Infection Prevention in Practice最新文献

{"title":"How did the COVID-19 pandemic affect antibiotic consumption within humanitarian emergencies? Results from five humanitarian contexts","authors":"","doi":"10.1016/j.infpip.2024.100385","DOIUrl":"10.1016/j.infpip.2024.100385","url":null,"abstract":"<div><h3>Introduction</h3><p>Both high- and low-income countries reported increased antibiotic consumption among COVID-19 patients during the first months of the pandemic. To date, however, no studies have examined changes in antibiotic consumption during the COVID-19 pandemic within humanitarian emergency contexts.</p></div><div><h3>Method</h3><p>Data was collected by Médecins Sans Frontières (MSF) for the years 2018–2021 across the following humanitarian settings: Afghanistan (Lashkar Gah), Bangladesh (Kutupalong), the Democratic Republic of Congo (Mweso and Baraka), and South Sudan (Bentiu). Inpatient and outpatient antibiotic consumption was calculated as Daily Defined Dose (DDD) per 1000 inhabitants per day, as per the World Health Organisation's (WHO) Collaborating Centre for Drug Statistics Methodology. Interrupted time series (ITS) analysis, using an autoregressive integrated moving average (ARIMA) model was used to analyse retrospective monthly antibiotic consumption. The impact of COVID-19 pandemic was evaluated as total antibiotic consumption and according to WHO Access, Watch, Reserve (AWaRe) group classifications within each humanitarian setting.</p></div><div><h3>Results</h3><p>The COVID-19 pandemic had no statistically significant impact on total antibiotic consumption in South Sudan (Bentiu) and Bangladesh (Kutupalong). Similarly, the pandemic had no impact on total antibiotic consumption in DR Congo (Baraka), despite an initial 0.27% (estimate=.274, p-value=0.006) increase in March 2020 driven by Access group antibiotics. Meanwhile, total antibiotic consumption in DR Congo (Mweso) and Afghanistan (Lashkar Gah) declined by 0.74% (estimate = −.744, p = 0.003) and 0.26% (estimate = −.26, p &lt; 0.001), respectively with the COVID-19 pandemic.</p></div><div><h3>Conclusion</h3><p>Further studies are required to investigate what may have contributed to these results.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000490/pdfft?md5=5ad2a6afb432bb553d59c9b69d07fad7&pid=1-s2.0-S2590088924000490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840867","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":"Bacterial Tree of Life: assessing the efficacy of microbiology teaching for foundation year doctors","authors":"","doi":"10.1016/j.infpip.2024.100384","DOIUrl":"10.1016/j.infpip.2024.100384","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000489/pdfft?md5=9626150ecd5b8a44c164d69fd3965071&pid=1-s2.0-S2590088924000489-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703534","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":"SARS-CoV-2 surveillance in a hospital and control of an outbreak on a geriatric ward using whole genome sequencing","authors":"","doi":"10.1016/j.infpip.2024.100383","DOIUrl":"10.1016/j.infpip.2024.100383","url":null,"abstract":"<div><h3>Background</h3><p>During the SARS-CoV-2 pandemic, dominant viral variants were repeatedly replaced by new variants with altered properties, frequently changing the dynamics of the infection event, as well as the effectiveness of vaccines and therapeutics. SARS-CoV-2 variant monitoring by whole genome sequencing was established at the University Medical Center Mainz, Germany to support patient management during the pandemic.</p></div><div><h3>Methods</h3><p>SARS-CoV-2 RNA samples from the University Medical Center were analysed weekly with whole genome sequencing. The genome sequences obtained were aligned with sequences from public databases to perform variant assignment. For classification purposes, phylogenetic trees were constructed to map the variant distribution in the clinical settings and the current outbreak events at that time. We describe the surveillance procedures using an example from a geriatric ward.</p></div><div><h3>Results</h3><p>For monitoring, a time series was created covering two years of the pandemic. The changes from the Alpha to the Delta and the Omicron variants of SARS-CoV-2 could thus be precisely observed. The increasingly rapid switch of Omicron subvariants in the recent past could be tracked. The elucidation of phylogenetic relationships between circulating strains allowed conclusions about transmission pathways. Using an example from a geriatric ward, we demonstrated how variant monitoring by whole genome sequencing supported the infection prevention and control procedures on a ward and contribute to the control of outbreaks.