GMS Hygiene and Infection Control最新文献

{"title":"Using patients' observations to evaluate healthcare workers' alcohol-based hand rub with Pulpe'friction audits: a promising approach?","authors":"Fanny Velardo, Muriel Péfau, Raymond Nasso, Pierre Parneix, Anne-Gaëlle Venier","doi":"10.3205/dgkh000455","DOIUrl":"https://doi.org/10.3205/dgkh000455","url":null,"abstract":"<p><strong>Background: </strong>Hand hygiene plays an important role in the transmission of nosocomial infections from healthcare workers (HCW) to patients. Patients could play a key role in improving hand hygiene by sharing their experience of the HCW's practices. Already in 2019, the French national mission of transversal support for actions to prevent healthcare-associated infections proposed the national \"Pulpe'friction\" audit, to assess HCW's reported practices, social representations, and barriers to using alcohol-based hand rubs (ABHR). This audit consisted of a positive discussion between an auditor and the HCW as well as patients, which led the HCW to declare their real practices and the barriers they faced in the field and the patients to report about the HCW's ABHR practices and the information they received about when they should perform hand hygiene.</p><p><strong>Objective: </strong>To assess whether an association existed between HCW's reported ABHR compliance and patients' declarations about HCW's compliance in the Pulpe'friction audit data.</p><p><strong>Methods: </strong>Data from Pulpe'friction were collected from 1^st January to 31^st December 2019, before the COVID-19 pandemic. Mixed linear models were performed to analyze the association between self-reporting by HCW and patients, regarding hand rubs performed by HCW prior to patient care.</p><p><strong>Results: </strong>There was a positive association between patients' observations and HCW's declared practices regarding the frequency of with which professionals performed hand rubs before patient contact. This indicates that professional and patient statements show the same tendency. The positive association was found in hospitals for patients under 45 and over 64 years old and for paramedics, but not for physicians and not in nursing homes or long-term care facilities. Patients felt more motivated to observe and evaluate HCWs' practices if they had received information about how to correctly wash their hands.</p><p><strong>Conclusion: </strong>Patients agreed to be involved in the evaluation or professional practices. The patients' observations were positively associated with HCWs reports. New indicators taking patients' observations into account could be interesting.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc29"},"PeriodicalIF":3.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801815","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":"Deployment of dentists in COVID-19 case investigation and contact tracing: An example from Turkey.","authors":"Ozlem Ozkan, Neslihan Sevim, Zeliha Ocek","doi":"10.3205/dgkh000453","DOIUrl":"https://doi.org/10.3205/dgkh000453","url":null,"abstract":"<p><strong>Aim: </strong>In Turkey, dentists working in public dental care centers were deployed in COVID-19 case investigation and contact tracing (CICT) teams during the pandemic. This study aims to explore the experiences of the dentists assigned to teams undertaking COVID-19 CICT practices to determine how healthcare workers should be supported when working in pandemic response and other crises.</p><p><strong>Material and method: </strong>The sample of this qualitative, phenomenological study consisted of thirty four public dentists assigned to COVID-19 CICT practices in four metropolitan areas of Turkey. Data were collected through semi-structured in-depth interviews that were conducted online in August and September 2020. The data were analyzed using thematic content analysis.</p><p><strong>Results: </strong>Six themes were revealed: preparation for CICT, basic requirements, work relations, working conditions, being a dentist assigned to CICT and COVID-19 pandemic management. The dentists complained that they were not appropriately assigned to CICT, as they lacked the preparations and sufficient training. They had to acquire personal protective equipment and other basic needs at their own expense. The working conditions were severe, and they had negative relations at work. The State and the Ministry of Health were criticized for inadequate implementation of institutional measures for COVID-19 pandemic management.</p><p><strong>Conclusions: </strong>The study showed that dentists were motivated to participate in the management of pandemics and similar crisis situations, but in a negative work environment - where they were deployed without adequate training, preparation, and ensuring their basic needs and requirements were met - they lost this motivation, and experienced stress and feelings of inadequacy.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc27"},"PeriodicalIF":3.