Healthcare infection最新文献

{"title":"Compliance with international guidelines on antibiotic prophylaxis for elective surgeries at a tertiary-level hospital in the Philippines","authors":"Maria Isabel P. Nabor MD ,&nbsp;Brian S. Buckley PhD ,&nbsp;Marie Carmela M. Lapitan MD","doi":"10.1071/HI15018","DOIUrl":"10.1071/HI15018","url":null,"abstract":"<div><h3>Background</h3><p>Surgical site infections (SSIs) are a major cause of morbidity, associated with extended hospital stays, increasing costs and even death. Perioperative antibiotic prophylaxis has been proven to prevent SSIs. Guidelines have been published to promote best practice but studies continue to highlight poor compliance.</p></div><div><h3>Objective</h3><p>This study aimed to assess adherence to antibiotic prophylaxis guidelines in common surgical operations in the teaching hospital of the national university in the Philippines.</p></div><div><h3>Methods</h3><p>This was a medical records-based, cross-sectional study. Common surgical procedures included were breast surgery, enterostomy closure, open and laparoscopic colectomy, and open and laparoscopic cholecystectomy performed from December 2013 to March 2014. Data were extracted relating to patients’ demographic characteristics, types of surgery, prophylactic antibiotic choice, route, dose, timing, redosing and duration of prophylaxis. Observed antibiotic prophylaxis was compared with guidelines.</p></div><div><h3>Results</h3><p>Of the 244 cases that warranted prophylaxis, 93% were given antibiotics. Of these, 44% conformed with the guideline for type of antibiotic, 39% for dose, 100% for route, 45% for timing, 93% for redosing, and 67% for duration. Only 13% conformed to guidelines for all parameters of prophylaxis. Most cholecystectomies received Cefuroxime, no longer recommended by latest international guidelines. Of the laparoscopic surgeries, 38% received antibiotics earlier than the 1 hour before surgery recommended in latest guidelines.</p></div><div><h3>Conclusions</h3><p>Ensuring surgeons fully follow guidelines on antibiotic prophylaxis remains a challenge, as highlighted by this study and others conducted around the world. Awareness-raising initiatives might be beneficial at institutional level to improve compliance with best practice guidelines.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 3","pages":"Pages 145-151"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI15018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59239662","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":"Characteristics of a successful hospital hand hygiene program: an Australian perspective","authors":"Joanne Brocket BN RN ,&nbsp;Ramon Z. Shaban RN EMT-P CICP PhD FACN FCENA","doi":"10.1071/HI15007","DOIUrl":"10.1071/HI15007","url":null,"abstract":"<div><h3>Introduction</h3><p>Healthcare-associated infections (HAIs) are the most common adverse health event affecting patients in hospital. Approximately 200 000 HAIs occur in Australian acute care facilities annually with an estimated annual cost of approximately $1 billion. They are largely preventable adverse events, which can be significantly reduced through the implementation of effective infection prevention and control programs and guidelines. Hand hygiene is well established as being fundamental in infection control programs for preventing and controlling HAIs. This paper will describe a successful hand hygiene program introduced into one Australian private hospital.</p></div><div><h3>Methods</h3><p>In2009, a323-bed, acute care facility implemented a program based on the Hand Hygiene Australia Hand Hygiene Culture Change Program. The aim of the program was to effect culture change using a structured multimodal approach, improving hand hygiene using the five elements of the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy.</p></div><div><h3>Results</h3><p>The program was successful at improving and maintaining hand hygiene compliance from 22% to 71% and this improvement was evidenced by an increase in the usage of alcohol-based handrub from 32 L per 10 000 bed days to 90 L, increases in the volumes of liquid soap used, a decrease in the bed days associated with surgical site infections, and a decrease in <em>Staphylococcus aureus</em> bacteraemia bed days.</p></div><div><h3>Conclusions</h3><p>Culture change for improvements in hand hygiene is difficult to achieve but possible to achieve through a structured multimodal whole-of-organisation program approach.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 3","pages":"Pages 101-107"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI15007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59239189","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":"2015 President's address: new ventures in publishing","authors":"Belinda C. Henderson CICP President","doi":"10.1071/HI15020","DOIUrl":"10.1071/HI15020","url":null,"abstract":"As a relatively new College with a long and rich history we have come of age in one of our major services that we provide to members and the profession – publishing. As foreshadowed in his editorial, Associate Professor Brett Mitchell describes the one important stage of the College’s growth and maturation as the peak body for the prevention and control of infection in our communities. The College is pleased to