Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-72-80
E. V. Chehvalova, E. Manin, A. Kulichenko
Relevance. Hemorrhagic fever with renal syndrome (HFRS), due to the severity of the course and high mortality, poses a serious threat to the health of the population of both the city of Sochi and its guests. Therefore, in order to implement more effective and less economically costly anti-epidemic and preventive measures, it is very important to constantly monitor the activity of the natural focus of HFRS, as well as to have a clear idea of the territories most dangerous for the risk of infection with this infection.Aims. Assessment of the epidemiological significance of the territory of the city of Sochi for the risk of infection with HFRS based on the maximum entropy method using a geographical information system.Materials & Methods. Based on the application of the maximum entropy algorithm implemented in the MaxEnt program, as well as the ArcGIS 10 program.8. Ranking of the territory of the city of Sochi according to the risk of infection with HFRS was performed. The paper uses: data on positive epizootological findings (a total of 131) for 2016-2021, which were obtained from the Sochi branch of the Federal Medical Institution «Center of Hygiene and Epidemiology in the Krasnodar Territory», the Sochi branch of the Federal Medical Institution «Black Sea Plague Station» of Rospotrebnadzor, as well as the Stavropol Plague Control Research Institute of the Rospotrebnadzor; materials on environmental conditions from the Biolclim data bank, vegetation index for 9 months (https://land.copernicus.eu/global/products/NDVI ). Preliminary preparation of the information was carried out using the ArcGIS 10 program.8. As a tool for building a training model, the MaxEnt program version 3.4.4 was used (https://biodiversityinformatics.amnh.org/open_source/maxent /).Results and discussion. The practical implementation of the tasks was to obtain maps of the epidemiological significance of the territory for the risk of infection with HFRS by superimposing the points of occurrence of the species (reservoir and carrier of HFRS) on maps of abiotic environmental factors affecting its spread. The implementation of this work consisted of the sequential implementation of four main stages: the first – the collection, generalization and transformation of bioclimatic and epizootic-epidemiological data; the second – the selection of the most significant data for the construction of the model; the third – the ranking of the territory of the city. Sochi on the risk of the spread of HFRS using GIS; the fourth is the analysis of the data obtained. In the course of the work, a model was obtained that allows dividing the study area according to the degree of risk of infection with HFRS with a high degree of reliability and significant prognostic value.Conclusions. The use of the model makes it possible to obtain new, more detailed data from a spatial point of view on the boundaries of potentially dangerous sites in the region in terms of GLPS. In particular, this applies to those
{"title":"Ranking of the Territory of Sochi by the Risk of Infection with HFRS Using the Method of Maximum Entropy","authors":"E. V. Chehvalova, E. Manin, A. Kulichenko","doi":"10.31631/2073-3046-2023-22-6-72-80","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-72-80","url":null,"abstract":"Relevance. Hemorrhagic fever with renal syndrome (HFRS), due to the severity of the course and high mortality, poses a serious threat to the health of the population of both the city of Sochi and its guests. Therefore, in order to implement more effective and less economically costly anti-epidemic and preventive measures, it is very important to constantly monitor the activity of the natural focus of HFRS, as well as to have a clear idea of the territories most dangerous for the risk of infection with this infection.Aims. Assessment of the epidemiological significance of the territory of the city of Sochi for the risk of infection with HFRS based on the maximum entropy method using a geographical information system.Materials & Methods. Based on the application of the maximum entropy algorithm implemented in the MaxEnt program, as well as the ArcGIS 10 program.8. Ranking of the territory of the city of Sochi according to the risk of infection with HFRS was performed. The paper uses: data on positive epizootological findings (a total of 131) for 2016-2021, which were obtained from the Sochi branch of the Federal Medical Institution «Center of Hygiene and Epidemiology in the Krasnodar Territory», the Sochi branch of the Federal Medical Institution «Black Sea Plague Station» of Rospotrebnadzor, as well as the Stavropol Plague Control Research Institute of the Rospotrebnadzor; materials on environmental conditions from the Biolclim data bank, vegetation index for 9 months (https://land.copernicus.eu/global/products/NDVI ). Preliminary preparation of the information was carried out using the ArcGIS 10 program.8. As a tool for building a training model, the MaxEnt program version 3.4.4 was used (https://biodiversityinformatics.amnh.org/open_source/maxent /).Results and discussion. The practical implementation of the tasks was to obtain maps of the epidemiological significance of the territory for the risk of infection with HFRS by superimposing the points of occurrence of the species (reservoir and carrier of HFRS) on maps of abiotic environmental factors affecting its spread. The implementation of this work consisted of the sequential implementation of four main stages: the first – the collection, generalization and transformation of bioclimatic and epizootic-epidemiological data; the second – the selection of the most significant data for the construction of the model; the third – the ranking of the territory of the city. Sochi on the risk of the spread of HFRS using GIS; the fourth is the analysis of the data obtained. In the course of the work, a model was obtained that allows dividing the study area according to the degree of risk of infection with HFRS with a high degree of reliability and significant prognostic value.Conclusions. The use of the model makes it possible to obtain new, more detailed data from a spatial point of view on the boundaries of potentially dangerous sites in the region in terms of GLPS. In particular, this applies to those ","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139448993","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-139-147
M. Kartashov, K. A. Svirin, E. I. Krivosheina, E. Chub, V. Ternovoi, G. V. Kochneva
Relevance. Hepatitis B often causes liver cirrhosis and hepatocellular carcinoma, especially among patients with HIV. Vaccination is the main prophylaxis of HBV for preventing infection and developing chronic disease. Studying the duration of postvaccination immunity and the expediency of revaccination in different age and risk groups is important for improving the strategy of immunoprophylaxis of B hepatitis.Aims. Study was to determine the level of post-vaccination immunity to HBV and specific antibodies (anti-HBc and anti-HBs) among HIV-positive patients and the healthy population of Novosibirsk and Tomsk.Materials and methods. 536 blood samples were taken from HIV-positive patients and 337 blood samples from healthy people (pregnant women and persons undergoing a routine medical examination). The presence of HBsAg, anti-HBs IgG, and anti-HBcIgG were determined in the samples.Results. The proportion of post-vaccination immunity decreased in older age groups with an increase in the proportion of post-exposure immunity. The proportion of HIV-positive patients who had contact with HBV was higher than among healthy people. Around 70% of people in each group had a low level of protective antibodies anti-HBs (lower than 100 IU). A high level of anti-HBs (higher than 400 IU) was determined in 10% of examined people. The proportion of low levels of anti-HBs increased with age, while average and high levels of post-vaccination immunity were less common with increasing age.Conclusion. A low proportion of HIV-positive people, who have been effectively vaccinated against hepatitis B, was noticed. Annual blood tests for the presence of HBsAg, anti-HBs, and anti-HBc, in combination with determining DNA HBV, can be recommended for HIV-positive patients who have a risk of developing an occult form of hepatitis B.
