Infection, disease & health最新文献

{"title":"Australian infection prevention and control governance, strategy and structure: Design for success.","authors":"Kathy Dempsey, Susan Jain, Patricia Bradd, Kate Clezy, David Greenfield","doi":"10.1016/j.idh.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.idh.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Governance, strategy and organisational structure for Infection Prevention and Control (IPC) programs across Australia remain variable. The standardisation and integration of these functions across jurisdictions are critical for effective advancement of IPC across health systems.</p><p><strong>Aim: </strong>Across the Australian Federal, State and Territory jurisdictions, the study examined a twofold research question: first, what are the governance, strategy and organisational structures of IPC programs?; and second, what are the essential elements for a standardised, consistent IPC governance framework?</p><p><strong>Methods: </strong>Comprising four integrated steps: preconference document analysis of key jurisdictional program information; a survey of conference participants; open discussion - an expert panel of jurisdictional leads and conference participants; and expert panel review, incorporating mixed methods and a modified Delphi approach for consensus and validated guidance.</p><p><strong>Results: </strong>IPC representatives across Australia participated in this study with 44 % (226/513) responses. Structures reported included: patient safety, public health, or infectious diseases. Reported key elements for effective IPC governance included IPC leadership expertise (42 %), a consistent and transparent structure (30 %), and adequate resourcing and funding for IPC (18 %). IPC governance structures across Australia remain substantially variable. The Australian Centre for Disease Control (AusCDC) is considered the pre-eminent IPC governance agency, that could enhance IPC governance, structure and strategic direction.</p><p><strong>Conclusion: </strong>Clear governance, strategy, and organisational structures have a critical role in the effectiveness of IPC programs and healthcare associated infection reduction strategies. The developed framework provides additional insight towards a comprehensive, standardised national IPC governance framework, offering opportunity for improvement and informing future priorities.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556257","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":"Nurses' knowledge of Clostridioides difficile pre and post education: A continuing challenge.","authors":"Wendy Smyth, Janine Carrucan, Mariann Hadland, Kara Finnimore, Cate Nagle","doi":"10.1016/j.idh.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.idh.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>Clostridium difficile is a cause of hospital acquired infection. Nurses require a sound understanding of infection prevention and control regardless of practice setting and competing infection control demands and priorities. This study aimed to identify nurses' knowledge and perceptions about Clostridium difficile infection following education.</p><p><strong>Methods: </strong>A cross-sectional anonymous survey was distributed to nurses across a regional Northern Australia health service. Descriptive statistics and content analysis were used to analyse, summarise, and report the findings.</p><p><strong>Results: </strong>A total of 167 completed surveys were included in the analysis. There were no significant differences in correct responses to the knowledge and practice survey statements compared to responses prior to the educational intervention. Additionally, there were no differences in total correct responses between nurses who received education about Clostridium difficile infection and those who did not, nor between nurses who worked in the tertiary hospital compared to nurses who worked in smaller rural facilities. Nurses who completed surveys prior to and following the educational intervention showed improved knowledge.</p><p><strong>Conclusions: </strong>Nurses continue to demonstrate significant knowledge gaps about the management of CDI, underscoring the need for sustained, targeted education. Although pandemic-related restrictions limited in-person learning, face-to-face formats remained the preferred mode, possibly due to the benefits of immediate feedback and practical relevance to the clinical settings. Addressing the knowledge gaps through interactive, scenario-based training may enhance both engagement and knowledge retention of nurses and should be the explored in future research.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546655","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":"Government funding for healthcare infection prevention research: A scoping review of the past decade.","authors":"Jessica A Schults, Alison Smith, Sally M Havers, Brett G Mitchell, Jason C Kwong, Philip L Russo, Andrew J Stewardson, Claire M Rickard","doi":"10.1016/j.idh.2025.05.003","DOIUrl":"10.1016/j.idh.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Healthcare infection prevention and control (IPC) programs are recognised globally as a system-wide strategy to support patient and staff safety. Research evidence is essential to underpin these programs, however it is unclear the level of national research funding invested into healthcare IPC in the past decade.