Journal of Hospital Infection最新文献

{"title":"Surgery and sustainability: time for multi-disciplinary collaboration to reduce the carbon footprint while not compromising infection prevention","authors":"H. Humphreys , A.D.K. Hill","doi":"10.1016/j.jhin.2025.01.001","DOIUrl":"10.1016/j.jhin.2025.01.001","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"158 ","pages":"Pages 69-70"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nosocomial bloodstream infection in critically ill patients: is extracorporeal membrane oxygenation a relevant factor?","authors":"A. Martínez ,&nbsp;M. Martín-Cerezuela ,&nbsp;C. Carrasco ,&nbsp;J. Frasquet ,&nbsp;R. Gimeno ,&nbsp;F. Perez-Esteban ,&nbsp;F. Álvarez ,&nbsp;J. Pemán ,&nbsp;Á. Castellanos ,&nbsp;P. Ramirez","doi":"10.1016/j.jhin.2025.03.004","DOIUrl":"10.1016/j.jhin.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Nosocomial bloodstream infection (BSI) in critically ill patients can cause clinical deterioration, prolong intensive care unit (ICU) stays, and increase mortality risk. Extracorporeal membrane oxygenation support (ECMO) is a known risk factor for BSI, and infections in these patients are assumed to have a worse prognosis.</div></div><div><h3>Aim</h3><div>To compare risk factors for BSI between ECMO and non-ECMO patients.</div></div><div><h3>Methods</h3><div>A three-year prospective observational study was conducted in a 24-bed medical ICU. Consecutive nosocomial BSI episodes were recorded, and BSIs in mechanically ventilated patients were analysed based on ECMO treatment status.</div></div><div><h3>Findings</h3><div>A total of 98 BSI episodes were included: 30 (30.6%) in ECMO and 68 (69.3%) in non-ECMO patients. The total number of ECMO patients during the study period was 110, with a bacteraemia rate of 27.7% (20.26 episodes per 1000 treatment-days). In non-ECMO patients, the BSI rate was 7.9% (<em>P</em> &lt; 0.001). ECMO patients were younger and had fewer comorbidities. BSI type and aetiology were similar between groups, but severity was higher in ECMO patients. Although multidrug-resistant micro-organisms were more frequent in ECMO patients, the appropriate treatment rate was similar. ICU mortality was 66.6% in ECMO patients and 30.8% in non-ECMO patients (<em>P</em> &lt; 0.001). However, continuous renal replacement therapy (odds ratio (OR): 3.67), Sepsis Organ Failure Assessment score (OR: 1.54), and COVID-19 diagnosis (OR: 1.54) were the only independent risk factors associated with mortality in BSI patients.</div></div><div><h3>Conclusion</h3><div>Although BSI was more frequent and severe in ECMO patients, ECMO support was not independently related to mortality in patients with healthcare-associated BSI.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 19-24"},"PeriodicalIF":3.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumatic tube transport system carriers made from urethane contaminated with environmental pathogens.","authors":"O Imataki, R Masumoto, M Hamano, M Ishimatsu, M Tamura, A Kitanaka","doi":"10.1016/j.jhin.2025.03.006","DOIUrl":"10.1016/j.jhin.2025.03.006","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation considerations for integrated face and respiratory protection: a qualitative study","authors":"L. Cordeiro ,&nbsp;A. Price ,&nbsp;N.A. de Oliveira ,&nbsp;C.L. Ciofi-Silva ,&nbsp;G. Girelli ,&nbsp;Y.L. Lin ,&nbsp;A.S. Levin ,&nbsp;F. Tumietto ,&nbsp;M.C. Padoveze","doi":"10.1016/j.jhin.2025.02.022","DOIUrl":"10.1016/j.jhin.2025.02.022","url":null,"abstract":"<div><h3>Background</h3><div>The implementation of an innovative form of personal protective equipment (PPE) as an infection and prevention control measure for respiratory transmissible diseases is complex, with several elements to be addressed.</div></div><div><h3>Aim</h3><div>To make considerations for integrated face and respiratory protection implementation in clinical settings.</div></div><div><h3>Methods</h3><div>This was a multi-site qualitative study with 87 health workers that compared traditional PPE or powered air-purifying (PAPR) respirators with lightweight PAPR (L-PAPR). Semi-structured interviews were performed based on the Consolidated Framework for Implementation Research (CFIR).</div></div><div><h3>Findings</h3><div>Insights into L-PAPR implementation were found. The advantages include enhanced sense of protection, pleasant ventilation, good visibility for both health worker and patient, no fogging of the visor interior, no movement restriction, and easy disinfection process. To enhance usability some barriers should be tackled: reduction of facial pressure; better accommodation for glasses and corrective lenses; reduction of number of steps for assembling the device; infrastructure provision for storage, charging and disinfection of the device; training of health workers for assembling, donning and doffing; and the cost benefit of implementation.