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Retrospective on molecular assay design for detecting pan-orthopox viruses and prospective on mpox laboratory preparedness and readiness 检测甲氧苄啶病毒的分子检测设计回顾及猴痘实验室准备和准备情况展望
Pub Date : 2023-07-26 DOI: 10.3389/fitd.2023.1221804
Kenneth B Yeh, Michael D. Powers, Ami Patel, F. Parekh, A. Tseng, E. Bradford, Kyle Parker, Ricky Soong, G. Olinger, Illich Mombo
The landscape of in vitro diagnostic (IVD) devices encompasses a broad range of tests that have been used to detect and diagnose pathogens, especially tropical diseases, for decades. The COVID-19 pandemic exemplified the greater need for bringing IVDs from the laboratory directly to the consumer, and recent outbreaks such as mpox, Sudan ebolavirus, and Marburg virus further reinforce this need. The increased emergence of tropical disease outbreaks requires more agile development, higher performance, and mass production of IVD devices. Furthermore, lessons learned in previous device developments can sometimes be used to accelerate new disease diagnostic applications. As an example, we describe one case history of an earlier pan-orthopox viral assay that detected smallpox variola and vaccinia strains, and also discerned related strains including mpox. This work established the foundation for the molecular detection of orthopox viruses, which could be mobilized to address public health needs once an emergency declaration was made that opened the FDA pathway for issuing an emergency use authorization for the use of these assays. Thus, the utilization of knowledge from earlier investments was shown to enhance preparedness and readiness. Here in this retrospective, we elaborate on the processes that enable this approach, including multi-disciplinary and multisectoral collaborations to accomplish a holistic, one health world.
几十年来,体外诊断(IVD)设备的应用范围广泛,包括用于检测和诊断病原体,特别是热带病的各种检测。2019冠状病毒病大流行表明,更需要将静脉注射药物从实验室直接送到消费者手中,而最近的麻疹、苏丹埃博拉病毒和马尔堡病毒等疫情进一步加强了这一需求。热带病暴发的日益增加需要更灵活的开发、更高的性能和大规模生产IVD设备。此外,在以前的设备开发中吸取的经验教训有时可以用来加速新的疾病诊断应用。作为一个例子,我们描述了一个早期泛痘病毒检测的病例史,该检测检测了天花天花和牛痘菌株,并识别了包括m痘在内的相关菌株。这项工作为正痘病毒的分子检测奠定了基础,一旦发布紧急声明,就可以动员起来解决公共卫生需求,为这些检测方法的使用打开了FDA发布紧急使用授权的途径。因此,利用从早期投资中获得的知识可以加强防备和准备。在本次回顾中,我们详细阐述了使这种方法得以实现的进程,包括多学科和多部门合作,以实现一个全面的、统一的卫生世界。
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引用次数: 0
A major dengue epidemic in 2022 in Nepal: need of an efficient early-warning system 尼泊尔2022年登革热疫情:需要有效的预警系统
Pub Date : 2023-07-25 DOI: 10.3389/fitd.2023.1217939
B. G. Dhoubhadel, Yumiko Hayashi, F. M. Domai, S. Bhattarai, K. Ariyoshi, B. Pandey
Dengue has become a recurrent and growing threat to public health in Nepal. The epidemic in 2022 was the largest ever reported, with cases being reported in all of the country’s seven provinces and 77 districts. Despite the establishment of an early-warning and reporting system (EWARS) in 1997, the lack of clear criteria for alarm signals and outbreak definitions in national guidelines delayed the epidemic declaration in 2022, which resulted in an increased number of cases and fatalities. For this article, we analyzed national data from previous years, which demonstrate that an epidemic could have been declared early in July, and that that would have resulted in fewer cases and fatalities if clear criteria for outbreak declarations had also been put in place. We also reviewed the existing national guidelines for dengue prevention and control, and propose recommendations to improve their implementation, particularly with regard to vector control measures. This article also highlights the need for a coordinated effort between multisector stakeholders, strengthened disease surveillance systems, and the establishment of predefined alarm signals and epidemic declaration criteria so that future epidemics are identified in a timely manner. The early outbreak warning system can potentially prevent future large outbreaks and minimize their negative impacts on the country’s health systems and economy.