</p><p><strong>Methods: </strong>Scoping review using Arksey and O'Malley's framework. A systematic search of national category 1 grants awarded between 2014 and 2023 on healthcare IPC was undertaken. Grants were eligible if they were focused on healthcare IPC, we excluded preclinical studies and vaccine development studies. Two independent reviewers screened and extracted data, result were summarised narratively.</p><p><strong>Results: </strong>We identified 10,394 grants, amounting to $19.7B, awarded between 2014 and 2023. A total of $37.11M was provided for 23 IPC research projects/programs (median per grant $1.10M, interquartile range 335k to 2.44M). Accounted for approximately 0.19 % of the total government health research funding in Australia from 2014 to 2023. No healthcare IPC related grants were awarded in 2020, the peak of the pandemic.</p><p><strong>Conclusion: </strong>IPC research funding in Australia remains disproportionately low relative to infection health and economic burden.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337312","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 impact of different training methods on the hand hygiene beliefs and practices of future home caregivers: A randomized controlled trial.","authors":"Banu Cihan Erdoğan, Nevin Doğan, Yağmur Betül Kalle","doi":"10.1016/j.idh.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.idh.2025.05.004","url":null,"abstract":"<p><strong>Background: </strong>Hand hygiene is a fundamental infection control practice. Effective training methods are needed to improve students' hand hygiene beliefs and behaviors, especially for future home caregivers.</p><p><strong>Aim: </strong>This study evaluates the effects of different training methods on hand hygiene beliefs and practices of future home caregivers.</p><p><strong>Methods: </strong>A randomized controlled trial with pre-test and post-test evaluations was conducted in 2023 with first-year university students in Türkiye. Of 87 participants, 75 completed the study (video group: 25, paint demonstration: 25, soap demonstration: 25). All received theoretical training, followed by practical sessions: video demonstration, acrylic paint demonstration, or soap and water demonstration. Data was collected using demographic and knowledge forms, Hand Washing Skills Checklist, Hand Hygiene Belief Scale, and Hand Hygiene Practice Inventory.</p><p><strong>Results: </strong>All groups showed significant improvement from pre-test to post-test (p < 0.05). There was a significant difference in post-test Hand Hygiene Belief Scale mean scores among the groups; the Soap group (93.52) scored higher than the Video (90.24) and Paint (88.40) groups (H = 6.564, p = 0.038). Hand Washing Skills scores were highest in the soap group, followed by paint and video groups, but differences were not statistically significant (p > 0.05).</p><p><strong>Conclusion: </strong>Different training methods had similar effects on hand hygiene skills, though soap demonstration was more effective for beliefs. Various training approaches may be beneficial, but further research is needed to determine the most effective method.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319061","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":"Nurses' experiences of providing oral care to hospitalised patients: A qualitative study.","authors":"Helen Rawson, Sonja Dawson, Auxillia Madhuvu, Julee McDonagh, Katrina Browne, Peta Ellen Tehan, Philip L Russo, Georgia Matterson, Allen C Cheng, Martin A Kiernan, Jenny Sim, Andrew J Stewardson, Rhonda Wilson, Brett G Mitchell","doi":"10.1016/j.idh.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.idh.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>Oral care has a critical role in hospital-acquired infection prevention, is part of fundamental nursing care, yet is poorly undertaken in hospital. The study's aim was to understand Australian nurses' perceptions of their role in oral care and their experience providing oral care in hospital, with the focus on enablers and barriers.</p><p><strong>Methods: </strong>A qualitative exploratory descriptive design. Seven registered nurses working in acute adult in-patient hospitals in Australia participated in three semi-structured focus groups in October and November 2023. Data analysis followed thematic analysis procedures. The study is reported using Standards for Reporting Qualitative Research.</p><p><strong>Results: </strong>Three themes were identified: nurses' perceptions of their role in oral care; barriers to providing oral care for hospitalised patients; and enablers to providing oral care for hospitalised patients. Nurses' experiences revealed expectations for different clinical settings. In the intensive care unit where patients required mechanical ventilation, oral care was inextricably linked to that care. In palliative care or oncology units, oral care was intrinsically linked to holistic care. Reported challenges include time and staffing constraints; limited resources; nurses' limited knowledge about the importance of oral care, and patient-related factors. Opportunities to promote oral care include empowering patients and educating nurses about the importance of oral care to health.