GMS Hygiene and Infection Control最新文献

{"title":"Prevalence and clonal lineages of biofilm-producing Staphylococcus aureus from clinical samples and healthcare workers at Ahmadu Bello University Teaching Hospital, Nigeria.","authors":"Kabir Umar, Idris Nasir Abdullahi, Abdulkadir Magaji Magashi, Abdullahi Hassan Kawo, Yahaya Usman, Abdurrahaman El-Fulaty Ahmad, Carmen Torres","doi":"10.3205/dgkh000504","DOIUrl":"10.3205/dgkh000504","url":null,"abstract":"<p><p>This study determined the frequency and molecular features of <i>Staph</i> <i>y</i> <i>lo</i> <i>coccus aureus</i> from 206 burn and wound patients (BWPs) as well as 94 healthcare workers (HCWs) at the Ahmadu Bello University Teaching Hospital, Zaria, Northern Nigeria. Nine (4.4%) and five (5.3%) samples from BWPs and HCWs were identified as S<i>. aureus</i> positive, respectively. Seven (50%) were <i>mecA</i>-positive (associated with SCC<i>mec</i> types IVa and V), while 35.7% presented a multidrug resistance (MDR) phenotype. The <i>S. aureus</i> isolates belonged to 11 diverse <i>spa</i> types, including three new (t4539, t6043, t11694) and one singleton (t779), which were assigned to four clonal complexes. Two <i>tst</i> and three <i>luk-F/S-PV</i> carrying strains were identified. All the <i>S. aureus</i> isolates were moderate biofilm producers with diverse combinations of the <i>icaABCD</i> biofilm and <i>icaR</i> regulatory genes. The detection of genetically diverse <i>S. aureus</i> lineages and toxigenic strains highlights the need for improved surveillance of resistant and pathogenic strains in healthcare facilities.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc49"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647444","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}

{"title":"An analysis of the efficacy of universal PCR and BACTEC 9120 BD for identifying bacteremia in pediatrics.","authors":"Azam Safarkhani, Fatemeh Shirkavand, Nafiseh Abdollahi, Nazanin Ahari Oskooie, Leila Azimi, Mohammad Rahbar, Abdollah Karimi","doi":"10.3205/dgkh000509","DOIUrl":"10.3205/dgkh000509","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSI) are serious diseases in pediatrics and can increase the rate of morbidity and mortality. Blood culture is time consuming and can have false negative results in some case such as the intracellular or fastidious bacteria. This study aimed to evaluate the PCR against automated blood culture with BACTEC.</p><p><strong>Materials and methods: </strong>In this observational cross-sectional study the blood samples of hospitalized children in Mofid Children's Hospital with bacteremia signs from February to May 2023 were enrolled. The causative bacteria in bacteremia were identified by phenotypic and PCR methods.</p><p><strong>Results: </strong>150 blood samples were enrolled to identify the presence of bacteremia by BACTEC and PCR. 60% and 40% of samples have negative and positive results in both methods, respectively. PCR showed 100% sensitivity and specificity in detecting bacteremia compared to BACTEC. A variety of bacteria were identified by phenotypic and molecular methods and coagulase negative <i>Staphylococcus</i> (CONS) is the most of them.</p><p><strong>Conclusion: </strong>The rapid and accurate detection of bacterial pathogens with the high sensitivity and specificity compared gold standard method are the most important profits of molecular assay.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc54"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647348","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}

{"title":"Trichophyton tonsurans infections after visiting a barbershop - findings from official hygiene monitoring.","authors":"Anne Marcic, Stephen Freytag, Katharina Langen","doi":"10.3205/dgkh000507","DOIUrl":"10.3205/dgkh000507","url":null,"abstract":"<p><strong>Background: </strong>The Public Health Department became aware of infections with <i>Trichophyton (T.) tonsurans</i> in a total of nine people who had visited the same barbershop.</p><p><strong>Method: </strong>Official hygiene monitoring of the barbershop was performed on an event-related basis, during which compliance with the requirements of the \"Schleswig-Holstein State Ordinance on the Prevention of Communicable Diseases (Hygiene Ordinance)\" was checked. In addition, hygienic-microbiological environmental examinations of materials and surfaces were performed in cooperation with the Department of Dermatology at the University Medical Center Schleswig-Holstein, Kiel Campus.</p><p><strong>Results: </strong>Significant deficiencies in hygiene management were identified. The hygiene requirements, especially for the reprocessing of work equipment and surfaces, were not known and were therefore not complied with. Environmental testing revealed the presence of <i>Trichophyton tonsurans</i> in three out of ten samples tested. Shaving equipment and a drawer used to store shaving equipment were positive.</p><p><strong>Conclusion: </strong>Barbershops can pose a relevant risk of infection, not only for pathogens that cause blood-borne infections. Barbershop operators need information and training regarding compliance with hygiene requirements. They should be included in the planning for the (random) infection hygiene monitoring of facilities by the public health department in accordance with Section 36 (2) of the Infection Protection Act (IfSG). The reprocessing frequencies established to date are not sufficient for the prevention of <i>T. tonsurans</i> infections and must be adapted.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc52"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647361","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}