</div></div><div><h3>Conclusion</h3><div>L-PAPR was overall perceived with advantages by many participants, and can be considered a potential option of PPE to be implemented to protect health workers during outbreaks of respiratory transmissible diseases.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 1-11"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for infection in patients undergoing hip replacement: a systematic review and meta-analysis","authors":"B. Yang ,&nbsp;Y. Lei ,&nbsp;Y. Zeng ,&nbsp;M. Luo ,&nbsp;Z. Li ,&nbsp;K. Lei ,&nbsp;Y. Wang ,&nbsp;Q. Xiao ,&nbsp;J. Wen ,&nbsp;W. Yan ,&nbsp;H. Yan","doi":"10.1016/j.jhin.2025.02.021","DOIUrl":"10.1016/j.jhin.2025.02.021","url":null,"abstract":"<div><div>A meta-analysis was conducted to determine the risk of infection following hip replacement and risk factors were identified for surgical site infection. PubMed/Medline, Embase and Cochrane Library databases were systematically searched, as well as the reference lists of previous systematic reviews and meta-analyses. The pooled odds ratio (OR) was estimated using a random effects model for each investigated factor. The evidence of observational studies was classified as high quality (class I), moderate quality (class II or III) or low quality (class IV) based on the GRADE system. A total of 25,383 potential articles met the inclusion criteria in the database search. After reviewing the titles, abstracts, and full texts, 27 articles were included in the final analysis, encompassing 699,473 patients who underwent hip arthroplasty. High-quality evidence shows that BMI (≥30 kg/m²) (OR 2.16; 95% CI 1.72–2.70), male sex (OR 1.39; 95% CI 1.26–1.53), operation time (≥120 min) (OR 1.72; 95% CI 1.39–2.14), American Society of Anesthesiologists (ASA) class ≥3 (OR 2.05; 95% CI 1.49–2.83), diabetes (OR 1.33; 95% CI 1.23–1.43), and heart disease (OR 1.99; 95% CI 1.48–2.68) are associated with a greater risk of infection. The meta-analysis revealed that age and renal disease were not associated with infection. In conclusion, this meta-analysis identified significant risk factors for infection after hip-replacement surgery, including BMI, male sex, operation time, heart disease, diabetes, and ASA class.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 60-73"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of single-use oral care sets on reducing ventilator-associated pneumonia among intensive care unit patients: a multi-centre study","authors":"A. Unahalekhaka ,&nbsp;P. Uirungroj ,&nbsp;C. Saenjum","doi":"10.1016/j.jhin.2025.03.005","DOIUrl":"10.1016/j.jhin.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Ventilator-associated pneumonia (VAP) is a serious hospital-associated infection among mechanically ventilated patients. Proper oral care is a critical intervention for reducing VAP incidence.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness of single-use oral care sets in reducing VAP incidence and assessing ICU nurses' perspectives on their use.</div></div><div><h3>Methods</h3><div>A multi-centre study was conducted in the ICUs of 14 tertiary-care hospitals. Single-use oral care sets were used for cleaning patients' oral cavities following a standardized oral care protocol. VAP rates and cost of VAP antibiotic treatment were compared before and after implementing the oral care sets. ICU nurses' opinions on the oral care sets were collected using a self-administered questionnaire.</div></div><div><h3>Findings</h3><div>Before implementing the oral care sets, there were 269 VAP cases over 34,731 ventilator-days, with a VAP rate of 7.74 per 1000 ventilator-days. The total antibiotic cost for VAP treatment was 5,137,622 Thai baht. After implementation, VAP cases decreased to 182 over 34,309 ventilator-days, with a significantly reduced VAP rate of 5.30 per 1000 ventilator-days – a 31.52% reduction (<em>P</em>&lt;0.05). Antibiotic treatment costs also declined significantly to 2,101,940 Thai baht (<em>P</em>&lt;0.05). Among 220 ICU nurses surveyed, 96.3% agreed or strongly agreed that the oral care sets helped prevent healthcare-associated infections (HAIs). Over 85% reported improved ease of use, increased patient comfort, and better adherence to evidence-based guidelines.</div></div><div><h3>Conclusion</h3><div>The use of single-use oral care sets within a standardized oral care protocol effectively reduces VAP incidence and associated costs. ICU nurses expressed high satisfaction with the oral care sets, highlighting their potential to enhance patient safety, improve adherence to guidelines, and reduce healthcare costs. Routine integration of single-use oral care sets into oral care protocols for mechanically ventilated patients is recommended.