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801750","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":"Surveillance of health-care associated infections in an intensive care unit at a tertiary care hospital in Central India.","authors":"Ruchita Lohiya, Vijayshri Deotale","doi":"10.3205/dgkh000454","DOIUrl":"https://doi.org/10.3205/dgkh000454","url":null,"abstract":"<p><strong>Introduction: </strong>Because the risk of health-care associated infections (HAIs) is high in intensive care units, and HAIs are one of the causes of morbidity and mortality and affects the overall quality of health care, the continuous monitoring of HAIs in intensive care patients is essential.</p><p><strong>Aim and objectives: </strong>This descriptive cross-sectional study was carried out over a period of five years in a tertiary-care teaching hospital. The aim of the study was to investigate the main and specific types of health-care associated Infections and determine the microbiological profile and antimicrobial susceptibility rates of isolates in patients with HAI.</p><p><strong>Methods: </strong>: The active surveillance method was used to detect HAIs in patients who spent over 48 hr in a targeted ICU. Patients with blood stream infections (BSI), central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and ventilator-associated events (VAE) were included in the study. HAI were diagnosed based on the Centre for Disease Control (CDC)'s National Healthcare Safety Network (NHSN) updated definitions of HAIs.</p><p><strong>Results: </strong>A total of 121,051 patient days, including 7,989 central line days, 64,557 urinary catheter days, and 18,443 ventilator days, were recorded in the study population and 832 HAIs were diagnosed (incidence rate 6.9%). The overall rates of BSI, CLABSI, CAUTI and possible ventilator-associated pneumonia (p-VAP) were 3.7, 10.6, 2.1 and 13.4/1,000 device days, respectively. The most common organism isolated from BSI was <i>Acinetobacter baumanii</i> (n=322, 29%), followed by <i>Klebsiella pneumoniae</i> 225 (n=225, 20.3%). 79.8% of <i>Acinetobacter baumanii</i> strains were resistant to imipenem, 77.1% to ciprofloxacin and 76.4% to ampicillin. The most common organisms isolated from CAUTI were non-albicans <i>Candida</i> species (n=38, 18%), followed by <i>E. coli</i> and <i>Citrobacter</i> spp<i>.</i> (each n=33, each 15.7%).</p><p><strong>Conclusions: </strong>A trend of increasing resistance of <i>Acinetobacter</i> <i>baumannii</i> to carbapenems was observed. Risk factor analysis showed invasive procedures during sepsis and organophosphorous poisoning as significant factors.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc28"},"PeriodicalIF":3.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801752","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 factor for children in the pandemic: the use of cleaning products at home.","authors":"Emine Güdek Seferoglu, Ümran Çevik Güner","doi":"10.3205/dgkh000451","DOIUrl":"https://doi.org/10.3205/dgkh000451","url":null,"abstract":"<p><strong>Background: </strong>Intensified cleaning protocols to maintain a safe environment during the pandemic caused an increase in the use of disinfectants. The use of cleaning products in safer conditions by mothers is one of the important practices that will reduce the risk of household accidents.</p><p><strong>Objective: </strong>The aim of research was determine the practices of mothers about the safe use of cleaning and disinfectant products in the COVID-19.</p><p><strong>Methods: </strong>Data were collected by online survey among 255 mothers of the children 0-6 age from April and July 2021. Percentage, mean and chi-square tests were used to evaluate the data.</p><p><strong>Results: </strong>It was reported that the amount of cleaning product usage (69%) increased significantly, 26.3% of the mothers store the products in a locked cabinet and 29.4% use the product in the recommended amount. It was detected 28.7% of the mothers use disinfectants close to children. It was detected that 37.6% of the families were exposed to cleaning and disinfectant products. There was not significant difference between exposure situations and maternal age, education, employment status.</p><p><strong>Conclusions: </strong>It can be suggested that health workers should organize screening and training programs for the community about safe cleaning and disinfection practices.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc25"},"PeriodicalIF":3.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465505","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 tuberculosis transmission by healthcare workers to children - a comprehensive review.","authors":"Roland Diel, Albert Nienhaus","doi":"10.3205/dgkh000452","DOIUrl":"https://doi.org/10.3205/dgkh000452","url":null,"abstract":"<p><strong>Background: </strong>Children <15 years are at elevated risk of becoming infected with <i>M. tuberculosis co</i>mplex (Mtbc).</p><p><strong>Objective: </strong>To assess the magnitude of Mtbc transmission by healthcare workers (HCW) to children.</p><p><strong>Methods: </strong>Medline, Google Scholar and Cochrane library were searched to select primary studies in which HCW was the presumed index case and exposed infants and children aged below 15 years were screened for latent TB infection (LTBI).