{"title":"Clovibactin and Staphylococcus aureus: a new weapon against resistant strains.","authors":"Shuaibu Suleiman Adeiza","doi":"10.3205/dgkh000501","DOIUrl":"10.3205/dgkh000501","url":null,"abstract":"<p><p>Clovibactin is a new depsipeptide and highly efficacious against <i>Sta</i> <i>p</i> <i>h</i> <i>y</i> <i>l</i> <i>o</i> <i>coccus</i> (<i>S.</i>) <i>aureus</i>, including methicillin-resistant and vancomycin-resistant <i>S.</i> <i>aureus</i>, with no apparent resistance. Clovibactin outclasses current antibiotics such as vancomycin. Here, we discuss its efficacy, emphasize the need for new antibiotics owing to growing global antibiotic resistance, highlight its mode of action and possible benefits over current treatments. We also highlight the challenges involved in large-scale manufacturing and the status of continuing research to advance effective and less toxic derivatives.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc46"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647442","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}

{"title":"The effect of AH26, Endoseal and ZOE sealers on Candida albicans and Enterococcus faecalis.","authors":"Seyedeh Zahra Hosseini, Elham Aboualigalehdari, Mahnaz Fatahinia, Maryam Erfaninejad, Nahid Mahdian, Leila Gheitani, Reza Pakzad, Amin Kheiri","doi":"10.3205/dgkh000505","DOIUrl":"10.3205/dgkh000505","url":null,"abstract":"<p><strong>Background: </strong>In the oral cavity, root canal treatment failure (endodontics) is often due to the persistence of microorganisms in the root canal system after treatment, or re-infection of the root due to insufficient flooding. In addition, microorganisms are essential for the development of peri radicular diseases and are one of the main factors related to root canal treatment failure. Microorganisms that are commonly isolated from teeth that have failed endodontic treatment include <i>Enterococcus (E.) faecalis</i> and <i>Candida (C.) albicans</i>. Bacterial infection is closely related to the failure of root canal treatment, and the use of root sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. One of the main goals of endodontic treatment is to eliminate intracanal infection and root canal flooding in order to prevent re-infection. Therefore, the aim of the current study is to evaluate the antibacterial and antifungal activity of ZOE, AH26 and Endoseal sealers <i>in vitro</i>.</p><p><strong>Methods: </strong>To study the effect of each sealer; AH26, ZOE and Endoseal on <i>E. faecalis</i> and <i>C. albicans</i>, 10 samples were considered. Firstly, the freshly prepared sealers were poured inside the microtube with nutrient broth and then 10 µl of <i>E. faecalis</i> and <i>C. albicans</i> suspensions were separately added into a microtube and were kept 24 hours in the incubator to grow.</p><p><strong>Results: </strong>The data were analyzed with Kolmogrov-Smirnov test and SPSS Version 19. Our results demonstrated that the resistance rate of <i>C. albicans</i> to ZOE, Endoseal and AH26 sealers was 0%, 100% and 70%, respectively. These values for the <i>E. faecalis</i> was 80%, 100% and 40% respectively. The resistance was defined when the microorganism was growth in subculture in LB agar.</p><p><strong>Conclusion: </strong>ZOE sealer has highest antimicrobial effect after that AH26 sealer and the least antimicrobial effect is related to Endoseal sealer.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc50"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647357","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}