announce that from 2016 we will be moving to a new official publication, which will see Healthcare Infection replaced by Infection, Disease and Health. The vision of President-Elect Professor Ramon Shaban and Editor-in-Chief Associate Professor Brett Mitchell, Infection, Disease and Health reinforces the importance of infection prevention and control on health and advances the College’s vision as the peak body for the prevention and control of infection in our communities. In his editorial, Brett outlines the history of this decision as well as the vision for the next stage in this journey in publishing for theCollege. Itwouldbeour hope that it is also a time of greater collaboration with our colleagues with content including public health and public health policy, health economics, food and animal health in preventing human infections. On behalf of the College I would like to place on record our appreciation to the many that have been instrumental in establishing and growing our current journal, Healthcare Infection. Whilst Associate Professor Brett Mitchell makes mention of the past Editors, Editorial Board and contributors I would like to acknowledge the drive and energy that Brett has brought to the role over the past three years. Quite apart from a demanding professional schedule Brett has also built relationships with other associations and journal editors to be informed about the challenges facing professional groupswho need to publish. It is the success of Healthcare Infection that makes this transition to a new journal possible. As President, and on behalf of the Executive Council, I commend Professor Shaban and Associate Professor Mitchell on their vision for the College and its new journal, and I encourage all our members to actively contribute to its success by sharing your knowledge and taking up the challenge to publish in Infection, Disease and Health.","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 3","pages":"Page 84"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI15020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59239270","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":"In-use effect of electrolysed water on transcutaneous oxygen sensors","authors":"Stephanie J. Dancer MD, FRCPath, FRCP(Ed) ,&nbsp;Julie Mallon MSc ,&nbsp;Rebecca Murphy Bsc(Hons), MChs ,&nbsp;Cliff Murch MBBS, MRCP, FRCR","doi":"10.1071/HI15017","DOIUrl":"10.1071/HI15017","url":null,"abstract":"<div><p>Reusable clinical equipment should be decontaminated between patients in order to reduce risk of pathogen transmission. Manufacturers are obliged to offer advice regarding decontamination but occasionally insufficient guidance is provided. Tissue oxygen sensors are reusable, costly and vulnerable to disinfectants. This pilot study describes an in-use protocol using neutral electrolysed water aimed at eliminating infection risk during transcutaneous oxygen monitoring of diabetic feet. Sensor components were screened for microbial contamination before, during, and after monitoring healthy and diabetic volunteers. Exposure to electrolysed water removed original skin commensals and alleviated the risk of transmitting microbial flora without affecting test results. The product is non-toxic, inexpensive and may be useful for decontaminating a wide range of sensitive clinical equipment.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 3","pages":"Pages 141-144"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI15017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59239607","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":"Surgical site infection in orthopaedic surgery: an audit of peri-operative practice at a tertiary centre","authors":"Peter Tao MBBS ,&nbsp;Caroline Marshall MBBS, FRACP, PhD ,&nbsp;Andrew Bucknill FRACS","doi":"10.1071/HI14030","DOIUrl":"10.1071/HI14030","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgical site infection (SSI) is a common but serious complication in orthopaedic surgery. Multiple peri-operative risk factors have been identified in the incidence of SSIs. A ‘bundle of care’ approach has been used to identify and treat the most common risk factors. The aim of this study was to audit current peri-operative practice and compare with current hospital protocols.</p></div><div><h3>Methods</h3><p>Orthopaedic surgeries were retrospectively audited at a 350-bed tertiary hospital. Data on peri-operative practice, including patient temperature, blood sugar levels (BSLs), oxygenation, antibiotic use and incidence of SSIs, were collected via online surveying software. Descriptive analysis was performed.</p></div><div><h3>Results</h3><p>There were a total of 88 patients who had 95 orthopaedic surgeries. Seven patients developed SSIs. Temperature monitoring occurred in 96% of patients. BSL monitoring was less prevalent, occurring in only 16% of patients without diabetes. Post-operative oxygenation was universal. Only three patients did not receive prophylactic antibiotics in the peri-operative stage.</p></div><div><h3>Conclusions</h3><p>We found current peri-operative care to be generally excellent, although implementing a formal ‘bundle of care’ may achieve higher rates of normoglycaemia and normothermia.