Journal of Infection最新文献

{"title":"Zidebactam restores cefiderocol sensitivity in resistant bacteria","authors":"Chen Xu , Xiaofan Li , Guangfen Zhang, Chunli Li, Jiayi You, Chenjie Zhang, Yuanyuan Li, Yunbing Li, Xiangkun Zeng, Lili Huang, Mi Zhou, Yi Yang, Jiani Jiang, Ruichao Li, Shigui Yang, Ning Dong","doi":"10.1016/j.jinf.2025.106417","DOIUrl":"10.1016/j.jinf.2025.106417","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106417"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-acetylcysteine modulates markers of oxidation, inflammation and infection in tuberculosis","authors":"Daniel Adon Mapamba ,&nbsp;Issa Sabi ,&nbsp;Julieth Lalashowi ,&nbsp;Elingarami Sauli ,&nbsp;Joram Buza ,&nbsp;Willyhelmina Olomi ,&nbsp;Bariki Mtafya ,&nbsp;Michael Kibona ,&nbsp;Abhishek Bakuli ,&nbsp;Andrea Rachow ,&nbsp;Kavindhran Velen ,&nbsp;Michael Hoelscher ,&nbsp;Nyanda E. Ntinginya ,&nbsp;Salome Charalambous ,&nbsp;Gavin Churchyard ,&nbsp;Robert S. Wallis ,&nbsp;the TB SEQUEL consortium","doi":"10.1016/j.jinf.2024.106379","DOIUrl":"10.1016/j.jinf.2024.106379","url":null,"abstract":"<div><h3>Background</h3><div>Half the global tuberculosis health burden is due to post-tuberculosis lung disease. Host-directed therapies have been proposed to reduce this burden. N-acetylcysteine (NAC) provides the conditionally essential amino acid cysteine required for synthesis of glutathione, an antioxidant thiol. We recently reported clinical outcomes of a trial of adjunctive NAC in patients with pulmonary tuberculosis, finding that NAC improved the secondary endpoint of recovery of lung function. Here we report the effects of NAC on biomarkers of oxidation, inflammation, and infection in that trial.</div></div><div><h3>Methods</h3><div>140 adults with moderate or far-advanced pulmonary tuberculosis were randomly assigned to standard tuberculosis treatment with or without NAC 1200 mg twice daily for months 1–4. Sputum and blood samples were obtained at specified intervals to measure total glutathione, MTB-induced cytokines, hemoglobin, whole blood mycobactericidal activity (WBA), and sputum MTB burden.</div></div><div><h3>Results</h3><div>NAC treatment rapidly increased total glutathione (P&lt;.0001), but levels did not reach those of healthy volunteers (P&lt;.001). NAC reduced MTB-induced TNF-α (P =.011) without affecting IL-10, and accelerated the recovery of hemoglobin in participants with low values on entry. NAC did not affect killing in <em>ex vivo</em> whole blood culture but did slow the clearance of MTB from sputum (P=0.003).</div></div><div><h3>Conclusion</h3><div>Adjunctive NAC showed antioxidant and anti-inflammatory effects consistent with the amelioration of immunopathology seen in preclinical models. Two biomarkers of antimicrobial activity showed discordant results; neither demonstrated the enhanced antimicrobial effects seen preclinically. The reduction of oxidative stress and inflammation by NAC may explain its effects on the recovery of lung function post-TB.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106379"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood-based diagnosis of pediatric tuberculosis: A prospective cohort study in South Africa and Dominican Republic","authors":"Lin Li ,&nbsp;Liyan Mao ,&nbsp;Marieke M. van der Zalm ,&nbsp;Juan Olivo ,&nbsp;Shan Liu ,&nbsp;Carlos Vergara ,&nbsp;Megan Palmer ,&nbsp;Qingbo Shu ,&nbsp;Anne-Marie Demers ,&nbsp;Christopher J. Lyon ,&nbsp;Pierre Goussard ,&nbsp;H. Simon Schaaf ,&nbsp;Anneke C. Hesseling ,&nbsp;Sharon Nachman ,&nbsp;Eddy Pérez-Then ,&nbsp;Charles D. Mitchell ,&nbsp;Elisabetta Ghimenton ,&nbsp;Tony Y. Hu","doi":"10.1016/j.jinf.2024.106404","DOIUrl":"10.1016/j.jinf.2024.106404","url":null,"abstract":"<div><h3>Objectives</h3><div>Pediatric tuberculosis (TB) diagnosis is complicated by challenges in obtaining invasive respiratory specimens that frequently contain few <em>Mycobacterium tuberculosis</em> (<em>Mtb</em>) bacilli. We report the diagnostic performance of an <em>Mtb</em> antigen<em>-</em>derived peptide (MAP-TB) assay and its ability to monitor TB treatment response.