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 12-18"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 national health alert on Enterobacterales hospital outbreaks in Chile","authors":"C. Lara ,&nbsp;M. Orsini ,&nbsp;M. Pohlenz ,&nbsp;K. Ulloa ,&nbsp;I. Castro ,&nbsp;C. Muñoz-Almagro ,&nbsp;P. Brotons","doi":"10.1016/j.jhin.2025.03.003","DOIUrl":"10.1016/j.jhin.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The impact of public health interventions against the coronavirus disease 2019 (COVID-19) pandemic on the occurrence of Enterobacterales outbreaks in hospitals remains unclear.</div></div><div><h3>Objective</h3><div>To determine the effect of the COVID-19 national health alert on the secular trend of Enterobacterales outbreaks in Chilean public hospitals while characterizing their antibiotic resistance patterns.</div></div><div><h3>Methods</h3><div>Nationwide retrospective ecological study using interrupted time series analysis of monthly outbreak-related cases over three periods: pre-pandemic (January 2017–February 2020), national health alert (March 2020–August 2023), and post-pandemic (September–December 2023).</div></div><div><h3>Results</h3><div>A total of 106 outbreaks, 1131 associated cases and 254 deaths were identified in 47/196 (24.0%) hospitals. Cases increased gradually [0.39 cases/month, 95% confidence interval (CI) 0.02–0.75; <em>P</em>=0.040] in the pre-pandemic years. A sudden increase of 33.42 cases (95% CI 7.53–59.31; <em>P</em>=0.012) occurred in March 2020, followed by a gradual decrease (1.28 cases/month, 95% CI 0.38–2.17; <em>P</em>=0.006) during the national health alert period. An increase of 18.02 cases (95% CI 2.89–33.15; <em>P</em>=0.020) occurred in September 2023, and preceded a gradual post-pandemic decline (6.21 cases/month, 95% CI 1.11–11.31; <em>P</em>=0.018). The prevalence of cases caused by carbapenemase-producing Enterobacterales increased significantly (<em>P</em>&lt;0.001) during (79.9%) and after (100.0%) the national health alert period compared with the pre-pandemic period (35.3%).</div></div><div><h3>Conclusions</h3><div>The COVID-19 national health alert was associated with significant shifts in the secular trend of cases associated with Enterobacterales outbreaks in Chilean public hospitals, including abrupt increases at the beginning and end of the national health alert period, and gradual decreases during and after this period. A sharp increase in carbapenemase production was observed across outbreaks after the onset of the COVID-19 pandemic.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 28-36"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More than rewards: insights into a hospital infection prevention and control gamification strategy","authors":"N. Reinoso Schiller ,&nbsp;G. Motaharina ,&nbsp;A. König ,&nbsp;G. Benze ,&nbsp;J. Eichkorn ,&nbsp;M. Weber-Krüger ,&nbsp;A.M. Köster ,&nbsp;L. Fischer ,&nbsp;E. Schulte ,&nbsp;V. Ellenrieder ,&nbsp;S. Scheithauer","doi":"10.1016/j.jhin.2025.02.019","DOIUrl":"10.1016/j.jhin.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>Traditional infection prevention and control (IPC) education and training of healthcare workers (HCWs) is expensive and rarely sustainable. Gamification strategies support behavioural change by capitalizing on psychological drivers such as intrinsic and extrinsic motivation. However, little is known about which type of reward presentation best supports the engagement of HCWs.</div></div><div><h3>Aim</h3><div>To examine which reward strategy can best facilitate engagement and acquisition of IPC knowledge.</div></div><div><h3>Methods</h3><div>This study was performed in three gastroenterology wards, and a palliative care ward served as the control. Data on bed occupancy and consumption of alcohol-based hand sanitizer (ABHS) were collected over a 2-month baseline period, and the number of correct answers was gathered during the intervention phases. Surveys on expectation and satisfaction were conducted pre and post intervention. Twice-weekly knowledge quizzes used loss aversion, standard reward and in-game reward strategies. Multi-variate analysis was used to analyse data on ABHS consumption and IPC knowledge.</div></div><div><h3>Findings</h3><div>In total, 105 HCWs participated in this study. A 170% increase in mean ABHS consumption was observed between baseline and the last phase of gamification. This represents a significant effect of gamification (<em>P</em>&lt;0.05). However, no significant difference in ABHS consumption was observed between the gamified wards (<em>P</em>&gt;0.05). Furthermore, gamified strategies showed higher engagement than the control strategy, but strategies of loss aversion and standard rewards did not display higher ABHS consumption or game engagement compared with gamification alone.