登革热已成为尼泊尔公众健康的一个反复出现且日益严重的威胁。2022年的疫情是有史以来报告的最大疫情,全国7个省和77个区都报告了病例。尽管1997年建立了预警和报告系统,但国家指南中缺乏明确的警报信号标准和疫情定义,推迟了2022年的疫情申报,导致病例和死亡人数增加。在这篇文章中,我们分析了前几年的国家数据,这些数据表明,疫情本可以在7月初宣布,如果疫情宣布的明确标准也到位,那么病例和死亡人数就会减少。我们还审查了现有的登革热预防和控制国家指南,并提出了改进其实施的建议,特别是在病媒控制措施方面。这篇文章还强调,需要在多部门利益攸关方之间进行协调,加强疾病监测系统,并建立预定义的警报信号和流行病申报标准,以便及时发现未来的流行病。疫情早期预警系统有可能预防未来的大规模疫情,并将其对国家卫生系统和经济的负面影响降至最低。
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引用次数: 0
Malaria mitochondrial diagnosis: challenges and pitfalls 疟疾线粒体诊断:挑战和陷阱
Pub Date : 2023-07-25 DOI: 10.3389/fitd.2023.1204195
Gabriel Luíz Costa, D. A. Alvarenga, Gabriela Maíra Pereira de Assis, A. Aguiar, Jaime Louzada, D. Pereira, A. Pina-Costa, Z. Hirano, S. B. Moreira, A. Pissinatti, P. Brasil, C. Daniel-Ribeiro, T. Sousa, C. F. Alves de Brito
High-copy genomic sequences could be used as PCR targets for the detection of Plasmodium infections, providing increased sensitivity over single- or low-copy genes. Mitochondrial genomes of malaria parasites are present in multiple copies in a single mitochondrion, and each parasite has many mitochondria. Here, we describe the development of seven species-specific qPCR assays for the diagnosis of Plasmodium vivax and Plasmodium falciparum, targeting coding and non-coding mitochondrial genomic regions.The optimization of the qPCR protocols involved a gradient of annealing temperatures and concentrations of primers and probes, as well as the inclusion of PCR additives/enhancers [e.g., dimethyl sulfoxide (DMSO), glycerol, bovine serum albumin (BSA)] to improve the specificity of qPCR amplification.Non-specific amplification of other Plasmodium species and of human targets was observed in different levels for all assays. Regardless of the late Cq values for most non-specific amplifications, the application of a cutoff value did not completely exclude false-positive amplification, compromising the specificity and also the sensitivity of the assays.Therefore, although mitochondrial targets have higher sensitivity, they frequently lose specificity due to their high levels of sequence conservation. A screening to evaluate the cross-reaction between Plasmodium species and the non-specific amplification of human malaria-free samples must be performed for Plasmodium mitochondrial assays.
高拷贝基因组序列可以用作检测疟原虫感染的PCR靶点,从而提高了对单拷贝或低拷贝基因的敏感性。疟原虫的线粒体基因组存在于单个线粒体中的多个拷贝中,每个寄生虫都有许多线粒体。在这里,我们描述了用于诊断间日疟原虫和恶性疟原虫的七种物种特异性qPCR检测的开发,靶向编码和非编码线粒体基因组区域。qPCR方案的优化涉及退火温度和引物和探针浓度的梯度,以及加入PCR添加剂/增强子[例如二甲基亚砜(DMSO)、甘油、牛血清白蛋白(BSA)]以提高qPCR扩增的特异性。对于所有测定,在不同水平上观察到其他疟原虫物种和人类靶标的非特异性扩增。不管大多数非特异性扩增的晚期Cq值如何,应用截止值并不能完全排除假阳性扩增,这损害了测定的特异性和敏感性。因此,尽管线粒体靶标具有更高的敏感性,但由于其高度的序列保守性,它们经常失去特异性。疟原虫线粒体测定必须进行筛选,以评估疟原虫物种之间的交叉反应和人类无疟疾样本的非特异性扩增。
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引用次数: 0
Editorial: Immunology of tuberculosis 社论:结核病免疫学
Pub Date : 2023-07-20 DOI: 10.3389/fitd.2023.1252114
Zhidong Hu, T. Barbosa, X-Y Fan
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引用次数: 0
Genomic analysis of circulating HIV and hepatitis C virus infections and coinfections in Cameroon: 2005–2006 and 2015–2016 喀麦隆循环HIV和丙型肝炎病毒感染和合并感染的基因组分析:2005-2006年和2015-2016年