</div></div><div><h3>Methods</h3><div>Study cohorts enrolled children who presented with presumptive TB at two hospitals in South Africa from 2012 to 2017 (157 children aged &lt;13 years) and at community-based clinics in the Dominican Republic from 2019 to 2023 (101 children aged &lt;18 years). Children were evaluated for TB at enrollment and six months post-enrollment and assigned confirmed, unconfirmed, or unlikely TB diagnoses using the 2015 NIH diagnostic criteria for pediatric TB. MAP-TB assay performance was evaluated using serum collected at baseline and at regular intervals post-enrollment following STARD guidelines.</div></div><div><h3>Results</h3><div>MAP-TB sensitivity for confirmed and unconfirmed TB was comparable to culture and Xpert sensitivity for confirmed TB, but MAP-TB specificity revealed age-dependence, decreasing from 98·1% to 78·4%, when including children aged &lt;1 year. MAP-TB values decreased by six months post-treatment initiation in children with symptom improvement.</div></div><div><h3>Conclusions</h3><div>Serum MAP-TB results can effectively diagnose pediatric TB, including unconfirmed and extrapulmonary TB missed by current methods, and correspond to effective treatment.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106404"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of antimicrobial stewardship ward rounds on antimicrobial use and predictors of advice, uptake, and outcomes","authors":"David W. Eyre ,&nbsp;Gemma Pill ,&nbsp;Bee Yean Ng ,&nbsp;Caroline Herin ,&nbsp;Bernadette O’Riordan ,&nbsp;Douglas Izzard ,&nbsp;Louise Dunsmure ,&nbsp;Stephane Paulus ,&nbsp;Katie Jeffery ,&nbsp;Nicola Jones","doi":"10.1016/j.jinf.2025.106419","DOIUrl":"10.1016/j.jinf.2025.106419","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the impact of introducing antimicrobial stewardship (AMS) ward rounds.</div></div><div><h3>Methods</h3><div>We used an interrupted time-series approach to investigate the impact of implementing AMS ward rounds with in-person feedback from a multidisciplinary team in Hospital-1, also comparing to Hospital-2 in the same city where AMS ward rounds were not yet implemented. Regression models were used to identify predictors of advice given and of whether advice was followed, and associations between advice uptake and length of stay.</div></div><div><h3>Results</h3><div>Introducing AMS ward rounds was followed by new or accelerated declines in ceftriaxone, ciprofloxacin, amoxicillin-clavulanate, meropenem and piperacillin-tazobactam use at Hospital-1. Except for ceftriaxone, similar declines were not seen at Hospital-2. Half of reviews (3471/6878; 50%) recommended an intervention; 2003/2726 (73%) subsequently evaluated recommendations were implemented. Senior doctors were more likely than pharmacists or specialist doctors in training to recommend de-escalation/stopping antibiotics and to have their advice followed. The more prior AMS reviews completed, the more likely advice was to be followed. Following advice to de-escalate/stop antimicrobials was associated with a 0.58 day [95%CI 0.22–0.94] reduction in hospital stay.</div></div><div><h3>Conclusions</h3><div>Multidisciplinary AMS ward rounds reduced antibiotic use and likely reduced length of hospital stay. Senior clinician input and more AMS experience increased advice uptake.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106419"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empirical antibiotic therapy improves outcomes in mechanically ventilated patients with COVID-19: An emulated targeted trial within a prospective, multicentre cohort study","authors":"Pedro D. Wendel-Garcia ,&nbsp;Adrian Ceccato ,&nbsp;Ana Motos ,&nbsp;Diego Franch-Llasat ,&nbsp;Mar O. Pérez-Moreno ,&nbsp;Marie F. Domenech-Spanedda ,&nbsp;Elena Chamarro-Martí ,&nbsp;Ricard Ferrer ,&nbsp;Laia Fernández-Barat ,&nbsp;Jordi Riera ,&nbsp;Sergio Álvarez-Napagao ,&nbsp;Oscar Peñuelas ,&nbsp;Jose A. Lorente ,&nbsp;Raquel Almansa ,&nbsp;Albert Gabarrús ,&nbsp;David de Gonzalo-Calvo ,&nbsp;Jessica González ,&nbsp;Jose M. Añon ,&nbsp;Carme Barberà ,&nbsp;José Barberán ,&nbsp;Ferran Roche-Campo","doi":"10.1016/j.jinf.2025.106411","DOIUrl":"10.1016/j.jinf.2025.106411","url":null,"abstract":"<div><h3>Background</h3><div>Bacterial pulmonary superinfections develop in a substantial proportion of mechanically ventilated COVID-19 patients and are associated with prolonged mechanical ventilation requirements and increased mortality. Albeit recommended, evidence supporting the use of empirical antibiotics at intubation is weak and of low quality. The aim of this study was to elucidate the effect of empirical antibiotics, administered within 24 h of endotracheal intubation, on superinfections, duration of mechanical ventilation, and mortality in mechanically ventilated patients with COVID-19.