</p><p><strong>Results: </strong>Of 4,702 abstracts, 19 original case reports covering one HCW each as presumed source case of Mtbc transmission to children, were identified. In sum, 11,511 children, of those 5,881 infants (51.1%), mostly in newborn nurseries, were considered contact persons and underwent tuberculin skin (TST) or Interferon gamma release assay (IGRA) testing. Test positivity was reported in 492/11,511 children (4.3%) coming from 14 studies. When test results considered falsely positive were excluded, the number of latently infected children decreased to 365/10,171 (3.6%). In all studies, the presumed duration of infectivity of the source case was, but the actual intensity and duration of exposure were not, decisive for the initiation of contact investigations. In only two of the studies, the contact time of the children towards the corresponding source case was estimated.</p><p><strong>Conclusions: </strong>The results of our review suggest that the risk of Mtbc transmission from HCW to children in healthcare setting is considerably lower than reported in household settings. However, as the preselection of pediatric contacts appeared in most cases to be vague, the data found in the literature probably underestimates the actual risk.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc26"},"PeriodicalIF":3.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459539","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":"Attitudes of primary care physicians towards antimicrobial stewardship and the impact of a multi-part training course - a pilot study.","authors":"Katharina Last, Arne Simon, Barbara C Gärtner, Sören L Becker, Cihan Papan","doi":"10.3205/dgkh000450","DOIUrl":"https://doi.org/10.3205/dgkh000450","url":null,"abstract":"<p><strong>Background: </strong>A plethora of antimicrobial stewardship (AMS) programs has been initiated during the past years, focusing on hospital settings. Primary-care physicians have seldom been addressed, although the majority of antibiotic prescriptions are issued for outpatients. We sought to investigate attitudes of primary-care physicians and the impact of a customized training course.</p><p><strong>Methods: </strong>Primary-care physicians in southwest Germany were invited to a multi-part training course on AMS in the primary-care setting. Participants were asked to answer a questionnaire about their attitude and factors that hinder them from implementing AMS or enable them to perform AMS. In addition, a knowledge assessment exam at the beginning and end of the training was conducted on selected infectious diseases/syndromes.</p><p><strong>Results: </strong>In total, 36 primary-care physicians participated in the training course. The predominant age group was 51-60 years old (36%; 13/36). The majority, 23/35 (66%), indicated never having had AMS training, while 22/35 (63%) acknowledged partly implementing AMS activities in their daily routine. The primary barrier was lack of expertise, while the main motives were reducing antimicrobial resistance and optimizing patient care. The provision of guidelines was regarded as more important than feedback on their prescription behavior. Exam performance improved from the initial to the final exam on all topics.</p><p><strong>Conclusion: </strong>Customized AMS training courses are a feasible and potentially complimentary tool to address antibiotic misuse in the primary-care setting.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc24"},"PeriodicalIF":3.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459538","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":"In vitro anti-biofilm properties of the peel of fruite wall of acorn against Streptococcus mutans.","authors":"Zahra Chavak,&nbsp;Nahid Mahdian,&nbsp;Iraj Pakzad,&nbsp;Mohammad Reza Soltani,&nbsp;Behzad Badakhsh,&nbsp;Sobhan Ghafourian","doi":"10.3205/dgkh000449","DOIUrl":"10.3205/dgkh000449","url":null,"abstract":"<p><p>Dental caries is a multi-factorial infectious disease. The primary cause is dental plaque, a complex of biofilm. It was postulated that the ethanolic extract of fruite wall of acorn may represent a new substance to prevent caries. Hence, the study was performed to evaluate the effect of ethanolic extract of fruite wall of acorn against biofilm formation by <i>Streptococcus</i> <i>mutans</i>, which is associated with dental plaque. The cytotoxicity of the ethanolic extract was determined against Vero cells resulting in an inhibitory concentration of 50 (IC₅₀) of 55 µg/ml. After bacterial collection, different concentrations under the IC₅₀ from the extract were evaluated against biofilm formation of <i>S. mutans</i>. 3 µg/ml of the extract inhibited the biofilm formation of <i>S. mutans</i>, and 1 to 3 µg/ml caused a decrease in <i>gtfB</i> and <i>brpA</i> biofilm-production genes. This study showed the potency of the ethanolic extract of fruite wall of acorn against biofilm formation by <i>S. mutans</i>.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc23"},"PeriodicalIF":3.