Pub Date : 2024-02-13DOI: 10.1186/s41182-024-00585-5
Saba Yarahmadi, Jasem Saki, Reza Arjmand, Heshmatolah Shahbazian
Background: The diagnosis and genetic characterization of Toxoplasma gondii (T. gondii) infection can make a significant influence to the prevention of the dangerous consequences of toxoplasmosis, particularly in immunocompromised people.
Objective: The aim of this investigation was to assess the frequency and genotyping of T. gondii in blood samples of patients with hemodialysis.
Materials and methods: In the current investigation, a total of 379 blood samples were taken from subjects with hemodialysis who were referred to teaching hospital of Ahvaz in the southwest of Iran. The samples were evaluated using the Nested PCR by targeting the B1 gene, and then, sequencing and phylogenetic tree were constructed.
Results: T. gondii DNA was found in 112 (29.55%) of the blood samples by Nested PCR. Amplicons from T. gondii revealed high identity with GenBank sequences. The phylogenetic analysis revealed that all sequences were closely related to Type I of T. gondii.
Conclusion: Because of the high incidence of toxoplasmosis with type I prevalent in hemodialysis patients, we recommend a systematic screening for toxoplasmosis to carry out for monitoring the possible dissemination of toxoplasmosis during hemodialysis.
{"title":"Toxoplasma gondii molecular detection and phylogenetic analysis in hemodialysis patients from Khuzestan, Southwest Iran.","authors":"Saba Yarahmadi, Jasem Saki, Reza Arjmand, Heshmatolah Shahbazian","doi":"10.1186/s41182-024-00585-5","DOIUrl":"10.1186/s41182-024-00585-5","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis and genetic characterization of Toxoplasma gondii (T. gondii) infection can make a significant influence to the prevention of the dangerous consequences of toxoplasmosis, particularly in immunocompromised people.</p><p><strong>Objective: </strong>The aim of this investigation was to assess the frequency and genotyping of T. gondii in blood samples of patients with hemodialysis.</p><p><strong>Materials and methods: </strong>In the current investigation, a total of 379 blood samples were taken from subjects with hemodialysis who were referred to teaching hospital of Ahvaz in the southwest of Iran. The samples were evaluated using the Nested PCR by targeting the B1 gene, and then, sequencing and phylogenetic tree were constructed.</p><p><strong>Results: </strong>T. gondii DNA was found in 112 (29.55%) of the blood samples by Nested PCR. Amplicons from T. gondii revealed high identity with GenBank sequences. The phylogenetic analysis revealed that all sequences were closely related to Type I of T. gondii.</p><p><strong>Conclusion: </strong>Because of the high incidence of toxoplasmosis with type I prevalent in hemodialysis patients, we recommend a systematic screening for toxoplasmosis to carry out for monitoring the possible dissemination of toxoplasmosis during hemodialysis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730608","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}
Pub Date : 2024-02-09DOI: 10.1186/s41182-024-00582-8
Esdras Mahoutin Odjo, Mathilde Tognidro, Renaud Govoetchan, Antoine Abel Missihoun, Gil Germain Padonou, Juvenal Minassou Ahouandjinou, Bruno Akinro, Zinsou Come Koukpo, Filémon T Tokponnon, Armel Djenontin, Clement Agbangla, Martin C Akogbeto
The study objective was to assess the frequency of the kdr-L995F and ace-1 G280S genetic mutations in Anopheles gambiae s.l. mosquitoes and examine their ability to transmit Plasmodium falciparum in areas where indoor residual spraying (IRS) was implemented with Clothianidin 50 WG. The study was conducted in six communes in the Alibori and Donga departments of which four were IRS-treated and two were untreated and served as control. Post-IRS monthly samples of adult mosquitoes were collected in study communes using human landing catches (HLC). An. gambiae s.l. specimens were processed to detect kdr-L995F and ace-1 G280S mutations via PCR as well as Plasmodium falciparum infectivity through CSP ELISA. Our data revealed a high and similar allelic frequency for the kdr-L995F mutation in both treated and control communes (79% vs. 77%, p = 0.14) whilst allelic frequency of the ace-1 G280S mutation was lower across the study area (2-3%, p = 0.58). The sporozoite rate was 2.6% and 2.4% respectively in treated and untreated communes (p = 0.751). No association was found between Plasmodium falciparum infection in Anopheles gambiae s.l. vectors and carriage of kdr-L995F and ace-1 G280S mutations regardless of genotypes. The study findings underline the need for an integrated approach to malaria control, combining different control methods to effectively target transmission. Regular monitoring of insecticide resistance and genetic mutations is essential to guide control strategies.
