Infection Prevention in Practice最新文献

{"title":"Effect of the implementation of infection prevention measures by an infection prevention link physician in trauma and orthopaedic surgery on hygiene-relevant processes and nosocomial infections","authors":"Meike M. Neuwirth ,&nbsp;Benedikt Marche ,&nbsp;Jerome Defosse ,&nbsp;Frauke Mattner ,&nbsp;Robin Otchwemah","doi":"10.1016/j.infpip.2024.100415","DOIUrl":"10.1016/j.infpip.2024.100415","url":null,"abstract":"<div><h3>Background</h3><div>The German Infection Protection Act and KRINKO recommend nominating one authorized medical specialist in every medical department as an infection prevention link physician (PLP). Detailed evidence on the contribution of PLPs to reducing infection rates is not available in Germany.</div></div><div><h3>Aim</h3><div>The \"HygArzt\"-study investigated whether, and to what extent, a PLP in orthopaedics/trauma surgery is able to improve hand hygiene adherence (HHA), process steps of dressing change, nosocomial infection (NI) and surgical site infection (SSI) rates by implementing an infection prevention bundle (IPB).</div></div><div><h3>Methods</h3><div>In consideration of a literature review on infection prevention measures in orthopaedics/trauma surgery and existing departmental hygiene standards, supported by the responsible infection control specialist, an IPB was developed by an interdisciplinary team and implemented by a PLP. The effects of IPB on NI, SSI, and HHA were determined in a pre-post study design on three trauma surgery/orthopaedic wards of a university hospital.</div></div><div><h3>Findings</h3><div>In pre-post comparison HHA was significantly increased, and NI rates were reduced significantly. The greatest increase in adherence occurred in the pre-indications \"Before touching a patient\" (pre: 37.3%; post: 73.0%), \"Before clean/aseptic procedure\" (pre: 34.2%; post: 75.5%) and \"Before surgery\" (pre: 9.7%; post: 57.0%). The analysis of NI and SSI rates (NI: <em>p</em>=0.03; SSI: <em>p</em>=0.01; relative risk (RR) of 0.53 in each case) revealed rate reductions.</div></div><div><h3>Conclusion</h3><div>The implementation of an IPB by a PLP led to an optimisation of processes and to a reduction of SSIs and NIs. PLPs seem to have the potential for targeted, group-specific implementation of complex IPBs.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100415"},"PeriodicalIF":1.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653376","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":"Is there an association between colonisation of vancomycin resistant Enterococci, methicillin resistant Staphylococcus Aureus, or Clostridiodes Difficile and mortality in sepsis?","authors":"Matthew JG. Sigakis ,&nbsp;Joseph Posluszny ,&nbsp;Michael D. Maile ,&nbsp;Elizabeth S. Jewell ,&nbsp;Milo Engoren","doi":"10.1016/j.infpip.2024.100413","DOIUrl":"10.1016/j.infpip.2024.100413","url":null,"abstract":"<div><h3>Background</h3><div>To determine if colonisation with drug resistant organisms is associated with worse outcomes in patients who subsequently develop sepsis.</div></div><div><h3>Methods</h3><div>Retrospective study of patients with sepsis employing logistic regression and linear regression to determine the independent association of colonisation with adverse outcomes.</div></div><div><h3>Results</h3><div>Mortality was higher in patients colonized with VRE [501 of 1937 (26%) v. 1052 of 5624 (19%) non-VRE colonised patients, difference 7% (95% confidence interval (5,9%), p&lt;0.001] and MRSA [168 of 708 (24%) v 1342 of 6804 (20%) non-MRSA colonised patients, difference 4% (1,7%), p = 0.014]. CDiff colonisation was not associated with increased mortality [153 of 757 (21%) v 762 of 7432 (18%), difference 3% (0,6%), p=0.052]. After multivariable logistic regression, VRE colonisation remained associated with increased hospital mortality [odds ratio = 1.273, 95% confidence interval (1.099, 1.475), p = 0.001]. VRE colonisation was also associated with subsequent receipt of mechanical ventilation [odds ratio = 1.179, 95% confidence interval (1.043, 1.334), p = 0.009] and with receipt of renal replacement therapy (RRT) [OR = 1.36 (1.11, 1.66), p = 0.003].</div></div><div><h3>Conclusions</h3><div>We found that VRE colonisation, but not MRSA or C. diff colonisation, was associated with increased hospital mortality in septic patients.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100413"},"PeriodicalIF":1.