Communicable diseases intelligence (2018)最新文献

{"title":"Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Surveillance Outcome Program (AESOP) Bloodstream Infection Annual Report 2023.","authors":"Geoffrey W Coombs, Denise A Daley, Princy Shoby, Auriane Form, Shakeel Mowlaboccus","doi":"10.33321/cdi.2024.48.56","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.56","url":null,"abstract":"<p><strong>Abstract: </strong>From 1 January to 31 December 2023, fifty-six institutions across Australia participated in the Australian Enterococcal Surveillance Outcome Program (AESOP). The aim of AESOP 2023 was to determine the proportion of enterococcal bacteraemia isolates in Australia that were antimicrobial resistant, and to determine the <i>Enterococcus faecium</i> molecular epidemiology. Of the 1,599 unique episodes of enterococcal bacteraemia investigated, 92.9% were caused by either <i>E. faecalis</i> (51.8%) or <i>E. faecium</i> (41.1%). Ampicillin and vancomycin resistance were not detected in <i>E. faecalis</i> but were detected in 94.2% and 50.8% of <i>E. faecium</i> respectively. Two linezolid-resistant <i>E. faecalis</i> were identified in 2023. Both isolates had linezolid minimum inhibitory concentrations (MICs) of 6.0 mg/L, were vancomycin susceptible, and harboured the <i>optrA</i> gene. Overall, 53.2% of <i>E. faecium</i> harboured either the <i>vanA</i> or the <i>vanB</i> gene; of these, 27.3% harboured <i>vanA</i>, 72.1% harboured <i>vanB</i>, and 0.6% harboured <i>vanA</i> and <i>vanB</i>. The percentage of vancomycin-resistant <i>E. faecium</i> bacteraemia isolates in Australia remains substantially higher than that recorded in most European countries. The <i>E. faecium</i> isolates consisted of 58 multi-locus sequence types (STs); 85.7% of isolates were classified into seven major STs, each containing ten or more isolates. All major STs belonged to clonal complex (CC) 17, a global hospital-adapted polyclonal <i>E. faecium</i> CC. The major STs (ST78, ST1424, ST17, ST80, ST796, ST1421 and ST555) were found across most regions of Australia, with ST78 identified in all regions. Overall, 58.3% of isolates belonging to the seven major STs harboured the <i>vanA</i> or <i>vanB</i> gene. AESOP 2023 has shown that enterococcal bacteraemia episodes in Australia continues to be frequently caused by polyclonal ampicillin-resistant high-level gentamicin-resistant <i>vanA</i>- or <i>vanB</i>-positive <i>E. faecium</i> which have limited treatment options.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847872","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":"Australian Group on Antimicrobial Resistance (AGAR) Australian Staphylococcus aureus Surveillance Outcome Program (ASSOP) Bloodstream Infection Annual Report 2023.","authors":"Geoffrey W Coombs, Denise A Daley, Princy Shoby, Sruthi Mamoottil Sudeep, Shakeel Mowlaboccus","doi":"10.33321/cdi.2024.48.57","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.57","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;From 1 January to 31 December 2023, fifty-seven institutions across Australia participated in the Australian &lt;i&gt;Staphylococcus aureus&lt;/i&gt; Surveillance Outcome Program (ASSOP). The aim of ASSOP 2023 was to determine the proportion of &lt;i&gt;Staphylococcus aureus&lt;/i&gt; bacteraemia (SAB) isolates in Australia that were antimicrobial resistant, with particular emphasis on methicillin resistance, and to characterise the methicillin-resistant &lt;i&gt;S. aureus&lt;/i&gt; (MRSA) molecular epidemiology. A total of 3,422 SAB episodes were reported, of which 77.0% were community-onset. Overall, 16.1% of &lt;i&gt;S, aureus&lt;/i&gt; were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 14.8%, which was not significantly different to the 16.5% all-cause mortality associated with methicillin-susceptible SAB (&lt;i&gt;p&lt;/i&gt; = 0.44). With the exception of the β-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible &lt;i&gt;S, aureus&lt;/i&gt; (MSSA) was infrequent. However, in addition to the β-lactams, approximately 33% of MRSA were resistant to ciprofloxacin; 30% to erythromycin; 13% to tetracycline; 13% to gentamicin; and 3% to co-trimoxazole. Two New South Wales daptomycin-resistant MRSA, with minimum inhibitory concentrations (MICs) of 3.0 and 4.0 mg/L, were identified as ST22-IV, with a V351E &lt;i&gt;mprF&lt;/i&gt; mutation, and ST45-V with a T345I &lt;i&gt;mprF&lt;/i&gt; mutation respectively. Three daptomycin-resistant MSSA were identified. One from Tasmania, with a daptomycin MIC of 1.5 mg/L, identified as ST9295 with a L341I &lt;i&gt;mprF&lt;/i&gt; mutation; one from New South Wales, with a daptomycin