</p><p><strong>Conclusions: </strong>Nurses have a pivotal role in oral care and it is important that this is part of patient care in hospital. The findings will inform a comprehensive co-design process to develop an intervention to be examined in a multi-centre randomised control trial.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228066","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":"Zero-shot large language model application for surgical site infection auditing.","authors":"Shrirajh Satheakeerthy, Brandon Stretton, James Tsimiklis, Andrew Ec Booth, Sarah Howson, Shaun Evans, Christina Guo, Joshua Kovoor, Aashray Gupta, Christina Gao, Weng Onn Chan, Tim French, Amelia Demopoulos, Alyssa Pradhan, Samuel Gluck, Toby Gilbert, Matthew Blake Roberts, Camille Kotton, Stephen Bacchi","doi":"10.1016/j.idh.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.idh.2025.05.001","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence, in particular large language models (LLM), may be able to assist with monitoring for surgical site infections (SSI).</p><p><strong>Method: </strong>This retrospective study involved the application of the Llama 3.0 70-billion parameter model to the identification of SSI in a group of all SSI in two metropolitan hospitals from a 4-month period. Randomly selected control patients were chosen as comparators. Clinical inpatient and outpatient progress notes were provided to the LLM individually and classified as indicating an SSI or not. These classifications were then analysed to determine binary performance characteristics and to determine the timing of positive case classification.</p><p><strong>Results: </strong>There was a total of 28 cases in the study, 14 in the case (SSI) group and 14 in the control group. The operations involved in the SSI cases were caesarean section (12/14, 85.7 %) and arthroplasty (2/14, 14.2 %). The LLM had an overall accuracy at the patient-level of 26/28 (93 %). There was a sensitivity of 100 % and specificity of 86%. At the note-level, for the first note flagged by the LLM for each case, 13/14 (92.3 %) were on the same day as, or before, the date noted as the onset of infection as identified by infection control clinicians.</p><p><strong>Conclusions: </strong>The use of LLM for the screening of medical notes for SSI is feasible. Further studies may seek to evaluate the outcomes of LLM when deployed as part of a clinical workflow.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129825","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":"Evaluating antibiotic prescribing practices for patients with asymptomatic bacteriuria in Saudi Arabia: The need for stewardship initiatives.","authors":"Ahlam Alghamdi","doi":"10.1016/j.idh.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.idh.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Patients with asymptomatic bacteriuria (ASB) often receive unnecessary antibiotic treatment, leading to antibiotic resistance without improving patient outcomes. We qualitatively assessed antibiotic use in patients with ASB at a teaching hospital in Saudi Arabia.</p><p><strong>Methods: </strong>This a retrospective observational study included patients diagnosed with ASB based on established criteria based on data collected through manual chart review. We evaluated antibiotic use, including indications, selection, and duration of therapy. Data were collected from August 2022-2023 and analyzed from December 2023 to May 2024.</p><p><strong>Results: </strong>Among 1250 episodes of bacteriuria, 731 were classified as ASB. The percentage of appropriate ASB antibiotic prescriptions, as indicated by the guidelines, was 51.8 %; 27.7 % of patients received antibiotics for recommended cases, whereas 24 % did not receive antibiotics in the absence of recommendation. The percentages of appropriate antibiotic selection and duration of antibiotic prescription for appropriate indications were 72 % and 59.6 %, respectively.</p><p><strong>Conclusion: </strong>Most bacteriuria among patients was ASB, with high rates of treatment and prolonged durations of therapy for ASB.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096581","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":"Co-design and user testing of a Japanese encephalitis vaccine decision aid (JEVaDA).","authors":"Sarah L McGuinness, Owen Eades, Jennifer Morris, Allen C Cheng, Holly Seale, Karin Leder","doi":"10.1016/j.idh.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.idh.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>Japanese encephalitis (JE) is a rare but potentially serious infection in travellers. While effective vaccines are available, uptake remains low. Vaccine decision aids are evidence-based tools designed to help users make informed vaccination decisions. This study details the development of a novel web-based Japanese encephalitis vaccine decision aid (JEVaDA) for travellers, following globally recognised standards.</p><p><strong>Methods: </strong>Collaborating with community members, healthcare providers and experts, we followed a multi-step approach, involving a scoping review, a survey of user needs, co-design workshops, user testing, and expert review. Findings from workshops and testing informed the development of decision aid prototypes, with input from a graphic designer. We used the Patient Education Materials Assessment Tool to assess understandability and actionability and the Ottawa acceptability tool to measure components of acceptability. The final version was adapted to a web-based format.