</div></div><div><h3>Methods</h3><div>Emulated targeted trial by means of a propensity score-matched analysis of a prospective multicentre cohort study of consecutive mechanically ventilated patients admitted to 62 Spanish intensive care units suffering from COVID-19 between March 2020 and February 2021.</div></div><div><h3>Results</h3><div>Overall, 8532 critically ill COVID-19 patients were included, of which 2580 mechanically ventilated patients remained after matching. Empirical antibiotics were prescribed to 1665 (64%) at intubation. Pulmonary superinfections developed in 39% and 47% of patients treated with and without empirical antibiotics, respectively (p&lt;0.01). Patients treated with empirical antibiotics had a shorter duration of mechanical ventilation (incidence risk ratio: 0.85 [95% confidence interval (CI), 0.78 – 0.94], p&lt;0.01) and a reduced stay in the intensive care unit (incidence risk ratio: 0.89 [95% CI, 0.82 – 0.97] days, p&lt;0.01). Mortality 28 days after endotracheal intubation was 28% in patients treated with empirical antibiotics as opposed to 32% in patients treated without (odds ratio: 0.76 [95% CI, 0.61 – 0.94], p&lt;0.01).</div></div><div><h3>Conclusion</h3><div>The administration of empirical antibiotics at intubation in mechanically ventilated COVID-19 patients was associated with a reduced incidence of pulmonary superinfections, a shorter duration of mechanical ventilation and intensive care unit stay, and a lower mortality rate. Notwithstanding these benefits, the applicability of these findings to other viral pneumonias and beyond the pandemic context remains uncertain.</div><div>Registration: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> (NCT04457505).</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106411"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The molecular bacterial load assay predicts treatment responses in patients with pre-XDR/XDR-tuberculosis more accurately than GeneXpert Ultra MTB/Rif","authors":"Marit Neumann ,&nbsp;Maja Reimann ,&nbsp;Dumitru Chesov ,&nbsp;Cristina Popa ,&nbsp;Antonela Dragomir ,&nbsp;Oana Popescu ,&nbsp;Roxana Munteanu ,&nbsp;Alexandra Hölscher ,&nbsp;Isobella Honeyborne ,&nbsp;Jan Heyckendorf ,&nbsp;Christoph Lange ,&nbsp;Christoph Hölscher ,&nbsp;Barbara Kalsdorf","doi":"10.1016/j.jinf.2024.106399","DOIUrl":"10.1016/j.jinf.2024.106399","url":null,"abstract":"<div><h3>Objectives</h3><div>Early detection of treatment failure is essential to improve the management of drug-resistant tuberculosis (DR-TB). We evaluated the molecular bacterial load assay (MBLA) in comparison to standard diagnostic tests for monitoring therapy of patients affected by drug-resistant TB.</div></div><div><h3>Methods</h3><div>The performance of MBLA in tracking treatment response in a prospective cohort of patients with pulmonary MDR/RR- and pre-XDR/XDR-TB was compared with mycobacterial culture, mycobacterial DNA detection using GeneXpert (Xpert) and microscopy detection of sputum acid-fast-bacilli.</div></div><div><h3>Results</h3><div><em>Mycobacterium tuberculosis</em> culture conversion was used as the read-out for treatment responses. The MBLA was most concordant during the early phase of treatment, detecting changes in bacterial load with similar accuracy to microscopy and outperforming Xpert. When considering all timepoints, concordance with MGIT results was 72.1% for MBLA, 57.4% for Xpert and 76.7% for microscopy. The AUC for culture conversion was higher for MBLA (0.88, CI 0.84–0.95) than for Xpert (0.78, CI 0.72–0.85) and microscopy (0.77, CI 0.71–0.83).</div></div><div><h3>Conclusions</h3><div>MBLA was superior in the early identification of successful culture conversion compared to microscopy and Xpert and could be a useful biomarker to evaluate novel entities in Phase IIA early-bactericidal-activity drug trials regardless of the degree of <em>M. tuberculosis</em> drug resistance.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106399"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of correlation between school reopening and trends in adult COVID-19 hospitalisations and death rates during the Delta and early Omicron periods: An ecological analysis of five countries","authors":"Darren Suryawijaya Ong ,&nbsp;Matthew Harris ,&nbsp;John D. Hart ,&nbsp;Fiona M. Russell","doi":"10.1016/j.jinf.2024.106390","DOIUrl":"10.1016/j.jinf.2024.106390","url":null,"abstract":"<div><h3>Objectives</h3><div>In this ecological study, we describe SARS-CoV-2 case incidence and COVID-19 hospitalisation and death rates for school-aged and adult populations during the Delta and early Omicron periods, before and after schools reopened in five countries.