nerve is a classic finding, abscesses involving a nerve also sometimes occur, albeit rarely (Sehgal, 1966). Such abscesses that are detected tend to develop in the major nerve trunks, most frequently in the ulnar nerve (Salafia and Chauhan, 1996). Histological examination is the ‘gold standard’ for diagnosis of such abscesses, as the presence of neural inflammation differentiates leprosy from other granulomatous disorders (Britton and Lockwood, 2004), but fine-needle aspiration cytology (FNAC) can also be useful (Siddaraju et al., 2009). Imaging, by ultrasonography and/or magnetic resonance, is generally unhelpful, as the features of neural leprosy can also be found in hypertrophic neuropathy, amyloid infiltration and chronic relapsing neuropathy, but the detection of a nerve granuloma or abscess is often indicative of leprosy (Hari et al., 2007).","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 8","pages":"673-4"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868780063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29524477","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}
I Stewart, R J Lewis, G K Eaglesham, G C Graham, S Poole, S B Craig
{"title":"Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning.","authors":"I Stewart, R J Lewis, G K Eaglesham, G C Graham, S Poole, S B Craig","doi":"10.1179/136485910X12851868779902","DOIUrl":"https://doi.org/10.1179/136485910X12851868779902","url":null,"abstract":"<p><p>Ciguatera poisoning is a food-borne neuro-intoxication caused by consumption of finfish that have accumulated ciguatoxins in their tissues. Ciguatera is a distressing and sometimes disabling condition that presents with a self-limiting though occasionally severe gastro-intestinal illness, progressing to a suite of aberrant sensory symptoms. Recovery can take from days to years; second and subsequent attacks may manifest in a more severe illness. Ciguatera remains largely a pan-tropical disease, although tourism and export fish markets facilitate increased presentation in temperate latitudes. While ciguatera poisoning in the South Pacific was recognised and eloquently described by seafarers in the 18th Century, it remains a public-health challenge in the 21st Century because there is neither a confirmatory diagnostic test nor a reliable, low-cost screening method to ascertain the safety of suspect fish prior to consumption. A specific antidote is not available, so treatment is largely supportive. The most promising pharmacotherapy of recent decades, intravenous mannitol, has experienced a relative decline in acceptance after a randomized, double-blind trial failed to confirm its efficacy. Some questions remain unanswered, however, and the use of mannitol for the treatment of acute ciguatera poisoning arguably deserves revisiting. The immunotoxicology of ciguatera is poorly understood, and some aspects of the epidemiology and symptomatology of ciguatera warrant further enquiry.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 7","pages":"557-71"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868779902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29481347","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":"In areas of low transmission, is the presumptive treatment of febrile but bloodsmear-negative patients for malaria validated by the results of PCR-based testing?","authors":"S M E A-Elgayoum, E-A El-Rayah, H A Giha","doi":"10.1179/136485910X12851868780027","DOIUrl":"https://doi.org/10.1179/136485910X12851868780027","url":null,"abstract":"<p><p>Presumptive malaria treatment (PMT) is a common strategy in many areas of the world, especially in settings where the facilities for diagnosis are limited. The subjects of a recent study in central Sudan, in an area with a low level of Plasmodium falciparum transmission, were 322 individuals who had each presented at one of seven suburban health facilities, complaining of repeated febrile episodes. Although all were found bloodsmear-negative for malarial parasites, all were presumptively diagnosed as cases of malaria and prescribed artemisinin-based combination therapy. When pretreatment samples of blood were, however, checked for P. falciparum histidine-rich protein 2, using a rapid diagnostic test (RDT), and for Plasmodium DNA, using a PCR-based assay, only one (0.03%) of the cases was found RDT-positive and none was found PCR-positive. Although more studies are needed, in different areas and seasons, to see if these results mirror the general situation, it appears that the wide use of PMT in central Sudan, among patients who are bloodsmear-negative, is unjustified, of little, if any, benefit, and a waste of resources that are already limited. An international consortium for the revision of the conceptual aspects of malaria diagnosis and PMT is suggested.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 7","pages":"573-81"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12851868780027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29481348","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":"Socio-economic aspects of neglected diseases: sleeping sickness and visceral leishmaniasis.","authors":"M Boelaert, F Meheus, J Robays, P Lutumba","doi":"10.1179/136485910X12786389891641","DOIUrl":"https://doi.org/10.1179/136485910X12786389891641","url":null,"abstract":"<p><p>Several tropical diseases that are essentially poverty-related have recently gained more attention under the label of 'neglected tropical diseases' or NTD. It is estimated that over 1000 million people currently suffer from one or more NTD. Here, the socio-economic aspects of two NTD - human African trypanosomiasis and human visceral leishmaniasis - are reviewed. Both of these diseases affect the poorest of the poor in endemic countries, cause considerable direct and indirect costs (even though the national control programmes tend to provide free care) and push affected households deeper into poverty.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"104 7","pages":"535-42"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/136485910X12786389891641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29481401","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}