MIC of 3.0 mg/L, identified as ST97 with a L776S &lt;i&gt;mprF&lt;/i&gt; mutation; and one from Western Australia, with a daptomycin MIC of 2.0 mg/L, identified as ST5. No previously reported mutations in known loci were detected in the Western Australian isolate. When applying the European Committee on Antimicrobial Susceptibility Testing breakpoints, teicoplanin resistance was detected in three MSSA isolates and one MRSA isolate. Vancomycin or linezolid resistance was not detected. Resistance to non-β-lactam antimicrobials was largely attributable to the healthcare-associated MRSA (HA-MRSA) clone ST22-IV [2B] (EMRSA-15), and the community-associated MRSA (CA-MRSA) clone ST45-V [5C2&5] which has acquired resistance to multiple antimicrobials including ciprofloxacin, clindamycin, erythromycin, gentamicin, and tetracycline. ST22-IV [2B] (EMRSA-15) was the predominant HA-MRSA clone in Australia. Overall, 85% of methicillin-resistant SAB were caused by community-associated MRSA (CA-MRSA) clones. Although polyclonal, approximately 70.3% of CA-MRSA clones were characterised as ST93-IV [2B] (Queensland clone); ST5-IV [2B]; ST1-IV [2B]; ST45-V [5C2&5]; ST30-IV [2B]; ST8-IV [2B]; ST6-IV [2B]; ST97-IV [2B]; and ST953-IV [2B]. As CA-MRSA is well established in the Australian community, it is important to monitor antimicrobial resistance patterns in commu","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847875","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":"An outbreak of dengue virus type 3 on Mer Island in the Torres Strait, Australia in 2024.","authors":"A Hempenstall, A Pyke, C Taunton, U Sabatino, S Kaigey, E Pickering, G Ehlers, M O Muzari, J Davis, C Paton, C Taylor, A van den Hurk, G Hewitson, S Schlebusch, J Hanson","doi":"10.33321/cdi.2024.48.63","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.63","url":null,"abstract":"<p><strong>Abstract: </strong>In early 2024, there were eight confirmed cases of locally acquired dengue on Mer Island in the Torres Strait. This dengue outbreak prompted an in-community public health response which included active case finding, health promotion and vector control. This was the first detected dengue outbreak in the Torres Strait since 2017. It highlights the importance of testing in primary healthcare, vector control and ongoing public health surveillance to minimise the risk of local transmission and establishment of endemic viruses which may cause significant and potentially life-threatening disease within populations in northern Australia.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847870","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":"Australian Meningococcal Surveillance Programme Annual Report, 2023.","authors":"Monica M Lahra, C R Robert George, Sebastiaan van Hal, Tiffany R Hogan","doi":"10.33321/cdi.2024.48.52","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.52","url":null,"abstract":"<p><strong>Abstract: </strong>In Australia, both probable and laboratory-confirmed cases of invasive meningococcal disease (IMD) are reported to the National Notifiable Diseases Surveillance System (NNDSS). When compared to 2022, the number of IMD notifications in 2023 increased by 14% to 143. Laboratory confirmation of IMD occurred in 140/143 (98%) of these cases, with 64% (90/140) diagnosed by bacterial culture and 36% (50/140) by nucleic acid amplification testing. The serogroup was determined for 96% of laboratory-confirmed cases (134/140): serogroup B (MenB) accounted for 84% of infections (112/134); MenW for 8% (11/134); MenY for 8% (11/134). There were no infections attributed to MenC disease. Fine typing was available on 75% of the cases for which the serogroup was determined (100/134). In MenB isolates, 25 <i>porA</i> types were detected, the most prevalent of which were P1.7-2,4 (32%; 26/82), P1.7,16-26 (16%; 13/82) and P1.22,14 (9%; 7/82). All eight typed MenW infections identified as <i>porA</i> type P1.5,2, with two different multi-locus sequence types (MLST) present: ST-11 (5) and ST-1287 (3) from the clonal complex 11, the hypervirulent strain reported in outbreaks in Australia and overseas. In MenY, the predominant <i>porA</i> type was P1.5-1,10-1 (90%; 9/10), ST-1655 and from clonal complex 23. Peaks of IMD occurred in children aged less than 5 years and in those aged 15-24 years, accounting for 21% (30/140) and 26% (37/140) of laboratory-confirmed cases respectively. In children aged under 5 years, 93% of IMD (27/29) was MenB; in those aged 15-24 years, 97% of IMD (36/37) was MenB, with serogroup not determined for one case in each of these age groups. Of note, 14-15% of IMD occurred in each of the older age groups