相关性。乙型肝炎通常会导致肝硬化和肝细胞癌,尤其是在艾滋病毒感染者中。接种疫苗是预防乙型肝炎病毒感染和慢性疾病的主要方法。研究不同年龄和风险群体接种疫苗后免疫力的持续时间以及再次接种疫苗的适宜性,对于改进乙型肝炎免疫预防策略非常重要。研究旨在确定新西伯利亚和托木斯克的 HIV 阳性患者和健康人群接种疫苗后对 HBV 的免疫水平以及特异性抗体(抗 HBc 和抗 HBs)。536 份血液样本来自艾滋病病毒阳性患者,337 份血液样本来自健康人群(孕妇和接受常规体检者)。结果显示,接种疫苗后免疫力下降的比例比接种疫苗前下降的比例要高。接种疫苗后免疫的比例在年龄越大的人群中越低,而暴露后免疫的比例则越高。曾接触过 HBV 的 HIV 阳性患者比例高于健康人群。每组中约有 70% 的人的抗 HBs 保护性抗体水平较低(低于 100 IU)。10%的受检者的抗-HBs 水平较高(高于 400 IU)。低水平抗-HBs的比例随着年龄的增长而增加,而平均水平和高水平的接种后免疫力则随着年龄的增长而降低。我们注意到,HIV 阳性者中有效接种过乙型肝炎疫苗的比例较低。建议有隐匿性乙型肝炎风险的 HIV 阳性患者每年抽血检测 HBsAg、抗-HBs 和抗-HBc,同时检测 DNA HBV。
{"title":"Evaluation of the Intensity of Post-Vaccination Immunity to Hepatitis B among HIV-infected and Conditionally Healthy Persons in Western Siberia","authors":"M. Kartashov, K. A. Svirin, E. I. Krivosheina, E. Chub, V. Ternovoi, G. V. Kochneva","doi":"10.31631/2073-3046-2023-22-6-139-147","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-139-147","url":null,"abstract":"Relevance. Hepatitis B often causes liver cirrhosis and hepatocellular carcinoma, especially among patients with HIV. Vaccination is the main prophylaxis of HBV for preventing infection and developing chronic disease. Studying the duration of postvaccination immunity and the expediency of revaccination in different age and risk groups is important for improving the strategy of immunoprophylaxis of B hepatitis.Aims. Study was to determine the level of post-vaccination immunity to HBV and specific antibodies (anti-HBc and anti-HBs) among HIV-positive patients and the healthy population of Novosibirsk and Tomsk.Materials and methods. 536 blood samples were taken from HIV-positive patients and 337 blood samples from healthy people (pregnant women and persons undergoing a routine medical examination). The presence of HBsAg, anti-HBs IgG, and anti-HBcIgG were determined in the samples.Results. The proportion of post-vaccination immunity decreased in older age groups with an increase in the proportion of post-exposure immunity. The proportion of HIV-positive patients who had contact with HBV was higher than among healthy people. Around 70% of people in each group had a low level of protective antibodies anti-HBs (lower than 100 IU). A high level of anti-HBs (higher than 400 IU) was determined in 10% of examined people. The proportion of low levels of anti-HBs increased with age, while average and high levels of post-vaccination immunity were less common with increasing age.Conclusion. A low proportion of HIV-positive people, who have been effectively vaccinated against hepatitis B, was noticed. Annual blood tests for the presence of HBsAg, anti-HBs, and anti-HBc, in combination with determining DNA HBV, can be recommended for HIV-positive patients who have a risk of developing an occult form of hepatitis B.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449489","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-183-200
E. P. Kharchenko
The article discusses the limitations of the protective potential of the immune system associated with the peculiarities of the evolutionary mechanisms of the emergence of protein diversity and the late emergence in the evolution of the adaptive immune system, as well as problems associated with the formation of immunity to viral infections and immune collisions during vaccination. Using the example of hemagglutinin of the H1N1 influenza virus and S protein of the SARS-Cov-2 coronavirus, the features of the amino acid composition of their immunodominant (NA1 and S1) and subdominant (NA2 and S2) subunits are illustrated and the possibility of creating a universal vaccine against influenza viruses is analyzed. The principle of a new method for detecting linear peptide immunoepitopes recognized by MHC I and II and biomarkers of long-term immunity in surface viral proteins used as vaccines is described. The model of proteolysis of vaccine proteins in immunoprotesomes and lysosomes, features of the amino acid composition of surface proteins of viruses to which vaccines cause long-term immunity, and viruses to which vaccines have not yet been developed, as well as possible collisions with mRNA vaccines are examined. Possible collisions with mRNA vaccines are also being considered in connection with the identification of gene encoding limitations.
