Infection Disease & Health最新文献

{"title":"Development of a rapid, multi-organisational, multi-modal assessment of a newly available disposable respirator","authors":"Irene Ng ,&nbsp;Charles Bodas ,&nbsp;Megan Roberts ,&nbsp;Andrew Coe ,&nbsp;Michelle Smith ,&nbsp;Helen McCann ,&nbsp;Daryl Lindsay Williams","doi":"10.1016/j.idh.2024.03.002","DOIUrl":"10.1016/j.idh.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><p>A rapid large-scale evaluation of a newly available duckbill style P2/N95 respirator, the Care Essentials (CE) MSK-003, was required to determine its suitability for deployment into the Victorian healthcare service. The aims of this study were to assess the feasibility of establishing a rapid, multi-organisational and multi-modal evaluation of the respirator, and to investigate whether this respirator would meet the needs of healthcare workers.</p></div><div><h3>Methods</h3><p>The evaluation was a collaboration among three healthcare organisations – two tertiary hospitals in metropolitan Melbourne and a rural-based hospital. Participants were healthcare workers undertaking their routine fit tests. They were required to complete quantitative fit testing and a usability assessment survey on the CE MSK-003 respirator. The a priori performance criteria were set as fit test pass rate of &gt;70%, plus satisfactory subjective overall comfort and performance assessments, defined as a rating of adequate, good, or very good in &gt;90% of the cohort.</p></div><div><h3>Results</h3><p>A total of 1070 participants completed the multi-modal assessment within a month. Seventy-eight percent of participants passed their quantitative fit test. Over 90% of survey respondents reported that the CE MSK-003 was adequate, good or very good in terms of its overall comfort and performance assessments.</p></div><div><h3>Conclusion</h3><p>We demonstrated that a multi-modal evaluation of a new respirator can be rapidly conducted with a high level of participation in a controlled, consistent manner across multiple organisations. The evaluation results of the CE MSK-003 respirator exceeded our predetermined (a priori) minimal criteria, making it suitable for broad distribution to healthcare organisations.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 3","pages":"Pages 124-129"},"PeriodicalIF":2.7,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045124000208/pdfft?md5=3221e2c1d4b780f669aad7db0f9a9261&pid=1-s2.0-S2468045124000208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768549","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":"Capacity building to address antimicrobial resistance in remote Australia: The inaugural HOT NORTH Antimicrobial Academy","authors":"A.C. Bowen ,&nbsp;B. Smith ,&nbsp;K. Daveson ,&nbsp;L. Eldridge ,&nbsp;A. Hempenstall ,&nbsp;T. Mylne ,&nbsp;R. Szalkowski ,&nbsp;K. Van Rooijen ,&nbsp;L. Anderson ,&nbsp;M. Stephens ,&nbsp;S.Y.C. Tong ,&nbsp;T. Yarwood","doi":"10.1016/j.idh.2024.03.001","DOIUrl":"10.1016/j.idh.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Rates of antimicrobial resistance (AMR) for some pathogens in Australia are considerably higher in rural and remote compared to urban regions. The inaugural Hot North Antimicrobial Academy was a 9-month educational programme aimed to build workforce knowledge and capacity in antimicrobial use, audit, stewardship, surveillance and drug resistance in remote primary health care.</p></div><div><h3>Methods</h3><p>The Academy was advertised to Aboriginal and Torres Strait Islander, regional and remote healthcare workers. Participants were Aboriginal health practitioners, nurses, pharmacists and doctors from Queensland, Northern Territory, South Australia and Western Australia working in remote primary health care with a focus on Indigenous health. Due to COVID-19 restrictions, the Academy ran virtually from February–November 2021 using Microsoft Teams. The Academy was evaluated using surveys and yarning circles to assess impact and knowledge gain.</p></div><div><h3>Results</h3><p>Participants and faculty from across Australia attended 19 lectures and mentorship sessions. Eleven participants commenced and eight (73%) completed the Academy. The Academy raised participants awareness of AMR guidelines, governance and generating change; built confidence in advocacy; grew knowledge about drug resistant infections; and created a community of AMR champions in Indigenous health.</p></div><div><h3>Conclusion</h3><p>The evaluation confirmed the Academy met the needs of participants, provided opportunities to move stewardship from tertiary hospitals into Indigenous and remote clinics and developed skills in research, audit, stewardship and advocacy for all involved. All sessions were recorded for future use, with facilitation by the National Aboriginal Community Controlled Health Organisation (NACCHO) in future years.