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653378","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":"Methicillin and vancomycin-resistant Staphylococcus aureus and associated risk factors among patients with wound infection in East Wallaga Zone, Western Ethiopia","authors":"Milkias Abebe ,&nbsp;Getachew Alemkere ,&nbsp;Gizachew Ayele","doi":"10.1016/j.infpip.2024.100409","DOIUrl":"10.1016/j.infpip.2024.100409","url":null,"abstract":"<div><h3>Background</h3><div>Methicillin and vancomycin-resistant <em>S. aureus</em> have become increasingly problematic in recent years. This may be explained by the indiscriminate use of this antibiotic. The aim of this study was to determine the prevalence of methicillin-resistant and vancomycin-resistant <em>Staphylococcus aureus</em> (VRSA) and associated risk factors in patients with wound infections in the East Wallaga Zone, Western Ethiopia.</div></div><div><h3>Methods</h3><div>A hospital-based cross-sectional prospective study was conducted on 384 patients with wound infections including surgical wound who sought healthcare at Nekemte Specialized Hospital. Wound samples were collected using aseptic techniques and cultured on blood agar and mannitol salt agar. Vancomycin E-test and cefoxitin (30 μg) antibiotic disc diffusion were used to detect MRSA and VRSA, respectively. Data were analyzed using SPSS version 23, and a <em>P</em>-value of less than 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of the 384 wound samples collected, 109 (28.4%) were identified as <em>Staphylococcus aureus</em>. Of these, 40.4% (44/109) were identified as MRSA, and 7.3% (8/109) were VRSA. Thirty-two (72.7%) MRSA isolates were showed multidrug resistance. The depth of the wound, patient setting, history of wound infection, and history of antibiotic use became significantly associated with the prevalence of MRSA wound infection.</div></div><div><h3>Conclusions</h3><div>This study found significant levels of <em>S. aureus</em>, MRSA, and VRSA in patients with wound infection. Therefore, it is crucial to implement effective infection prevention and control measures to prevent the spread of antimicrobial resistance.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100409"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653399","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":"Asymptomatic bacteriuria and urinary tract infection in geriatric inpatients after indwelling urinary catheter removal: a descriptive two-centre study","authors":"Aysel Kulbay ,&nbsp;Eva Joelsson-Alm ,&nbsp;Karin Amilon ,&nbsp;Ann Tammelin","doi":"10.1016/j.infpip.2024.100411","DOIUrl":"10.1016/j.infpip.2024.100411","url":null,"abstract":"<div><h3>Background</h3><div>Patients with indwelling urinary catheters (IUC) are common in geriatric care. Catheterization increases the risk of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI). The prevalence of ASB after IUC-removal is only sparsely studied. This study aimed to compare the occurrence of ASB and UTI in geriatric patients with and without a history of catheterization and to explore factors associated with ASB.</div></div><div><h3>Methods</h3><div>Patients were included at two geriatric rehabilitation wards in Stockholm, Sweden. Data were collected about history of catheterization, antibiotic treatment, and diabetes mellitus. Urine samples were analysed. Occurrence of UTI during inpatient care was identified by patient records.</div></div><div><h3>Results</h3><div>In total 196 asymptomatic patients were included in the analysis. Asymptomatic bacteriuria was significantly more common in patients with a history of catheterization (38/104, 36.5%) compared to those without IUC during the past four weeks (19/92, 20.6%, <em>P</em>=0.018). Enterococci were more commonly found in patients with a history of catheterization. Of 124 patients possible to follow up, five UTI-cases were found during hospital stay. All cases had had ASB and 4/5 had had an IUC on admission.</div><div>Catheterization was significantly associated with ASB after adjustment for confounders (OR 2.79, CI 1.31–5.91, <em>P=</em>0.008).</div></div><div><h3>Conclusions</h3><div>Catheterization is associated with ASB, this persists after IUC-removal. The results indicate that colonisation by <em>Enterococcus</em> species linked to catheterization may persist for at least four weeks after IUC-removal.</div></div><div><h3>Trial registration</h3><div>The study is registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> with the identification number NCT05039203 (09/09/2021).