文章讨论了与蛋白质多样性出现的进化机制的特殊性和适应性免疫系统进化过程中出现较晚有关的免疫系统保护潜力的局限性,以及与病毒感染免疫力的形成和疫苗接种过程中的免疫碰撞有关的问题。以甲型 H1N1 流感病毒的血凝素和 SARS-Cov-2 冠状病毒的 S 蛋白为例,说明了它们的免疫优势亚基(NA1 和 S1)和亚优势亚基(NA2 和 S2)的氨基酸组成特点,并分析了创建流感病毒通用疫苗的可能性。介绍了检测 MHC I 和 II 识别的线性肽免疫表位和用作疫苗的病毒表面蛋白中长期免疫的生物标志物的新方法的原理。研究了疫苗蛋白在免疫原体和溶酶体中的蛋白水解模式、可产生长期免疫力的疫苗和尚未开发出疫苗的病毒表面蛋白的氨基酸组成特征,以及与 mRNA 疫苗可能发生的碰撞。在确定基因编码限制的同时,还考虑了与 mRNA 疫苗可能发生的碰撞。
{"title":"Problems and Collisions of Vaccinology","authors":"E. P. Kharchenko","doi":"10.31631/2073-3046-2023-22-6-183-200","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-183-200","url":null,"abstract":"The article discusses the limitations of the protective potential of the immune system associated with the peculiarities of the evolutionary mechanisms of the emergence of protein diversity and the late emergence in the evolution of the adaptive immune system, as well as problems associated with the formation of immunity to viral infections and immune collisions during vaccination. Using the example of hemagglutinin of the H1N1 influenza virus and S protein of the SARS-Cov-2 coronavirus, the features of the amino acid composition of their immunodominant (NA1 and S1) and subdominant (NA2 and S2) subunits are illustrated and the possibility of creating a universal vaccine against influenza viruses is analyzed. The principle of a new method for detecting linear peptide immunoepitopes recognized by MHC I and II and biomarkers of long-term immunity in surface viral proteins used as vaccines is described. The model of proteolysis of vaccine proteins in immunoprotesomes and lysosomes, features of the amino acid composition of surface proteins of viruses to which vaccines cause long-term immunity, and viruses to which vaccines have not yet been developed, as well as possible collisions with mRNA vaccines are examined. Possible collisions with mRNA vaccines are also being considered in connection with the identification of gene encoding limitations.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449497","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-108-123
Y. V. Mikhailova, A. D. Molchanov, A. Shelenkov, M. Tyumentseva, K. Karbyshev, A. I. Tyumentsev, A. Egorova, N. G. Kulikova, I. N. Manzenyuk, V. G. Akimkin
Relevance. Listeria monocytogenes is a ubiquitous bacterium that causes listeriosis, which represents a widespread infectious disease currently inflicting great damage to livestock production and posing a serious threat to human health.Aim. To analyze the population structure and assess the pathogenic potential of Listeria monocytogenes isolates isolated on the territory of the Russian Federation.Materials and methods. A total of 79 listeria isolates were isolated from food products. Species identification and phenotypic analysis for antibiotic resistance were performed using VITEK MS system (bioMerieux, Marcyl’toile, France). Thirty-five antibiotic-resistant isolates were characterized by analysis of whole-genome sequencing data.Results. Whole genome sequences of thirty-five antibiotic-resistant Listeria monocytogenes isolates of food origin were analyzed. We determined clonal structure of this population and revealed a small number of antibiotic resistance determinants (fosX, tetM и сlpL), extensive set of virulence factors, as well as the presence of CRISPR/Cas systems. Most of the isolates belonged to phylogenetic line II and were divided into nine clonal complexes with the prevalence of CC121, which was one of the epidemiologically significant genetic clones. Two CC2 isolates belonging to the most pathogenic phylogenetic lineage I were also found. Thirteen isolates were characterized by the presence of putative CRISPR/Cas systems of IB and IIA types. All ST 121 isolates contained two types of identified adaptive immunity systems simultaneously in their genomes. Correlation analysis confirmed their functionality.Conclusion. We believe that the whole genome data obtained for the foodborne Listeria monocytogenes isolates will facilitate and complement further epidemiological studies of this pathogen, as well as the investigations of its genome variability in terms of the acquisition of various genetic elements associated with adaptation, antimicrobial resistance, and virulence. Moreover, the results of such studies will help to develop preventive measures to effectively solve problems associated with the bacterial contamination of animal products and ensure food safety in production conditions and the «farm-to-table» chain.
