Infection Disease & Health最新文献

{"title":"Comparative evaluation of stand-alone HEPA-based air decontamination systems","authors":"Jonathan A. Otter, Louise Clark, Graham Taylor, Amal Hussein, Latchmin Gargee, Simon D. Goldenberg","doi":"10.1016/j.idh.2023.05.001","DOIUrl":"10.1016/j.idh.2023.05.001","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10404626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An educational program on antimicrobial resistance and stewardship for staff nurses in a public tertiary care hospital in India","authors":"Niti Mittal ,&nbsp;Himani Deswal ,&nbsp;Rakesh Mittal ,&nbsp;Sumit Sharma ,&nbsp;Pankaj Kaushik","doi":"10.1016/j.idh.2023.03.003","DOIUrl":"10.1016/j.idh.2023.03.003","url":null,"abstract":"<div><h3>Background</h3><p><span>Nurses, the largest group among healthcare professionals, hold a pivotal position to positively influence antimicrobial management by virtue of being in constant touch with patients and their widespread engagement in multiple activities relating to antimicrobial use. However, the existing gap in nursing curriculum particularly in areas related to antimicrobial resistance and optimal use of these agents limits the clinical application of nurses' skills and pose barrier to their contribution towards achieving desirable outcomes </span>in patient care. This training program was conducted to increase the nurses' awareness on antimicrobial resistance (AMR) and sensitize them on their role in optimal antimicrobial management and stewardship activities.</p></div><div><h3>Methods</h3><p><span>Training comprised of 4 modules focussing on topics like key concepts on antimicrobials, AMR, infection prevention and control, antibiotic </span>allergy, optimal use of antibiotics and antimicrobial stewardship (AS). The participants' knowledge at baseline and 1 week after program were assessed.</p></div><div><h3>Results and conclusions</h3><p>190 nurses participated in the program. Post program there was a consistent increase in the number of correct responses to all knowledge-based questions pertaining to 4 modules. A significant improvement in knowledge scores for all modules from baseline was also seen. The participants rated the overall quality of program as very good and agreed on its applicability in their practice. The training program was quite successful in educating nurses on critical issues related to AMR and AS. Nurses need to be constantly trained and sensitized for their potential contributions in the field of AMR and stewardship.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026683","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":"Investigation of the selection and use of “other” personal protective equipment to prevent mucous membrane exposure in nurses: A cross-sectional study","authors":"Peta-Anne Zimmerman ,&nbsp;Jacqueline H. Byrne ,&nbsp;Brigid M. Gillespie ,&nbsp;Deborough Macbeth","doi":"10.1016/j.idh.2023.03.004","DOIUrl":"10.1016/j.idh.2023.03.004","url":null,"abstract":"<div><h3>Background</h3><p>Selection and use of personal protective equipment (PPE) to prevent non-percutaneous body fluid exposure (NP BFE) is determined by a clinical assessment of risk. The aim of this study was to explore the selection and use of PPE, particularly masks and eye protection to prevent NP BFE, by nurses.</p></div><div><h3>Methods</h3><p>This quantitative single-site two-phased study was guided by the Health Belief Model (HBM). Phase 1 was a retrospective electronic database audit of body fluid exposure surveillance data. Phase 2 included a cross-sectional survey.</p></div><div><h3>Results</h3><p>The highest incidence of reported NP BFE to non-intact skin and mucous membranes during the study period were identified in the emergency department (ED) at 51.3% (20/39), intensive care unit (ICU) at 30.8% (12/39), operating theatre (OT) with 12.9% (5/39), and inpatient renal ward with 5.1% (2/39). Reported PPE use during NP BFE was: 0% face shields or masks, 10% gown/apron, and 15% goggles.</p><p>Survey results related to <em>Prevention of mucocutaneous exposures</em> were similar across all high-risk units, though ED nurses reported poorer compliance with the use of PPE to prevent exposure. Risk assessment for prevention of NP BFE was reported, yet there was a lack of compliance. The ICU results indicated a positive safety culture in contrast to the ED.</p></div><div><h3>Conclusion</h3><p>The findings are consistent with research identifying inadequate prevention of NP BFE, although nurses are aware of the importance of risk assessment. The HBM has the potential to increase understanding of the differences in nurses’ perceptions of risk in safety culture.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029669","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":"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.2023.02.001","DOIUrl":"10.1016/j.idh.2023.