</div></div><div><h3>Methods</h3><div>Data were extracted from government websites. Cases and COVID-19 hospitalisation and death incidence rates were calculated during the Delta and early Omicron periods in Australia, Canada, Denmark, Finland and the United Kingdom, for two weeks preceding and six weeks after schools reopened. We summarised stringency of public health measures (GRI), COVID-19 vaccination rates by age and SARS-CoV-2 testing rates.</div></div><div><h3>Results</h3><div>During Delta, cases increased in 2/7 sites after schools reopened, hospitalisations increased in 1/5 sites, while deaths decreased in one and increased then decreased in another. During Omicron, cases increased in 2/8 sites, hospitalisations increased in 1/6 sites and deaths increased in 1/4 sites. The hospitalisation and death rate trends that commenced before schools reopened continued on the same trajectory after schools reopened. Vaccination rates in ≥70-year-olds were 75–100% during Delta and 95–100% during Omicron. Wide variations in testing rates may explain differences in case incidence. GRI were higher and more variable during Delta than during Omicron.</div></div><div><h3>Conclusions</h3><div>Reopening schools did not change the existing trajectory of COVID-19 rates.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106390"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of Diphtheria, Tetanus and Pertussis (DTP) vaccination strategy in China","authors":"Shimo Zhang,&nbsp;Jue Liu","doi":"10.1016/j.jinf.2025.106416","DOIUrl":"10.1016/j.jinf.2025.106416","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106416"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outpatient treatment of SARS-COV-2 infection in non-hospitalised high-risk paediatric patients in London, UK","authors":"Borbala Zsigmond,&nbsp;Nadia Trecchi,&nbsp;Shamez N. Ladhani,&nbsp;Katja Doerholt","doi":"10.1016/j.jinf.2025.106425","DOIUrl":"10.1016/j.jinf.2025.106425","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106425"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and outcome of brain abscess after introduction of CT and MRI: A meta-analysis","authors":"Jacob Bodilsen ,&nbsp;Emilie Marie Eriksen ,&nbsp;Mikkel Dreyer Nielsen ,&nbsp;Lærke Storgaard Duerlund ,&nbsp;Theis Mariager ,&nbsp;Henrik Nielsen ,&nbsp;Matthijs C. Brouwer","doi":"10.1016/j.jinf.2024.106394","DOIUrl":"10.1016/j.jinf.2024.106394","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical features and outcome of brain abscess since introduction of computerised tomography and magnetic resonance imaging.</div></div><div><h3>Methods</h3><div>MEDLINE and Embase were searched using “brain abscess” or “cerebral abscess” from 1970 through 2023 and analyses restricted to study populations hospitalised after 1980. Single-variable meta-analyses were done using a random-effects model.</div></div><div><h3>Results</h3><div>A total of 21,840 patients from 209 studies were included. The mean age was 34 years (95% confidence interval [CI] 30–38) and 11,817/17,406 (66%, 95% CI 64–67) were male. The aetiologies were consistent across time and continents with <em>Streptococcus spp</em>. 2064/6393 (32%, 95% CI 28–36), <em>Staphylococcus</em> spp. 1061/6393 (14%, 95% CI 12–16), and Gram-negative enteric bacteria 696/6393 (9%, 95% CI 7–11) as the most common. Predisposing conditions included otitis media/mastoiditis 1909/6433 (27%, 95% CI 22–33), immunocompromise 1022/4652 (19%, 95% CI 14–24), sinusitis 565/3725 (16%, 95% CI 12–20), and neurosurgery 745/4927 (16%, 95% CI 12–20). The case-fatality was 2444/18,991 (12%, 95% CI 11–14) and good recovery was found in 3419/5409 (63%, 95% CI 58–68).</div></div><div><h3>Conclusions and relevance</h3><div>Brain abscess remains a disease predominantly occurring in men and is caused by contiguous or distant infections. Case fatality and outcome have not improved during recent decades.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106394"},"PeriodicalIF":14.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}