</p></div><div><h3>Conclusions</h3><p>This example of SARS-CoV-2 demonstrates the effectiveness of targeted, local monitoring by molecular variant analysis. The program proved to be instrumental in controlling an outbreak on a geriatric ward.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000477/pdfft?md5=7f2e12844b2c8865f36edf4ce8fb22de&pid=1-s2.0-S2590088924000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623586","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":"Digital epidemiology: harnessing big data for early detection and monitoring of viral outbreaks","authors":"Deema Ibrahim Fallatah ,&nbsp;Hafeez Aderinsayo Adekola","doi":"10.1016/j.infpip.2024.100382","DOIUrl":"https://doi.org/10.1016/j.infpip.2024.100382","url":null,"abstract":"<div><p>Digital epidemiology is the process of investigating the dynamics of disease-related patterns, both social and clinical, as well as the causes of these trends in epidemiology. Digital epidemiology, utilising big data from a variety of digital sources, has emerged as a viable method for early detection and monitoring of viral outbreaks. The present review gives an overview of digital epidemiology, emphasising its importance in the timely detection of infectious disease outbreaks. Researchers may discover and track outbreaks in real time using digital data sources such as search engine queries, social media trends, and digital health records. However, data quality, concerns about privacy, and data interoperability must be addressed to maximise the effectiveness of digital epidemiology. As the global landscape of infectious diseases evolves, integrating digital epidemiology becomes critical to improving pandemic preparedness and response efforts. Integrating digital epidemiology into routine monitoring systems has the potential to improve global health outcomes and save lives in the event of viral outbreaks.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000465/pdfft?md5=e05f6a6d77c5330cfbb64071abca868d&pid=1-s2.0-S2590088924000465-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594820","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 impact of meropenem shortage and post-prescription review and feedback on broad-spectrum antimicrobial use: An interrupted time-series analysis","authors":"Kohei Maruyama ,&nbsp;Kiyoshi Sekiya ,&nbsp;Noriyuki Yanagida ,&nbsp;Shuhei Yasuda ,&nbsp;Daisuke Fukumoto ,&nbsp;Satoshi Hosoya ,&nbsp;Hiromitsu Moriya ,&nbsp;Motoko Kawabe ,&nbsp;Tatsuya Mori","doi":"10.1016/j.infpip.2024.100380","DOIUrl":"https://doi.org/10.1016/j.infpip.2024.100380","url":null,"abstract":"<div><h3>Background</h3><p>Meropenem (MEPM) holds significance in treating severe infections and drug-resistant bacteria. There are concerns that antimicrobial shortages may lead to the use of alternative antimicrobials that are less effective and safer. We have responded to the MEPM shortage with post-prescription monitoring and feedback (PPRF) with no restrictions on MEPM initiation. We aimed to assess the impact of the MEPM shortage and the PPRF on broad-spectrum antimicrobial use and mortality.</p></div><div><h3>Methods</h3><p>This retrospective study was conducted in a single hospital in Japan. The period from October 2021 to August 2022 was defined as the period before the MEPM shortage, and the period from September 2022 to March 2023 was defined as the period during the MEPM shortage. To support the appropriate use of antimicrobials during MEPM shortages, the antimicrobial stewardship team (AST) developed a list of alternatives to MEPM. An interrupted time series analysis was used to assess changes in use and mortality among patients receiving broad-spectrum antimicrobials over the study period.</p></div><div><h3>Discussion</h3><p>The shortage of MEPM and PPRF temporarily increased the use of alternative cefepime; however, the subsequent change in days of therapy and days of coverage of broad-spectrum antimicrobials suggests a decrease in the use of these antimicrobials. Despite these shifts, the mortality rates remained stable, suggesting that the response to the shortage did not adversely affect treatment outcomes.</p></div><div><h3>Conclusion</h3><p>In the context of antimicrobial shortages, AST support plays an important role in enabling physicians to make optimal use of antimicrobials.