Infection Disease & Health最新文献

{"title":"Applicability of the ATP assay in monitoring the cleanliness of hospital environments","authors":"Naoaki Ishino ,&nbsp;Chiharu Miyaji ,&nbsp;Megumi Ogata ,&nbsp;Miki Inada ,&nbsp;Mayu Nagata ,&nbsp;Mayumi Shimamoto","doi":"10.1016/j.idh.2023.09.034","DOIUrl":"10.1016/j.idh.2023.09.034","url":null,"abstract":"<div><h3>Background</h3><p>The adenosine triphosphate (ATP) assay is widely used for simple and rapid evaluation of the cleanliness of environmental surfaces. However, there remain concerns regarding the reliability of the ATP assay in hospital settings. This study aimed to assess whether the ATP assay could detect inadequate cleaning within hospital environments as well as monitor the effectiveness of routine cleaning.</p></div><div><h3>Methods</h3><p>The cleanliness of seven types of high-touch surfaces in operating rooms that were routinely cleaned was evaluated by testing the ATP assay and aerobic colony counts (ACC). For pressure redistribution mattresses (Soft-nurse®) that were found to be particularly at risk of infection, cleaning methods were improved, and the effectiveness of these improvements was monitored using the same two methods.</p></div><div><h3>Results</h3><p>The ATP assay quantitatively detected contamination on seven high-touch surfaces but showed no correlation with ACC. However, a significant positive correlation between luminescence and ACC was found on one specific surface, allowing for determining a theoretical cutoff value. Additionally, the ATP assay effectively identified the risk of future infection, which the ACC test could not assess.</p></div><div><h3>Conclusions</h3><p>The ATP assay can monitor the effectiveness of routine cleaning by setting a theoretical cutoff value for each subject. The method provides quantitative and meaningful values when used with an understanding of its limitations.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"29 1","pages":"Pages 32-38"},"PeriodicalIF":3.5,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A commentary on “Care bundle for the prevention of peripheral venous catheter blood stream infections at a secondary care university hospital: Implementation and results” (Lladó Maura et al., 2023)","authors":"Ema Mata,&nbsp;Gisela Silva,&nbsp;Teresa Peralta","doi":"10.1016/j.idh.2023.08.001","DOIUrl":"10.1016/j.idh.2023.08.001","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 308-310"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10192041","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":"Risk of organism acquisition from prior room occupants: An updated systematic review","authors":"Brett G. Mitchell ,&nbsp;Julee McDonagh ,&nbsp;Stephanie J. Dancer ,&nbsp;Sindi Ford ,&nbsp;Jenny Sim ,&nbsp;Bismi Thottiyil Sultanmuhammed Abdul Khadar ,&nbsp;Philip L. Russo ,&nbsp;Jean-Yves Maillard ,&nbsp;Helen Rawson ,&nbsp;Katrina Browne ,&nbsp;Martin Kiernan","doi":"10.1016/j.idh.2023.06.001","DOIUrl":"10.1016/j.idh.2023.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Evidence from a previous systematic review indicates that patients admitted to a room where the previous occupant had a multidrug-resistant bacterial infection resulted in an increased risk of subsequent colonisation and infection with the same organism for the next room occupant. In this paper, we have sought to expand and update this review.</p></div><div><h3>Methods</h3><p>A systematic review and meta-analysis was undertaken. A search using Medline/PubMed, Cochrane and CINHAL databases was conducted. Risk of bias was assessed by the ROB-2 tool for randomised control studies and ROBIN-I for non-randomised studies.</p></div><div><h3>Results</h3><p>From 5175 identified, 12 papers from 11 studies were included in the review for analysis. From 28,299 patients who were admitted into a room where the prior room occupant had any of the organisms of interest, 651 (2.3%) were shown to acquire the same species of organism. In contrast, 981,865 patients were admitted to a room where the prior occupant did not have an organism of interest, 3818 (0.39%) acquired an organism(s). The pooled acquisition odds ratio (OR) for all the organisms across all studies was 2.45 (95% CI: 1.53–3.93]. There was heterogeneity between the studies (I² 89%, P &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>The pooled OR for all the pathogens in this latest review has increased since the original review. Findings from our review provide some evidence to help inform a risk management approach when determining patient room allocation. The risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 290-297"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10055040","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":"Metagenomic insights into microbial contamination in critical healthcare environments and the efficacy of a novel “HLE” disinfectant","authors":"Hikmate Abriouel ,&nbsp;Julia Manetsberger ,&nbsp;Leyre Lavilla Lerma ,&nbsp;María Dolores Pestaña Blanco ,&nbsp;Rafael Martínez Nogueras ,&nbsp;Natacha Caballero Gómez ,&nbsp;Nabil Benomar","doi":"10.1016/j.idh.2023.07.002","DOIUrl":"10.1016/j.idh.2023.07.002","url":null,"abstract":"<div><h3>Background</h3><p>Bacterial contamination on inanimate clinical surfaces is directly linked to severe health problems, especially those caused by multidrug resistant (MDR) pathogens. Here, we evaluated the microbial burden in these environments and tested the efficacy of a novel HLE disinfectant solution.