Infection Prevention in Practice最新文献

{"title":"Minimising the duration of N95 respirator use during hospital SARS-CoV-2 outbreaks: A mixed-effects analysis of post-screening infection reduction","authors":"Mari Yanaka ,&nbsp;Toshibumi Taniguchi ,&nbsp;Misuzu Yahaba ,&nbsp;Shota Murata ,&nbsp;Hiroshi Yoshikawa ,&nbsp;Hitoshi Chiba ,&nbsp;Misao Urushihara ,&nbsp;Hidetoshi Igari","doi":"10.1016/j.infpip.2025.100484","DOIUrl":"10.1016/j.infpip.2025.100484","url":null,"abstract":"<div><div>Hospital SARS-CoV-2 outbreaks require effective interventions. We evaluated targeted universal N95 respirator use among staff from outbreak identification until screening results. Analysing 18 cluster outbreaks using generalised linear mixed models, we found that N95 respirator use was associated with a 72% reduction in new infections (<em>P</em>&lt;0.001) compared to surgical masks. The mean duration of N95 respirator use was 5.25 days. Policy effectiveness was independent of outbreak size. Bootstrap analysis confirmed significant reduction (mean difference -3.02 cases, 95% CI: -5.98 to -0.08). Infection source showed substantial variability while ward-level variation was minimal. Short-term targeted N95 respirator use effectively controls hospital outbreaks while optimising resources and staff comfort.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100484"},"PeriodicalIF":1.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on alcohol-based hand rub consumption and hand hygiene compliance: a cross-sectional study using digital direct-observation tools in Slovakia","authors":"Chebenová Vanesa ,&nbsp;Bučková Veronika ,&nbsp;Škvarková Zuzana ,&nbsp;Balintová Natália ,&nbsp;Sokolová Jaroslava","doi":"10.1016/j.infpip.2025.100481","DOIUrl":"10.1016/j.infpip.2025.100481","url":null,"abstract":"<div><h3>Background</h3><div>Hand hygiene (HH) among healthcare professionals (HCPs) is a key component in ensuring safe and high-quality healthcare. Monitoring the Five moments for HH according to World Health Organization (WHO) guidelines remains the gold standard for compliance assessment. Proper HH is the most effective measure to prevent healthcare-associated infections (HAI).</div></div><div><h3>Aim</h3><div>This cross-sectional study aimed to quantify HH compliance and alcohol-based hand rub (ABHR) consumption among HCPS at the University Hospital Trnava in Slovakia and to compare results between the pre-pandemic and post-pandemic periods.</div></div><div><h3>Methods</h3><div>HH compliance was monitored during the pre-pandemic period (2018–2019) and the post-pandemic period (2022–2023). Compliance was assessed among different groups of HCPs – physicians, nurses and other healthcare personnel (e.g., physiotherapists, orderlies and students). Monitoring was conducted using WHO methodology and recorded via the OBSERVE app.</div></div><div><h3>Findings</h3><div>During the pre-pandemic period, overall HH compliance was 50.2% (95% CI, 48.7.-51.8), with nurses demonstrating the highest compliance rate. In the post-pandemic period, HH compliance remained nearly unchanged at (50.8%; 95% CI, 48.9–52.7). ABHR consumption increased significantly during the COVID-19 pandemic, peaking at 48.4 litres/1 000 patient days (PD), but declined to 31.5 litres/1 000 PD by 2023.</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic positively influenced ABHR consumption and raised awareness of the importance of HH in clinical practice. However, overall HH compliance did not improve post-pandemic. Direct observation supported by a digital application proved to be an effective method for collecting HH compliance data.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100481"},"PeriodicalIF":1.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the landscape of carbapenemase-producing organisms (CPOs), and spotlighting opportunities for control in England","authors":"Akaninyene Otu ,&nbsp;Jacquelyn McCormick ,&nbsp;Katherine L. Henderson ,&nbsp;Alice Ledda ,&nbsp;Danièle Meunier ,&nbsp;Bharat Patel ,&nbsp;Colin S. Brown ,&nbsp;Susie Singleton ,&nbsp;Emily L. Mason ,&nbsp;Jasmin Islam ,&nbsp;Ginny Moore ,&nbsp;Katie L. Hopkins ,&nbsp;Dakshika Jeyaratnam","doi":"10.1016/j.infpip.2025.100480","DOIUrl":"10.1016/j.infpip.2025.100480","url":null,"abstract":"<div><div>Carbapenemase-producing organisms (CPOs) are an increasing global public health threat for which there are limited effective and affordable therapeutic options. The rise in the incidence of CPO infections and colonisations recorded across the UK and beyond over the last 20 years necessitates a need to review and update strategies for control. It is important to review other countries’ frameworks for CPO control and significant CPO outbreaks as these could inform the design of an efficient