Pub Date : 2023-07-13 DOI: 10.3389/fitd.2023.1094286
Sana Tamim, J. Nwobegahay, Armelle Gaelle Fepa Kwesseu, Ida Marlene Guiateu Tamo, Marceline Djuidje Ngounoue
In humans, RNA viruses are responsible for a wide range of acute, chronic, emerging and re-emerging infections. Human Immunodeficiency virus (HIV) and hepatitis C virus (HCV) rank as some of the most important public health challenges affecting Africa.We performed enzyme-linked immune-sorbent assays to confirm positive specimens, and the genomic characterization on two cohorts of people living with HIV in Douala and Yaoundé for the periods 2005-2006 and 2015-2016. These groups were tested for co-infection with HCV using the enzyme-linked immunosorbent assays. Viral RNA was extracted from positive patients’ plasma samples by QIAGEN method, and specific primers were used to amplify the genes of interest on HIV and HCV genomes. The amplification products were subsequently cloned and sequenced. The nucleotide sequences were aligned, genotyped and phylogenetically analyzed.The HIV isolate identified in this study belongs to HIV-1 group M Subtype A1. The HCV subtypes characterized in this study are 1h and 4t corresponding to the dominant strains that circulate in Cameroon. Phylogenetic analysis of the HCV NS5B gene showed that the study viruses cluster with Gabonese, Canadian, and previously sequenced viruses from Cameroon.These results shed light on the genetic diversity of HIV and HCV in Cameroon. Virulent HCV infections are common in Cameroon, and therefore there is a great need for further analysis of the viral evolutionary and spatio-temporal patterns.
在人类中,RNA病毒是各种急性、慢性、新发和再发感染的罪魁祸首。人类免疫缺陷病毒(HIV)和丙型肝炎病毒(HCV)是影响非洲的一些最重要的公共卫生挑战。我们对2005-2006年和2015-2016年期间Douala和yaound的两组HIV感染者进行了酶联免疫吸附测定以确认阳性标本,并进行了基因组表征。使用酶联免疫吸附试验检测这些组是否与HCV合并感染。采用QIAGEN方法从阳性患者血浆样本中提取病毒RNA,并使用特异性引物在HIV和HCV基因组上扩增感兴趣的基因。扩增产物随后被克隆并测序。对核苷酸序列进行比对、基因分型和系统发育分析。本研究鉴定的HIV分离物属于HIV-1组M亚型A1。本研究表征的HCV亚型为1h和4t,与喀麦隆流行的优势株相对应。HCV NS5B基因的系统发育分析显示,研究病毒与加蓬病毒、加拿大病毒和先前测序的喀麦隆病毒聚类。这些结果揭示了喀麦隆艾滋病毒和丙型肝炎病毒的遗传多样性。强毒性丙肝病毒感染在喀麦隆很常见,因此非常需要进一步分析病毒进化和时空模式。
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引用次数: 0
The first mass drug administration campaign for schistosomiasis control in Lagos, Nigeria: lessons for future control programs 尼日利亚拉各斯首次大规模药物管理血吸虫病控制运动:未来控制计划的经验教训
Pub Date : 2023-06-29 DOI: 10.3389/fitd.2023.1094320
Francisca O Olamiju, O. Nebe, H. Mogaji, I. Abdus-salam, Lanre Jenrola, Ayodele J. Marcus, Olatunwa J Olamiju, S. Isiyaku, Perpetua Amodu-Agbi, I. Nwoye, Ijeoma Achu, E. Abah
Background In this study we summarized the lessons learnt during the first effective mass drug administration (MDA) campaign in one of the most urbanized states in Nigeria. We particularly discuss the implementation approach including associated challenges and future prospects. Methods We implemented schistosomiasis MDA with praziquantel in seven endemic districts of the state, using a sub-district/ward-level implementation approach. Upon completion, we conducted desk reviews of field reports and a high-level stakeholder meeting among 95 key personnel involved in the MDA. We reviewed excerpts from the meetings to