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 3","pages":"Pages 117-123"},"PeriodicalIF":2.7,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045124000075/pdfft?md5=0089701908f6317a79e2dfdf3e2b6e78&pid=1-s2.0-S2468045124000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330443","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":"Catheter-associated urinary tract infections in Africa: Systematic review and meta-analysis","authors":"Zelalem Asmare ,&nbsp;Mulat Erkihun ,&nbsp;Wagaw Abebe ,&nbsp;Agenagnew Ashagre ,&nbsp;Tadesse Misganaw ,&nbsp;Sefineh Fenta Feleke","doi":"10.1016/j.idh.2024.02.005","DOIUrl":"10.1016/j.idh.2024.02.005","url":null,"abstract":"<div><h3>Background</h3><p>Catheter-associated urinary tract infections (CAUTIs) account for the majority of device-associated healthcare-acquired infections with significant morbidity and mortality worldwide. In developing countries with limited resources, the burden of CAUTI have substantial burden owing to the lack of well-organized infection prevention and control. Although there are studies in African countries, the magnitude of CAUTI is inconsistent. Therefore this systematic review and meta-analysis aimed to determine the pooled prevalence of CAUTI in Africa and identify the pathogens involved.</p></div><div><h3>Methods</h3><p>Systematic review of articles from different databases and search engines such as Medline/PubMed, Google Scholar, Science Direct, and African Journal online were systematically searched to identify potential studies. Data were extracted on Microsoft Excel spreadsheet and analyzed using STATA 17.0. The pooled prevalence of CAUTI was estimated using a random effects model, inverse of variance was used to assess statistical heterogeneity across studies. Egger's tests was performed to identify possible publication bias.</p></div><div><h3>Results</h3><p>This systematic review and meta-analysis incorporated twenty studies, revealing a pooled prevalence of CAUTI at 43.28%. Gram-negative bacteria were the leading cause of CAUTI accounts for 82.9%. <em>Escherichia coli</em> (45.06%) was the most frequent gram-negative bacterial isolate involved in CAUTI followed by <em>Klebsiella</em> spp (24.17%). <em>Staphylococcus aureus</em> was the predominant gram-positive bacterial isolate, accounting for 53.24% of gram-positive associated cases in CAUTI.</p></div><div><h3>Conclusion and recommendations</h3><p>In conclusion, the high prevalence of CAUTI in Africa underlines a pressing healthcare challenge. Addressing this issue requires a concerted effort, encompassing health education, infection prevention measures, resource allocation, and collaborative initiatives to enhance patient safety and mitigate the impact of CAUTI on healthcare systems in the region. As prolonged catheterization increases the risk of infection, catheters should only be used for proper indications and removed promptly when no longer needed.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 3","pages":"Pages 172-179"},"PeriodicalIF":2.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133650","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":"Haemodialysis machine designation for patients with chronic Hepatitis B virus: A practice and attitudes survey of Australian renal healthcare workers","authors":"Sarah Russo ,&nbsp;Jill Telfer ,&nbsp;Carla Silva ,&nbsp;Eliza Daly ,&nbsp;Sarah Browning","doi":"10.1016/j.idh.2024.02.003","DOIUrl":"10.1016/j.idh.2024.02.003","url":null,"abstract":"<div><h3>Background</h3><p>To reduce the risk of viral transmission, guidelines recommend the use of designated haemodialysis machines and patient isolation for patients with chronic hepatitis B virus (HBV). These practices are without a strong evidence base, and may no longer be necessary in the setting of heat disinfection programs and standard precautions.</p></div><div><h3>Methods</h3><p>An online cross-sectional survey was developed for renal clinicians across Australia and New Zealand to explore infection prevention policy concerning patients with chronic HBV in haemodialysis units. We sought to determine whether psychosocial and cultural impacts might result from the mandatory use of machine designation and patient isolation practices, as perceived by multidisciplinary healthcare workers with experience working with this patient population.</p></div><div><h3>Results</h3><p>Sixty-seven responses from 27 health districts across all states of Australia and one New Zealand district were received. Most respondents were from urban areas (65%), and were nurses (87%). 50% of health districts reported using designated machines, while 32% isolate patients. Lack of necessary resources limited the use of designated machines (57%), and patient isolation (78%). Respondents not routinely using these precautions were more likely to express concerns regarding patient psychosocial wellbeing and cultural appropriateness. Overall, 30% of respondents expressed concerns regarding the cultural appropriateness of these recommendations.</p></div><div><h3>Conclusion</h3><p>We demonstrate wide variation in haemodialysis infection prevention and control policy and practice with regards to managing patients with chronic HBV. While use of standard precautions and machine disinfection are consistently applied, resource availability and concerns for patient psychosocial wellbeing limit adherence to international guidelines.