{"title":"Malaria transmission potential of Anopheles gambiae s.l. in indoor residual spraying areas with clothianidin 50 WG in northern Benin.","authors":"Esdras Mahoutin Odjo, Mathilde Tognidro, Renaud Govoetchan, Antoine Abel Missihoun, Gil Germain Padonou, Juvenal Minassou Ahouandjinou, Bruno Akinro, Zinsou Come Koukpo, Filémon T Tokponnon, Armel Djenontin, Clement Agbangla, Martin C Akogbeto","doi":"10.1186/s41182-024-00582-8","DOIUrl":"10.1186/s41182-024-00582-8","url":null,"abstract":"<p><p>The study objective was to assess the frequency of the kdr-L995F and ace-1 G280S genetic mutations in Anopheles gambiae s.l. mosquitoes and examine their ability to transmit Plasmodium falciparum in areas where indoor residual spraying (IRS) was implemented with Clothianidin 50 WG. The study was conducted in six communes in the Alibori and Donga departments of which four were IRS-treated and two were untreated and served as control. Post-IRS monthly samples of adult mosquitoes were collected in study communes using human landing catches (HLC). An. gambiae s.l. specimens were processed to detect kdr-L995F and ace-1 G280S mutations via PCR as well as Plasmodium falciparum infectivity through CSP ELISA. Our data revealed a high and similar allelic frequency for the kdr-L995F mutation in both treated and control communes (79% vs. 77%, p = 0.14) whilst allelic frequency of the ace-1 G280S mutation was lower across the study area (2-3%, p = 0.58). The sporozoite rate was 2.6% and 2.4% respectively in treated and untreated communes (p = 0.751). No association was found between Plasmodium falciparum infection in Anopheles gambiae s.l. vectors and carriage of kdr-L995F and ace-1 G280S mutations regardless of genotypes. The study findings underline the need for an integrated approach to malaria control, combining different control methods to effectively target transmission. Regular monitoring of insecticide resistance and genetic mutations is essential to guide control strategies.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713157","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}
Background: Although the Philippines targets malaria elimination by 2030, it remains to be a disease that causes considerable morbidity in provinces that report malaria. Pregnant women residing in endemic areas are a vulnerable population, because in addition to the risk of developing severe malaria, their pregnancy is not followed through, and the outcome of their pregnancy is unknown. This study determined the utility of real-world data integrated with disease surveillance data set as real-world evidence of pregnancy and delivery outcomes in areas endemic for malaria in the Philippines.
Methods: For the period of 2015 to 2019, electronic data sets of malaria surveillance data and Ospital ng Palawan hospital admission log of pregnant women residing in the four selected barangays of Rizal, Palawan were merged using probabilistic linkage. The source data for record linkage were first and last names, birth date, and address as the mutual variable. The data used for characteristics of the pregnant women from the hospital data set were admission date, discharge date, admitting and final diagnosis and body weight on admission. From the malaria surveillance data these were date of consultation, and malaria parasite species. The Levenshtein distance formula was used for a fuzzy string-matching algorithm. Chi-square test, and Mann-Whitney U test were used to compare the means of the two data sets.
Results: The prevalence of pregnant women admitted to the tertiary referral hospital, Ospital ng Palawan, was estimated to be 8.34/100 overall, and 11.64/100 from the four study barangays; that of malaria during pregnancy patients was 3.45/100 and 2.64/100, respectively. There was only one true-positive matched case from 238 women from the hospital and 54 women from the surveillance data sets. The overall Levenshstein score was 97.7; for non-matched cases, the mean overall score was 36.6 (35.6-37.7). The matched case was a minor who was hospitalized for severe malaria. The outcome of her pregnancy was detected from neither data set but from village-based records.
Conclusions: This proof-of-concept study demonstrated that probabilistic record linkage could match real-world data in the Philippines with further validation required. The study underscored the need for more integrated and comprehensive database to monitor disease intervention impact on pregnancy and its outcome in the Philippines.
