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Prevalence of group B Streptococcus colonisation in mother–newborn dyads in low-income and middle-income south Asian and African countries: a prospective, observational study 南亚和非洲低收入和中等收入国家母婴二人组中 B 群链球菌定植的流行率:一项前瞻性观察研究。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-10-01 DOI: 10.1016/S2666-5247(24)00129-0
Gaurav Kwatra PhD , Alane Izu PhD , Clare Cutland PhD , Godwin Akaba MPH , Musa Mohammed Ali PhD , Zabed Ahmed MSc , Prof Manisha Madhai Beck MD , Hellen Cherono Barsosio MBBS , Prof James A Berkley MD , Tolossa E Chaka MD , Anélsio Cossa MSc , Sowmitra Chakraborty MSc , Nisha Dhar PhD , Phurb Dorji MD , Maksuda Islam PhD , Adama Mamby Keita MD , Stella Mwakio MD , Salim Mwarumba MSc , Nubwa Medugu MD , Helio Mucavele MD , Prof Shabir A Madhi PhD
<div><h3>Background</h3><div>Rectovaginal group B <em>Streptococcus</em> (GBS) colonisation in pregnant individuals at the time of labour is a major risk factor for invasive GBS disease by age 7 days (early-onset disease). We aimed to investigate the prevalence of rectovaginal GBS colonisation at the time of labour among pregnant women and vertical transmission to their newborns across selected low-income and middle-income African and south Asian countries.</div></div><div><h3>Methods</h3><div>This prospective, observational study was undertaken at 11 maternity and obstetric care facilities based in Ethiopia, Kenya, Mozambique, Nigeria, Mali, South Africa, Bangladesh, India, and Bhutan. HIV-negative pregnant women aged 18–45 years who were in the early stages of labour and at least 37 weeks’ gestation were eligible for inclusion. Lower vaginal and rectal swabs and urine were collected from the women, and swabs of the umbilicus, outer ear, axillary fold, rectum, and throat were obtained from their newborns, for GBS culture. Standardised sampling and culture using direct plating and selective media broth for detection of GBS colonisation was undertaken at the sites. Serotyping of GBS isolates was done in South Africa. The primary outcome was the prevalence of rectovaginal GBS among pregnant women, analysed in participants with available data. This study is registered with the South African National Clinical Trials Register, number DOH-27–0418–4989.</div></div><div><h3>Findings</h3><div>6922 pregnant women were enrolled from Jan 10, 2016, to Dec 11, 2018, of whom 6514 (94·1%; 759–892 per country) were included in the analysis; data from Bhutan were not included in the study due to issues with specimen collection and processing. Overall, the prevalence of maternal GBS colonisation was 24·1% (95% CI 23·1–25·2; 1572 of 6514); it was highest in Mali (41·1% [37·7–44·6]; 314 of 764) and lowest in Ethiopia (11·6% [9·5–14·1]; 88 of 759). The overall rate of vertical transmission of GBS from women with rectovaginal GBS colonisation was 72·3% (70·0–74·4; 1132 of 1566); it was highest in Mozambique (79·2% [73·3–84·2]; 168 of 212) and lowest in Bangladesh (55·8%, 47·5–63·8; 77 of 138). The five most common GBS colonising serotypes were Ia (37·3% [34·9–39·7]; 586 of 1572), V (28·5% [26·3–30·8]; 448 of 1572), III (25·1% [23·0–27·3]; 394 of 1572), II (9·2% [7·8–10·7]; 144 of 1572), and Ib (6·5% [5·4–7·8]; 102 of 1572). There was geographical variability in serotype proportion distribution; serotype VII was the third most common serotype in India (8·6% [5·3–13·7]; 15 of 174) and serotype VI was mainly identified in Bangladesh (5·8% [3·0–11·0]; eight of 138) and India (5·7% [3·2–10·3]; ten of 174).</div></div><div><h3>Interpretation</h3><div>Our study reported a high prevalence of GBS colonisation in most settings, with some geographical variability even within African countries. Our findings suggest that serotypes not included in current multivalent capsular-polysa
背景:孕妇在分娩时直肠阴道B群链球菌(GBS)定植是7天内发生侵袭性GBS疾病(早发疾病)的主要风险因素。我们的目的是调查选定的中低收入非洲国家和南亚国家孕妇在分娩时直肠阴道 GBS 定植的流行率及其对新生儿的垂直传播:这项前瞻性观察研究在埃塞俄比亚、肯尼亚、莫桑比克、尼日利亚、马里、南非、孟加拉国、印度和不丹的 11 家妇产医院进行。年龄在 18-45 岁之间、处于分娩早期阶段、妊娠至少 37 周的 HIV 阴性孕妇均符合纳入研究的条件。从孕妇身上采集下阴道拭子、直肠拭子和尿液,从新生儿身上采集脐部、外耳、腋窝、直肠和咽喉拭子,进行 GBS 培养。各医疗点均采用标准化的采样和培养方法,使用直接平板和选择性培养基肉汤检测 GBS 定植情况。在南非对分离出的 GBS 进行了血清分型。主要结果是孕妇直肠阴道 GBS 患病率,分析对象为有数据的参与者。该研究已在南非国家临床试验登记处登记,编号为 DOH-27-0418-4989:从2016年1月10日到2018年12月11日,共登记了6922名孕妇,其中6514名(94-1%;每个国家759-892名)纳入分析;由于标本采集和处理问题,不丹的数据未纳入研究。总体而言,产妇 GBS 定植率为 24-1%(95% CI 23-1-25-2;6514 人中有 1572 人);马里最高(41-1% [37-7-44-6];764 人中有 314 人),埃塞俄比亚最低(11-6% [9-5-14-1];759 人中有 88 人)。直肠阴道 GBS 定殖的妇女垂直传播 GBS 的总比例为 72-3%(70-0-74-4;1566 例中的 1132 例);莫桑比克最高(79-2% [73-3-84-2];212 例中的 168 例),孟加拉国最低(55-8%,47-5-63-8;138 例中的 77 例)。最常见的五种 GBS 定植血清型是 Ia(37-3% [34-9-39-7];1572 例中的 586 例)、V(28-5% [26-3-30-8];1572 例中的 448 例)、III(25-1% [23-0-27-3];1572 例中的 394 例)、II(9-2% [7-8-10-7];1572 例中的 144 例)和 Ib(6-5% [5-4-7-8];1572 例中的 102 例)。血清型比例分布存在地域差异;血清 VII 型是印度第三常见的血清型(8-6% [5-3-13-7];174 人中有 15 人),血清 VI 型主要在孟加拉国(5-8% [3-0-11-0];138 人中有 8 人)和印度(5-7% [3-2-10-3];174 人中有 10 人)发现:我们的研究报告显示,大多数环境中的 GBS 定植率都很高,即使在非洲国家内部也存在一定的地域差异。我们的研究结果表明,目前多价荚膜多糖 GBS 疫苗中未包括的血清型在某些地区很普遍,因此疫苗效力和许可后效力研究应评估接种疫苗对孕产妇 GBS 定植的影响,因为非疫苗血清型有可能取代疫苗血清型:比尔及梅琳达-盖茨基金会。
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引用次数: 0
Addressing the risk of global spread of Neisseria meningitidis: strategies for the forthcoming 2024 Hajj following cases in the UK, France, and the USA 应对脑膜炎奈瑟氏菌全球传播的风险:继英国、法国和美国出现病例后,为即将到来的 2024 年朝觐制定战略。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-10-01 DOI: 10.1016/S2666-5247(24)00148-4
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引用次数: 0
Fatal meningoencephalitis associated with Ebola virus persistence in two survivors of Ebola virus disease in the Democratic Republic of the Congo: a case report study 刚果民主共和国两名埃博拉病毒病幸存者的致命脑膜脑炎与埃博拉病毒持续存在有关:病例报告研究。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-10-01 DOI: 10.1016/S2666-5247(24)00137-X