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 2","pages":"Pages 39-45"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI14030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59238505","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":"Success in the South Pacific: a case study of successful diffusion of an infection prevention and control program","authors":"Peta-Anne Zimmerman BN, MHSc(Infection Control), DrPH ,&nbsp;Heather Yeatman DrPH ,&nbsp;Michael Jones BCOM, Hons, PhD ,&nbsp;Helen Murdoch BN, GDip CritCare, GDip PH","doi":"10.1071/HI14036","DOIUrl":"10.1071/HI14036","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this study was to explore the role of the Diffusion of Innovations framework in adopting an infection prevention and control program (IPCP) in a low and middle income (LMI) country, the Republic of Kiribati.</p></div><div><h3>Methods</h3><p>Case-study methodology was used to examine and contextualise the analysis of the Republic of Kiribati's adoption of the IPCP from 2003 to 2010. Data were collected from multiple sources including semi-structured interviews, IPCP documentation, program evaluation and a healthcare worker survey. Data were subjected to thematic analysis and descriptive statistics where relevant to the study design.</p></div><div><h3>Results</h3><p>It was found that the self-initiated progression of activities and stimuli has resulted in the successful adoption of a comprehensive IPCP. The process followed the staged model of the classic Diffusion of Innovations process in organisations described by Everett Rogers.</p></div><div><h3>Conclusion</h3><p>This case study provides an illustration of how a comprehensive IPCP can be adopted in a LMI country setting with little involvement from external agencies. It identifies key stimuli, opportunities and activities which could be similarly adopted and implemented by other LMI countries.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 2","pages":"Pages 54-61"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI14036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37832427","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":"The emergence of community-acquired Clostridium difficile in an Australian hospital","authors":"Teresa M. Wozniak BMedSc, MPH, PhD ,&nbsp;George Rubin FAFPHM, FAChaM, FRACP ,&nbsp;C. Raina MacIntyre MBBS, M App Epid, PhD","doi":"10.1071/HI15003","DOIUrl":"10.1071/HI15003","url":null,"abstract":"<div><h3>Introduction</h3><p>The epidemiology of <em>Clostridium difficile</em>-related illness is changing. This study aimed to compare risk factors between community- and hospital-acquired <em>Clostridium difficile</em> (<em>C. difficile)</em> cases.</p></div><div><h3>Methods</h3><p>This study was a case-series analysis in a metropolitan tertiary care hospital. A total of 136 hospitalised patients aged 18 years or older who had laboratory-confirmed <em>C. difficile-</em> positive stool samples between 1 September 2011 and 30 September 2012 were analysed. Data were collected electronically from hospital administrative databases. Medical records of patients with toxigenic <em>C. difficile</em> were retrospectively reviewed for clinical information. Data matching was used to provide event-based data of the number of cases infected with <em>C. difficile</em> and their hospital outcomes.</p></div><div><h3>Results</h3><p>Amonthly average of 9% (15 of 168) of diarrhoeal stool samples were toxigenic test-positive. One-third (n <em>=</em> 37) of <em>C. difficile</em> cases had acquired infection before their hospital admission. These patients were significantly more likely to be diagnosed with enterocolitis due to <em>C. difficile</em> compared with patients who were infected in hospital (24% versus 7%, <em>P</em> = 0.02). Community-acquired <em>C. difficile</em> patients had significantly shorter mean lengths of stay in hospital (14 days versus 48 days for hospital-acquired infection) and were more likely to be discharged before 21 days (81% v. 38%, <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Patients with community-acquired <em>C. difficile</em> infection (CDI) contributed to a third of the burden of this infection in the hospital. A quarter of these patients presented to hospital with potentially life-threatening enterocolitis related to the infection. These data suggest that infection with <em>C. difficile</em> demands greater attention, in particular in the community setting.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 2","pages":"Pages 72-77"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI15003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59238916","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":"Improving the central venous access devices maintenance process to reduce associated infections in paediatrics: evaluation of a practical, multi-faceted quality-improvement initiative","authors":"Tricia Kleidon RN, MNP ,&nbsp;Abby Illing RN, BN ,&nbsp;Gerry Fogarty RN, BN ,&nbsp;Rachel Edwards RN, BN ,&nbsp;Jane Tomlinson RN, BN ,&nbsp;Amanda Ullman RN, MAppSci, PhD(Candidate)","doi":"10.1071/HI14038","DOIUrl":"10.1071/HI14038","url":null,"abstract":"<div><h3>Introduction</h3><p>Central venous access devices (CVADs) provide essential and reliable vascular access, but infection is a common and serious complication with paediatric patients. CVAD bundles have been demonstrated to effectively reduce central line-associated bloodstream infections (CLABSI), but primarily during CVAD insertion. Another emerging strategy to encourage best practice is the use of a dedicated CVAD trolley for maintenance.