背景:尽管菲律宾的目标是到 2030 年消灭疟疾,但在报告有疟疾的省份,疟疾仍然是一种会导致相当高发病率的疾病。居住在疟疾流行地区的孕妇是易感人群,因为她们除了有罹患重症疟疾的风险外,其怀孕过程也没有得到跟踪,怀孕结果也不得而知。本研究确定了与疾病监测数据集相结合的真实世界数据作为菲律宾疟疾流行地区怀孕和分娩结果的真实世界证据的效用:在 2015 年至 2019 年期间,使用概率链接法合并了疟疾监测数据电子数据集和 Ospital ng Palawan 医院对居住在巴拉望省里扎尔市四个选定镇的孕妇的入院记录。记录链接的源数据是姓名、出生日期和地址作为互变量。医院数据集中的孕妇特征数据包括入院日期、出院日期、入院诊断和最终诊断以及入院时的体重。疟疾监测数据包括就诊日期和疟疾寄生虫种类。莱文斯坦距离公式用于模糊字符串匹配算法。采用卡方检验(Chi-square test)和曼-惠特尼U检验(Mann-Whitney U test)比较两组数据的平均值:据估计,在三级转诊医院巴拉望医院(Ospital ng Palawan)住院的孕妇发病率为 8.34/100,在四个研究区的发病率为 11.64/100;孕期疟疾患者的发病率分别为 3.45/100 和 2.64/100。在 238 名来自医院的妇女和 54 名来自监测数据集的妇女中,只有一个匹配的真阳性病例。总的莱文施坦因评分为 97.7;非匹配病例的平均总评分为 36.6(35.6-37.7)。配对病例是一名因严重疟疾住院的未成年人。她的妊娠结果既不是从数据集中检测到的,也不是从村里的记录中检测到的:这项概念验证研究表明,概率记录关联可以匹配菲律宾的实际数据,但还需要进一步验证。该研究强调,有必要建立更综合、更全面的数据库,以监测疾病干预对菲律宾妊娠及其结果的影响。
{"title":"First malaria in pregnancy followed in Philippine real-world setting: proof-of-concept of probabilistic record linkage between disease surveillance and hospital administrative data.","authors":"Takuya Kinoshita, Fe Espino, Raymart Bunagan, Dodge Lim, Chona Daga, Sabrina Parungao, Aileen Balderian, Katherine Micu, Rutchel Laborera, Ramon Basilio, Marianette Inobaya, Mario Baquilod, Melecio Dy, Hitoshi Chiba, Takehiro Matsumoto, Takeo Nakayama, Kiyoshi Kita, Kenji Hirayama","doi":"10.1186/s41182-024-00583-7","DOIUrl":"10.1186/s41182-024-00583-7","url":null,"abstract":"<p><strong>Background: </strong>Although the Philippines targets malaria elimination by 2030, it remains to be a disease that causes considerable morbidity in provinces that report malaria. Pregnant women residing in endemic areas are a vulnerable population, because in addition to the risk of developing severe malaria, their pregnancy is not followed through, and the outcome of their pregnancy is unknown. This study determined the utility of real-world data integrated with disease surveillance data set as real-world evidence of pregnancy and delivery outcomes in areas endemic for malaria in the Philippines.</p><p><strong>Methods: </strong>For the period of 2015 to 2019, electronic data sets of malaria surveillance data and Ospital ng Palawan hospital admission log of pregnant women residing in the four selected barangays of Rizal, Palawan were merged using probabilistic linkage. The source data for record linkage were first and last names, birth date, and address as the mutual variable. The data used for characteristics of the pregnant women from the hospital data set were admission date, discharge date, admitting and final diagnosis and body weight on admission. From the malaria surveillance data these were date of consultation, and malaria parasite species. The Levenshtein distance formula was used for a fuzzy string-matching algorithm. Chi-square test, and Mann-Whitney U test were used to compare the means of the two data sets.</p><p><strong>Results: </strong>The prevalence of pregnant women admitted to the tertiary referral hospital, Ospital ng Palawan, was estimated to be 8.34/100 overall, and 11.64/100 from the four study barangays; that of malaria during pregnancy patients was 3.45/100 and 2.64/100, respectively. There was only one true-positive matched case from 238 women from the hospital and 54 women from the surveillance data sets. The overall Levenshstein score was 97.7; for non-matched cases, the mean overall score was 36.6 (35.6-37.7). The matched case was a minor who was hospitalized for severe malaria. The outcome of her pregnancy was detected from neither data set but from village-based records.</p><p><strong>Conclusions: </strong>This proof-of-concept study demonstrated that probabilistic record linkage could match real-world data in the Philippines with further validation required. The study underscored the need for more integrated and comprehensive database to monitor disease intervention impact on pregnancy and its outcome in the Philippines.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707983","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}
Pub Date : 2024-02-01DOI: 10.1186/s41182-024-00578-4
Shahla Amani, Soheila Alinejad, Negar Asadi, Elham Yousefi, Shahram Khademvatan, Gordon Stanley Howarth
Background: Leishmaniasis, caused by protozoan parasites of the genus Leishmania, is a neglected tropical disease with 700,000 to 1,000,000 global new cases annually. Adverse effects associated with expense, long-term treatment and drug resistance have made conventional therapies unfavorable, encouraging the search for alternative drugs based on plant products. In this study, the effect of Calotropis procera (Asclepiadaceae) extract against viability of promastigotes and amastigotes of Leishmania major was evaluated in vitro.