Daniel Mukadi-Bamuleka PhD , François Edidi-Atani MD , Maria E Morales-Betoulle PhD , Anaïs Legand MPH , Antoine Nkuba-Ndaye PhD , Junior Bulabula-Penge MD , Placide Mbala-Kingebeni PhD , Ian Crozier MD , Fabrice Mambu-Mbika MD , Shannon Whitmer PhD , Olivier Tshiani Mbaya MD , Lisa E Hensley PhD , Richard Kitenge-Omasumbu MD , Richard Davey MD , Sabue Mulangu PhD , Peter N Fonjungo PhD , Michael R Wiley PhD , John D Klena PhD , Martine Peeters PhD , Eric Delaporte PhD , Hugo Kavunga-Membo
<div><h3>Background</h3><div>During the 2018–20 Ebola virus disease outbreak in the Democratic Republic of the Congo, thousands of patients received unprecedented vaccination, monoclonal antibody (mAb) therapy, or both, leading to a large number of survivors. We aimed to report the clinical, virological, viral genomic, and immunological features of two previously vaccinated and mAb-treated survivors of Ebola virus disease in the Democratic Republic of the Congo who developed second episodes of disease months after initial discharge, ultimately complicated by fatal meningoencephalitis associated with viral persistence.</div></div><div><h3>Methods</h3><div>In this case report study, we describe the presentation, management, and subsequent investigations of two patients who developed recrudescent Ebola virus disease and subsequent fatal meningoencephalitis. We obtained data from epidemiological databases, Ebola treatment units, survivor programme databases, laboratory datasets, and hospital records. Following national protocols established during the 2018–20 outbreak in the Democratic Republic of the Congo, blood, plasma, and cerebrospinal fluid (CSF) samples were collected during the first and second episodes of Ebola virus disease from both individuals and were analysed by molecular (quantitative RT-PCR and next-generation sequencing) and serological (IgG and IgM ELISA and Luminex assays) techniques.</div></div><div><h3>Findings</h3><div>The total time between the end of the first Ebola virus episode and the onset of the second episode was 342 days for patient 1 and 137 days for patient 2. In both patients, Ebola virus RNA was detected in blood and CSF samples during the second episode of disease. Complete genomes from CSF samples from this relapse episode showed phylogenetic relatedness to the genome sequenced from blood samples collected from the initial infection, confirming in-host persistence of Ebola virus. Serological analysis showed an antigen-specific humoral response with typical IgM and IgG kinetics in patient 1, but an absence of an endogenous adaptive immune response in patient 2.</div></div><div><h3>Interpretation</h3><div>We report the first two cases of fatal meningoencephalitis associated with Ebola virus persistence in two survivors of Ebola virus disease who had received vaccination and mAb-based treatment in the Democratic Republic of the Congo. Our findings highlight the importance of long-term monitoring of survivors, including continued clinical, virological, and immunological profiling, as well as the urgent need for novel therapeutic strategies to prevent and mitigate the individual and public health consequences of Ebola virus persistence.