highlight the strengths, weaknesses, threats and opportunities (SWOT) of the sub-district/ward-level implementation approach. Quantitative data were summarized using basic descriptive statistics, while qualitative data were analyzed to identify emerging themes. Results About 1.45 million children between age 5 and 15 were targeted for treatment, and a geographic (100%) and therapeutic coverage of 85.5% was achieved. Therapeutic coverage was optimal (>75%), across all the implementation districts (Range:76.2- 95.3%). Ifako-Ijaiye had the highest therapeutic coverage (95.3%), while Oshodi-Isolo as the least (76.2%). Strategies supporting high coverage includes; (1) adequate delineation of hard-to reach areas and allocation of commensurate resources, (2) improved consultation and microplanning among programmers, (3) addressing traffic congestion on transportation routes, (4) strengthened engagements and collaborations with community gatekeepers, (5) optimizing cash flow to mitigate financial risk, (6) capacity building of field stakeholders and, (7) regular advocacy and sensitization among stakeholders. Conclusion This study provides possible directions for implementation of schistosomiasis control by programs and agencies at sub-district/ward-level in a cosmopolitan and urbanized state, like that of Lagos, Nigeria.
背景在这项研究中,我们总结了在尼日利亚城市化程度最高的州之一开展的第一次有效的大规模药物管理(MDA)运动中吸取的教训。我们特别讨论了执行方法,包括相关的挑战和未来前景。方法我们在该州的七个流行区使用吡喹酮实施血吸虫病MDA,采用分区/病房级实施方法。完成后,我们对现场报告进行了案头审查,并在参与MDA的95名关键人员中举行了一次高层利益相关者会议。我们回顾了会议摘录,以强调街道/病房级实施方法的优势、劣势、威胁和机遇(SWOT)。使用基本描述性统计对定量数据进行了总结,同时对定性数据进行了分析,以确定新出现的主题。结果约145万名5岁至15岁的儿童成为治疗目标,地理(100%)和治疗覆盖率达到85.5%。在所有实施地区,治疗覆盖率最佳(>75%)(范围:76.2-95.3%)。Ifako Ijaiye的治疗覆盖率最高(95.3%),而Oshodi Isolo最低(76.2%)。支持高覆盖率的策略包括:;(1) 充分划定难以到达的地区并分配相应的资源,(2)改善程序员之间的协商和微观规划,(3)解决交通路线上的交通拥堵问题,(4)加强与社区看门人的接触和合作,(5)优化现金流以减轻财务风险,(6)实地利益相关者的能力建设,(7)利益相关者定期进行宣传和提高认识。结论本研究为在国际化和城市化的州,如尼日利亚拉各斯,分区/区一级的项目和机构实施血吸虫病控制提供了可能的指导。
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引用次数: 0
Case report of cerebral cystic echinococcosis in a 5-year-old child 5岁儿童脑囊性包虫病1例报告
Pub Date : 2023-06-08 DOI: 10.3389/fitd.2023.1090644
Denis Menschaert, A. Daron, J. Frere
Cystic echinococcosis is a zoonosis caused by the larval form of the tapeworm Echinococcus granulosus. It has a worldwide distribution and represents a particularly significant economic and health burden in endemic areas. The most affected organs are the liver and the lungs. Cerebral involvement is relatively rare. This is a case study of a clinical presentation of cerebral cystic echinococcosis in a 5-year-old female patient of Moroccan origin who had developed recurrent seizures. Currently, diagnosis is based on radiological imaging in the context of anamnestic suspicion. Beyond the conclusions that can be drawn from the various case reports, there are no guidelines on management methods or randomized controlled trials that have compared management methods, and their absence can be deleterious for children. We present this clinical case report to add to the existing ones and to assist clinicians in their therapeutic decision-making while they await guidelines.