</p></div><div><h3>Methods</h3><p>Microbial contamination of healthcare surfaces [Intensive Care Unit (ICU), Long Period Hospitalization Room (LPHR) and Otolaryngology Consultation (OC)] and the efficacy of HLE disinfectant solution were determined analyzing the viable counts on general and selective media, and also by molecular studies focused on metagenomic and specific qPCR.</p></div><div><h3>Results</h3><p>Different contamination loads were detected with LPHR showing the highest contamination. Treatment with the HLE disinfectant solution curbed the spread of well-adapted pathogens on touched surfaces (ICU, LPHR and OC). Metagenomic analysis of microbial diversity of the Patient Table (most contaminated surface in LPHR) revealed the presence of mainly <em>A. johnsonii</em> and <em>P. putida</em>. Furthermore, functional annotation of toxin, virulence and antibiotic resistance sequences showed a high diversity of <em>Acinetobacter</em> spp. and <em>Pseudomonas</em> spp. In this context, specific qPCR analysis confirmed the efficacy of HLE disinfectant solution against the most prevalent and critical pathogens <em>Pseudomonas</em> sp. and <em>Acinetobacter</em> sp. achieving their complete eradication.</p></div><div><h3>Conclusion</h3><p>Given the persistence of detrimental resistant pathogens, the application of HLE disinfection solution could be a highly beneficial and effective option -used either alone or in combination-for infection prevention and control with the aim to eliminate microbial pathogens and their genes from contaminated contact-surfaces and thus limit the spread to humans and other ecological niches.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 282-289"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9969240","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":"Comparing the use of midline catheters versus peripherally inserted central catheters for patients requiring peripherally compatible therapies: A pilot randomised controlled trial (the compact trial)","authors":"Nicole Marsh ,&nbsp;Emily N. Larsen ,&nbsp;Catherine O'Brien ,&nbsp;Peter Groom ,&nbsp;Tricia M. Kleidon ,&nbsp;Evan Alexandrou ,&nbsp;Emily Young ,&nbsp;Kate McCarthy ,&nbsp;Claire M. Rickard","doi":"10.1016/j.idh.2023.03.007","DOIUrl":"10.1016/j.idh.2023.03.007","url":null,"abstract":"<div><h3>Background</h3><p><span>Midline catheter<span> (MC) use has increased in acute-care settings, particularly for patients with difficult venous access or requiring peripherally compatible intravenous therapy for up-to 14 days. Our aim was to assess feasibility and generate clinical data comparing MCs with </span></span>Peripherally Inserted Central Catheters (PICCs).</p></div><div><h3>Methods</h3><p>A two-arm parallel group pilot randomised controlled trial<span> (RCT), comparing MCs with PICCs, was conducted in a large tertiary hospital in Queensland between September 2020 and January 2021. The primary outcome was study feasibility, measured against rates of eligibility (&gt;75%), consent (&gt;90%), attrition (&lt;5%); protocol adherence (&gt;90%) and missing data (&lt;5%). The primary clinical outcome was all-cause device failure.</span></p></div><div><h3>Results</h3><p>In total, 25 patients were recruited. The median patient age was 59–62 years; most patients were overweight/obese, with ≥2 co-morbidities. Primary outcomes: The eligibility and protocol adherence criteria were not met; of 159 screened patients, only 25 (16%) were eligible, and three patients did not receive their allocated intervention post-randomisation (88% adherence). All-cause failure occurred in two patients allocated to MC (20%) and one PICC (8.3%).</p></div><div><h3>Conclusions</h3><p>Our study found that a fully powered RCT testing MCs compared with PICCs is not currently feasible in our setting. We recommend a robust process evaluation before the introduction of MCs into clinical practice.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 259-264"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9763543","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 evaluation of influenza, pneumococcal and herpes zoster vaccination coverage in Australian aged care residents, 2018 to 2022","authors":"Noleen Bennett ,&nbsp;Brett Morris ,&nbsp;Michael J. Malloy ,&nbsp;Lyn-li Lim ,&nbsp;Eliza Watson ,&nbsp;Ann Bull ,&nbsp;Janet Sluggett ,&nbsp;Leon J. Worth ,&nbsp;NISPAC Advisory Group","doi":"10.1016/j.idh.2023.03.005","DOIUrl":"10.1016/j.idh.2023.03.005","url":null,"abstract":"<div><h3>Background</h3><p>For older persons, vaccination<span> mitigates the harmful impact of vaccine preventable infections. Our study objectives were to evaluate in the Victorian public sector residential aged care services (PSRACS) (1) the existence of local vaccination policies and admission assessment practices, (2) the current documented status of resident influenza, pneumococcal and herpes zoster vaccination uptake and (3) changes in documented resident vaccination uptake over time.