</div></div><div><h3>Funding</h3><div>Ministry of Health of the Democratic Republic of the Congo, Institut National de Recherche Biomédicale, Infectious Disease Rapid Response Reserve Fund, US Centers for Disease Control and Prevention, US National Cancer Institute (National Institutes o
背景:在 2018-20 年刚果民主共和国爆发埃博拉病毒病期间,数以千计的患者接受了前所未有的疫苗接种、单克隆抗体(mAb)治疗或两者兼用,从而产生了大量幸存者。我们旨在报告两名曾接种疫苗并接受过 mAb 治疗的刚果民主共和国埃博拉病毒病幸存者的临床、病毒学、病毒基因组学和免疫学特征:在本病例报告研究中,我们描述了两名埃博拉病毒复发患者的表现、管理和后续调查情况,这两名患者随后患上了致命的脑膜脑炎。我们从流行病学数据库、埃博拉治疗单位、幸存者计划数据库、实验室数据集和医院记录中获取数据。根据 2018-20 年刚果民主共和国疫情爆发期间制定的国家协议,在埃博拉病毒病第一次和第二次发作期间收集了两人的血液、血浆和脑脊液样本,并通过分子(定量 RT-PCR 和下一代测序)和血清学(IgG 和 IgM ELISA 和 Luminex 检测)技术进行了分析:从第一次埃博拉病毒发作结束到第二次发作开始的总时间,1 号患者为 342 天,2 号患者为 137 天。在第二次发病期间,两名患者的血液和脑脊液样本中都检测到了埃博拉病毒 RNA。从这次复发的脑脊液样本中提取的完整基因组与从初次感染时采集的血液样本中测序的基因组显示出系统发育相关性,证实了埃博拉病毒在宿主体内的持续存在。血清学分析显示,患者1出现了抗原特异性体液反应,具有典型的IgM和IgG动力学,但患者2缺乏内源性适应性免疫反应:我们报告了首两例与埃博拉病毒持续存在相关的致命脑膜脑炎病例,这两例病例是在刚果民主共和国接受过疫苗接种和基于 mAb 治疗的埃博拉病毒病幸存者。我们的研究结果突显了对幸存者进行长期监测的重要性,包括持续的临床、病毒学和免疫学分析,以及迫切需要新型治疗策略来预防和减轻埃博拉病毒持续存在对个人和公共卫生造成的后果:资金来源:刚果民主共和国卫生部、国家生物医学研究所、传染病快速反应储备基金、美国疾病控制和预防中心、法国国家发展研究院和世界卫生组织。
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引用次数: 0
Climate change and Trypanosoma cruzi transmission in North and central America 气候变化与北美洲和中美洲的克鲁兹锥虫传播。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-10-01 DOI: 10.1016/j.lanmic.2024.07.009
Colin Forsyth PhD , Nelson Ivan Agudelo Higuita MD , Sarah A Hamer PhD DVM , Carlos N Ibarra-Cerdeña PhD , Alba Valdez-Tah PhD , Paula Stigler Granados PhD , Gabriel L Hamer PhD , Michael Vingiello MPH , Norman L Beatty MD
Trypanosoma cruzi is a protozoan parasite that causes Chagas disease in humans. Transmission of T cruzi by triatomine vectors is dependent on diverse environmental and socioeconomic factors. Climate change, which is disrupting patterns of human habitation and land use, can affect the epidemiology of Chagas disease by influencing the distribution of vector and host species. We conducted a review using triatomine distribution as a proxy for T cruzi transmission in North America (Canada, Mexico, and the USA) and central America (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama) and investigated the association of T cruzi transmission with climate change, identifying 12 relevant studies. Most studies (n=9) modelled the effect of the scenario of climate change on the distribution of relevant vector species and found that global warming could sometimes favour and sometimes hinder triatomine distribution. There is a need for more research in parasite biology and social sciences to further understand how climate change and socioeconomic factors can affect the epidemiology of this neglected tropical disease.
