{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:00:47Z","timestamp":1790413247592,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T00:00:00Z","timestamp":1609372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Intramural Research Program of the National Institutes of Health","award":["AI001123"],"award-info":[{"award-number":["AI001123"]}]},{"name":"Intramural Research Program of the National Institutes of Health","award":["AI001124"],"award-info":[{"award-number":["AI001124"]}]},{"name":"Intramural Research Program of the National Institutes of Health","award":["DC000064"],"award-info":[{"award-number":["DC000064"]}]},{"name":"Intramural Research Program of the National Institutes of Health","award":["UO1 AI109657"],"award-info":[{"award-number":["UO1 AI109657"]}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N91019D00024"],"award-info":[{"award-number":["75N91019D00024"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N91019F00130"],"award-info":[{"award-number":["75N91019F00130"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cryptococcal meningoencephalitis (CM) is a major cause of mortality in immunosuppressed patients and previously healthy individuals. In the latter, a post-infectious inflammatory response syndrome (PIIRS) is associated with poor clinical response despite antifungal therapy and negative cerebrospinal fluid (CSF) cultures. Data on effective treatment are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between March 2015 and March 2020, 15 consecutive previously healthy patients with CM and PIIRS were treated with adjunctive pulse corticosteroid taper therapy (PCT) consisting of intravenous methylprednisolone 1 gm daily for 1 week followed by oral prednisone 1 mg\/kg\/day, tapered based on clinical and radiological response plus oral fluconazole. Montreal cognitive assessments (MOCA), Karnofsky performance scores, magnetic resonance imaging (MRI) brain scanning, ophthalmic and audiologic exams, and CSF parameters including cellular and soluble immune responses were compared at PIIRS diagnosis and after methylprednisolone completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median time from antifungal treatment to steroid initiation was 6 weeks. The most common symptoms at PIIRS diagnosis were altered mental status and vision changes. All patients demonstrated significant improvements in MOCA and Karnofsky scores at 1 month (P\u2005&amp;lt;\u2005.0003), which was accompanied by improvements in CSF glucose, white blood cell (WBC) count, protein, cellular and soluble inflammatory markers 1 week after receiving corticosteroids (CS) (P\u2005&amp;lt;\u2005.003). All patients with papilledema and visual field deficits also exhibited improvement (P\u2005&amp;lt;\u2005.0005). Five out of 7 patients who underwent audiological testing demonstrated hearing improvement. Brain MRI showed significant improvement of radiological findings (P\u2005=\u2005.001). CSF cultures remained negative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PCT in this small cohort of PIIRS was associated with improvements in CM-related complications with minimal toxicity in the acute setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1901","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T07:40:13Z","timestamp":1609141213000},"page":"e2789-e2798","source":"Crossref","is-referenced-by-count":50,"title":["Outcomes in Previously Healthy Cryptococcal Meningoencephalitis Patients Treated With Pulse Taper Corticosteroids for Post-infectious Inflammatory Syndrome"],"prefix":"10.1093","volume":"73","author":[{"given":"Seher","family":"Anjum","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Dean","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kosa","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Teresa","family":"Magone","sequence":"additional","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A","family":"King","sequence":"additional","affiliation":[{"name":"National Institute on Deafness and Other Communication Disorders, National Institute of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmond","family":"Fitzgibbon","sequence":"additional","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H Jeff","family":"Kim","sequence":"additional","affiliation":[{"name":"National Institute on Deafness and Other Communication Disorders, National Institute of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Zalewski","sequence":"additional","affiliation":[{"name":"National Institute on Deafness and Other Communication Disorders, National Institute