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Venous catheterization for diagnostic and therapeutic purposes is part of routine hospital practice, as approximately 70% of hospitalized patients have a peripheral venous catheter (PVC). This practice, however, can lead to both local complications, (e.g., chemical, mechanical and infectious phlebitis) and systemic complications (e.g., PVC-related bloodstream infections [PVC-BSIs]). Surveillance data and activities are central to preventing nosocomial infections, phlebitis and improving patient care and safety.</p><p>The aim of this study was to evaluate the impact of a care bundle on reducing PVC-BSI rates and phlebitis at a secondary care hospital in Mallorca, Spain.</p></div><div><h3>Methods</h3><p>Three-phase intervention study targeting hospitalized patients with a PVC. The VINCat criteria were used to define PVC-BSIs and calculate incidence. In phase I (August–December 2015), we retrospectively analyzed baseline PVC-BSI rates at our hospital. In phase II (2016–2017), we conducted safety rounds and developed a care bundle with the goal of reducing PVC-BSI rates. In phase III (2018), we expanded the PVC-BSI bundle to prevent phlebitis and analyzed its impact.</p></div><div><h3>Results</h3><p>The incidence of PVC-BSIs decreased from 0.48 episodes per 1000 patient-days in 2015 to 0.17 episodes per 1000 patient-days in 2018. The 2017 safety rounds also detected a reduction in phlebitis (from 4.6% of 2.6%). Overall, 680 healthcare professionals were trained in catheter care and five safety rounds were conducted to assess bedside care.</p></div><div><h3>Conclusion</h3><p>Implementation of a care bundle significantly reduced PVC-BSI rates and phlebitis at our hospital. Continuous surveillance programs are needed to adapt measures to improve patient care and guarantee safety.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031339","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":"Could human-to-human transmission of avian influenza spark a public health crisis in Southeast Asia?","authors":"Nguyen Khoi Quan,&nbsp;Andrew W. Taylor-Robinson","doi":"10.1016/j.idh.2023.05.004","DOIUrl":"10.1016/j.idh.2023.05.004","url":null,"abstract":"","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10404643","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":"The role of online marketing to engage healthcare workers with infection prevention and control information and resources: A pilot study","authors":"Lynley Pilon ,&nbsp;Aby Foster ,&nbsp;Peta-Anne Zimmerman ,&nbsp;Deborough Macbeth","doi":"10.1016/j.idh.2023.02.002","DOIUrl":"10.1016/j.idh.2023.02.002","url":null,"abstract":"<div><h3>Background</h3><p>The successful adoption and application of infection prevention and control (IPC) principles in all healthcare settings is dependent on the degree to which healthcare workers (HCWs) are aware of the requirements, have access to program resources and information, and engage with the IPC program. This study investigates the impact of redesigning the Infection Control Department (ICD) intranet site based on user feedback followed by a targeted marketing campaign to improve website usability, awareness, and access.</p></div><div><h3>Methods</h3><p>In this systematic study, we used a survey plus two focus group interviews to elicit user requirements for the content and look of the ICD intranet page and identify the best communication platforms to use for the marketing campaign to launch the redesigned intranet page. The information was used to redesign the intranet page and develop the marketing campaign. The survey was repeated post-intervention and these results, along with a comparison of website analytics monitoring traffic, were used to determine the success of the intervention.</p></div><div><h3>Results</h3><p>The ICD intranet page redesign increased the information and resources. Post-intervention survey results demonstrated a significant improvement in user satisfaction including ease of navigation and access to IPC information and resources. The marketing campaign resulted in a significant increase in website traffic to the ICD intranet page, demonstrating enhanced engagement with HCWs.</p></div><div><h3>Conclusion</h3><p>This study demonstrated that website redesign based on user feedback, combined with a marketing campaign, can increase the traffic to the website and improve the user experience when accessing and navigating the site making the information and resources more accessible to HCWs.