克鲁兹锥虫是一种原生动物寄生虫,会导致人类患上南美锥虫病。克鲁兹锥虫通过三蠹类媒介传播取决于各种环境和社会经济因素。气候变化扰乱了人类居住和土地使用的模式,会通过影响病媒和宿主物种的分布来影响恰加斯病的流行病学。我们以北美(加拿大、墨西哥和美国)和中美洲(伯利兹、哥斯达黎加、萨尔瓦多、危地马拉、洪都拉斯、尼加拉瓜和巴拿马)的三螨分布作为南美锥虫病传播的替代物进行了回顾,并调查了南美锥虫病传播与气候变化的关系,确定了 12 项相关研究。大多数研究(9 项)模拟了气候变化情景对相关病媒物种分布的影响,发现全球变暖有时有利于三蠹的分布,有时则会阻碍三蠹的分布。有必要在寄生虫生物学和社会科学方面开展更多研究,以进一步了解气候变化和社会经济因素如何影响这种被忽视的热带疾病的流行病学。
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引用次数: 0
Prevalence and clinical relevance of viraemia in viral respiratory tract infections: a systematic review. 病毒性呼吸道感染中病毒血症的发病率和临床意义:系统综述。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-26 DOI: 10.1016/j.lanmic.2024.100967
Karl Hagman, Tamara Postigo, David Diez-Castro, Johan Ursing, Jesús F Bermejo-Martin, Amanda de la Fuente, Ana P Tedim

In this Review, we analysed the prevalence of viraemia during infection with SARS-CoV-2 and other relevant respiratory viruses, including other human coronaviruses such as MERS-CoV and SARS-CoV, adenovirus, human metapneumovirus, human rhinovirus/enterovirus, influenza A and B virus, parainfluenza virus, and respiratory syncytial virus. First, a preliminary systematic search was conducted to identify articles published before May 23, 2024 that reported on viraemia during infection with respiratory viruses. The articles were then analysed for relevant terms to identify the prevalence of viraemia, its association with the disease severity and long-term consequences, and host responses. A total of 202 articles were included in the final study. The pooled prevalence of viraemia was 34% for SARS-CoV-2 and between 6% and 65% for other viruses. Association of viraemia with disease severity was extensively reported for SARS-CoV-2 and also for SARS-CoV, MERS-CoV, adenoviruses, rhinoviruses, respiratory syncytial virus, and influenza A(H1N1)pdm09 (albeit with low evidence). SARS-CoV-2 viraemia was linked to memory problems and worsened quality of life. Viraemia was associated with signatures denoting dysregulated host responses. In conclusion, the high prevalence of viraemia and its association with disease severity suggests that viraemia could be a relevant pathophysiological event with important translational implications in respiratory viral infections.

在本综述中,我们分析了感染 SARS-CoV-2 和其他相关呼吸道病毒时病毒血症的流行情况,包括其他人类冠状病毒(如 MERS-CoV 和 SARS-CoV)、腺病毒、人类偏肺病毒、人类鼻病毒/肠道病毒、甲型和乙型流感病毒、副流感病毒和呼吸道合胞病毒。首先,对 2024 年 5 月 23 日之前发表的报道呼吸道病毒感染期间病毒血症的文章进行了初步系统检索。然后对这些文章的相关术语进行分析,以确定病毒血症的流行情况、病毒血症与疾病严重程度和长期后果的关系以及宿主反应。最终研究共纳入了 202 篇文章。经汇总,SARS-CoV-2病毒的病毒血症发病率为34%,其他病毒的发病率为6%至65%。关于病毒血症与疾病严重程度的关系,SARS-CoV-2 以及 SARS-CoV、MERS-CoV、腺病毒、鼻病毒、呼吸道合胞病毒和甲型 H1N1 流感 pdm09 都有大量报道(尽管证据不足)。SARS-CoV-2 病毒血症与记忆问题和生活质量恶化有关。病毒血症与宿主反应失调的特征有关。总之,病毒血症的高发病率及其与疾病严重程度的关系表明,病毒血症可能是一种相关的病理生理事件,对呼吸道病毒感染具有重要的转化意义。
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引用次数: 0
Surge in Oropouche fever: the tip of the iceberg in a new public health challenge in Brazil. 奥罗普切热的激增:巴西公共卫生新挑战的冰山一角。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-24 DOI: 10.1016/j.lanmic.2024.100994
Joziana Muniz de Paiva Barçante, José Cherem
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引用次数: 0
Global age-stratified seroprevalence of enterovirus D68: a systematic literature review. 肠道病毒 D68 的全球年龄分层血清流行率:系统性文献综述。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-24 DOI: 10.1016/j.lanmic.2024.07.001
David Jorgensen, Nicholas C Grassly, Margarita Pons-Salort