public health response. Despite many nations reacting to the rise by upscaling public health surveillance of CPOs (and the introduction of mandatory notification in England), improvements in laboratory detection methods, and the linkage of data across jurisdictions, significant challenges remain. For example, though predominantly acquired via cross-transmission between patients in healthcare, there are reports of human infections putatively acquired from CPOs harboured in the natural environment. Given the role of one-health in AMR, this is an important consideration. In this article, we outline some of the CPO control strategies adopted across different countries to give a sense of the global picture, and expand on why, in addition to controls in healthcare, there is a strong need to consider a One-Health approach. We describe the existing framework for CPO control in England and emphasise the importance of an integrated, multi-disciplinary and cross-sectoral strategy for dealing with the multifaceted problem posed by CPO in England.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100480"},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the acute national blood culture bottle shortage on the two-set blood culture rate in a single center in Japan: Insights from an interrupted time-series analysis","authors":"Tetsuji Morishita ,&nbsp;Masao Kuwabara ,&nbsp;Masayoshi Monji ,&nbsp;Shin Lee ,&nbsp;Makoto Hayashi ,&nbsp;Hisashi Tsurumi ,&nbsp;Hidetoshi Matsunami","doi":"10.1016/j.infpip.2025.100479","DOIUrl":"10.1016/j.infpip.2025.100479","url":null,"abstract":"<div><h3>Background</h3><div>In 2024, a worldwide shortage of blood culture bottles prompted efforts to mitigate its impact, including strategies to reduce blood culture orders. This study aimed to evaluate the effect of the shortage on the two-set blood culture rate in a single center in Japan.</div></div><div><h3>Methods</h3><div>In this retrospective, single-center, observational study, blood culture data from April 2019 to January 2025 were analyzed. An interrupted time-series (ITS) analysis was performed to assess changes in the two-set blood culture rate, a key quality indicator. A Poisson segmented regression model was employed, with the shortage period as the breakpoint.</div></div><div><h3>Results</h3><div>The ITS analysis revealed a significant immediate reduction in the level of two-set blood cultures following the shortage (risk ratio [RR]: 0.22, <em>P</em> &lt; 0.01), with a subsequent significant rise in the trend (RR: 1.25, <em>P</em> &lt; 0.01). The two-set blood culture rate gradually improved after the supply restriction was lifted in October, returning to pre-shortage levels by December, following an intervention by the infection control team. The total blood culture test numbers remained stable during the study period (<em>P</em> = 0.64).</div></div><div><h3>Conclusions</h3><div>The blood culture bottle shortage led to a significant reduction in the two-set blood culture rate, demonstrating adaptation to shortage mitigation strategies. Monitoring the two-set blood culture rate served as an effective quality measure, enabling timely intervention by the infection control team and subsequent recovery of appropriate blood culture practices.The blood culture bottle shortage significantly reduced two-set blood culture rates. An interrupted time-series analysis showed an immediate drop, followed by recovery after an intervention. Monitoring enabled appropriate interventions to improve practices. Adapting strategies during shortages with continuous monitoring can optimize resources and patient care.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100479"},"PeriodicalIF":1.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-pronged system strengthening approach to improving infection prevention and control practices in Tanzania","authors":"Doris Lutkam ,&nbsp;Niranjan Konduri ,&nbsp;Joseph C. Hokororo ,&nbsp;Eliudi S. Eliakimu ,&nbsp;Fozo Alombah ,&nbsp;Stephano Simba ,&nbsp;Cecilia Muiva ,&nbsp;Ruth R. Ngowi ,&nbsp;Radenta P. Bahegwa ,&nbsp;Yohannes S. Msigwa ,&nbsp;Dan Schwarz ,&nbsp;Edgar Lusaya ,&nbsp;Mohan P. Joshi","doi":"10.1016/j.infpip.2025.100477","DOIUrl":"10.1016/j.infpip.2025.100477","url":null,"abstract":"<div><div>To ensure the effectiveness of its infection prevention and control (IPC) programs, Tanzania recognised a need to revise IPC guidelines and standards; upgrade IPC training materials to address knowledge gaps among preservice health care students and health workers; improve IPC governance and practice at the national and health facility levels; and improve monitoring of IPC program performance and surveillance of healthcare associated infections (HAIs). Overall, our work addressed 20 out of 21 IPC-related actions