相关性。单核细胞增生李斯特菌是一种无处不在的细菌,可导致李斯特菌病,是一种广泛传播的传染病,目前对畜牧业生产造成了巨大破坏,并对人类健康构成严重威胁。分析俄罗斯联邦境内分离出的李斯特菌的种群结构并评估其致病潜力。共从食品中分离出 79 株李斯特菌。使用 VITEK MS 系统(bioMerieux,Marcyl'toile,法国)进行了菌种鉴定和抗生素耐药性表型分析。通过分析全基因组测序数据,对 35 株抗生素耐药性分离菌进行了鉴定。我们分析了 35 个食品来源的耐抗生素李斯特菌分离物的全基因组序列。我们确定了这一群体的克隆结构,发现了少量抗生素耐药性决定因子(fosX、tetM и сlpL)、大量毒力因子以及 CRISPR/Cas 系统的存在。大多数分离株属于系统发育线 II,分为 9 个克隆复合体,其中以 CC121 为主,它是具有流行病学意义的基因克隆之一。此外,还发现了两个属于致病性最强的系统发育系 I 的 CC2 分离物。13 个分离物的特征是存在 IB 和 IIA 类型的假定 CRISPR/Cas 系统。所有 ST 121 分离物的基因组中都同时含有两种类型的适应性免疫系统。相关性分析证实了它们的功能性。我们相信,从食源性单核细胞增生李斯特菌分离物中获得的全基因组数据将促进和补充对该病原体的进一步流行病学研究,以及对其基因组变异性的调查,即获得与适应性、抗菌药耐药性和毒力相关的各种遗传因子。此外,此类研究的结果将有助于制定预防措施,有效解决与动物产品细菌污染有关的问题,确保生产条件和 "从农场到餐桌 "链条中的食品安全。
{"title":"Heterogeneity of Antibiotic-Resistant Isolates of Listeria Monocytogenes Isolated from Food Products in Moscow","authors":"Y. V. Mikhailova, A. D. Molchanov, A. Shelenkov, M. Tyumentseva, K. Karbyshev, A. I. Tyumentsev, A. Egorova, N. G. Kulikova, I. N. Manzenyuk, V. G. Akimkin","doi":"10.31631/2073-3046-2023-22-6-108-123","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-108-123","url":null,"abstract":"Relevance. Listeria monocytogenes is a ubiquitous bacterium that causes listeriosis, which represents a widespread infectious disease currently inflicting great damage to livestock production and posing a serious threat to human health.Aim. To analyze the population structure and assess the pathogenic potential of Listeria monocytogenes isolates isolated on the territory of the Russian Federation.Materials and methods. A total of 79 listeria isolates were isolated from food products. Species identification and phenotypic analysis for antibiotic resistance were performed using VITEK MS system (bioMerieux, Marcyl’toile, France). Thirty-five antibiotic-resistant isolates were characterized by analysis of whole-genome sequencing data.Results. Whole genome sequences of thirty-five antibiotic-resistant Listeria monocytogenes isolates of food origin were analyzed. We determined clonal structure of this population and revealed a small number of antibiotic resistance determinants (fosX, tetM и сlpL), extensive set of virulence factors, as well as the presence of CRISPR/Cas systems. Most of the isolates belonged to phylogenetic line II and were divided into nine clonal complexes with the prevalence of CC121, which was one of the epidemiologically significant genetic clones. Two CC2 isolates belonging to the most pathogenic phylogenetic lineage I were also found. Thirteen isolates were characterized by the presence of putative CRISPR/Cas systems of IB and IIA types. All ST 121 isolates contained two types of identified adaptive immunity systems simultaneously in their genomes. Correlation analysis confirmed their functionality.Conclusion. We believe that the whole genome data obtained for the foodborne Listeria monocytogenes isolates will facilitate and complement further epidemiological studies of this pathogen, as well as the investigations of its genome variability in terms of the acquisition of various genetic elements associated with adaptation, antimicrobial resistance, and virulence. Moreover, the results of such studies will help to develop preventive measures to effectively solve problems associated with the bacterial contamination of animal products and ensure food safety in production conditions and the «farm-to-table» chain.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449588","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-90-98
A. A. Murzina, A. V. Zubkov, O. A. Svitich, A. Kaira
Relevance. On the territory of the Russian Federation, mass vaccination of the population is recognized as a priority health strategy against COVID-19, Gam-COVID-Vac vaccine has been widely used. The main risk group, which is subject to priority vaccination, are employees of medical organizations (MO). The determination of IgG to SARS-CoV-2 is an important parameter for assessing the intensity and duration of post-vaccination immunityAims. Study the immunological efficacy of the vaccine Gam-COVID-Vac used by employees of a psychiatric hospital and a regional hospital.Materials and methods. A study of the blood sera of 410 employees of two MO of various profiles who received one full course of the Gam-COVID-Vac» vaccine for the presence of IgG to RBD Spike SARS-CoV-2 using a set of reagents «SARS-CoV-2-IgG quantitative-ELISA-BEST» and IgG to NC SARS-CoV-2 using a set of reagents «ELISA anti-SARS-CoV-2 IgG».Results and discussion. Specific IgG to RBD Spike SARS-CoV-2 after vaccination with «Gam-COVIDVac » were found in 92.9% of psychiatric hospital staff and 98.0% of the regional hospital. Antibodies of class G to SARS-CoV-2 with a level of 300 BAU/ml or more were detected in 11.6% of psychiatric hospital staff and in 70.0% of regional hospitals, which is associated with the smallest proportion of persons in a psychiatric hospital with hybrid immunity than in a regional hospital (67.4% vs. 89.0%, respectively). A study of employees of the Ministry of Defense of various profiles revealed a difference in the level of IgG to RBD Spike SARS-CoV-2: 178.0 BAU/ml in a psychiatric hospital and 366.0 BAU/ml in a regional hospital. In a psychiatric hospital, the IgG level was highest up to 3 months after the completed vaccination – 166.4 BAU/ml, in a regional hospital from 3 to 6 months – 362.8 BAU/ml, then the number of antibodies decreases, which indicates the importance of monitoring for class G antibodies to SARS-CoV-2 at different times after vaccinations. Among the employees of the two MO, mild forms of the COVID-19 disease prevailed.Conclusion. Thus, the high immunological effectiveness of vaccination against COVID-19 with Gam-COVID-Vac was established in a group of employees of two MO, and the need for serological monitoring for the purpose of revaccination was also shown.