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10404114","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":"Masking strategy to protect healthcare workers from COVID-19: An umbrella meta-analysis","authors":"Yijun Lu ,&nbsp;Arnold Ikedichi Okpani ,&nbsp;Christopher B. McLeod ,&nbsp;Jennifer M. Grant ,&nbsp;Annalee Yassi","doi":"10.1016/j.idh.2023.01.004","DOIUrl":"10.1016/j.idh.2023.01.004","url":null,"abstract":"<div><h3>Background</h3><p>The burden of severe disease and death due to SARS-CoV-2 (COVID-19) pandemic among healthcare workers (HCWs) worldwide has been substantial. Masking is a critical control measure to effectively protect HCWs from respiratory infectious diseases, yet for COVID-19, masking policies have varied considerably across jurisdictions. As Omicron variants began to be predominant, the value of switching from a permissive approach based on a point of care risk assessment (PCRA) to a rigid masking policy needed to be assessed.</p></div><div><h3>Methods</h3><p>A literature search was conducted in MEDLINE (Ovid platform), Cochrane Library, Web of Science (Ovid platform), and PubMed to June 2022. An umbrella review of meta-analyses investigating protective effects of N95 or equivalent respirators and medical masks was then conducted. Data extraction, evidence synthesis and appraisal were duplicated.</p></div><div><h3>Results</h3><p>While the results of Forest plots slightly favoured N95 or equivalent respirators over medical masks, eight of the ten meta-analyses included in the umbrella review were appraised as having very low certainty and the other two as having low certainty.</p></div><div><h3>Conclusion</h3><p>The literature appraisal, in conjunction with risk assessment of the Omicron variant, side-effects and acceptability to HCWs, along with the precautionary principle, supported maintaining the current policy guided by PCRA rather than adopting a more rigid approach. Well-designed prospective multi-centre trials, with systematic attention to the diversity of healthcare settings, risk levels and equity concerns are needed to support future masking policies.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028322","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":"Impact of COVID-19 pandemic waves on health-care worker hand hygiene activity in department of medicine and ICU as measured by an automated monitoring system","authors":"Amine Si Ali ,&nbsp;Olivia Cherel ,&nbsp;Paula Brehaut ,&nbsp;Valérie Garrait ,&nbsp;Cécile Lombardin ,&nbsp;Frédérique Schortgen ,&nbsp;Adrien Constan ,&nbsp;Francine Lanceleur ,&nbsp;Abderrahim El-Assali ,&nbsp;Stéphanie Poullain ,&nbsp;Camille Jung","doi":"10.1016/j.idh.2022.11.003","DOIUrl":"10.1016/j.idh.2022.11.003","url":null,"abstract":"<div><h3>Background</h3><p>Hand hygiene (HH) compliance among health-care workers is important for preventing transmission of infectious diseases.</p></div><div><h3>Aim</h3><p>To describe health-care worker hand hygiene activity in ICU and non-ICU patients’ rooms, using an automated monitoring system (AMS), before and after the onset of the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>At the Intercommunal Hospital of Créteil, near Paris, France, alcohol-based hand sanitizer (ABHS) consumption in the Department of Medicine (DM) and ICU was recorded using an AMS during four periods: before, during, and after the first wave of the COVID-19 pandemic, and during its second wave.</p></div><div><h3>Findings</h3><p>From 1st February to 30th November 2020, in the DM, the mean number of doses per patient-day for each of the four periods was, respectively, 5.7 (±0.3), 19.4 (±1.3), 17.6 (±0.7), and 7.9 (±0.2, <em>P</em> &lt; 0.0001). In contrast, ICU ABHS consumption remained relatively constant. In the DM, during the pandemic waves, ABHS consumption was higher in rooms of COVID-19 patients than in other patients’ rooms. Multivariate analysis showed ABHS consumption was associated with the period in the DM, and with the number of HCWs in the ICU.</p></div><div><h3>Conclusion</h3><p>An AMS allows real-time collection of ABHS consumption data that can be used to adapt training and prevention measures to specific hospital departments.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9760610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776994","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":"Nosocomial SARS-CoV-2 transmission in multi-bedded hospital cubicles over successive pandemic waves: Lower mortality but wider spread with Omicron despite enhanced infection-prevention measures","authors":"Liang En Wee ,&nbsp;Edwin Philip Conceicao ,&nbsp;May Kyawt Aung ,&nbsp;Myat Oo Aung ,&nbsp;Yong Yang ,&nbsp;Shalvi Arora ,&nbsp;Karrie Kwan-Ki Ko ,&nbsp;Indumathi Venkatachalam","doi":"10.1016/j.idh.2022.09.003","DOIUrl":"10.1016/j.idh.2022.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Increased transmissibility of severe-acute-respiratory-syndrome-coronavirus-2(SARS-CoV-2) variants, such as the Omicron-variant, presents an infection-control challenge. We contrasted nosocomial transmission amongst hospitalized inpatients across successive pandemic waves attributed to the Delta- and Omicron variants, over a 9-month period in which enhanced-infection-prevention-measures were constantly maintained.