Enterovirus D68 (EV-D68), first isolated in 1962, emerged in 2014, causing outbreaks of severe respiratory infections and acute flaccid myelitis. In this systematic review, we have compiled all available literature on age-stratified seroprevalence estimates of EV-D68. Ten studies from six countries were retained, all conducted using microneutralisation assays, despite wide variations in protocols and challenge viruses. The age profiles of seroprevalence were similar across time and regions; seroprevalence increased quickly with age, reaching roughly 100% by the age of 20 years and with no sign of decline throughout adulthood. This suggests continuous or frequent exposure of the populations to the virus, or possible cross-reactivity with other viruses. Studies with two or more cross-sectional surveys reported consistently higher seroprevalence at later timepoints, suggesting a global increase in transmission over time. This systematic review concludes that standardising serological protocols, understanding the contribution of cross-reactivity with other pathogens to the high reported seroprevalence, and quantifying individual exposure to EV-D68 over time are the main research priorities for the future.

肠道病毒 D68(EV-D68)于 1962 年首次分离出来,2014 年出现,引起了严重呼吸道感染和急性弛缓性脊髓炎的爆发。在这篇系统性综述中,我们汇编了有关 EV-D68 年龄分层血清流行率估计值的所有现有文献。尽管研究方案和挑战病毒存在很大差异,但我们保留了来自六个国家的十项研究,这些研究均采用微中和作用测定法进行。不同时间和不同地区的血清流行率年龄分布情况相似;血清流行率随着年龄的增长而迅速上升,到 20 岁时大约达到 100%,而且在整个成年期没有下降的迹象。这表明这些人群持续或频繁接触病毒,或可能与其他病毒发生交叉反应。进行过两次或两次以上横断面调查的研究报告称,后期时间点的血清流行率一直较高,这表明随着时间的推移,全球传播率在上升。本系统综述的结论是,标准化血清学方案、了解与其他病原体的交叉反应对所报告的高血清流行率的贡献,以及量化随着时间推移个人暴露于 EV-D68 的情况,是未来研究的主要优先事项。
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引用次数: 0
Functional antibody responses associated with effectiveness of RTS,S malaria vaccine in children: new insights and implications. 与儿童接种 RTS S 疟疾疫苗的有效性相关的功能性抗体反应:新的见解和影响。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-24 DOI: 10.1016/j.lanmic.2024.101001
Rajesh Kanna Gopal, Pitchaipillai Sankar Ganesh, Naji Naseef Pathoor
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引用次数: 0
Epidemiology and drug resistance among Candida pathogens in Africa: Candida auris could now be leading the pack. 非洲念珠菌病原体的流行病学和耐药性:白色念珠菌现在可能处于领先地位。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-21 DOI: 10.1016/j.lanmic.2024.100996
Chibuike Ibe, Carolina Henritta Pohl
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引用次数: 0
Data for action: the crucial role of hospitals in controlling Clostridioides difficile infection in England. 行动数据:英国医院在控制艰难梭状芽孢杆菌感染中的关键作用》(Data for Action: the crucial role of hospitals in controlling Clostridioides difficile infection in England)。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-19 DOI: 10.1016/j.lanmic.2024.100991
Akaninyene Otu, Dimple Chudasama, Russell Hope, Dakshika Jeyaratnam
{"title":"Data for action: the crucial role of hospitals in controlling Clostridioides difficile infection in England.","authors":"Akaninyene Otu, Dimple Chudasama, Russell Hope, Dakshika Jeyaratnam","doi":"10.1016/j.lanmic.2024.100991","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100991","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"100991"},"PeriodicalIF":20.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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