Methods: The extract from the leaves of C. procera seedlings was prepared using a methanol maceration method. The colorimetric cell viability 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to determine the growth-inhibitory effect of the extract on promastigotes. The level of reactive oxygen species (ROS) in promastigote cultures was determined after treatment with the extract using the 2',7'-dichlorofluorescein diacetate (DCFH-DA) method and compared with untreated cultures (control). After exposure to the extract the expression levels of tumor necrosis factor-α (TNF-α), interferon gamma (IFN-γ) and inducible nitric oxide synthase (iNOS) genes were determined and compared to control in peripheral blood mononuclear cells (PBMCs) infected with L. major.
Results: Based on the MTT assay, the C. procera extract significantly reduced the proliferation of L. major promastigotes with IC50 values of 377.28 and 222.44 μg/mL for 24 and 72 h, respectively (p < 0.01). After treatment with 222.44 and 377.28 μg/mL of C. procera extract, ROS production in L. major promastigote cultures increased 1.2- to 1.65-fold and 2- to 4-fold compared to the control, respectively (p < 0.05). C. procera extract induced significant increases in gene expression of TNF-α (2.76-14.83 fold), IFN-γ (25.63-threefold) and iNOS (16.32-3.97 fold) in infected PBMCs compared to control (p < 0.01).
Conclusions: On the basis of its anti-leishmanial activity, C. procera can be considered as a promising new plant source for the potential treatment of leishmaniasis.
{"title":"Anti-Leishmania major activity of Calotropis procera extract by increasing ROS production and upregulating TNF-α, IFN-γ and iNOS mRNA expression under in vitro conditions.","authors":"Shahla Amani, Soheila Alinejad, Negar Asadi, Elham Yousefi, Shahram Khademvatan, Gordon Stanley Howarth","doi":"10.1186/s41182-024-00578-4","DOIUrl":"10.1186/s41182-024-00578-4","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis, caused by protozoan parasites of the genus Leishmania, is a neglected tropical disease with 700,000 to 1,000,000 global new cases annually. Adverse effects associated with expense, long-term treatment and drug resistance have made conventional therapies unfavorable, encouraging the search for alternative drugs based on plant products. In this study, the effect of Calotropis procera (Asclepiadaceae) extract against viability of promastigotes and amastigotes of Leishmania major was evaluated in vitro.</p><p><strong>Methods: </strong>The extract from the leaves of C. procera seedlings was prepared using a methanol maceration method. The colorimetric cell viability 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to determine the growth-inhibitory effect of the extract on promastigotes. The level of reactive oxygen species (ROS) in promastigote cultures was determined after treatment with the extract using the 2',7'-dichlorofluorescein diacetate (DCFH-DA) method and compared with untreated cultures (control). After exposure to the extract the expression levels of tumor necrosis factor-α (TNF-α), interferon gamma (IFN-γ) and inducible nitric oxide synthase (iNOS) genes were determined and compared to control in peripheral blood mononuclear cells (PBMCs) infected with L. major.</p><p><strong>Results: </strong>Based on the MTT assay, the C. procera extract significantly reduced the proliferation of L. major promastigotes with IC<sub>50</sub> values of 377.28 and 222.44 μg/mL for 24 and 72 h, respectively (p < 0.01). After treatment with 222.44 and 377.28 μg/mL of C. procera extract, ROS production in L. major promastigote cultures increased 1.2- to 1.65-fold and 2- to 4-fold compared to the control, respectively (p < 0.05). C. procera extract induced significant increases in gene expression of TNF-α (2.76-14.83 fold), IFN-γ (25.63-threefold) and iNOS (16.32-3.97 fold) in infected PBMCs compared to control (p < 0.01).</p><p><strong>Conclusions: </strong>On the basis of its anti-leishmanial activity, C. procera can be considered as a promising new plant source for the potential treatment of leishmaniasis.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672783","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}
Background: Among the medically important snakes in Nigeria, Echis ocellatus and Bitis arietans have the most lethal venom. These venoms were classified according to the presence of snake venom metalloproteinases (SVMPs), snake venom phospholipase A2 (PLA2s), and snake venom serine proteases (SVSPs). Toxicological analyzes were performed to understand the significance of different protein families in venoms.