</span></p></div><div><h3>Methods</h3><p>Standardised data were annually reported by all PSRACS between 2018 and 2022. The influenza, pneumococcal and herpes zoster vaccination status of each resident was classified as vaccinated, declined, contraindicated or unknown. Annual trends in vaccination status were assessed using Spearman's correlation.</p></div><div><h3>Results</h3><p><span>In 2022, most PSRACS reported an influenza immunisation policy existed (87.1%) and new residents were assessed for their influenza vaccination status (97.2%); fewer PSRACS reported the same for pneumococcal disease (73.1% and 78.9%) and herpes zoster (69.3% and 75.6%). The median resident influenza, pneumococcal and herpes zoster (70–79 years old) vaccination uptake was 86.8%, 32.8% and 19.3% respectively. The median unknown status was 6.9%, 63.0% and 76.0% respectively. Statistical evidence of an increase in annual uptake was observed for the herpes zoster (all resident) surveillance module (r</span>_s = 0.900, p = 0.037).</p></div><div><h3>Conclusions</h3><p>Our study showed local influenza vaccination policies and practices exist and influenza vaccination uptake was consistently high. Pneumococcal and herpes zoster vaccination uptake were lower. Quality improvement strategies that at least determine the status of those residents classified as unknown are required.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 253-258"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405863","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":"Peripheral intravenous catheter material and design to reduce device failure: A systematic review and meta-analysis","authors":"Robyn Matthews ,&nbsp;Nicole C. Gavin ,&nbsp;Nicole Marsh ,&nbsp;Louise Marquart-Wilson ,&nbsp;Samantha Keogh","doi":"10.1016/j.idh.2023.05.005","DOIUrl":"10.1016/j.idh.2023.05.005","url":null,"abstract":"<div><h3>Background</h3><p>Patients require vascular access for medical treatments, diagnostic procedures and symptom management. Current failure rates of peripheral intravascular catheters (PIVCs) are unacceptably high (40–50%). This systematic review aimed to determine the effect of different PIVC materials and designs on the incidence of PIVC failure.</p></div><div><h3>Methods</h3><p>A systematic search was conducted in November 2022 using CINAHL, PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Randomised controlled trials that compared PIVC novel PIVC material/design and standard material/design were included. The primary outcome was all causes of PIVC failure, any reason for device removal due to cessation of device function; and secondary outcomes included individual PIVC complications and infection (local or systemic), and dwell times. Quality appraisal was conducted using the Cochrane risk of bias tool. A meta-analysis was performed using random effects model.</p></div><div><h3>Results</h3><p>Seven randomised controlled trials were eligible for inclusion. In meta-analysis, the impact of material and design on PIVC failure in the studies favoured the intervention arms (RR 0.71, 95% CI 0.57–0.89), however there was substantial heterogeneity (I² = 81%, 95% CI 61–91%). Through subgroup analyses, a significant difference on PIVC failure favoured the closed system over the open system (RR 0.85, 95% CI 0.73 to 0.99; I² = 23%, 95% CI 0–90%).</p></div><div><h3>Conclusion</h3><p>Catheter material and design can impact PIVC outcome. Conclusive recommendations are limited due to the small number of studies and inconsistent reporting of clinical outcomes. Further rigorous research of PIVC types is necessary to improve clinical practice and device selection pathways should reflect the resulting evidence.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 298-307"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817473","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":"Time-to-first-isolation of methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF): An underutilised metric in infection control?","authors":"John E. Moore ,&nbsp;Jacqueline C. Rendall ,&nbsp;Beverley C. Millar","doi":"10.1016/j.idh.2023.05.002","DOIUrl":"10.1016/j.idh.2023.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Methicillin-resistant <em>Staphylococcus aureus</em><span> (MRSA) has emerged as a significant pathogen<span><span> in people with cystic fibrosis (PwCF). There is a paucity of reports on </span>MRSA infection dynamics within CF. It was the aim to examine the utility of </span></span><strong><em>T</em></strong><em>ime-</em> <strong><em>T</em></strong><em>o-</em><strong><em>F</em></strong><em>irst</em> <strong><em>I</em></strong><em>solation</em><span> (TTFI) metric and to correlate this with patient gender and CF transmembrane conductance regulator (CFTR) mutation type.