</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100411"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653447","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":"Assessing the state of infection prevention and control in cameroon: a cross-sectional workshop evaluation using socioecological models","authors":"Boris Arnaud Kouomogne Nteungue ,&nbsp;Erick Tandi ,&nbsp;Jeffrey Campbell ,&nbsp;Chanceline Bilounga Ndongo ,&nbsp;Bissouma-Ledjou Tania ,&nbsp;Alphonse Acho ,&nbsp;Dieudonnée Reine Ndougou ,&nbsp;Reverien Habimana ,&nbsp;Ambomo Sylvie Myriam ,&nbsp;Bertolt Brecht Kouam Nteungue ,&nbsp;Oyono Yannick ,&nbsp;Louis Joss Bitang ,&nbsp;Georges Alain Etoundi Mballa ,&nbsp;Yap Boum","doi":"10.1016/j.infpip.2024.100408","DOIUrl":"10.1016/j.infpip.2024.100408","url":null,"abstract":"<div><h3>Objectives</h3><div>Infection prevention and control (IPC) contributes to the reduction of healthcare associated infections. Notwithstanding the global attention with available guidelines and tools, low- and middle-income countries (LMICs) still struggle to put into place effective IPC programmes. Here, we use a socioecological approach to summarize the findings of a recent workshop on the implementation of IPC activities in Cameroon.</div></div><div><h3>Study design</h3><div>We conducted a cross-sectional study on the assessment of the IPC in Cameroon.</div></div><div><h3>Methods</h3><div>Experts and key stakeholders involved in IPC in Cameroon evaluated the implementation of infection prevention and control during a 4-day workshop. Detailed summaries of workshop discussions and recommendations were created. Data were clustered into themes guided by the WHO core component of IPC. Results were analyzed using the socioecological model of Bronfenbrenner, McLeroy and the theory of Grol and Wensing on successful implementation of practices in healthcare settings.</div></div><div><h3>Results</h3><div>Cameroon does not have an effective IPC programme in place but has developed some areas of the World Health Organization (WHO) IPC core components across the guideline level, the individual level, the organizational level, and the political level.</div></div><div><h3>Conclusion</h3><div>Cameroon is still far from the norms and standards laid out by the WHO. The evidence generated from the current analysis should contribute to improve policies and strategies towards an effective IPC programme in Cameroon and other LMICs.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100408"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593454","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":"Analysis of COVID-19 nosocomial clusters in an Omicron strain epidemic: importance of patient education on infection control measures","authors":"Tomonori Takano ,&nbsp;Yoshiko Nakatani ,&nbsp;Akihiro Nagai ,&nbsp;Natsuki Izumoto ,&nbsp;Yuta Ono ,&nbsp;Atsushi Inoue ,&nbsp;Hiromu Takemura ,&nbsp;Hiroyuki Kunishima","doi":"10.1016/j.infpip.2024.100410","DOIUrl":"10.1016/j.infpip.2024.100410","url":null,"abstract":"<div><div>A cluster of 129 patients with coronavirus disease 2019 (COVID-19) nosocomial infections was analysed during the Omicron strain epidemic. The incubation period for nosocomial Omicron strain infections was found to be 3 days. The transmission route of the first patient with COVID-19 (FCP) in each room is a critical factor within these clusters. There have been few cases of healthcare-worker-to-patient transmission, and most FCPs maintained high levels of activity in daily living. The primary routes of nosocomial infection among FCPs likely involved patient visits or direct conversations between patients. Therefore, hospital clusters can potentially be mitigated by educating patients on infection control measures, such as proper mask-waring and hand hygiene.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100410"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653097","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 Law of Unintended Consequences’ – Staphylococcus aureus bloodstream infection complicating peripheral intravascular cannulation in an epilepsy monitoring unit","authors":"Niamh Reidy ,&nbsp;Julian Larkin ,&nbsp;Peter Widdess-Walsh ,&nbsp;Karen Burns","doi":"10.1016/j.infpip.2024.100412","DOIUrl":"10.1016/j.infpip.2024.100412","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100412"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593456","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 financial burden of healthcare-associated infections: a propensity score analysis in an Italian healthcare setting","authors":"S. Orlando ,&nbsp;M. Cicala ,&nbsp;C. De Santo ,&nbsp;C. Mosconi ,&nbsp;F. Ciccacci ,&nbsp;L. Guarente ,&nbsp;M. Carestia ,&nbsp;G. Liotta ,&nbsp;D. Di Giovanni ,&nbsp;E. Buonomo ,&nbsp;F. Riccardi ,&nbsp;L. Palombi ,&nbsp;L. Emberti Gialloreti","doi":"10.1016/j.infpip.2024.100406","DOIUrl":"10.1016/j.infpip.2024.100406","url":null,"abstract":"<div><h3>Introduction</h3><div>Hospital-acquired infections (HAIs) present a global public health challenge, impacting patient safety and incurring substantial economic costs across healthcare settings. This study aims to accurately measure the financial burden of HAIs by analyzing real costs associated with various infections, providing insights for targeted prevention and management strategies.