</p></div><div><h3>Methods</h3><p>Enhanced-infection-prevention-measures in-place at a large tertiary hospital included universal N95-usage, routine-rostered-testing (RRT) for all inpatient/healthcare-workers (HCWs), rapid-antigen-testing (RAT) for visitors, and outbreak-investigation coupled with enhanced-surveillance (daily-testing) of exposed patients. The study-period lasted from 21st June 2021–21st March 2022. Chi-square test and multivariate-logistic-regression was utilized to identify factors associated with onward transmission and 28d-mortality amongst inpatient cases of hospital-onset COVID-19.</p></div><div><h3>Results</h3><p>During the Delta-wave, hospital-onset cases formed 2.7% (47/1727) of all COVID-19 cases requiring hospitalisation; in contrast, hospital onset-cases formed a greater proportion (17.7%, 265/1483; odds-ratio, OR = 7.78, 95%CI = 5.65–10.70) during the Omicron-wave, despite universal N95-usage and other enhanced infection-prevention measures that remained unchanged. The odds of 28d-mortality were higher during the Delta-wave compared to the Omicron-wave (27.7%, 13/47, vs. 10.6%, 28/265, adjusted-odds-ratio, aOR = 2.78, 95%CI = 1.02–7.69). Onward-transmission occurred in 21.2% (66/312) of hospital-onset cases; being on enhanced-surveillance (daily-testing) was independently associated with lower odds of onward-transmission (aOR = 0.18, 95%CI = 0.09–0.38). Costs amounted to $USD7141 per-hospital-onset COVID-19 case.</p></div><div><h3>Conclusion</h3><p>A surge of hospital-onset COVID-19 cases was encountered during the Omicron-wave, despite continuation of enhanced infection-prevention measures; mortality amongst hospital-onset cases was reduced. The Omicron variant poses an infection-control challenge in contrast to Delta; surveillance is important especially in settings where infrastructural limitations make room-sharing unavoidable, despite the high risk of transmission.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9408819","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":"Cystic fibrosis: Infection prevention & control recommendations for universities, colleges and institutes of further and higher education – A practical guide","authors":"Beverley C. Millar ,&nbsp;Margaret McCafferty ,&nbsp;Ciara McCann ,&nbsp;Damian O'Neill ,&nbsp;Jacqueline C. Rendall ,&nbsp;John E. Moore","doi":"10.1016/j.idh.2022.12.002","DOIUrl":"10.1016/j.idh.2022.12.002","url":null,"abstract":"<div><h3>Background</h3><p>The avoidance of cross-infection remains of critical importance to prevent the transmission of cystic fibrosis (CF)-related microbial pathogens to persons/people with cystic fibrosis (PwCF). To date, there has been a paucity of infection prevention and control (IPC) guidance relating to infection risk at higher educational institutions. With improvements in treatments, more PwCF are now attending universities/colleges and educational institutions now seek CF-specific guidance on IPC from clinical CF teams/centres.</p></div><div><h3>Methods</h3><p>Real world infection-related questions from university students, educators, university support staff and the CF multidisciplinary team were received and collated from various stakeholders, including individual consultations and focus group sessions with two local universities. Subsequently, evidence-based recommendations were compiled from existing peer-reviewed literature and from cystic fibrosis organisations. Glossaries were constructed relating to clinical, microbiological and educational/pedagogical terminology to aid with the understanding amongst these stakeholder groups.</p></div><div><h3>Results</h3><p>This review addresses CF-related IPC recommendations across five areas of university/college life, including (i) on campus estate, (ii) teaching (lectures/tutorials/small study group work/group assignments), (iii) laboratory practicals, (iv) field trips/study visits/work placements and (v) residential accommodation and lists practical recommendations to help prevent the transmission of infections to PwCF students.</p></div><div><h3>Conclusions</h3><p>It is important that the educational institutional environment is safe permitting the PwCF student to enjoy their educational experience and journey through higher education, culminating in achievement of their educational goals, employment and independent living. The guidance presented in this review is intended to equip educational establishments in creating their own bespoke and robust IPC policies relating to PwCF students.</p></div>","PeriodicalId":45006,"journal":{"name":"Infection Disease & Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9407250","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}