{"title":"Association of matrix metalloproteinases (MMPs) gene polymorphisms with periodontitis: a systematic review.","authors":"Ruchi Pandey, Nandini Gupta, Tripti Jha, Tooba Bint E Manzoor","doi":"10.3205/dgkh000508","DOIUrl":"10.3205/dgkh000508","url":null,"abstract":"<p><p>Matrix metalloproteinases (MMPs) are proteinases released by gingival cells, macrophages and neutrophils, induced by potentially pathogenic periodontal bacteria of the subgingival plaque, which play a critical role in the pathogenesis of periodontal disease. The expression of MMPs is controlled by chromosome 11. Single nucleotide polymorphisms (SNPs) are linked with variations in the secretion of MMPs, resulting in periodontal disease progression. Genetic studies aim to find the markers for early diagnosis and prevention of the related diseases. This systematic review focuses on finding the association between the MMPs and periodontitis among Indians. A literature review was performed, including studies published between January 1^st 2012 and May 2024 were incorporated. This systematic review included 1,046 participants in seven Indian studies, and substantial evidence was found for an association between MMP-9 (-1562C/T) and periodontitis in Indian population.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc53"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647353","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}

{"title":"The role of small extracellular vesicles in spreading and inhibiting arthropod-borne diseases.","authors":"Iman Owliaee, Mehran Khaledian, Ali Shojaeian, Armin Khaghani Boroujeni","doi":"10.3205/dgkh000503","DOIUrl":"10.3205/dgkh000503","url":null,"abstract":"<p><p>Arthropod-borne diseases (ABDs) refer to a group of viral pathogens that affect a wide range of vertebrate hosts, including humans and non-human primates. In addition to being transmitted by mosquitoes and ticks, arthropods can also spread pathogens that cause severe human diseases. On the other hand, extracellular vesicles (EVs) can serve as cross-placental drug delivery vehicles (DDVs) to the fetus and even as antigen-presenting cells (APCs). To this end, the current review aimed to examine the role of small EVs (sEVs) in the transmission and inhibition of arthropod-borne viruses, also known as arboviruses. First, a deeper understanding of the mechanistic aspects of how these vesicles function during insect-pathogen interactions is required. Next, scalability and yield optimization must be addressed while introducing EV-based therapeutics on an industrial scale in order to implement them effectively. Finally,it is recommended to consider that sEV-mediated transfer plays a crucial role in the spread of ABDs. This is because it transfers pathogenic agents between cells within vectors, resulting in subsequent transmission to hosts. Consequently, sEVs provide potential targets for the development of novel therapies that inhibit pathogen replication or reduce arthropod vector populations. Future research in this area should emphasize how these vesicles function within host-vector systems, using advanced imaging techniques - such as high-resolution microscopy (HRM) - and cost-effective methods, in order to produce sufficient quantities for large-scale implementation.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc48"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647358","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}

{"title":"Clinical burden of community-associated infections caused by multidrug-resistant Pseudomonas aeruginosa: a propensity-matched longitudinal cohort study in Southern China.","authors":"Mouqing Zhou, Baohua Xu, Zhusheng Guo, Yongfeng Zeng, Jiayao Lei, Evangelos I Kritsotakis, Jiancong Wang","doi":"10.3205/dgkh000506","DOIUrl":"10.3205/dgkh000506","url":null,"abstract":"<p><strong>Background: </strong>Limited research has been conducted on the burden of community-associated infections caused by multidrug-resistant <i>Pseudomonas aeruginosa</i> (CA-MDRPa). We quantitatively modeled the incidence rate and clinical factors associated with CA-MDRPa among hospitalized patients in Southern China.</p><p><strong>Methods: </strong>Data were obtained from the local nosocomial surveillance system. Poisson regression was applied to estimate annual incidence rate ratios (IRRs) from 2018 to 2021. After propensity-score 1:2 matching, multivariable conditional logistic regression was used to identify factors for CA-MDRPa upon admission and adverse clinical outcomes during hospitalization.</p><p><strong>Results: </strong>278 patients were clinically and microbiologically diagnosed with CA-MDRPa and 647 with CA-non-MDRPa. CA-MDRPa rate exhibited a slight, non-significant, increase during the research period (IRR=1.03; 95% confidence interval [CI], 0.93-1.15). Neurological conditions, cardiovascular diseases, respiratory disorders, urinary tract infections, and use of cefoperazone/sulbactam prior to admission were identified as risk factors for CA-MDRPa upon admission. CA-MDRPa upon admission was associated with ESBL-producing <i>P. aeruginosa</i> acquisition during hospitalization (odds ratio [OR], 2.70; 95% CI, 1.53-4.77) and increased in-hospital mortality (OR, 2.24; 95% CI, 1.17-4.28).</p><p><strong>Conclusions: </strong>The findings emphasize the importance of regular targeted screening for CA-MDRPa upon hospital admission and offer valuable insights for strengthening infection control and antimicrobial stewardship programs.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc51"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647437","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}