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000441/pdfft?md5=6d24510e9e8b8625422d85dc2ec1996a&pid=1-s2.0-S2590088924000441-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141487144","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":"Hair removal with a clipper and microbial colonisation prior to knee arthroplasty: a randomised controlled trial","authors":"Trine Herskind Hasløv ,&nbsp;Cecilie Fuglsbjerg ,&nbsp;Anne Kirstine Nielsen ,&nbsp;Anne Brun Hesselvig ,&nbsp;Blaine Gabriel Fritz ,&nbsp;Lene Bay ,&nbsp;Tom Møller ,&nbsp;Thomas Bjarnsholt ,&nbsp;Anders Odgaard","doi":"10.1016/j.infpip.2024.100377","DOIUrl":"10.1016/j.infpip.2024.100377","url":null,"abstract":"<div><h3>Background</h3><p>Despite the widely reported success of knee arthroplasty, studies show that 1.6–3 % of patients undergo revision within the first postoperative year predominantly due to infection. Preoperative skin preparation may potentially decrease the bacterial load and consequently, the risk of periprosthetic joint infections. The effects of hair removal on prosthetic joint infection are inconsistent. Our primary aim was to investigate if hair removal with a clipper influenced skin colonisation and bacterial composition.</p></div><div><h3>Methods</h3><p>Forty Caucasian male participants who were planned to undergo knee arthroplasty, (mean age 63.8 years), were included. Patients were randomised to hair removal in a within-person study design. As a control, the opposite leg of the patient was used. Swabs were collected prior to hair removal (baseline), immediately after hair removal (Day 0), and with follow-up after one and seven days.</p></div><div><h3>Results</h3><p>The intervention showed significant decrease in mean log colony-forming units per. cm² from baseline 2.97 to 2.67 (<em>P</em>&lt;0.01) immediately after hair removal and sustained at Day 1 (<em>P</em>=0.01). At Day 7, the mean was non-significant compared to baseline. The control group did not show any decrease of skin microbiota at follow-up on Day 0, 1 or 7.</p><p>No significant differences within the bacterial composition were found between the intervention and control leg at baseline among the six most prevalent detected bacterial species: <em>Staphylococcus epidermidis, Micrococcus luteus, S</em>. <em>hominis, S</em>. <em>capitis, S</em>. <em>haemolyticus and S</em>. <em>aureus.</em> The study did not find any changes in the bacterial composition over time.</p></div><div><h3>Conclusion</h3><p>Hair removal with a clipper within 24 hours prior to surgery causes a significant non-selective reduction in skin colonisation.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000416/pdfft?md5=9b309d3013575d9996c87595086c470c&pid=1-s2.0-S2590088924000416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402764","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":"Infection prevention and control: knowledge, practices and associated factors among cleaners at a National Referral Hospital in Uganda","authors":"Edwin Kigozi ,&nbsp;Livingstone Kamoga ,&nbsp;Nelson Ssewante ,&nbsp;Patrick Banadda ,&nbsp;Faith Atai ,&nbsp;Lydia Kabiri ,&nbsp;Scovia Nalugo Mbalinda","doi":"10.1016/j.infpip.2024.100376","DOIUrl":"10.1016/j.infpip.2024.100376","url":null,"abstract":"<div><h3>Background</h3><p>While most infection prevention and control (IPC) studies focus on healthcare professionals, IPC is everyone's responsibility in any healthcare facility. There is little known about the IPC knowledge among the cleaners who are responsible for housekeeping, environmental cleaning, and waste management within hospitals. This study sought to evaluate the knowledge and practice of IPC among cleaners at Mulago National Referral Hospital (MNRH) to establish a foundation for empowering a strategic workforce that will improve IPC practices within the hospital.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted among the cleaners in a national referral hospital in Uganda. The participants were purposively sampled, and data was collected using a web-based, interviewer-administered, questionnaire about IPC knowledge and practices.</p></div><div><h3>Results</h3><p>Of the 120 cleaners recruited, 52.5% were female. Good IPC knowledge was demonstrated in 58.3%, and 30.8% reported good IPC practices. Participants with at least 5 years' work experience had higher knowledge levels (aOR: 10.3, <em>P</em>=0.006, 95% CI: 2–54). Those closely supervised had lower IPC knowledge compared with those with less supervision. Participants with fixed work schedules (aOR: 0.2, <em>P</em>=0.028, 95%CI: 0–0.8), were less likely to exhibit good IPC practices. In addition, 63.1% were knowledgeable about waste segregation, recognising bin colours and the correct disposal of sharps and needles. Despite good compliance with personal protective equipment, poor hand-washing practices were reported. A positive correlation between knowledge and practice scores was established.</p></div><div><h3>Conclusion</h3><p>Hospital cleaners in a national referral hospital in Uganda IPC reported poor infection prevention practices despite good knowledge. For IPC knowledge and practice to correlate positively, ongoing practical training is vital to maintain knowledge and good practice to establish a successful IPC program.