reported: adults 25-44 years (14%, 19/140), 45-64 years (14%, 20/140), and in those aged 65 years and older (15%, 21/140). Whilst MenB predominated in all age groups, the majority of MenY and MenW IMD cases were reported in adults aged 45 years and older. All cultured IMD isolates (n = 90) had antimicrobial susceptibility testing performed. Minimum inhibitory concentration (MIC) values were reported using Clinical Laboratory Standards Institute (CLSI) interpretative criteria: 9% (8/90) were defined as penicillin resistant (MIC value: ≥ 0.5 mg/L); 71% (64/90) had intermediate susceptibility to penicillin (MIC values: 0.125 and 0.25 mg/L) and 20% (18/90) were susceptible to penicillin (MIC values: ≤ 0.064 mg/L). All isolates tested susceptible to ceftriaxone, ciprofloxacin and rifampicin.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847900","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":"Measles secondary vaccine failure in a childcare setting: an outbreak report.","authors":"Donna Barnekow, Debbie Neucom, Wendy Tout, Dustylee Williams, Michael J Thomas, Sanmarié Schlebusch, Alyssa Pyke, Madisen S Roser, Isaac Tranter, Amalie Dyda, Colleen L Lau, Nicolas R Smoll","doi":"10.33321/cdi.2024.48.61","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.61","url":null,"abstract":"<p><strong>Abstract: </strong>The Sunshine Coast Public Health Unit (SCPHU) identified a measles case in a childcare educator (CE) with secondary vaccine failure (SVF). The CE had been exposed to a confirmed measles case in a hospital emergency department and later developed symptoms including fever, cough, malaise, and a rash. Diagnostic tests confirmed measles virus infection. Sunshine Coast Public Health Unit (SCPHU) implemented control measures including contact tracing, vaccination, post-exposure prophylaxis, and quarantine for susceptible contacts. Out of 372 identified contacts, 72 were identified as susceptible, all of whom were infants and children. Despite the CE having close contact to all susceptible infants and children, no onward transmission occurred. This suggests that SVF cases pose a lower risk of spreading measles compared to immunologically naïve individuals. This report highlights the importance of prioritising immunologically naïve cases in outbreak responses.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682502","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":"Meningococcal Surveillance Australia: Reporting period 1 April to 30 June 2024.","authors":"Monica M Lahra, Sonya Natasha Hutabarat, Tiffany R Hogan","doi":"10.33321/cdi.2024.48.54","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.54","url":null,"abstract":"<p><strong>Abstract: </strong>The reference laboratories of the Australian Meningococcal Surveillance Programme (AMSP) report data on the number of cases of invasive meningococcal disease (IMD) confirmed by laboratory testing using culture and molecular based techniques. Data contained in quarterly reports are restricted to a description of case numbers of IMD by jurisdiction and serogroup, where known and expanded in 2024 to include antimicrobial resistance data for ceftriaxone, penicillin, ciprofloxacin and rifampicin. A full analysis of laboratory confirmations of IMD in each calendar year is contained in the AMSP annual reports.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682503","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":"Never waste a measles outbreak.","authors":"David N Durrheim","doi":"10.33321/cdi.2024.48.62","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.62","url":null,"abstract":"<p><strong>Abstract: </strong>This editorial focuses on the instructive value of carefully investigated measles outbreaks with reference to the outbreak report, also published today in CDI (doi: /10.33321/cdi.2024.48.61), documenting an apparent measles secondary vaccine failure affecting a Sunshine Coast childcare facility with no ongoing transmission.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682777","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":"Meningococcal Surveillance Australia: Reporting period 1 January to 31 March 2024.","authors":"Monica M Lahra, Sonya Natasha Hutabarat, Tiffany R Hogan","doi":"10.33321/cdi.2024.48.53","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.53","url":null,"abstract":"<p><strong>Abstract: </strong>The reference laboratories of the Australian Meningococcal Surveillance Programme (AMSP) report data on the number of cases of invasive meningococcal disease (IMD) confirmed by laboratory testing using culture and molecular based techniques. Data contained in quarterly reports are restricted to a description of case numbers of IMD by jurisdiction and serogroup, where known and expanded in 2024 to include antimicrobial resistance data for ceftriaxone, penicillin, ciprofloxacin and rifampicin. A full analysis of laboratory confirmations of IMD in each calendar year is contained in the AMSP annual reports.