{"title":"Immunological Efficacy of Vaccination against COVID-19 in Employees of Medical Institutions of Various Profiles: Psychiatric Hospital and Regional Hospital","authors":"A. A. Murzina, A. V. Zubkov, O. A. Svitich, A. Kaira","doi":"10.31631/2073-3046-2023-22-6-90-98","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-90-98","url":null,"abstract":"Relevance. On the territory of the Russian Federation, mass vaccination of the population is recognized as a priority health strategy against COVID-19, Gam-COVID-Vac vaccine has been widely used. The main risk group, which is subject to priority vaccination, are employees of medical organizations (MO). The determination of IgG to SARS-CoV-2 is an important parameter for assessing the intensity and duration of post-vaccination immunityAims. Study the immunological efficacy of the vaccine Gam-COVID-Vac used by employees of a psychiatric hospital and a regional hospital.Materials and methods. A study of the blood sera of 410 employees of two MO of various profiles who received one full course of the Gam-COVID-Vac» vaccine for the presence of IgG to RBD Spike SARS-CoV-2 using a set of reagents «SARS-CoV-2-IgG quantitative-ELISA-BEST» and IgG to NC SARS-CoV-2 using a set of reagents «ELISA anti-SARS-CoV-2 IgG».Results and discussion. Specific IgG to RBD Spike SARS-CoV-2 after vaccination with «Gam-COVIDVac » were found in 92.9% of psychiatric hospital staff and 98.0% of the regional hospital. Antibodies of class G to SARS-CoV-2 with a level of 300 BAU/ml or more were detected in 11.6% of psychiatric hospital staff and in 70.0% of regional hospitals, which is associated with the smallest proportion of persons in a psychiatric hospital with hybrid immunity than in a regional hospital (67.4% vs. 89.0%, respectively). A study of employees of the Ministry of Defense of various profiles revealed a difference in the level of IgG to RBD Spike SARS-CoV-2: 178.0 BAU/ml in a psychiatric hospital and 366.0 BAU/ml in a regional hospital. In a psychiatric hospital, the IgG level was highest up to 3 months after the completed vaccination – 166.4 BAU/ml, in a regional hospital from 3 to 6 months – 362.8 BAU/ml, then the number of antibodies decreases, which indicates the importance of monitoring for class G antibodies to SARS-CoV-2 at different times after vaccinations. Among the employees of the two MO, mild forms of the COVID-19 disease prevailed.Conclusion. Thus, the high immunological effectiveness of vaccination against COVID-19 with Gam-COVID-Vac was established in a group of employees of two MO, and the need for serological monitoring for the purpose of revaccination was also shown.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449402","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-66-71
B. Aslanov, V. Kolodzhieva, E. Lebedeva, I. Tumanyan, Yu. D. Won, A. Mokhov, A. A. Dolgiy, A. E. Goncharov
Relevance. Infections caused by methicillin-resistant strains of Staphylococcus aureus are an urgent problem of hospital epidemiology, and control measures involve the development of new antimicrobials. Probiotics based on bacterial strains isolated fro natural habitats are considered promising means of combating MRSA.Aims. To test the possibility of using the Bacillus safensis 440-1 strain isolated from Antarctic soil. as an antibacterial agent for the treatment of experimental staphylococcal infection.Purpose of the study – check the possibility of using the Bacillus safensis 440-1 strain, isolated from Antarctic soil, as a topical antibacterial agent for the treatment of experimental staphylococcal infection.Material and methods. The potential virulence of Bacillus safensis strain 440-1 was studied on a mouse peritonitis model, and its activity against the methicillin-resistant Staphylococcus aureus SA776 test strain was studied on a localized wound infection model.Results and discussion. Our study demonstrated the safety of the tested strain due intraperitoneal use. We found that the use of the studied strain reduces the staphylococci amount in wounds from the third day from the start of the study to the end of the observation period, without aggravating the course of the infection.Conclusion. Bacillus safensis strain is a promising potential probiotic and it can be used as a part of complex antiseptic or disinfectant after additional studies aimed at developing an optimal mode of its use.