</p></div><div><h3>Methods</h3><p>A quality-improvement initiative was undertaken to improve CVAD maintenance and to evaluate the effectiveness of the chosen interventions at the Royal Children's Hospital, Brisbane. Nursing staff from four wards within the hospital elected to participate and the wards were allocated to receive either Intervention A (CVAD maintenance bundle only) or Intervention B (CVAD maintenance bundle and dedicated CVAD trolley). Effectiveness of the interventions was evaluated by: (i) rate of CLABSI per 1000 catheter-days; and (ii) audits of clinician compliance with evidence-based CVAD maintenance strategies.</p></div><div><h3>Results</h3><p>During the initiative, the hospital-wide CLABSI rate decreased from 9.07 to 1.05 episodes per 1000 catheter-days (<em>P</em> = 0.01). The rate of CLABSI in Intervention A wards reduced from 7.6 to 2.2 episodes per 1000 catheter-days (<em>P</em>&lt;0.001) and in Intervention B wards reduced from 8.0 to 0.5 episodes per 1000 catheter-days <em>(P &lt;</em> 0.001). Hospital-wide audits of clinician compliance increased from 11.9% to 3 5% <em>(P =</em> 0.001) in the Intervention A wards and to 83% <em>(P&lt;</em> 0.001) in the Intervention B wards.</p></div><div><h3>Conclusion</h3><p>Implementation of CVAD maintenance bundles and a dedicated CVAD trolley successfully reduced CLABSI and improved audited compliance to evidence-based practices within our tertiary paediatric hospital.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 2","pages":"Pages 46-53"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI14038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59238710","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":"Does our bundle stack up! Innovative nurse-led changes for preventing catheter-associated urinary tract infection (CAUTI)","authors":"Michelle Giles RN BBus MIS PhD candidate ,&nbsp;Wendy Watts RN CM Cert Oncology Cert Urology ,&nbsp;Anthony O’Brien RN BN PhD ,&nbsp;Sandy Berenger RN ,&nbsp;Michelle Paul RN BN MN ,&nbsp;Karen McNeil BComm MBA ,&nbsp;Kamana Bantawa MBBS MS","doi":"10.1071/HI14035","DOIUrl":"10.1071/HI14035","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this project was to develop and implement an innovative nurse-led model of care in the use and management of indwelling urinary catheters (IUC) utilising evidence-based ‘bundle interventions’ to reduce the incidence of catheter-associated urinary tract infections (CAUTI).</p></div><div><h3>Design and method</h3><p>A pre and post intervention study designed to progress in three phases was conducted in the orthopaedic ward and urology ward of a large tertiary referral facility. Phase one involved a clinical data collection pre intervention on all inpatients receiving an IUC over a 3-month period from February to April 2013. A staff survey assessed knowledge and skills and an evidence-based care bundle, nurse-led protocols, and education resources were developed through collaboration with clinicians. Phase two involved implementation and Phase three was an evaluation with the primary outcome targets being reduced IUC usage, days IUC <em>in situ</em> and incidence of CAUTI.</p></div><div><h3>Results</h3><p>Pre audit data revealed a high rate of IUC use: 31% of all inpatients in the orthopaedic ward and 25% in the urology ward. Compliance with current guidelines was inconsistent and documentation related to IUCs was poor. Overall CAUTI rate was relatively low at 2.2% of all patients with an IUC and was higher in the orthopaedic ward.</p></div><div><h3>Conclusion</h3><p>The development of a systematic and standardised approach to IUC care for inpatients using bundle care interventions will potentially reduce IUC use, provide a clear pathway for nurse-initiated IUC removal and reduce the incidence of catheter-associated urinary tract infections (CAUTI).</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 2","pages":"Pages 62-71"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI14035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59238574","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":"Infection prevention and control lessons learned from the management of the first suspected Ebola virus disease case admitted to a New Zealand hospital","authors":"Ruth Barratt RN, BSc, MAdvPrac(Hons)","doi":"10.1071/HI15006","DOIUrl":"10.1071/HI15006","url":null,"abstract":"<div><p>This report describes the infection prevention and control involvement in the care of the first suspected Ebola virus disease (EVD) case to be admitted to a New Zealand hospital. Prior planning and detailed preparations enabled a smooth admission process and ongoing patient treatment. Prepared infection prevention and control procedures ensured the public and healthcare workers were not put at risk of acquiring EVD. Further refinement of personal protective equipment is required.</p></div>","PeriodicalId":90514,"journal":{"name":"Healthcare infection","volume":"20 2","pages":"Pages 78-80"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1071/HI15006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59239141","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}