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 2","pages":"Pages 107-111"},"PeriodicalIF":3.5,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246804512400004X/pdfft?md5=61394b4ab9f1f173c0d11bb2fc884b8e&pid=1-s2.0-S246804512400004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133651","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":"Post implementation quarantine recommendations that support preparedness: A systematic review and quarantine implementation capability framework","authors":"Matiu Bush ,&nbsp;Catherine M. Bennett ,&nbsp;Ana Hutchinson ,&nbsp;Stéphane L. Bouchoucha","doi":"10.1016/j.idh.2024.02.004","DOIUrl":"10.1016/j.idh.2024.02.004","url":null,"abstract":"<div><h3>Background</h3><p>During COVID-19, countries utilised various quarantine systems to achieve specific outcomes. At different stages and durations, voluntary and mandatory quarantine occurred in homes, hotels and facilities based on local and national elimination strategies. Countries are incorporating quarantine lessons from COVID-19 into revising pandemic plans as part of the World Health Organization's Preparedness and Resilience for Emerging Threats (PRET) activities. This review aimed to amalgamate quarantine post implementation recommendations from a whole-of-system perspective.</p></div><div><h3>Methods</h3><p>This review utilised MEDLINE, Embase, CINAHL, APA, and PsycINFO. To capture all pandemics, no date restriction was applied. Recommendations were synthesised and inductively grouped into quarantine capability categories. This review was registered in PROSPERO (CRD42023420765).</p></div><div><h3>Results</h3><p>A total of 449 published articles were screened, with 51 articles included and 156 recommendations extracted. Recommendations were grouped into 15 quarantine capability categories, comprising governance, preparation, infection prevention and control, ventilation, compliance, data, information and technology, safety-quality-risk, communication, healthcare model, home quarantine, hotel quarantine, facility quarantine, workforce, and resident considerations. The capability categories were further consolidated into strategic, structural, and operational domains to support the whole-of-system perspective.</p></div><div><h3>Conclusion</h3><p>The quarantine implementation capability framework generated provides comprehensive and deeper insights into the essential capabilities required for quarantine systems to support governments in PRET activities, including reviewing and revising pandemic plans and developing quarantine preparedness exercises.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 3","pages":"Pages 152-171"},"PeriodicalIF":2.7,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045124000051/pdfft?md5=e086b586fdc3b84af927fdd6f3c788be&pid=1-s2.0-S2468045124000051-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112531","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":"Awareness and attitudes towards infectious diseases among teachers and administrators: Evaluation of health-related school program and practices","authors":"Kaan Aksun ,&nbsp;Veysel Alcan","doi":"10.1016/j.idh.2024.02.002","DOIUrl":"10.1016/j.idh.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><p>Schools play a crucial role in promoting health education and awareness about infectious diseases. This study aims to examine teachers' and administrators' awareness and attitudes towards infectious diseases and their specific health-related applications.</p></div><div><h3>Methods</h3><p>This study used a new scale to collect survey data from 435 teachers and administrators. The validity and reliability of the scale were assessed by factor analysis. Pearson correlation and regression analysis were conducted to explore the relationships between variables. T-tests and one-way ANOVA were employed for group comparisons.</p></div><div><h3>Results</h3><p>The findings revealed a concerning skepticism among a significant portion of participants towards the effectiveness of vaccines in ending epidemics and a lack of health education activities in schools. Significant differences were observed in the scores for physical measures, educational activities, awareness, observation, and attitudes based on school type and ownership of certificates (p ≤ 0.05).</p></div><div><h3>Conclusions</h3><p>This study highlights the need for continuous education and awareness-raising efforts to develop sustainable school health practices. Integrating diverse health professionals into school health management teams can enhance health services in educational settings. The present study also emphasizes the importance of comprehensive health education in understanding infectious diseases, preventive measures, and proper hygiene practices.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 2","pages":"Pages 91-106"},"PeriodicalIF":3.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066391","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":"Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers","authors":"","doi":"10.1016/j.idh.2024.02.001","DOIUrl":"10.1016/j.idh.2024.02.001","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 2","pages":"Pages 114-115"},"PeriodicalIF":3.5,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045124000026/pdfft?md5=d460523444bca5b9b655eb4c37047b5a&pid=1-s2.0-S2468045124000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139967094","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":"Unveiling the efficacy of latex gloves in preventing viral infections during needlestick injuries: An in vitro mixed-methods study","authors":"Marinila Buzanelo Machado ,&nbsp;Viviane de Cássia Oliveira ,&nbsp;Pedro Castania Amadio Domingues ,&nbsp;Rachel Maciel Monteiro ,&nbsp;André Pereira dos Santos ,&nbsp;Lucas Lazarini Bim ,&nbsp;Denise de Andrade ,&nbsp;Evandro Watanabe","doi":"10.1016/j.idh.2023.10.001","DOIUrl":"10.1016/j.idh.