Pub Date : 2008-11-01DOI: 10.1177/1469044608098324
A. Maclean, Rachel M Fuller, Elizabeth G Jaffrey, A. J. Hay, D. Ho-Yen
A pilot study using an integrated care pathway (ICP) when caring for patients suffering from Clostridium difficile associated disease (CDAD) was undertaken over a six-month period within six wards in two hospitals. The aim was to standardise practice and improve communications for this group of patients. There was increased staff knowledge and understanding with 91% of nursing staff reporting that the use of a CDAD ICP had improved patient care and treatment. Seventy-seven per cent of staff expressed that communications had improved since using the ICP and 77% felt that accessibility of patient information had improved. Lastly 86% of the staff felt better equipped to nurse patients with CDAD. A literature review yielded no other documented evidence of the use of an ICP for this patient group.
{"title":"Integrated care pathway for Clostridium difficile helps patient management","authors":"A. Maclean, Rachel M Fuller, Elizabeth G Jaffrey, A. J. Hay, D. Ho-Yen","doi":"10.1177/1469044608098324","DOIUrl":"https://doi.org/10.1177/1469044608098324","url":null,"abstract":"A pilot study using an integrated care pathway (ICP) when caring for patients suffering from Clostridium difficile associated disease (CDAD) was undertaken over a six-month period within six wards in two hospitals. The aim was to standardise practice and improve communications for this group of patients. There was increased staff knowledge and understanding with 91% of nursing staff reporting that the use of a CDAD ICP had improved patient care and treatment. Seventy-seven per cent of staff expressed that communications had improved since using the ICP and 77% felt that accessibility of patient information had improved. Lastly 86% of the staff felt better equipped to nurse patients with CDAD. A literature review yielded no other documented evidence of the use of an ICP for this patient group.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114648550","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 : 2008-11-01DOI: 10.1177/1469044608098709
M. Kiernan
{"title":"The First European Union Antibiotic Awareness Day: raising awareness to protect the future","authors":"M. Kiernan","doi":"10.1177/1469044608098709","DOIUrl":"https://doi.org/10.1177/1469044608098709","url":null,"abstract":"","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120956724","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 : 2008-11-01DOI: 10.1177/1469044608098325
C. Kilpatrick, J. Prieto, N. Wigglesworth
A variety of infection prevention and control precautions are used to minimise the risk of infection spread from person to person, both patients and staff. Standard Precautions (SPs), including hand hygiene and use of personal protective equipment (PPE), are applied routinely to all patients, whereas transmission-based precautions (TBPs) are used when a patient is known or suspected to have an epidemiologically important infectious disease or condition, in order to further reduce the risk of spread of infection. The use of single room isolation is part of TBPs and is a cornerstone of hospital infection prevention and control practice. However, successfully implementing TBPs, including single room isolation, continues to be a challenge in the UK for a number of reasons. Effective approaches to increasing the quality and safety of patient care are increasingly based on utilising simple tools that increase the likelihood that care will be provided in a reliable way. The tool presented is intended to facilitate both learning and practice in relation to TBPs and to promote the delivery of safe patient care in relation to single room isolation. It is designed for use in those situations when a single room is available for patient isolation. It also highlights the other important TBPs to be taken to prevent the spread of infection, whether or not a single room is available. It can be adapted for use with any organism or disease for which TBPs are recommended. At a time when healthcare associated infections (HCAI) such as Clostridium difficile and meticillin resistant Staphylococcus aureus (MRSA) continue to have an impact on both acute and community care settings, and their reduction is embedded within national targets for NHS healthcare providers, tools that make it easy for healthcare workers to apply safe practices within their daily routines are essential. Initial testing suggests that this tool is acceptable to healthcare workers and further study will identify its potential contribution to healthcare workers' knowledge and practice in this area.
{"title":"Single room isolation to prevent the transmission of infection: development of a patient journey tool to support safe practice","authors":"C. Kilpatrick, J. Prieto, N. Wigglesworth","doi":"10.1177/1469044608098325","DOIUrl":"https://doi.org/10.1177/1469044608098325","url":null,"abstract":"A variety of infection prevention and control precautions are used to minimise the risk of infection spread from person to person, both patients and staff. Standard Precautions (SPs), including hand hygiene and use of personal protective equipment (PPE), are applied routinely to all patients, whereas transmission-based precautions (TBPs) are used when a patient is known or suspected to have an epidemiologically important infectious disease or condition, in order to further reduce the risk of spread of infection. The use of single room isolation is part of TBPs and is a cornerstone of hospital infection prevention and control practice. However, successfully implementing TBPs, including single room isolation, continues to be a challenge in the UK for a number of reasons. Effective approaches to increasing the quality and safety of patient care are increasingly based on utilising simple tools that increase the likelihood that care will be provided in a reliable way. The tool presented is intended to facilitate both learning and practice in relation to TBPs and to promote the delivery of safe patient care in relation to single room isolation. It is designed for use in those situations when a single room is available for patient isolation. It also highlights the other important TBPs to be taken to prevent the spread of infection, whether or not a single room is available. It can be adapted for use with any organism or disease for which TBPs are recommended. At a time when healthcare associated infections (HCAI) such as Clostridium difficile and meticillin resistant Staphylococcus aureus (MRSA) continue to have an impact on both acute and community care settings, and their reduction is embedded within national targets for NHS healthcare providers, tools that make it easy for healthcare workers to apply safe practices within their daily routines are essential. Initial testing suggests that this tool is acceptable to healthcare workers and further study will identify its potential contribution to healthcare workers' knowledge and practice in this area.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122238688","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 : 2008-11-01DOI: 10.1177/1469044607097219
Shui Shan Lee, B. Yau, Joe Huang, J. You
A telephone survey was conducted in Hong Kong and Sydney to identify factors associated with appropriate antibiotic use in the community. The overall knowledge score was high in both cities. Satisfactory knowledge and appropriate attitude were associated with age >40, residency in Sydney, and a higher education level. Both residency in Sydney and good antibiotic knowledge were predictors of appropriate attitude. There was a higher expectation of antibiotics for minor ailments in Hong Kong than Sydney. In both cities, Sydney in particular, expectation for antibiotic prescription increased when one was sick or when there was fever. Completion of full course of treatment and a positive attitude were, however, associated with a good knowledge of antibiotics, irrespective of one's residency and demographics. The promotion of proper use of antibiotic requires not just good knowledge and a positive attitude, but an understanding of one's expectations at different stages of illnesses.