{"title":"The effect of Locally Applied Bacillus safensis Strain 440-1 from Antarctic Soil on the Course of Experimental Wound Staphylococcal Infection","authors":"B. Aslanov, V. Kolodzhieva, E. Lebedeva, I. Tumanyan, Yu. D. Won, A. Mokhov, A. A. Dolgiy, A. E. Goncharov","doi":"10.31631/2073-3046-2023-22-6-66-71","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-66-71","url":null,"abstract":"Relevance. Infections caused by methicillin-resistant strains of Staphylococcus aureus are an urgent problem of hospital epidemiology, and control measures involve the development of new antimicrobials. Probiotics based on bacterial strains isolated fro natural habitats are considered promising means of combating MRSA.Aims. To test the possibility of using the Bacillus safensis 440-1 strain isolated from Antarctic soil. as an antibacterial agent for the treatment of experimental staphylococcal infection.Purpose of the study – check the possibility of using the Bacillus safensis 440-1 strain, isolated from Antarctic soil, as a topical antibacterial agent for the treatment of experimental staphylococcal infection.Material and methods. The potential virulence of Bacillus safensis strain 440-1 was studied on a mouse peritonitis model, and its activity against the methicillin-resistant Staphylococcus aureus SA776 test strain was studied on a localized wound infection model.Results and discussion. Our study demonstrated the safety of the tested strain due intraperitoneal use. We found that the use of the studied strain reduces the staphylococci amount in wounds from the third day from the start of the study to the end of the observation period, without aggravating the course of the infection.Conclusion. Bacillus safensis strain is a promising potential probiotic and it can be used as a part of complex antiseptic or disinfectant after additional studies aimed at developing an optimal mode of its use.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449103","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-124-132
O. P. Chernyavskaya, N. A. Kononenko, K. N. Kabakova, N. M. Obolskaya
Relevance. Widespread use of endoscopic methods in diagnosis and treatment increases the potential risks of infection of patients in case of improper handling of flexible endoscopes. The main cause of the problem is inattention, low level of competence of personnel. One of the best solutions to this problem is to provide documentation (standard operating procedure – SOP) regulating the processes of handling flexible endoscopes in medical organizations in order to minimize the human factor.Aim. The Development of the SOP for processing of a flexible nasal pharyngeal mirror adjusted for the epidemiological risks of nonsterile endoscopic interventions.Materials & Methods. The epidemiological risks of non-sterile endoscopic interventions were evaluated on the basis of scientific publications and statutory regulations, and the example of SOP was introduced for the flexible nasal pharyngeal mirror.Results. Considering the factors, causing development of infections, related to delivery of health care, and requirements of the sanitary law, a sample of SOP was designed for manual processing of the flexible nasal pharyngeal mirror. Moreover, The main courses were defined, which should be followed by health-care workers while developing of SOP in a healthcare organization.Conclusions. The standardization of the procedure of processing of the flexible endoscopes allows to perform manipulations after clearly developed algorithm, excludes misunderstanding from the stuff, reduces the quantity of faults and mistakes and, as result, reduces probability of the healthcare-associated infections (HAI).
{"title":"Methodology for the Development of a Standard Operating Procedure for Reprocessing Flexible Endoscope, Taking into Account the Epidemiological Risks","authors":"O. P. Chernyavskaya, N. A. Kononenko, K. N. Kabakova, N. M. Obolskaya","doi":"10.31631/2073-3046-2023-22-6-124-132","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-124-132","url":null,"abstract":"Relevance. Widespread use of endoscopic methods in diagnosis and treatment increases the potential risks of infection of patients in case of improper handling of flexible endoscopes. The main cause of the problem is inattention, low level of competence of personnel. One of the best solutions to this problem is to provide documentation (standard operating procedure – SOP) regulating the processes of handling flexible endoscopes in medical organizations in order to minimize the human factor.Aim. The Development of the SOP for processing of a flexible nasal pharyngeal mirror adjusted for the epidemiological risks of nonsterile endoscopic interventions.Materials & Methods. The epidemiological risks of non-sterile endoscopic interventions were evaluated on the basis of scientific publications and statutory regulations, and the example of SOP was introduced for the flexible nasal pharyngeal mirror.Results. Considering the factors, causing development of infections, related to delivery of health care, and requirements of the sanitary law, a sample of SOP was designed for manual processing of the flexible nasal pharyngeal mirror. Moreover, The main courses were defined, which should be followed by health-care workers while developing of SOP in a healthcare organization.Conclusions. The standardization of the procedure of processing of the flexible endoscopes allows to perform manipulations after clearly developed algorithm, excludes misunderstanding from the stuff, reduces the quantity of faults and mistakes and, as result, reduces probability of the healthcare-associated infections (HAI).","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449210","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}
Pub Date : 2024-01-06DOI: 10.31631/2073-3046-2023-22-6-133-138
M. P. Kostinov, Chen Zhang, I. A. Khrapunova, A. S. Pechenik, V. A. Brazhnik, V. A. Utkin, M. N. Laktionova, A. V. Linok, S. Raicic
Relevance. COVID-19 vaccination reduces mortality and the course of severe diseases. However, there is an insufficiency of studies evaluating factors leading to infection among COVID-19 vaccinated individuals.Aim. Identification of epidemiological features that distinguish cases of the disease in vaccinated and unvaccinated cohorts.Materials and methods. The analysis of the incidence of COVID-19 in 1126 hospitalized patients in the period from 23.06.2021 to 01.05.2022 was carried out taking into account the presence or absence of vaccination against the SARS-CoV-2 virus.Results. It was found that the risk of COVID-19 getting sick in the unimmunized was 1.5 times higher than in the vaccinated (p < 0.05). The incidence of hospitalization, due to the severity of the condition (moderate, severe and extremely severe), in unvaccinated people with no history of comorbidities, is more than 3 times higher than in vaccinated people (p < 0.05) in the same group. The probability of death from COVID-19 among vaccinated people is 1.5 times lower than among unimmunized people (p < 0.05). The age characteristic of mortality in vaccinated people shifts to the «senile» age (76.93 ± 1.32), while among the unimmunized, the age of death is closer to the category of «elderly» (73.74 ± 1.39 years) (p ≤ 0.05). In the structure of mortality among the vaccinated, the main share was made up of patients with a history of 3 to 7 concomitant systemic diseases (66.7%), while among the unvaccinated, the main share (74.5%) were patients either without comorbidities or with a history of 1 to 2 concomitant diseases.Conclusion. The results of the epidemiological features of the COVID-2 epidemic process have shown that vaccination against the SARS-CoV-2 virus is vital for elderly and senile people with comorbid conditions.