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Gloves are personal protective equipment designed to prevent contamination and reduce the spread of microorganisms. This study aimed to assess <em>in vitro</em> the physical integrity of latex gloves and the retention of biological contamination in healthcare simulation.</p></div><div><h3>Method</h3><p>Three different batches of latex procedure gloves from five different brands and specific batches were evaluated before use for physical integrity by the standard protocols of the Society for Testing and Materials (ASTM) and of the American Food and Drug Administration (FDA). Moreover, the retention of biological contamination by latex procedure gloves in needlestick injury simulation with crystal violet and bacteriophages were applied in order to mimic human blood and virus presence.</p></div><div><h3>Results</h3><p>Brands D and C showed the best and worst results in the immediate inspections and after 2 min, respectively. For Brand C, damage occurred in one finger/region in a total of 12 gloves, while seven gloves were damaged/unable to be worn. Brand D presented only two gloves with tears and/or holes in one finger/region. Regarding the viral contamination, in a simulated needlestick injury, data showed no significant difference among the groups.</p></div><div><h3>Conclusion</h3><p>All glove brands presented physical damage that might affect the spread of microorganisms. The gloves did not exert an additional protective effect during a needlestick injury simulation in accordance with the two techniques used in this study.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 2","pages":"Pages 65-72"},"PeriodicalIF":3.5,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898382","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":"SARS-CoV-2 self-testing: Handle with care","authors":"Giuseppe Lippi","doi":"10.1016/j.idh.2023.12.002","DOIUrl":"10.1016/j.idh.2023.12.002","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 2","pages":"Pages 112-113"},"PeriodicalIF":3.5,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716760","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":"Regulating antimicrobial use within hospitals: A qualitative study","authors":"Jennifer Broom ,&nbsp;Alex Broom ,&nbsp;Katherine Kenny ,&nbsp;Pamela Konecny ,&nbsp;Jeffrey J. Post","doi":"10.1016/j.idh.2023.12.001","DOIUrl":"10.1016/j.idh.2023.12.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To examine how regulatory structures and processes focused on antimicrobial stewardship and antimicrobial resistance are experienced by hospital managers and clinicians.</p></div><div><h3>Methods</h3><p>Forty-two hospital managers and clinicians working within accreditation and antimicrobial stewardship teams in three Australian hospitals participated in individual in-depth interviews. Thematic analysis was performed.</p></div><div><h3>Results</h3><p>Thematic analysis revealed participants’ experiences of hospital antimicrobial regulation and their perceptions of what would be required for meaningful antimicrobial optimisation.</p><p><strong>Theme 1: Experience of regulation of antimicrobials within hospitals:</strong> Participants described an increased profile of antimicrobial resistance with inclusion in regulatory requirements, but also the risks of bureaucratic manoeuvring to meet standards rather than governance-inducing systemic changes.</p><p><strong>Theme 2: Growth of accreditation processes and hospitals over time:</strong> Both regulatory requirements and hospitals were described as evolving over time, each manoeuvring in response to each other (e.g. development of short notice accreditation).</p><p><strong>Theme 3: Perceived requirements for change:</strong> Participants perceived a need for top-down buy-in, resource prioritisation, complex understanding of power and influence on clinician behaviour, and a critical need for medical engagement.</p></div><div><h3>Conclusions</h3><p>This study around antimicrobials shows the tension and dynamic relationship between regulatory processes and hospital responses, bringing to light the enduring balance of a system that positions itself to meet regulatory requirements and emerging “demands”, without necessarily addressing the key underlying concerns. Antimicrobial resistance-related solutions are perceived as likely to require further resourcing and buy-in across multiple levels, engagement across professional streams and require strategies that consider complex systems change in order for regulatory structures to have potency.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 2","pages":"Pages 81-90"},"PeriodicalIF":3.5,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468045123001128/pdfft?md5=aee2bfbb28291422ffebf148af8d687c&pid=1-s2.0-S2468045123001128-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433197","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}