</div></div><div><h3>Conclusion</h3><div>The intervention effectively engaged medical and non-medical staff in IPC topics, positively influencing HCW work flow and increasing ABHS consumption. These findings highlight gamification as a promising approach for IPC education.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 74-80"},"PeriodicalIF":3.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between use of medication and hospital-acquired infections: a multi-centre case–control study","authors":"X-L. Zhang ,&nbsp;F-B. Li ,&nbsp;L. Li ,&nbsp;Y. Liang ,&nbsp;H-J. Zhang","doi":"10.1016/j.jhin.2025.03.001","DOIUrl":"10.1016/j.jhin.2025.03.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Hospital-acquired infections (HAIs) pose a significant risk to hospitalized patients. This study aimed to assess the relationship between the use of medication and the occurrence of HAIs.</div></div><div><h3>Methods</h3><div>This retrospective multi-centre case–control study included 604 HAI cases reported across three hospitals in north-west China from January 2023 to July 2024. The control group consisted of 604 patients without HAIs from the same period and same hospitals. Multi-variable log-binomial regression was performed to assess the association between use of medication and HAIs, adjusting for confounding variables. A trend Chi-squared test was used to evaluate whether the risk of HAIs increased with prolonged use of medication.</div></div><div><h3>Results</h3><div>Univariate analysis revealed that the use of proton pump inhibitors (PPIs), antibiotics, glucocorticoids and H2 receptor blockers increased the risk of HAIs significantly (<em>P</em>&lt;0.05). Multi-variable log-binomial regression indicated that the use of PPIs, glucocorticoids and H2 receptor antagonists was associated with increased risk of HAIs, with relative risks of 1.37 [95% confidence interval (CI) 1.19–1.57], 1.33 (95% CI 1.10–1.62) and 1.84 (95% CI 1.04–3.24), respectively. The period of use of PPIs and glucocorticoids was significantly longer in the case group.</div></div><div><h3>Conclusions</h3><div>Use of glucocorticoids, PPIs and H2 receptor antagonists increases the risk of HAIs, with prolonged use exacerbating this risk. The use of a single antibiotic for up to 10 days is not associated with HAI acquisition.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"160 ","pages":"Pages 45-52"},"PeriodicalIF":3.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability and inactivation of hepatitis A virus on inanimate surfaces","authors":"L. Pottkämper ,&nbsp;M. Jagst ,&nbsp;D. Todt ,&nbsp;E. Steinmann","doi":"10.1016/j.jhin.2025.02.020","DOIUrl":"10.1016/j.jhin.2025.02.020","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis A virus (HAV) is one of the leading causes of viral hepatitis with an estimated 159 million acute infections annually. The primary route of transmission is faecal–oral through contaminated drinking water and food. Limited data regarding its surface stability and sensitivity to surface disinfectants are available. Implementing effective disinfectants could have a significant impact on the prevention of HAV transmission.</div></div><div><h3>Aim</h3><div>To evaluate HAV stability and sensitivity to surface disinfectants based on an established carrier assay.</div></div><div><h3>Methods</h3><div>The stability of HAV on stainless steel discs was evaluated over a period of 60 days and its sensitivity to different commercially available surface disinfectants. Steel-disc carriers were inoculated with HAV particles and incubated over a respective period. Furthermore, HAV resistance against several groups of disinfectant agents were tested with varying concentrations and exposure times according to the manufacturers' guidelines.</div></div><div><h3>Findings</h3><div>HAV was recoverable from stainless steel discs for up to 40 days with an estimated half-life of 18.63 days. The evaluation of several surface disinfectants showed that, except for the aldehyde-based products, all other products insufficiently inactivated HAV.</div></div><div><h3>Conclusion</h3><div>Overall, HAV demonstrated a high resistance to a wide range of the tested surface disinfectants. Out of the nine surface disinfectants evaluated, only two aldehyde-based products demonstrated a reduction in viral titre below the limit of detection. These findings have strong implications for the recommendation of evidence-based hygiene guidelines to reduce HAV transmission.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"161 ","pages":"Pages 68-73"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}