</span></p></div><div><h3>Methods</h3><p>The microbiology of respiratory specimens from 100 adult (≥18 years) PwCF was examined (50 females; 50 males; mean age 24.6 years ±6.25 (SD)) from birth to present, equating to 2455 patient years. TTFI was determined in relation to (i) presence/absence of MRSA, (ii) CFTR mutation type and (iii) PwCF gender.</p></div><div><h3>Results</h3><p>MRSA was noted in 23% patients (10 female/13 males); (i) F508del/F508del homozygous (43.5%) and (ii) F508del/other heterozygous (56.5%). No non-F508del CFTR mutations types were noted. The median and mean TTFI was 137 months and 127.4 months respectively, shortest time was 23 months, longest time 211 months. There was no statistical significance in TTFI in relation to CFTR mutation group (p = 0.39) or gender (p = 0.71).</p></div><div><h3>Conclusions</h3><p>TTFI is useful and applicable to the chronic infection model, where patients with a specific underlying disease are predisposed to acquire infections and where these infections are likely to become chronic. Intelligence offered by TTFI provides a window of opportunity to target IPC interventions, to help prevent MRSA acquisition. CF multidisciplinary teams, microbiologists and infection prevention specialists should utilise such TTFI data from their respective centres to help inform and plan intervention strategies to help prevent MRSA acquisition.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 265-270"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9551886","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 educational intervention in the emergency department seeking to improve COVID-19 vaccination rates among unvaccinated patients aged 20-64","authors":"Shelby DeWaard ,&nbsp;Zachary Dewyer ,&nbsp;Talal Al Assil ,&nbsp;Rachael Gallap ,&nbsp;Lauren Patrick ,&nbsp;Noelle Fukuda ,&nbsp;Maureen Ford","doi":"10.1016/j.idh.2023.07.001","DOIUrl":"10.1016/j.idh.2023.07.001","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 vaccination<span> rate in the US has plateaued, especially among minorities and young populations. Previous efforts within the Emergency Department<span> (ED) setting to address this disparity<span> have shown positive results. The ED can play a crucial role in engaging vaccine-hesitant individuals, particularly those with limited access to healthcare. By providing education, addressing concerns, and using positive framing, vaccination rates can be improved in the ED. This quality improvement project aimed to increase vaccination rates through one-on-one educational interventions and open discussions with patients.</span></span></span></p></div><div><h3>Methods</h3><p>Between November 2021 and June 2022, unvaccinated adult patients aged 20 to 64 visiting a local ED in Kalamazoo, MI were approached for a discussion on COVID vaccines. A research team, trained in motivational interviewing techniques, provided an educational intervention, offering evidence-based information and resources to unvaccinated participants.</p></div><div><h3>Results</h3><p>A total of 37 participants were enrolled, and their demographics were recorded. The participants expressed various concerns about the vaccine, including potential side effects, speed of testing and production, perceived ineffectiveness, mistrust, and low personal risk. At the four-week follow-up, three participants (8%) had received their first dose of the COVID-19 vaccine.</p></div><div><h3>Conclusion</h3><p>The study fell short of its desired sample size and the intervention failed to raise vaccination rates among ED patients. Factors like low perceived risk, vaccine hesitancy, and limited resources may have influenced these outcomes. Future research should focus on staffing, operational hours, repeated educational interventions, and targeted approaches for different populations. Improving participant recruitment through institutional engagement and involvement of multiple EDs should be explored. Addressing these factors can help inform effective interventions to increase COVID-19 vaccination rates in the ED.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 276-281"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965509","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":"Response to the letter: Comment on “Care bundle for the prevention of peripheral venous catheter blood stream infections at a secondary care university hospital: Implementation and results”","authors":"Yolanda Lladó Maura,&nbsp;Magdalena Lucía Berga Figuerola,&nbsp;M José Rodríguez Moreno,&nbsp;Verónica Lluch Garvi,&nbsp;Elisabet E Soler Felsner,&nbsp;Adrián Rodríguez-Rodríguez,&nbsp;Alexander Almendral,&nbsp;Enric Limón,&nbsp;Ester Fusté","doi":"10.1016/j.idh.2023.07.003","DOIUrl":"10.1016/j.idh.2023.07.003","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":"28 4","pages":"Pages 311-313"},"PeriodicalIF":3.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9938018","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}