Methods: Proteins were separated from venom using column chromatography. The skin and footpad of mice were used to determine hemorrhagic and edematogenic activities. Caprine blood plasma was used to test fibrinolytic activity in vitro.
Results: The results showed that, compared to the crude venom, the SVMP fraction induced hemorrhagic effects with a diameter of 26.00 ± 1.00 mm in E. ocellatus and 21.33 ± 1.52 mm in B. arietans. Both SVSP and SVMP had anticoagulant effects; however, the SVSP fraction had a stronger effect, with a longer anticoagulation time of 30.00 ± 3.00 min in E. ocellatus and 26.00 ± 2.00 min in B. arietans. These main venom toxins, SVMPs, SVSPs, and PLA2, were found to have edema-forming effects that were optimal at 2 h after envenomation. PLA2s had the highest edema-inducing activity, with onset 30 min after envenomation.
Conclusions: Given the importance of SVMPs in altering the integrity of the membrane structure and impairing the blood coagulation system, an antivenom that can specifically neutralize its activity could inhibit the hemorrhage effects of the venoms.
{"title":"Toxicological analyses of the venoms of Nigerian vipers Echis ocellatus and Bitis arietans.","authors":"Emeka John Dingwoke, Fatima Adis Adamude, Aliyu Salihu, Mujitaba Suleiman Abubakar, Abdullahi Balarabe Sallau","doi":"10.1186/s41182-024-00581-9","DOIUrl":"10.1186/s41182-024-00581-9","url":null,"abstract":"<p><strong>Background: </strong>Among the medically important snakes in Nigeria, Echis ocellatus and Bitis arietans have the most lethal venom. These venoms were classified according to the presence of snake venom metalloproteinases (SVMPs), snake venom phospholipase A<sub>2</sub> (PLA<sub>2</sub>s), and snake venom serine proteases (SVSPs). Toxicological analyzes were performed to understand the significance of different protein families in venoms.</p><p><strong>Methods: </strong>Proteins were separated from venom using column chromatography. The skin and footpad of mice were used to determine hemorrhagic and edematogenic activities. Caprine blood plasma was used to test fibrinolytic activity in vitro.</p><p><strong>Results: </strong>The results showed that, compared to the crude venom, the SVMP fraction induced hemorrhagic effects with a diameter of 26.00 ± 1.00 mm in E. ocellatus and 21.33 ± 1.52 mm in B. arietans. Both SVSP and SVMP had anticoagulant effects; however, the SVSP fraction had a stronger effect, with a longer anticoagulation time of 30.00 ± 3.00 min in E. ocellatus and 26.00 ± 2.00 min in B. arietans. These main venom toxins, SVMPs, SVSPs, and PLA<sub>2</sub>, were found to have edema-forming effects that were optimal at 2 h after envenomation. PLA<sub>2</sub>s had the highest edema-inducing activity, with onset 30 min after envenomation.</p><p><strong>Conclusions: </strong>Given the importance of SVMPs in altering the integrity of the membrane structure and impairing the blood coagulation system, an antivenom that can specifically neutralize its activity could inhibit the hemorrhage effects of the venoms.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570116","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}
Pub Date : 2024-01-29DOI: 10.1186/s41182-024-00580-w
Bhim Gopal Dhoubhadel, Ikumi Sawada, Dhruba Shrestha, Yoshifumi Fukuya, Ganendra Bhakta Raya, Eric Ipyn Nébié, Yumiko Hayashi, Rasila Pasakhala, Motoi Suzuki, Konosuke Morimoto, Christopher M Parry, Koya Ariyoshi
Background: A 7.8 R scale earthquake hit Nepal in April 2015 and caused about 9000 deaths along with damage to infrastructure, including the water and sewage system. Bhaktapur was one of the highly affected districts. A typhoid vaccination campaign (pre-emptive) was carried out among children who were living in the temporary shelters in this district. The assessment of vaccine effectiveness after a pre-emptive typhoid vaccine campaign following an earthquake has previously not been attempted in Nepal.
Objective: To describe the pre-emptive typhoid Vi capsular polysaccharide vaccination campaign and an evaluation of the vaccine effectiveness.