{"title":"Risk of bacterial colonization by torniquet during arthroscopy of the knee joint.","authors":"Peter Melcher, Nadine Dietze, Christoph Hellmund, Pierre Hepp, Ralf Henkelmann","doi":"10.3205/dgkh000502","DOIUrl":"10.3205/dgkh000502","url":null,"abstract":"<p><strong>Purpose: </strong>The following study investigated the risk of transmission or spread of potentially pathogenic bacteria via surgical gloves and/or with an elastic bandage to achieve a bloodless surgical site during arthroscopy.</p><p><strong>Methods: </strong>This was a single-center, prospective study performed at a level-1 trauma center. The included patients were between 18 and 65 years of age and underwent arthroscopy of the knee joint. Before arthroscopy, two skin swabs (one before and one after wrapping the leg with an elastic bandage) were taken for further microbiological analysis. In addition, the thumb and index finger of the right glove of the surgeon's gloves and the part of the bandage covering the knee joint was kept for microbiological examination.</p><p><strong>Results: </strong>208 samples from 52 patients were included. No patient had a surgical site infection (SSI) during the follow-up period of at least 12 months. The evaluation of the microbiological findings detected contamination of the elastic wrapping material in 83% (43/52) of the cases, primarily with <i>Bacillus spp</i>. The gloves showed bacterial contamination in only two cases; a transfer to the patient's skin was not be detected. Overall, there was no evidence of contamination from the elastic bandage or the gloves to the skin or from the skin to the wrapping material during the surgical procedure.</p><p><strong>Conclusion: </strong>Preoperative skin antisepsis is mandatory due to the risk of SSI caused by skin flora. However, in a population without a history of joint infection, the current preoperative standards for skin antisepsis seem to be sufficient to minimize SSIs during knee arthroscopy. A glove change after elastic wrapping is not necessary.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc47"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647447","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}

{"title":"Can the use of iron phthalocyanine-derivative mouthrinses in COVID-19 patients provide systemic benefits? Research into this potential should be considered.","authors":"Bernardo da Fonseca Orcina, Laura Bertin, Emilene Cristine Izu Nakamura Pietro, Juliana Pescinelli Garcia Kuroda, Lucas Marques da Costa Alves, Fabiano Vieira Vilhena, Paulo Sérgio da Silva Santos","doi":"10.3205/dgkh000500","DOIUrl":"10.3205/dgkh000500","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this brief report is to discuss the impact of an oral rinse and spray containing an iron phthalocyanine derivative as an additional therapy in hospitalized COVID-19 patients.</p><p><strong>Methods: </strong>In the first study by this group of authors published on this topic, the clinical status of 22 patients with COVID-19 who were hospitalized and receiving PDMS (phthalocyanine derivative mouth spray) was assessed using the Karnofsky scale (KS) for thtree days (D0, D2, and D4). In another study, the laboratory data (CBC, D-dimer, Ferritin, and C-reactive protein [CRP]) of 41 patients hospitalized with COVID-19 who took part in a randomized clinical trial with an MIPD (mouthwash with iron phthalocyanine derivative) were evaluated retrospectively on the first day of intervention (D1) and 48 hours later (D2). The present study used these data to determine a correlation between clinical symptoms and laboratory data.</p><p><strong>Results: </strong>In individuals receiving PDMS and evaluated using the KS, a statistically significant intra-group difference (p=0.03, Friedman's test) was identified. The Durbin-Conover test found a significant difference between D0 and D2 (p=0.008). Laboratory data from only 9 patients in the experimental group and 13 patients in the control group were found in the retrospective analysis. There were no statistically significant confounders in the survival analysis using the Cox regression model. In the descriptive analysis, the intervention group's CRP was lower than that of the control group.</p><p><strong>Conclusion: </strong>PDMS demonstrated considerable clinical improvement in patients, whereas MIPD appears to lower CRP, an inflammatory marker, in descriptive analysis.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"19 ","pages":"Doc45"},"PeriodicalIF":1.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647427","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}