</p><p><strong>Results: </strong>Five co-design workshops conducted with 16 participants (nine community members, seven healthcare providers) gathered input and feedback on the initial PDF prototype. The refined prototype was user-tested by another group of 22 participants (16 community members, six healthcare providers) and reviewed by five subject matter experts. Feedback indicated areas for improvement in risk visualisation, personalised content, and catering to diverse user needs. The decision aid scored highly for understandability (89 %) and actionability (87 %). All participants (100 %) found it suitable for decision making.</p><p><strong>Conclusion: </strong>We successfully co-designed and user-tested a JE vaccine decision aid with community members, healthcare providers and experts. The interactive, web-based version is now freely available at www.monash.edu/vaccinedecisionaids-je.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032495","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":"Implementation of a proposed algorithm to assess and de-label false penicillin allergy labels in the community.","authors":"Angelina Lim, Sharmila Khumra, Elise A Mitri, Jenny Qian, Katija Juric, Limhour Kruoch, Lydia Liu, Simon James","doi":"10.1016/j.idh.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.idh.2025.04.002","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacists could have a pivotal role to play in de-labelling false penicillin allergies or preventing false penicillin allergy labels from occurring to reduce inappropriate prescribing of less effective and broader-spectrum antibiotics.</p><p><strong>Methods: </strong>A quasi-experimental study aimed at implementing and evaluating an algorithm to assess and de-label false penicillin allergy labels in the community. Between April and May 2024, the algorithm was rolled out to five community pharmacies in Victoria, Australia. De-labelling outcomes of Type A reactions were recorded. Barriers and enablers to implementing the penicillin allergy assessment algorithm were also collected through semi-structured interviews.</p><p><strong>Results: </strong>Of 18,646 patients who presented to the pharmacies, 163 individuals (0.87 %) had a penicillin allergy label. Of these 163 patients, 30 (18.4 %) patients were assessed as having a Type A reaction (a non true allergy; non-immune related). All patients with Type A reactions were engaged in an attempt to de-label their allergy; 77 % of patients were accepting whilst 23 % were hesitant or non-receptive, due to time restraints or disbelief that their allergy is not a true allergy. Qualitative interview data revealed there remains a public misconception that antibiotic allergy labels do not impact the appropriateness of antibiotic prescribing or affect patient safety through increased risk of adverse drug events and antimicrobial resistance.</p><p><strong>Conclusions: </strong>The proposed algorithm was able to support the de-labelleling of false penicillin allergies. Future research could implement the use of the algorithm in other primary care settings and ascertain the long-term retention of the initiation of de-labelleling in the community.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047401","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":"Speciation of coagulase-negative staphylococci: A cohort study on clinical relevance and outcomes.","authors":"Samantha Keogh, Emily N Larsen, Felicity Edwards, Makrina Totsika, Nicole Marsh, Patrick N A Harris, Kevin B Laupland","doi":"10.1016/j.idh.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.idh.2025.04.001","url":null,"abstract":"<p><strong>Introduction: </strong>Coagulase-negative staphylococci (CoNS) are common causes of bloodstream infections (BSI), but species-specific epidemiology is under-researched. This study aimed to examine the occurrence, clinical features, and outcomes of CoNS BSI in a large Australian population.</p><p><strong>Methods: </strong>All incidents of CoNS BSI in the Queensland Health system (2000-2019) were included.</p><p><strong>Results: </strong>Among 4046 CoNS BSI cases, 3353 were monomicrobial, with S. epidermidis (n = 1665), S. haemolyticus (n = 224), S. hominis (n = 220), S. capitis (n = 185), S. lugdunensis (n = 57), S. warneri (n = 47), and other species (n = 38). In 27% of cases, CoNS isolates were not assigned to species. Significant differences in age, onset classification, co-morbidities, and flucloxacillin resistance were observed across species. S. epidermidis, S. haemolyticus. S. capitis were predominantly hospital-onset, while S. lugdunensis was community-associated. The cohort had Charlson scores indicating high co-morbidity, with malignancy common among S. haemolyticus patients. Most speciated isolates of CoNS demonstrated resistance to flucloxacillin (2224/2827; 79%). The 30-day mortality rate was higher for polymicrobial (14%) vs. monomicrobial BSI (11%), p = 0.024. Mortality varied by species and was highest for S. lugdunensis (22%).</p><p><strong>Conclusions: </strong>These findings underscore the value of species-level identification in managing CoNS BSIs, particularly in cases with clinical signs and symptoms, to support antimicrobial stewardship.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065507","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}