of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Murphy","sequence":"additional","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridgette Jeanne","family":"Billioux","sequence":"additional","affiliation":[{"name":"Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Chisholm","sequence":"additional","affiliation":[{"name":"National Institute on Deafness and Other Communication Disorders, National Institute of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen C","family":"Brewer","sequence":"additional","affiliation":[{"name":"National Institute on Deafness and Other Communication Disorders, National Institute of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Krieger","sequence":"additional","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Elsegeiny","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri L","family":"Scott","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Hunsberger","sequence":"additional","affiliation":[{"name":"Biostatistics Research Branch, NIAID, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E","family":"Bennett","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avindra","family":"Nath","sequence":"additional","affiliation":[{"name":"Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieren A","family":"Marr","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibiana","family":"Bielekova","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wendler","sequence":"additional","affiliation":[{"name":"Department of Bioethics, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dima A","family":"Hammoud","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Imaging (CIDI), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Williamson","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,31]]},"reference":[{"key":"2021110300351599200_CIT0001","doi-asserted-by":"crossref","first-page":"e56269","DOI":"10.1371\/journal.pone.0056269","article-title":"Epidemiology of cryptococcal meningitis in the US: 1997-2009","volume":"8","author":"Pyrgos","year":"2013","journal-title":"PLoS One"},{"key":"2021110300351599200_CIT0002","first-page":"61","article-title":"Cryptococcal infections in non-HIV-infected patients","volume":"124","author":"Pappas","year":"2013","journal-title":"Trans Am Clin Climatol Assoc"},{"key":"2021110300351599200_CIT0003","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S1473-3099(14)70805-9","article-title":"Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study","volume":"14","author":"Castelblanco","year":"2014","journal-title":"Lancet Infect Dis"},{"key":"2021110300351599200_CIT0004","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1086\/649858","article-title":"Clinical practice guidelines for the management of cryptococcal disease: 2010 Update by the Infectious Diseases Society of America","volume":"50","author":"Perfect","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2021110300351599200_CIT0005","doi-asserted-by":"crossref","first-page":"e60431","DOI":"10.1371\/journal.pone.0060431","article-title":"Predictors of mortality and differences in clinical features among patients with cryptococcosis according to immune status","volume":"8","author":"Brizendine","year":"2013","journal-title":"PLoS One"},{"key":"2021110300351599200_CIT0006","doi-asserted-by":"crossref","first-page":"e657","DOI":"10.1097\/MAO.0000000000002242","article-title":"Audiologic and otologic complications of cryptococcal meningoencephalitis in non-HIV previously healthy patients","volume":"40","author":"King","year":"2019","journal-title":"Otol Neurotol"},{"key":"2021110300351599200_CIT0007","doi-asserted-by":"crossref","first-page":"18442","DOI":"10.1038\/s41598-019-54876-7","article-title":"HIV-negative cryptococcal meningoencephalitis results in a persistent frontal-subcortical syndrome","volume":"9","author":"Traino","year":"2019","journal-title":"Sci Rep"},{"key":"2021110300351599200_CIT0008","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/cid\/ciz193","article-title":"A multicenter, longitudinal cohort study of cryptococcosis in human immunodeficiency virus-negative people in the United States","volume":"70","author":"Marr","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2021110300351599200_CIT0009","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/nrneurol.2016.167","article-title":"Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy","volume":"13","author":"Williamson","year":"2017","journal-title":"Nat Rev Neurol"},{"key":"2021110300351599200_CIT0010","article-title":"Central nervous system cryptococcal infections in non-HIV infected patients","volume":"5","author":"Beardsley","year":"2019","journal-title":"J Fungi (Basel)"},{"key":"2021110300351599200_CIT0011","doi-asserted-by":"crossref","first-page":"e02063-","DOI":"10.1128\/mBio.02063-17","article-title":"Immune-mediated damage completes the parabola: Cryptococcus neoformans pathogenesis can reflect the outcome of a weak or strong immune response","volume":"8","author":"Pirofski","year":"2017","journal-title":"mBio"},{"key":"2021110300351599200_CIT0012","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1128\/CMR.00008-11","article-title":"Pathogenesis and pathophysiology of pneumococcal meningitis","volume":"24","author":"Mook-Kanamori","year":"2011","journal-title":"Clin Microbiol Rev"},{"key":"2021110300351599200_CIT0013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/hiv.12676","article-title":"Shedding light on IRIS: from pathophysiology to treatment of cryptococcal meningitis and immune reconstitution inflammatory syndrome in HIV-infected individuals","volume":"20","author":"Balasko","year":"2019","journal-title":"HIV Med"},{"key":"2021110300351599200_CIT0014","first-page":":e1078","article-title":"Post-infectious inflammatory response syndrome (PIIRS): Dissociation of T-cell-macrophage signaling in previously healthy individuals with cryptococcal fungal meningoencephalitis","volume":"2","author":"Williamson","year":"2015","journal-title":"Macrophage (Houst)"},{"key":"2021110300351599200_CIT0015","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s12281-019-00345-7","article-title":"Clinical aspects of immune damage in cryptococcosis","volume":"13","author":"Anjum","year":"2019","journal-title":"Curr Fungal Infect Rep"},{"key":"2021110300351599200_CIT0016","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3389\/fmed.2019.00129","article-title":"Immunomodulatory role of capsular polysaccharides constituents of Cryptococcus neoformans","volume":"6","author":"Decote-Ricardo","year":"2019","journal-title":"Front Med (Lausanne)"},{"key":"2021110300351599200_CIT0017","doi-asserted-by":"crossref","first-page":"651","DOI":"10.3389\/fimmu.2018.00651","article-title":"Immunology of cryptococcal infections: developing a rational approach to patient therapy","volume":"9","author":"Elsegeiny","year":"2018","journal-title":"Front Immunol"},{"key":"2021110300351599200_CIT0018","doi-asserted-by":"crossref","first-page":"e1004884","DOI":"10.1371\/journal.ppat.1004884","article-title":"Paradoxical immune responses in non-HIV cryptococcal meningitis","volume":"11","author":"Panackal","year":"2015","journal-title":"PLoS Pathog"},{"key":"2021110300351599200_CIT0019","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1093\/infdis\/jiu664","article-title":"Cellular immune activation in cerebrospinal fluid from Ugandans with cryptococcal meningitis and immune reconstitution inflammatory syndrome","volume":"211","author":"Meya","year":"2015","journal-title":"J Infect Dis"},{"key":"2021110300351599200_CIT0020","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.mmcr.2014.12.003","article-title":"Successful treatment of Cryptococcus neoformans immune reconstitution inflammatory syndrome in an immunocompetent host using thalidomide","volume":"7","author":"Somerville","year":"2015","journal-title":"Med Mycol Case Rep"},{"key":"2021110300351599200_CIT0021","doi-asserted-by":"crossref","first-page":"322","DOI":"10.4103\/aian.AIAN_29_18","article-title":"Cryptococcal postinfectious inflammatory response syndrome in an immunocompetent host","volume":"22","author":"Kulkarni","year":"2019","journal-title":"Ann Indian Acad Neurol"},{"key":"2021110300351599200_CIT0022","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ana.24408","article-title":"Cerebrospinal fluid markers reveal intrathecal inflammation in progressive multiple sclerosis","volume":"78","author":"Komori","year":"2015","journal-title":"Ann Neurol"},{"key":"2021110300351599200_CIT0023","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s11065-019-09412-9","article-title":"Montreal cognitive assessment (MOCA) for HIV-associated neurocognitive disorders","volume":"29","author":"Rosca","year":"2019","journal-title":"Neuropsychol Rev"},{"key":"2021110300351599200_CIT0024","doi-asserted-by":"crossref","first-page":"454","DOI":"10.3389\/fneur.2017.00454","article-title":"Insight into metabolic 1H-MRS changes in natalizumab induced progressive multifocal leukoencephalopathy brain lesions","volume":"8","author":"Schneider","year":"2017","journal-title":"Front Neurol"},{"key":"2021110300351599200_CIT0025","doi-asserted-by":"crossref","first-page":"310","DOI":"10.3928\/1542-8877-20050701-10","article-title":"Assessment of the effects of morphological changes related to age-related