Methods: We conducted a pre-emptive typhoid Vi capsular polysaccharide vaccination campaign among children between 2 and 15 years of age dwelling in 23 temporary shelters in Bhaktapur district after the earthquake. Surveillance of clinical typhoid was carried out from 2014 to 2017 in Siddhi Memorial Hospital, the only hospital for children in the district. We calculated vaccine effectiveness using a case-control study design (clinical typhoid as cases and chest x-ray confirmed pneumonia as controls).
Results: Three thousand nine hundred sixteen children of age 2-15 years residing in the 23 temporary shelters in Bhaktapur received the typhoid Vi capsular polysaccharide vaccine between July and December 2015. 2193 children of age 2-15 years were admitted to the hospital during the study period and 260 (11.9%) were diagnosed with clinical typhoid. The numbers of children admitted with clinical typhoid decreased over the study period (105 in 2014 and 47 in 2017; P = 0.001). Overall vaccine effectiveness was calculated at 52% (95% CI -46 to 85%), and it was 87% (95% CI -25 to 99) among children less than 5 years of age.
Conclusions: We successfully conducted a pre-emptive vaccination campaign against typhoid after the 2015 Nepal earthquake. The pre-emptive vaccination campaign appeared to be more effective among children less than 5 years of age. Further studies are needed to assess the effectiveness of pre-emptive use of typhoid vaccines in the emergency situations. We highlight the challenges of calculating vaccine effectiveness of a typhoid vaccine in an emergency setting.
背景:2015 年 4 月,尼泊尔发生 7.8 级地震,造成约 9000 人死亡,包括供水和污水处理系统在内的基础设施遭到破坏。巴克塔普尔是受灾严重的地区之一。在该县临时避难所居住的儿童中开展了伤寒疫苗接种活动(预防性)。此前,尼泊尔从未尝试过在地震后开展预防性伤寒疫苗接种活动后对疫苗效果进行评估:描述预防性伤寒 Vi 型荚膜多糖疫苗接种活动和疫苗效果评估:地震后,我们对居住在巴克塔普尔县 23 个临时避难所中的 2 至 15 岁儿童开展了伤寒 Vi 胶囊多糖疫苗预防接种活动。西迪纪念医院是该地区唯一一家儿童医院,从2014年至2017年对临床伤寒进行了监测。我们采用病例对照研究设计(临床伤寒为病例,胸部X光确诊肺炎为对照)计算疫苗的有效性:2015年7月至12月期间,居住在巴克塔普尔23个临时庇护所的3916名2-15岁儿童接种了伤寒Vi荚膜多糖疫苗。在研究期间,共有 2193 名 2-15 岁儿童入院治疗,其中 260 人(11.9%)被诊断为临床伤寒。在研究期间,临床伤寒入院儿童人数有所减少(2014 年为 105 人,2017 年为 47 人;P = 0.001)。总体疫苗接种效果为52%(95% CI -46至85%),5岁以下儿童的接种效果为87%(95% CI -25至99):我们在 2015 年尼泊尔地震后成功开展了伤寒疫苗预防接种活动。预防接种活动在 5 岁以下儿童中似乎更有效。我们需要开展进一步研究,以评估在紧急情况下预先接种伤寒疫苗的效果。我们强调了在紧急情况下计算伤寒疫苗有效性所面临的挑战。
{"title":"A description of a pre-emptive typhoid Vi capsular polysaccharide vaccination campaign after the 2015 earthquake in Nepal and vaccine effectiveness evaluation.","authors":"Bhim Gopal Dhoubhadel, Ikumi Sawada, Dhruba Shrestha, Yoshifumi Fukuya, Ganendra Bhakta Raya, Eric Ipyn Nébié, Yumiko Hayashi, Rasila Pasakhala, Motoi Suzuki, Konosuke Morimoto, Christopher M Parry, Koya Ariyoshi","doi":"10.1186/s41182-024-00580-w","DOIUrl":"10.1186/s41182-024-00580-w","url":null,"abstract":"<p><strong>Background: </strong>A 7.8 R scale earthquake hit Nepal in April 2015 and caused about 9000 deaths along with damage to infrastructure, including the water and sewage system. Bhaktapur was one of the highly affected districts. A typhoid vaccination campaign (pre-emptive) was carried out among children who were living in the temporary shelters in this district. The assessment of vaccine effectiveness after a pre-emptive typhoid vaccine campaign following an earthquake has previously not been attempted in Nepal.</p><p><strong>Objective: </strong>To describe the pre-emptive typhoid Vi capsular polysaccharide vaccination campaign and an evaluation of the vaccine effectiveness.</p><p><strong>Methods: </strong>We conducted a pre-emptive typhoid Vi capsular polysaccharide vaccination campaign among children between 2 and 15 years of age dwelling in 23 temporary shelters in Bhaktapur district after the earthquake. Surveillance of clinical typhoid was carried out from 2014 to 2017 in Siddhi Memorial Hospital, the only hospital for children in the district. We calculated vaccine effectiveness using a case-control study design (clinical typhoid as cases and chest x-ray confirmed pneumonia as controls).</p><p><strong>Results: </strong>Three thousand nine hundred sixteen children of age 2-15 years residing in the 23 temporary shelters in Bhaktapur received the typhoid Vi capsular polysaccharide vaccine between July and December 2015. 2193 children of age 2-15 years were admitted to the hospital during the study period and 260 (11.9%) were diagnosed with clinical typhoid. The numbers of children admitted with clinical typhoid decreased over the study period (105 in 2014 and 47 in 2017; P = 0.001). Overall vaccine effectiveness was calculated at 52% (95% CI -46 to 85%), and it was 87% (95% CI -25 to 99) among children less than 5 years of age.</p><p><strong>Conclusions: </strong>We successfully conducted a pre-emptive vaccination campaign against typhoid after the 2015 Nepal earthquake. The pre-emptive vaccination campaign appeared to be more effective among children less than 5 years of age. Further studies are needed to assess the effectiveness of pre-emptive use of typhoid vaccines in the emergency situations. We highlight the challenges of calculating vaccine effectiveness of a typhoid vaccine in an emergency setting.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570158","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}