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682776","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":"Fresh produce-associated foodborne disease outbreaks in Australia, 2001 to 2017.","authors":"Joanna G Rothwell, Rhiannon Wallace, Mark Bradbury, Laura Ford, Kathryn Glass, Robyn McConchie, Dee Carter, Martyn D Kirk","doi":"10.33321/cdi.2024.48.19","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.19","url":null,"abstract":"<p><strong>Abstract: </strong>Fresh produce is an important source of foodborne outbreaks in Australia. Using descriptive analysis, we examined confirmed and suspected foodborne outbreaks associated with fresh produce in Australia recorded in the OzFoodNet outbreak register from 2001 to 2017. The outbreak register contains reports of foodborne disease outbreaks collected by OzFoodNet epidemiologists and public health officials. A fresh produce outbreak was defined as the occurrence of two or more cases of the same illness in which the investigation had implicated a common food and this food contained fresh produce. A total of 92 fresh produce outbreaks were reported, encompassing 3,422 reported illnesses, 446 hospitalisations and four deaths. Of these outbreaks, 76.1% (70/92) were caused by a known pathogen, with the majority caused by either Salmonella enterica (n = 30) or Norovirus (n = 29). Most outbreaks (77.2%; 71/92) were associated with consumption of foods containing multiple ingredients, some of which were not fresh produce. The largest outbreaks associated with a single fresh produce item included bean sprouts contaminated with S. enterica serovar Saintpaul (419 illnesses and 76 hospitalisations) and semi-dried tomatoes contaminated with Hepatitis A (372 illnesses and 169 hospitalisations). Restaurants (45.7%; n = 42/92) and commercial catering (15.2%: n = 14/92) were common settings for fresh produce outbreaks. Outbreaks occurred in all states and territories of Australia and in all seasons, with an increased frequency in the warmer months (September-May). Although the number of fresh produce-associated outbreaks did not seem to be increasing in Australia, integrated surveillance is needed to rapidly identify sources of infection due to the propensity of these outbreaks to be large and widespread.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509748","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":"An outbreak of double carbapenemase-producing Klebsiella pneumoniae, harbouring NDM-5 and OXA-48 genes, at a tertiary hospital in Canberra, Australia.","authors":"Malizgani Mhango, Frances Sheehan, Callum Thirkell, Karina Kennedy","doi":"10.33321/cdi.2024.48.50","DOIUrl":"https://doi.org/10.33321/cdi.2024.48.50","url":null,"abstract":"<p><strong>Abstract: </strong>In July 2023, a carbapenemase-producing <i>Klebsiella pneumoniae</i> (CPKP) with New Delhi metallo-beta-lactamase (NDM-5) and oxacillinase (OXA-48) carbapenemase genes was detected in the urine sample of a patient. A similar CPKP organism had previously been isolated from a surveillance rectal swab of an admitted patient, prompting an outbreak investigation. A confirmed case was defined as any suspected case in which a species of Enterobacterales was isolated from a clinical or surveillance specimen (infection or colonisation) exhibiting an NDM-5 or OXA-48 CPE gene or both, irrespective of phenotypic susceptibility. A descriptive epidemiological investigation was conducted to describe the investigation, infection prevention and control responses, and public health intervention carried out. Three confirmed cases of CPKP were identified, including the index case; 62 contacts were identified, of which 13 contacts were screened. CPKP transmission occurred between two patients on contact transmission-based precautions in separate single ensuite rooms. Despite being in the same ward, the patients did not share medical teams but shared nursing teams and ancillary staff. This study emphasises the importance of strict adherence to infection prevention and control practices and contact transmission-based precautions for patients admitted with carbapenemase-producing Enterobacterales.</p>","PeriodicalId":36867,"journal":{"name":"Communicable diseases intelligence (2018)","volume":"48 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509746","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}