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000404/pdfft?md5=cbf6574d12b9410643dd12f901007cfe&pid=1-s2.0-S2590088924000404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396715","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":"Phytobacter spp: the emergence of a new genus of healthcare-associated Enterobacterales encoding carbapenemases in Argentina: a case series","authors":"Marisa Almuzara ,&nbsp;Roxana Cittadini ,&nbsp;Germán Traglia ,&nbsp;María Sol Haim ,&nbsp;Denise De Belder ,&nbsp;Carla Alvarez ,&nbsp;Zandra de Lourdes Reynal O'Connor ,&nbsp;Cecilia Vera Ocampo ,&nbsp;Claudia Barberis ,&nbsp;Mónica Prieto ,&nbsp;Josefina Campos ,&nbsp;Carlos Vay","doi":"10.1016/j.infpip.2024.100379","DOIUrl":"10.1016/j.infpip.2024.100379","url":null,"abstract":"<div><p>Members of the genus <em>Phytobacter</em> (order <em>Enterobacterales</em>) are isolated from the natural environment and clinical settings. Identification of <em>Phytobacter</em> strains based on biochemical characteristics is complicated due to taxonomic confusion, and they are often misidentified by automated identification systems in laboratories.</p><p>In this study we describe the first three clinical cases associated with <em>Phytobacter</em> spp. reported in Argentina. We describe the identification, the molecular analysis using whole genome sequencing and the potential clinical relevance.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259008892400043X/pdfft?md5=9220c17852ef2c830645d9cae3a3040a&pid=1-s2.0-S259008892400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403476","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 outbreak of Pseudomonas aeruginosa urinary tract infections following cystoscopy traceable to a malfunctioning drying cabinet","authors":"Leonie A.J. Derickx ,&nbsp;Diana Willemse-Erix ,&nbsp;Anne van Piggelen ,&nbsp;Paul Steegh ,&nbsp;A. Caroline Heijckmann ,&nbsp;Mirjam H.A. Hermans ,&nbsp;Thijn F. de Vocht ,&nbsp;Peter C. Wever","doi":"10.1016/j.infpip.2024.100378","DOIUrl":"10.1016/j.infpip.2024.100378","url":null,"abstract":"<div><h3>Background</h3><p><em>Pseudomonas aeruginosa</em> is an important bacterial pathogen, particularly as a cause of nosocomial infections in hospitalized patients. Only few reports exist in which cystoscopes were implicated as an outbreak source. We describe an investigation into the cause of a sudden increase in the number of urinary tract infections (UTI) with <em>P</em>. <em>aeruginosa</em> in patients after cystoscopy. In addition, we share the lessons learned and measures taken to reduce the risk of similar infections in the future.</p></div><div><h3>Presentation of Case</h3><p>Over a period of two weeks the urology outpatient department noticed a UTI in four patients following cystoscopy. An investigation was started for a common source of the outbreak in the urological treatment room. Additional screening of patients revealed a total of eleven males with <em>P. aeruginosa</em> UTI following cystoscopy. The infections were found to be due to a defective drying cabinet, which lacked an alarm signaling in case of loss of airflow. Amplified fragment length polymorphism (AFLP) analysis revealed that <em>P. aeruginosa</em> isolates from three patients and six isolates from environmental cultures (including cystoscopes from the drying cabinet) genotypically belonged to one strain.</p></div><div><h3>Discussion</h3><p>The AFLP results suggest that contaminated cystoscopes caused <em>P. aeruginosa</em> UTI in 11 patients, with the drying cabinet as site of transfer of the infective strain. To our knowledge, this is the first report describing a malfunctioning drying cabinet as source of an outbreak following cystoscopy.</p></div><div><h3>Conclusion</h3><p>In case of concomitant <em>P. aeruginosa</em> infections, cystoscopes and drying cabinets should be suspected as a potential source. Molecular techniques are helpful in investigating the epidemiology of an outbreak.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000428/pdfft?md5=75187789065eb04702fa41f45dea7cb0&pid=1-s2.0-S2590088924000428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407045","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":"Diabetes and MRSA Infections: A comparative analysis in an Indian tertiary healthcare setting","authors":"M. Sagiraju ,&nbsp;R. Prasad ,&nbsp;A. Gopi","doi":"10.1016/j.infpip.2024.100372","DOIUrl":"10.1016/j.infpip.2024.100372","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000362/pdfft?md5=1ac03f80876b955eb6b47205a38d028f&pid=1-s2.0-S2590088924000362-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139455","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}