Background: Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area.
Methods: Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the "strong" educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a "weak" intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention.
Results: Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6-9.9) in the first intervention group, 1.9 mm Hg (95% CI - 0.5-4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4-7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis.
Conclusions: Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.
{"title":"Community-based intervention for managing hypertension and diabetes in rural Bangladesh.","authors":"Yurie Kobashi, Syed Emdadul Haque, Kayako Sakisaka, Isamu Amir, Megumi Kaneko, Mahmuda Mutahara, Sanzida Mubassara, Abul Kashem, Masaharu Tsubokura","doi":"10.1186/s41182-023-00574-0","DOIUrl":"10.1186/s41182-023-00574-0","url":null,"abstract":"<p><strong>Background: </strong>Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area.</p><p><strong>Methods: </strong>Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the \"strong\" educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a \"weak\" intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention.</p><p><strong>Results: </strong>Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6-9.9) in the first intervention group, 1.9 mm Hg (95% CI - 0.5-4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4-7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis.</p><p><strong>Conclusions: </strong>Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10807096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545847","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}
Pub Date : 2024-01-17DOI: 10.1186/s41182-023-00566-0
Madoka Kishino, Azumi Hida, Evans A Chadeka, Manabu Inoue, Mayuko Osada-Oka, Sohkichi Matsumoto, Sammy M Njenga, Shinjiro Hamano, Sachiyo Nagi
Background: Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya.
Methods: This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status.
Results: Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016).
Conclusions: A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.
{"title":"Association between diet quality and risk of stunting among school-aged children in Schistosoma mansoni endemic area of western Kenya: a cross-sectional study.","authors":"Madoka Kishino, Azumi Hida, Evans A Chadeka, Manabu Inoue, Mayuko Osada-Oka, Sohkichi Matsumoto, Sammy M Njenga, Shinjiro Hamano, Sachiyo Nagi","doi":"10.1186/s41182-023-00566-0","DOIUrl":"10.1186/s41182-023-00566-0","url":null,"abstract":"<p><strong>Background: </strong>Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya.</p><p><strong>Methods: </strong>This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status.</p><p><strong>Results: </strong>Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016).</p><p><strong>Conclusions: </strong>A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10792916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486150","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}
Pub Date : 2024-01-16DOI: 10.1186/s41182-023-00575-z
Ephrem Damene, Fekadu Massebo
Background: Although many countries have shown interest in eliminating malaria, approaches that complement existing vector control interventions are needed because existing methods have been scaled up but malaria still persists. Therefore, the effect of ivermectin administration to cattle was evaluated for its effect on mortality, survivorship and mortality of laboratory reared Anopheles arabiensis.
Methods: Three calves were randomly selected and injected with ivermectin at a therapeutic dose of 0.2 mg/kg, while the other two calves received no treatment and served as controls. Five tents were constructed for the trial. Calves were housed in tents (one per tent) and then 30 starved female An. arabiensis were introduced into each tent. Only fully engorged females were collected from each tent and placed in different mosquito cages to monitor their mortality, survival and fecundity. Data analysis was done using SPSS version 16.