in the World Health Organisation Benchmarks for International Health Regulations capacities tool between 2018 and 2024. Over a one-year period, we found that the percentage of patients developing surgical site infections remained at 1% on average in the 10 intervention hospitals, which is lower than the global average of around 2.5%. The Ministry of Health subsequently scaled up HAI surveillance to 69 additional hospitals. As a result, Tanzania achieved a score of 3 (developed capacity) for HAI surveillance specifically in the Joint External Evaluation conducted in August 2023. Building on this progress, the Ministry of Health will continue to scale up IPC programs in all public and private health facilities. Given the health security risks associated with Ebola, Marburg, Mpox, and other pathogens, significant efforts are needed to educate the public on the importance of practicing IPC measures to protect themselves from infectious diseases.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100477"},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of vaccination and healthcare acquisition in respiratory failure during a COVID-19 outbreak in an acute hospital in Wales","authors":"Craig Hogg ,&nbsp;Caoimhe McKerr ,&nbsp;Noel Craine ,&nbsp;Dafydd Williams ,&nbsp;Malorie Perry ,&nbsp;Simon Cottrell","doi":"10.1016/j.infpip.2025.100474","DOIUrl":"10.1016/j.infpip.2025.100474","url":null,"abstract":"<div><div>This study provides descriptive analysis of a COVID-19 outbreak of 323 cases in a Welsh hospital in early 2021, with a focus on respiratory failure (RF) as a severe outcome. Multivariate analysis demonstrated decreased odds of RF in healthcare acquired cases (aOR 0.40 (95%CI 0.24–0.65), <em>p</em>&lt;0.001) and individuals with at least one dose of vaccine 14 days before first positive test (aOR 0.45 (95%CI 0.28–0.75), <em>p</em>=0.002). In healthcare acquired cases, vaccination significantly reduced the odds of RF (OR 0.47 (95%CI 0.22-0.00), <em>p</em>=0.037). This analysis highlights the importance of vaccination as a protective factor against severe respiratory outcomes.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100474"},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3% hydrogen peroxide to disinfect urine-contaminated surfaces","authors":"Brianna Tsuyuki ,&nbsp;Dena Shahriari","doi":"10.1016/j.infpip.2025.100476","DOIUrl":"10.1016/j.infpip.2025.100476","url":null,"abstract":"<div><h3>Purpose</h3><div>Disinfecting urine-contaminated floors, surfaces and objects is a persistent challenge in healthcare. While chlorine-based compounds such as bleach are often used to decontaminate surfaces, they are known to degrade plastics and may leave harmful residues and release potentially irritant vapors making them unsuitable disinfectants for materials that come in direct contact with humans. The objective of this study was to evaluate an alternative urine disinfection procedure. Treating urine-contaminated surfaces with 3% hydrogen peroxide (H₂O₂) was hypothesized to remove bacteria. Furthermore, when applicable, the efficacy of the same H₂O₂ stock solution for its repeated use over time was assessed further increasing simplicity and accessibility.</div></div><div><h3>Materials and methods</h3><div>The effectiveness of disinfecting two materials, a flat plastic surface and a long lumen representing a more challenging surface to clean, was evaluated with a commonly used method of water and soap versus using a 3% H₂O₂ solution.</div></div><div><h3>Results</h3><div>Contamination persisted when washing with soap and water but was effectively removed after one hour of H₂O₂ storage for flat plastic surfaces and after 3 hours for lumen surfaces. The same stock of H₂O₂ solution could be reused for up to three weeks with no colony formation.</div></div><div><h3>Conclusions</h3><div>The results show that bacteria can be removed from a urine-contaminated surface by being soaked in 3% H₂O₂ for one to three hours based on the surface type without the need for scrubbing or rinsing. The same stock solution can be used for repeated washes for up to three weeks to expand its sustainability and accessibility.