囊性棘球蚴病是由细粒棘球蚴幼虫引起的人畜共患病。它在世界各地都有分布,在流行地区造成了特别严重的经济和健康负担。受影响最大的器官是肝脏和肺部。大脑受累相对罕见。这是一例摩洛哥裔5岁女性患者的脑囊性棘球蚴病临床表现的病例研究,该患者反复发作。目前,诊断是基于记忆怀疑背景下的放射学成像。除了从各种病例报告中得出的结论外,没有关于管理方法或随机对照试验的指导方针来比较管理方法,缺乏这些指导方针可能对儿童有害。我们提交这份临床病例报告是为了补充现有的病例报告,并在临床医生等待指南时帮助他们做出治疗决策。
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引用次数: 0
Coalescing disparate data sources for the geospatial prediction of mosquito abundance, using Brazil as a motivating case study 结合不同的数据来源对蚊子丰度进行地理空间预测,以巴西为激励案例研究
Pub Date : 2023-05-26 DOI: 10.3389/fitd.2023.1039735
A. Musah, Ella Browning, Aisha Aldosery, Iuri Valerio Graciano Borges, T. Ambrizzi, M. Tunali, Selma Basibüyük, O. Yenigün, G. Moreno, Clarisse Lins de Lima, Ana Clara Gomes da Silva, W. P. dos Santos, T. Massoni, L. Campos, P. Kostkova
One of the barriers to performing geospatial surveillance of mosquito occupancy or infestation anywhere in the world is the paucity of primary entomologic survey data geolocated at a residential property level and matched to important risk factor information (e.g., anthropogenic, environmental, and climate) that enables the spatial risk prediction of mosquito occupancy or infestation. Such data are invaluable pieces of information for academics, policy makers, and public health program managers operating in low-resource settings in Africa, Latin America, and Southeast Asia, where mosquitoes are typically endemic. The reality is that such data remain elusive in these low-resource settings and, where available, high-quality data that include both individual and spatial characteristics to inform the geospatial description and risk patterning of infestation remain rare. There are many online sources of open-source spatial data that are reliable and can be used to address such data paucity in this context. Therefore, the aims of this article are threefold: (1) to highlight where these reliable open-source data can be acquired and how they can be used as risk factors for making spatial predictions for mosquito occupancy in general; (2) to use Brazil as a case study to demonstrate how these datasets can be combined to predict the presence of arboviruses through the use of ecological niche modeling using the maximum entropy algorithm; and (3) to discuss the benefits of using bespoke applications beyond these open-source online data sources, demonstrating for how they can be the new “gold-standard” approach for gathering primary entomologic survey data. The scope of this article was mainly limited to a Brazilian context because it builds on an existing partnership with academics and stakeholders from environmental surveillance agencies in the states of Pernambuco and Paraiba. The analysis presented in this article was also limited to a specific mosquito species, i.e., Aedes aegypti, due to its endemic status in Brazil.
在世界上任何地方进行蚊子占用或侵扰的地理空间监测的障碍之一是缺乏位于住宅物业水平的初级昆虫学调查数据,并与重要的风险因素信息(例如,人为、环境和气候)相匹配,从而能够预测蚊子占用或侵扰的空间风险。这些数据对于在蚊虫典型流行的非洲、拉丁美洲和东南亚资源匮乏地区开展工作的学者、决策者和公共卫生项目管理者来说是非常宝贵的信息。现实情况是,在这些资源匮乏的环境中,这类数据仍然难以获得,即使有,也很少有高质量的数据,包括个体和空间特征,为虫害的地理空间描述和风险模式提供信息。有许多可靠的开放源代码空间数据在线来源,可用于解决这方面的数据缺乏问题。因此,本文的目的有三个:(1)强调这些可靠的开源数据可以从哪里获得,以及如何将它们作为风险因素来预测蚊子占用的空间;(2)以巴西为例,展示如何通过使用最大熵算法的生态位建模,将这些数据集结合起来预测虫媒病毒的存在;(3)讨论在这些开源在线数据源之外使用定制应用程序的好处,展示它们如何成为收集初级昆虫学调查数据的新“金标准”方法。本文的范围主要限于巴西的情况,因为它建立在与伯南布哥州和帕拉伊巴州环境监测机构的学术界和利益相关者的现有伙伴关系的基础上。由于埃及伊蚊在巴西的地方性地位,本文的分析也仅限于一种特定的蚊子,即埃及伊蚊。