{"title":"Rationale for Vaccination against COVID-19 among Elderly and Senile People with Comorbid Conditions","authors":"M. P. Kostinov, Chen Zhang, I. A. Khrapunova, A. S. Pechenik, V. A. Brazhnik, V. A. Utkin, M. N. Laktionova, A. V. Linok, S. Raicic","doi":"10.31631/2073-3046-2023-22-6-133-138","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-133-138","url":null,"abstract":"Relevance. COVID-19 vaccination reduces mortality and the course of severe diseases. However, there is an insufficiency of studies evaluating factors leading to infection among COVID-19 vaccinated individuals.Aim. Identification of epidemiological features that distinguish cases of the disease in vaccinated and unvaccinated cohorts.Materials and methods. The analysis of the incidence of COVID-19 in 1126 hospitalized patients in the period from 23.06.2021 to 01.05.2022 was carried out taking into account the presence or absence of vaccination against the SARS-CoV-2 virus.Results. It was found that the risk of COVID-19 getting sick in the unimmunized was 1.5 times higher than in the vaccinated (p < 0.05). The incidence of hospitalization, due to the severity of the condition (moderate, severe and extremely severe), in unvaccinated people with no history of comorbidities, is more than 3 times higher than in vaccinated people (p < 0.05) in the same group. The probability of death from COVID-19 among vaccinated people is 1.5 times lower than among unimmunized people (p < 0.05). The age characteristic of mortality in vaccinated people shifts to the «senile» age (76.93 ± 1.32), while among the unimmunized, the age of death is closer to the category of «elderly» (73.74 ± 1.39 years) (p ≤ 0.05). In the structure of mortality among the vaccinated, the main share was made up of patients with a history of 3 to 7 concomitant systemic diseases (66.7%), while among the unvaccinated, the main share (74.5%) were patients either without comorbidities or with a history of 1 to 2 concomitant diseases.Conclusion. The results of the epidemiological features of the COVID-2 epidemic process have shown that vaccination against the SARS-CoV-2 virus is vital for elderly and senile people with comorbid conditions.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449547","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}
Pub Date : 2024-01-05DOI: 10.31631/2073-3046-2023-22-6-54-65
N. G. Davidova, S. Ugleva, S. Shabalina
Relevance. COVID-19 remains an urgent disease for long-term care institutions (LTCI), because local outbreaks of COVID-19 continue to be registered in 2022 and in 2023.Aims. To study the epidemic process of COVID-19 in LTCI (nursing homes, neuropsychiatric boarding schools) in Moscow for 2020–2022.Materials and methods. The analysis of the epidemic process of COVID-19 in LTCI was carried out for the period 2020–2022. Data of Automatic information system «Department of Registration and Accounting of Infectious Diseases was used: 5390 COVID-19 residents and employees of 28 institutions in Moscow and 3,239,617 residents of Moscow; 15 acts of epidemiological investigation of the focus of infectious disease in the period from 2020 to 2022.Results. In total, 9 increases in the incidence of COVID-19 were registered. The first rise was the most intense, which affected morbidity (81.14 per 1,000 beds per week), indicators of activity of epidemic foci (KO – 100%, IO – 21.08, R – 20.08), mortality (for 2020 – 32.6%). In the first rise of morbidity in nursing homes, there is a direct correlation of a high degree of connection with the morbidity of the population of Moscow (r = 0.906), and for subsequent rises there is a noticeable relationship (r = 0.580) at p<0.05. From 2 to 9 rises, the incidence tended to decrease. All the rises of COVID-19 occurred due to the formation of foci in institutions where the source of infection was employees. For 2020–2022, the proportion of severe cases of infection with a fatal outcome among residents ranged from 14.6 ±6.7% to 31.8 ± 6.5%.Conclusion. The analysis of the manifestations of the COVID-19 epidemic process in long-term care institutions in Moscow for 2020–2022 allowed us to distinguish two stages of morbidity.