</div></div><div><h3>Methods</h3><div>This retrospective cohort study at a university hospital in Rome, Italy, analysed Hospital Discharge Records (HDR) from January to December 2018, focusing on patients with and without HAIs. The study employed ICD-9-CM codes, microbiology databases, and stratified analyses by infection site and microorganism. Cost increments were calculated using DRG reimbursement data. Propensity score matching compared infected patients with matched non-infected counterparts, simulating a randomized trial through two models: one adjusting for length of stay and mortality (less conservative), and one not using these factors as confounders (more conservative).</div></div><div><h3>Results</h3><div>In the study of 12,033 patients at Policlinico Universitario Tor Vergata, 10.07% developed an HAI, significantly raising mean DRG by 53.4% (€3,744 to €5,744). Propensity score analysis showed HAIs elevated costs by €4,695 (60.45%) in one model, and by €3,335 (31.15%) in another. Specific microbes and infection sites further influenced the cost impact, highlighting the need for targeted HAI prevention strategies.</div></div><div><h3>Conclusion</h3><div>Our study reveals the significant economic impact of hospital-acquired infections (HAIs), with a substantial increase in costs linked to specific microorganisms and infection sites. These findings highlight the need for effective HAI prevention strategies to enhance patient safety and reduce healthcare expenditures.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 1","pages":"Article 100406"},"PeriodicalIF":1.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932807","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":"Successful control of an outbreak of Panton–Valentine leucocidin positive meticillin resistant Staphylococcus aureus in a National Burns Unit through early detection by whole genome sequencing","authors":"R. Traynor ,&nbsp;G.I. Brennan ,&nbsp;T. Hoban ,&nbsp;A.M. Dolan ,&nbsp;B. Boyle ,&nbsp;B. O’ Connell ,&nbsp;O. Shelley ,&nbsp;T.K. Teoh","doi":"10.1016/j.infpip.2024.100400","DOIUrl":"10.1016/j.infpip.2024.100400","url":null,"abstract":"<div><div>We report an outbreak of PVL-producing MRSA in the Irish National Burns Unit in 2022 involving seven patients, two staff members and two positive environmental samples. This outbreak was successfully controlled using a range of measures including staff screening, environmental screening and enhanced cleaning. The use of real time whole genome sequencing (WGS) allowed for rapid identification of relatedness and for a rapid outbreak response. We share our successful approach to control this outbreak.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100400"},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434100","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":"Susceptibility patterns of Candida species collected from intensive care units in Portugal: a prospective study in 2020–2022","authors":"Teresa Nascimento ,&nbsp;João Inácio ,&nbsp;Daniela Guerreiro ,&nbsp;Priscila Diaz ,&nbsp;Patrícia Patrício ,&nbsp;Luís Proença ,&nbsp;Cristina Toscano ,&nbsp;Helena Barroso","doi":"10.1016/j.infpip.2024.100403","DOIUrl":"10.1016/j.infpip.2024.100403","url":null,"abstract":"<div><h3>Background</h3><div>For <em>Candida</em> infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions.</div></div><div><h3>Aims</h3><div>To monitor the epidemiology and antifungal susceptibility of <em>Candida</em> spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8).</div></div><div><h3>Methods</h3><div>From 2020 to 2022, 675 patients from three ICUs were enrolled. <em>Candida</em> isolates were identified by MALDI-TOF MS and PCR. <em>In vitro</em> antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique.</div></div><div><h3>Results</h3><div>Out of 988 swabs, 355 isolates were identified as <em>Candida</em> species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all <em>Candida</em> isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 <em>C. albicans</em>, 2 out of 89 <em>C. parapsilosis</em> and 2 out of 24 <em>C. glabrata</em> isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one <em>C. albicans</em> isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three <em>Candida</em> spp. exhibited resistance to anidulafungin, <em>C. albicans</em>, <em>C. tropicalis</em>, and <em>C. parapsilosis</em>.</div></div><div><h3>Conclusions</h3><div>This study highlights the importance of <em>C. albicans</em> as a frequent coloniser and showed that antifungal resistance remains uncommon among <em>Candida</em> isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"6 4","pages":"Article 100403"},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422315","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}