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引用次数: 0
Editorial: Highlights in emerging tropical diseases 2021/22 社论:《2021/22年度新发热带病重点报告》
Pub Date : 2023-05-23 DOI: 10.3389/fitd.2023.1199049
J. Gómez‐Marín, W. Villamil-Gómez, A. Rodríguez-Morales
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引用次数: 0
Distribution of genetic diversity of neotropical Biomphalaria (Preston 1910) (Basommatophora: Planorbidae) intermediate hosts for schistosomiasis in Southeast Brazil 巴西东南部新热带生物phalaria (Preston 1910) (basommatophhora: Planorbidae)血吸虫病中间宿主遗传多样性分布
Pub Date : 2023-05-16 DOI: 10.3389/fitd.2023.1143186
R. Palasio, F. Chiaravalloti-Neto, R. Tuan
Introduction Biomphalaria glabrata, B. tenagophila, and B. straminea occurrence are crucial for estimating the risk of infectious human schistosomiasis in the neotropics. How different geographic sample strategies influence snail genetic diversity estimations were here investigated for three Schistosoma mansoni hosts. Methods Mitochondrial gene sequences were employed for Cytochrome C Oxidase I (COI), ribosomal RNA (rRNA) 16S, and a dataset with concatenated gene sequences (COI+16S), resulting in an improved scientific hypothesis regarding the geographical distribution of snail species. This study compared the sequences of snails from the Middle Paranapanema (MP) hydrographic basin in a geographically restricted area (inner group) to snails widely distributed across a broad geographical range in São Paulo (outer group), Brazil from 1999 to 2017. DNA sequence polymorphisms and haplotype diversity were estimated using DNAsp software. Haplotype network trees were constructed using a network program. The geographical distribution of the haplotypes was mapped using QGIS. Haplotype variation and distribution were tested for population structure using analysis of molecular variance (AMOVA). Results and discussion The genetic diversity of B. glabrata, sampled from disconnected but geographically close freshwater collections, was partitioned into two sequence groups. The haplotype network showed that the diversity of B. straminea was more spatially partitioned than in B. tenagophila, which exhibited two population groups. The haplotype distribution pattern for B. tenagophila showed many unique and exclusive haplotypes for all three loci. AMOVA showed that genetic diversity could be high in species inhabiting small geographical areas, and a large river is not a local geographical barrier for snail migration. This study found that the survey dimensions and snail samplings influenced the genetic diversity results obtained by mitochondrial DNA molecular markers.
在新热带地区,光斑生物phalaria glabrata, B. tenagophila和B. streaminea的发生对于估计传染性人类血吸虫病的风险至关重要。本文研究了不同地理样本策略对三种曼氏血吸虫宿主蜗牛遗传多样性的影响。方法采用线粒体基因序列分析细胞色素C氧化酶I (COI)、核糖体RNA (rRNA) 16S,并建立COI+16S串联基因序列数据集,完善蜗牛物种地理分布的科学假设。本研究比较了1999年至2017年在巴西圣保罗(外组)广泛地理范围内分布的蜗牛序列,这些蜗牛来自地理受限区域(内组)的中Paranapanema (MP)水文盆地。DNA序列多态性和单倍型多样性用DNAsp软件估计。利用网络程序构建单倍型网络树。利用QGIS绘制单倍型的地理分布图。利用分子方差分析(AMOVA)对种群结构进行单倍型变异和分布分析。结果与讨论从不同地理位置相近的淡水采集区取样的光斑b的遗传多样性可划分为两个序列群。单倍型网络表明,菌株多样性在空间上的分异程度明显高于线虫的两居群。单倍型分布模式在三个位点上均显示出许多独特的单倍型。AMOVA分析表明,居住在小地理区域的物种遗传多样性可能较高,大河不会成为蜗牛迁徙的局部地理障碍。本研究发现,调查尺度和蜗牛样本对线粒体DNA分子标记获得的遗传多样性结果有影响。
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引用次数: 1
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