Results: During the follow-up period (until day 21), ivermectin induced significantly higher mortality when compared to controls. It resulted in an average 24-h mortality rate of 81.6% against An. arabiensis on the first day following treatment. 100% An. arabiensis that fed on ivermectin-treated calves on the first day after treatment died within four days. Egg production rate of An. arabiensis that fed on ivermectin-treated calves was significantly lower compared to controls (F = 768.7, P < 0.001).
Conclusion: In conclusion, ivermectin induced mortality, reduced fecundity and survivorship of laboratory maintained An. arabiensis. Further study is recommended using a wild mosquito population. Moreover, mass ivermectin administration to domestic animals could be recommended to supplement the existing indoor based interventions.
{"title":"Administration of ivermectin to cattle induced mortality, reduced fecundity and survivorship of Anopheles arabiensis in Ethiopia: an implication for expansion of vector control toolbox.","authors":"Ephrem Damene, Fekadu Massebo","doi":"10.1186/s41182-023-00575-z","DOIUrl":"10.1186/s41182-023-00575-z","url":null,"abstract":"<p><strong>Background: </strong>Although many countries have shown interest in eliminating malaria, approaches that complement existing vector control interventions are needed because existing methods have been scaled up but malaria still persists. Therefore, the effect of ivermectin administration to cattle was evaluated for its effect on mortality, survivorship and mortality of laboratory reared Anopheles arabiensis.</p><p><strong>Methods: </strong>Three calves were randomly selected and injected with ivermectin at a therapeutic dose of 0.2 mg/kg, while the other two calves received no treatment and served as controls. Five tents were constructed for the trial. Calves were housed in tents (one per tent) and then 30 starved female An. arabiensis were introduced into each tent. Only fully engorged females were collected from each tent and placed in different mosquito cages to monitor their mortality, survival and fecundity. Data analysis was done using SPSS version 16.</p><p><strong>Results: </strong>During the follow-up period (until day 21), ivermectin induced significantly higher mortality when compared to controls. It resulted in an average 24-h mortality rate of 81.6% against An. arabiensis on the first day following treatment. 100% An. arabiensis that fed on ivermectin-treated calves on the first day after treatment died within four days. Egg production rate of An. arabiensis that fed on ivermectin-treated calves was significantly lower compared to controls (F = 768.7, P < 0.001).</p><p><strong>Conclusion: </strong>In conclusion, ivermectin induced mortality, reduced fecundity and survivorship of laboratory maintained An. arabiensis. Further study is recommended using a wild mosquito population. Moreover, mass ivermectin administration to domestic animals could be recommended to supplement the existing indoor based interventions.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478956","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}
Measles poses a significant global health threat, exacerbated by the COVID-19 pandemic. Despite the efficacy of two vaccine doses, under-5 mortality rates persist, with over 61 million delayed measles vaccinations worldwide. Nepal, striving to eliminate measles by 2023, faces a resurgence, attributing 1013 cases to inadequate vaccination and healthcare accessibility issues. Compounded by disruptions from the COVID-19 pandemic, the outbreak highlights the urgent need for vaccination promotion, improved healthcare access, and misinformation mitigation. This situation underscores the critical role of global collaboration and healthcare infrastructure investment to safeguard children's lives in Nepal and similar vulnerable regions.
{"title":"Stumbling blocks on the path to measles-free Nepal: impact of the COVID-19 pandemic.","authors":"Chandan Kumar Thakur, Nitin Gupta, Nayanum Pokhrel, Samita Adhikari, Meghnath Dhimal, Pradip Gyanwali","doi":"10.1186/s41182-024-00576-6","DOIUrl":"10.1186/s41182-024-00576-6","url":null,"abstract":"<p><p>Measles poses a significant global health threat, exacerbated by the COVID-19 pandemic. Despite the efficacy of two vaccine doses, under-5 mortality rates persist, with over 61 million delayed measles vaccinations worldwide. Nepal, striving to eliminate measles by 2023, faces a resurgence, attributing 1013 cases to inadequate vaccination and healthcare accessibility issues. Compounded by disruptions from the COVID-19 pandemic, the outbreak highlights the urgent need for vaccination promotion, improved healthcare access, and misinformation mitigation. This situation underscores the critical role of global collaboration and healthcare infrastructure investment to safeguard children's lives in Nepal and similar vulnerable regions.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471858","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}