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100476"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contamination of hospital surfaces by third-generation cephalosporin-resistant gram-negative bacteria in district hospitals in Mwanza, Tanzania: Urgent need for enhanced infection prevention and control","authors":"Ezekiel Gamuya ,&nbsp;Mulki S. Salum ,&nbsp;Beatrice Augustino Mtewele ,&nbsp;Baraka Minja ,&nbsp;Prisca Damiano ,&nbsp;Conjester I. Mtemisika ,&nbsp;Kulwa P. Mnibi ,&nbsp;Reuben N. Abednego ,&nbsp;Bernard C. Okamo ,&nbsp;Vitus Silago ,&nbsp;Stephen E. Mshana ,&nbsp;Heike Claus ,&nbsp;Jeremiah Seni","doi":"10.1016/j.infpip.2025.100475","DOIUrl":"10.1016/j.infpip.2025.100475","url":null,"abstract":"<div><h3>Background</h3><div>Hospital surfaces are critical reservoirs of multidrug-resistant pathogens, including third-generation cephalosporin-resistant Gram-negative bacteria (3GC-R-GNB), significantly contributing to healthcare-associated infections (HCAIs). This challenge is pronounced in low- and middle-income countries, where resource constraints limit effective infection prevention and control (IPC) measures. This study screened hospital surfaces for 3GC-R-GNB in selected District Hospitals (DHs) in Mwanza, Tanzania.</div></div><div><h3>Methods</h3><div>This cross-sectional hospital-based study was conducted between June and July, 2023. Door handles, hand-washing sinks, patients' beds, and ward floors were sampled. Isolation of 3GC-R-GNB was done on MacConkey agar supplemented with cefotaxime (2 μg/ml). Bacterial identification was done by MALDI-TOF on Vitek MS while antimicrobial susceptibility testing was done by the Kirby-Bauer method. A multiplex PCR assay was applied for the detection of extended-spectrum beta-lactamase (ESBL) genes (<em>bla</em>_CTX-M, <em>bla</em>_SHV, and <em>bla</em>_TEM).</div></div><div><h3>Results</h3><div>A total of 892 swabs were collected from hospital surfaces, of which 243 (27.2%) were 3GC-R-GNB positive. From the 243 positive samples, 55 samples exhibited polymicrobial growth making a total of 300 bacterial isolates. The most prevalent species was <em>Acinetobacter baumannii</em> (26.0%, 78/300), followed by <em>Klebsiella pneumoniae</em> (11.0%, 33/300), <em>Escherichia coli</em> (8.0%, 24/300), and <em>Leclercia adecarboxylata</em> (7.0%, 21/300). Multiplex PCR of selected isolates (n=243) revealed that 99.6% (242/243), 93.4% (227/243), and 2.9% (7/243) 3GC-R-GNB harbored <em>bla</em>_TEM, <em>bla</em>_CTX-M, and <em>bla</em>_SHV genes encoding ESBLs, respectively.</div></div><div><h3>Conclusion</h3><div>This study reveals substantial dispersion of highly resistant Gram-negative bacteria to hospital surfaces, showing the need to prevent dispersion of such contamination and targeted hospital hygiene measures to protect patients.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100475"},"PeriodicalIF":1.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of epidemiology and incidence of carbapenemase-producing bacteria in a tertiary hospital in southern Europe","authors":"I. González-Gómez ,&nbsp;G. Ruíz-Carrascoso ,&nbsp;R. Herruzo-Cabrera","doi":"10.1016/j.infpip.2025.100469","DOIUrl":"10.1016/j.infpip.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing Enterobacterales (CPE) are a growing issue that healthcare systems all over the world are facing and which have been producing clinical cases for &gt;20 years, with a spike in incidence in the last decade. In the Universitary Hospital of La Paz (HULP), the first CPE outbreak occurred in 2011 and incidence has been variable since then.</div></div><div><h3>Aim</h3><div>To conduct an epidemiological analysis of the distribution and microbiological characteristics of the four main types of carbapenemases (OXA-48, VIM, KPC, and NDM) obtained from bacteria isolated in the HULP, a tertiary hospital north of the city of Madrid, between 2012 and 2022.</div></div><div><h3>Methods</h3><div>An observational retrospective analysis was performed to attain the incidence characteristics of CPE and their associated outbreaks. The study used data from 5723 individual cases for which the sex and age of the patient, type of sample, isolated bacteria, type of carbapenemase, type of case (infection or colonization) and where and when the isolate was obtained.</div></div><div><h3>Results</h3><div>Since the first outbreak of CPE was detected in 2011, contain-and-response protocols were put in place to avoid the spread of CPE within the hospital setting.</div></div><div><h3>Conclusion</h3><div>The implementation of CPE infection preventention and control guidance since 2013 and (in 2022) updated protocols has impacted the number of cases, but further incidence studies should be conducted to analyse the effectiveness of these measures and assess the patterns of carbapenemase genes over time.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100469"},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiviral effect of 222 nm far-UVC light against human coronavirus and rhinovirus, and murine norovirus using dried inocula","authors":"Ana C. Lorenzo-Leal,&nbsp;Donald Tam,&nbsp;Horacio Bach","doi":"10.1016/j.infpip.2025.100473","DOIUrl":"10.1016/j.infpip.2025.100473","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 3","pages":"Article 100473"},"PeriodicalIF":1.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}