{"title":"The COVID-19 Epidemic Process in Long-Term Care Facilities in Moscow","authors":"N. G. Davidova, S. Ugleva, S. Shabalina","doi":"10.31631/2073-3046-2023-22-6-54-65","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-54-65","url":null,"abstract":"Relevance. COVID-19 remains an urgent disease for long-term care institutions (LTCI), because local outbreaks of COVID-19 continue to be registered in 2022 and in 2023.Aims. To study the epidemic process of COVID-19 in LTCI (nursing homes, neuropsychiatric boarding schools) in Moscow for 2020–2022.Materials and methods. The analysis of the epidemic process of COVID-19 in LTCI was carried out for the period 2020–2022. Data of Automatic information system «Department of Registration and Accounting of Infectious Diseases was used: 5390 COVID-19 residents and employees of 28 institutions in Moscow and 3,239,617 residents of Moscow; 15 acts of epidemiological investigation of the focus of infectious disease in the period from 2020 to 2022.Results. In total, 9 increases in the incidence of COVID-19 were registered. The first rise was the most intense, which affected morbidity (81.14 per 1,000 beds per week), indicators of activity of epidemic foci (KO – 100%, IO – 21.08, R – 20.08), mortality (for 2020 – 32.6%). In the first rise of morbidity in nursing homes, there is a direct correlation of a high degree of connection with the morbidity of the population of Moscow (r = 0.906), and for subsequent rises there is a noticeable relationship (r = 0.580) at p<0.05. From 2 to 9 rises, the incidence tended to decrease. All the rises of COVID-19 occurred due to the formation of foci in institutions where the source of infection was employees. For 2020–2022, the proportion of severe cases of infection with a fatal outcome among residents ranged from 14.6 ±6.7% to 31.8 ± 6.5%.Conclusion. The analysis of the manifestations of the COVID-19 epidemic process in long-term care institutions in Moscow for 2020–2022 allowed us to distinguish two stages of morbidity.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449374","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}
Pub Date : 2024-01-05DOI: 10.31631/2073-3046-2023-22-6-44-53
K. Lomonosov
Relevance. According to WHO, the number of patients with a new coronavirus infection amounted to more than 676 million people for the period from January 2020 to January 2023. It is obvious that the consequences of COVID-19 will prevail in medical practice in the coming years, so medical rehabilitation should be the focus of attention when providing medical care to patients with coronavirus infection.Aims. To investigate the approach to physicians' selection of rehabilitation interventions for patients who have undergone Covid-19.Materials and methods. The analysis of 1832 case histories of patients of one of the temporary covid hospitals in Moscow, who are being treated in the hospital in 2020–2022, was carried out. Statistical analysis was carried out using the StatTech v. 3.1.3 program (developed by Stattech LLC, Russia). Predictive models characterizing adherence to rehabilitation measures were developed using the logistic regression method.Results and discussions. The analysis of predictors of statistically significant regression models showed that when deciding on the appointment of rehabilitation measures or additional consultation when a patient is discharged from the hospital, doctors rely on pathologies already present in patients before COVID-19 disease, without taking into account the occurrence of possible pathology after a new coronavirus infection in any organ system. For example, the appointment of a cardiologist's consultation increases 6 times in the presence of a history of cardiovascular diseases or atherosclerosis and 10 times in the presence of cardiovascular diseases and atherosclerosis at the same time. The presence of bronchial asthma increased the probability of consulting a pulmonologist by almost 3 times, and in the absence of diabetes mellitus, the probability of getting additional advice from an endocrinologist decreased by 11 times.Conclusions. An individual rehabilitation plan should take into account the severity of the COVID-19 disease, the degree of damage to the lung tissue, heart, blood vessels and other organs. The regression models can be used for economic analysis in order to identify the need for working hours and the number of medical workers necessary to ensure the optimal volume and effectiveness of rehabilitation measures for patients who have suffered a new coronavirus infection.
{"title":"Doctors' Choice of Rehabilitation Measures for Patients Who Have Suffered Covid-19","authors":"K. Lomonosov","doi":"10.31631/2073-3046-2023-22-6-44-53","DOIUrl":"https://doi.org/10.31631/2073-3046-2023-22-6-44-53","url":null,"abstract":"Relevance. According to WHO, the number of patients with a new coronavirus infection amounted to more than 676 million people for the period from January 2020 to January 2023. It is obvious that the consequences of COVID-19 will prevail in medical practice in the coming years, so medical rehabilitation should be the focus of attention when providing medical care to patients with coronavirus infection.Aims. To investigate the approach to physicians' selection of rehabilitation interventions for patients who have undergone Covid-19.Materials and methods. The analysis of 1832 case histories of patients of one of the temporary covid hospitals in Moscow, who are being treated in the hospital in 2020–2022, was carried out. Statistical analysis was carried out using the StatTech v. 3.1.3 program (developed by Stattech LLC, Russia). Predictive models characterizing adherence to rehabilitation measures were developed using the logistic regression method.Results and discussions. The analysis of predictors of statistically significant regression models showed that when deciding on the appointment of rehabilitation measures or additional consultation when a patient is discharged from the hospital, doctors rely on pathologies already present in patients before COVID-19 disease, without taking into account the occurrence of possible pathology after a new coronavirus infection in any organ system. For example, the appointment of a cardiologist's consultation increases 6 times in the presence of a history of cardiovascular diseases or atherosclerosis and 10 times in the presence of cardiovascular diseases and atherosclerosis at the same time. The presence of bronchial asthma increased the probability of consulting a pulmonologist by almost 3 times, and in the absence of diabetes mellitus, the probability of getting additional advice from an endocrinologist decreased by 11 times.Conclusions. An individual rehabilitation plan should take into account the severity of the COVID-19 disease, the degree of damage to the lung tissue, heart, blood vessels and other organs. The regression models can be used for economic analysis in order to identify the need for working hours and the number of medical workers necessary to ensure the optimal volume and effectiveness of rehabilitation measures for patients who have suffered a new coronavirus infection.","PeriodicalId":11736,"journal":{"name":"Epidemiology and Vaccinal Prevention","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139450468","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}