macular degeneration on optical coherence tomography retinal thickness measurements","volume":"36","author":"Menke","year":"2005","journal-title":"Ophthalmic Surg Lasers Imaging"},{"key":"2021110300351599200_CIT0026","doi-asserted-by":"crossref","first-page":"e657","DOI":"10.1097\/MAO.0000000000002242","article-title":"Audiologic and otologic complications of cryptococcal meningoencephalitis in non-HIV previously healthy patients","volume":"40","author":"King","year":"2019","journal-title":"Otol Neurotol"},{"key":"2021110300351599200_CIT0027","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1093\/cid\/ciw739","article-title":"Spinal arachnoiditis as a complication of cryptococcal meningoencephalitis in non-HIV previously healthy adults","volume":"64","author":"Panackal","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2021110300351599200_CIT0028","first-page":"CD001331","article-title":"Corticosteroids or ACTH for acute exacerbations in multiple sclerosis","volume":"4","author":"Filippini","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"2021110300351599200_CIT0029","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4314\/ahs.v12i2.23","article-title":"Challenges in diagnosis and management of cryptococcal immune reconstitution inflammatory syndrome (IRIS) in resource limited settings","volume":"12","author":"Musubire","year":"2012","journal-title":"Afr Health Sci"},{"key":"2021110300351599200_CIT0030","doi-asserted-by":"crossref","first-page":":bcr2016216496","DOI":"10.1136\/bcr-2016-216496","article-title":"Corticosteroid-induced cryptococcal meningitis in patient without HIV","volume":"2017","author":"Nidhi","year":"2017","journal-title":"BMJ Case Rep"},{"key":"2021110300351599200_CIT0031","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1056\/NEJMoa1509024","article-title":"Adjunctive dexamethasone in HIV-associated cryptococcal meningitis","volume":"374","author":"Beardsley","year":"2016","journal-title":"N Engl J Med"},{"key":"2021110300351599200_CIT0032","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1038\/ni.3153","article-title":"IL-6 as a keystone cytokine in health and disease","volume":"16","author":"Hunter","year":"2015","journal-title":"Nat Immunol"},{"key":"2021110300351599200_CIT0033","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3389\/fimmu.2019.00119","article-title":"The immunology of macrophage activation syndrome","volume":"10","author":"Crayne","year":"2019","journal-title":"Front Immunol"},{"key":"2021110300351599200_CIT0034","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1212\/WNL.0000000000001506","article-title":"Will CSF biomarkers guide future therapeutic decisions in multiple sclerosis?","volume":"84","author":"Bielekova","year":"2015","journal-title":"Neurology"},{"key":"2021110300351599200_CIT0035","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s12879-015-0826-y","article-title":"A retrospective study of contributing factors for prognosis and survival length of cryptococcal meningoencephalitis in Southern part of China (1998\u20132013)","volume":"15","author":"Zheng","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2021110300351599200_CIT0036","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1136\/bjo.82.6.704","article-title":"Systemic corticosteroid therapy\u2014side effects and their management","volume":"82","author":"Stanbury","year":"1998","journal-title":"Br J Ophthalmol"},{"key":"2021110300351599200_CIT0037","article-title":"In: (CIOMS) CfIOoMS, ed. International ethical guidelines for health-related research involving humans. 4th ed. Geneva: World Health Organization, 2016.","author":"Bhan"},{"key":"2021110300351599200_CIT0038","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1086\/374557","article-title":"Voriconazole treatment for less-common, emerging, or refractory fungal infections","volume":"36","author":"Perfect","year":"2003","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaa1901\/36297282\/ciaa1901.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/73\/9\/e2789\/41060957\/ciaa1901.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/73\/9\/e2789\/41060957\/ciaa1901.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T20:37:23Z","timestamp":1635885443000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/73\/9\/e2789\/6056677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,31]]},"references-count":38,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,12,31]]},"published-print":{"date-parts":[[2021,11,2]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaa1901","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2020,12,31]]}}}