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41198858","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":"COVID-19 research in South Asia: a bibliometric analysis of the 100 most-cited articles.","authors":"Bisal Naseer,&nbsp;Mohsan Ali,&nbsp;Neha Azhar","doi":"10.3205/dgkh000448","DOIUrl":"10.3205/dgkh000448","url":null,"abstract":"<p><strong>Background: </strong>With the surge in the number of infected individuals during the COVID-19 pandemic, there was also a surge observed in the number of publications discussing its epidemiology, characteristics, path-o-phys-i-ol-o-gy, diagnosis, prevention and treatment. This bibliometric analysis focuses on the papers published on COVID-19 in South Asia.</p><p><strong>Methods: </strong>We searched articles in the Scopus database from December 2019 to October, 2022. After manual screening, a list of the 100 most-cited articles was obtained, which was analyzed for various factors, including the type of article, citation count, author's affiliation, country of origin, funding bodies, etc.</p><p><strong>Results: </strong>The majority of the top 100 articles (n=79) in South Asia were published during 2020. India was affiliated with the highest number of articles (n=68), followed by Bangladesh (n=18) and Pakistan (n=12). However, 7 articles were authored by a researcher in Bangladesh. Female authors were under represented (32.38%), with no female author in lists of authors with 4 or more articles. The average number of citations for each of the top 100 most-cited articles was 180.8. Original articles constituted the major portion of the publications (82%), followed by letters (11%) and reviews (4%). Half of the publications belonged to the field of medicine (n=49), while others were contributed by science, psychology, social sciences, and biochemistry and allied sciences (n=8). Vaccine trials were under-represented. Jahangirnagar University, Bangladesh was affiliated with the maximum number of articles. Most articles were published in Science of The Total Environment (n=8) while Indian Council of Medical Research (n=4) was the top funding body.</p><p><strong>Conclusion: </strong>These findings highlight that South Asia has a great potential to conduct research addressing its challenging health problems. But lack of funds hinders conducting trials of new medications and vaccines. Thus, there is need for allocation of sufficient funds for research and clinical trials by governments and the private sector to enhance the research productivity of this region.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc22"},"PeriodicalIF":3.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41198855","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":"Cutaneous leishmaniasis lowers the quality of life: a neglected truth.","authors":"Nader Aghakhani,&nbsp;Mehdi Azami,&nbsp;Mohammad Ali Mohaghegh","doi":"10.3205/dgkh000447","DOIUrl":"10.3205/dgkh000447","url":null,"abstract":"Dear Editor, Leishmaniasis is a neglected tropical disease caused by a parasite transmitted by infected female sandflies. There are 3 main forms of the disease [1]: Cutaneous leishmaniasis (Cl) is the most common form and causes skin lesions, mainly ulcers, on exposed parts of the body (see examples in Figure 1 and Figure 2). It is estimated that 600,000 to 1 million new cases occur worldwide annually. Mucocutaneous leishmaniasis leads to partial or total destruction of mucous membranes of the nose, mouth and throat. Over 90% of mucocutaneous leishmaniasis cases occur in Bolivia, Brazil, Ethiopia and Peru.","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc21"},"PeriodicalIF":3.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41198856","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":"Sequence-type diversity of invasive Streptococcus pneumoniae isolates in Iran among children under 15 years of age.","authors":"Sedigheh Rafiei Tabatabaei,&nbsp;Marjan Tariverdi,&nbsp;Abdollah Karimi,&nbsp;Ali Nazari-Alam,&nbsp;Hannan Khodaei,&nbsp;Leila Azimi","doi":"10.3205/dgkh000445","DOIUrl":"10.3205/dgkh000445","url":null,"abstract":"<p><strong>Background: </strong>Infection with viruses, bacteria, or other pathogens can lead to inflammation of the meninges. Finding the pathogen and identifying the most common type is necessary for each country. Using multi-locus sequence typing (MLST), the aim of this study was to determine the genetic relationship among <i>S. pneumoniae</i> isolated from CSF in children with bacterial meningitis.</p><p><strong>Materials and methods: </strong>: Fourteen isolates of <i>S. pneumoniae</i> from CSF in children with bacterial meningitis were included in this study. The seven housekeeping genes, primer, and analysis of the sequencing used in MLST were extracted from PubMLST.</p><p><strong>Results: </strong>The sequencing analysis showed four MLST types in the studied strains. The most frequent type is ST13649 and the least frequent are ST708 and ST285.</p><p><strong>Conclusion: </strong>Finding the bacterial sequence types (ST) enables comparing the ST in different, especially neighbouring, countries.</p>","PeriodicalId":12738,"journal":{"name":"GMS Hygiene and Infection Control","volume":"18 ","pages":"Doc19"},"PeriodicalIF":3.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41198859","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}