{"title":"Determinants of appropriate antibiotic use in the community — a survey in Sydney and Hong Kong","authors":"Shui Shan Lee, B. Yau, Joe Huang, J. You","doi":"10.1177/1469044607097219","DOIUrl":"https://doi.org/10.1177/1469044607097219","url":null,"abstract":"A telephone survey was conducted in Hong Kong and Sydney to identify factors associated with appropriate antibiotic use in the community. The overall knowledge score was high in both cities. Satisfactory knowledge and appropriate attitude were associated with age >40, residency in Sydney, and a higher education level. Both residency in Sydney and good antibiotic knowledge were predictors of appropriate attitude. There was a higher expectation of antibiotics for minor ailments in Hong Kong than Sydney. In both cities, Sydney in particular, expectation for antibiotic prescription increased when one was sick or when there was fever. Completion of full course of treatment and a positive attitude were, however, associated with a good knowledge of antibiotics, irrespective of one's residency and demographics. The promotion of proper use of antibiotic requires not just good knowledge and a positive attitude, but an understanding of one's expectations at different stages of illnesses.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128663355","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 : 2008-11-01DOI: 10.1177/1469044607097220
Yvonne Hanson, S. Honey
Healthcare associated infections cost the National Health Service around £1 billion each year and cause pain and reduced quality of life. Essential Steps to Safe, Clean Care was introduced by the Department of Health in 2006 and was aimed at organisations that provide and commission health and social services in community and non-acute settings. The engagement and empowerment of frontline clinical staff, especially the infection, prevention and control linkworkers, was central to the programme. This article describes the process by which Essential Steps was introduced and implemented in a teaching primary care trust and how the changes required were managed.
{"title":"Essential Steps to Safe, Clean Care: The process of managing change","authors":"Yvonne Hanson, S. Honey","doi":"10.1177/1469044607097220","DOIUrl":"https://doi.org/10.1177/1469044607097220","url":null,"abstract":"Healthcare associated infections cost the National Health Service around £1 billion each year and cause pain and reduced quality of life. Essential Steps to Safe, Clean Care was introduced by the Department of Health in 2006 and was aimed at organisations that provide and commission health and social services in community and non-acute settings. The engagement and empowerment of frontline clinical staff, especially the infection, prevention and control linkworkers, was central to the programme. This article describes the process by which Essential Steps was introduced and implemented in a teaching primary care trust and how the changes required were managed.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123539537","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 : 2008-09-01DOI: 10.1177/1469044608095537
J. E. Grice, Ibraham Roushdi, D. Ricketts
Introduction: Hand cleansing with alcohol gel is important in reducing health care associated infection (HCAI). HCAI affects 8% of acute hospital admissions in the UK costing the NHS an estimated ®1 billion per annum1. The aim of this study was to determine the effect of posters and placement of alcohol dispensers on use of alcohol dispensers by staff and visitors passing through hospital foyers. Method: We noted the use of alcohol gel for hand cleansing in pedestrians entering through the hospital foyers. Three scenarios were noted: ■ Display 1. Poster and gel dispenser in the centre of the foyer. ■ Display 2. Poster and gel dispenser on the wall of the foyer. ■ Display 3. No poster with a gel dispenser on the wall of the foyer. Results: For display 1 uptake of alcohol gel was 38.4%, for display 2 it was 8.6% and for display 3 it was 2.7%. There was a significant increase in uptake of alcohol hand cleansing when a display was used (p > 0.001). Regarding gender, males were better users of alcohol hand gel overall. Employment group: the highest use was amongst female visitors with display 1 (51.6%). Displays had least influence on male doctors (44% with display 1, 10% with display 3). Conclusion: We recommend the use of prominently placed posters and gel dispensers in hospital foyers.
{"title":"The effect of posters and displays on the use of alcohol gel","authors":"J. E. Grice, Ibraham Roushdi, D. Ricketts","doi":"10.1177/1469044608095537","DOIUrl":"https://doi.org/10.1177/1469044608095537","url":null,"abstract":"Introduction: Hand cleansing with alcohol gel is important in reducing health care associated infection (HCAI). HCAI affects 8% of acute hospital admissions in the UK costing the NHS an estimated ®1 billion per annum1. The aim of this study was to determine the effect of posters and placement of alcohol dispensers on use of alcohol dispensers by staff and visitors passing through hospital foyers. Method: We noted the use of alcohol gel for hand cleansing in pedestrians entering through the hospital foyers. Three scenarios were noted: ■ Display 1. Poster and gel dispenser in the centre of the foyer. ■ Display 2. Poster and gel dispenser on the wall of the foyer. ■ Display 3. No poster with a gel dispenser on the wall of the foyer. Results: For display 1 uptake of alcohol gel was 38.4%, for display 2 it was 8.6% and for display 3 it was 2.7%. There was a significant increase in uptake of alcohol hand cleansing when a display was used (p > 0.001). Regarding gender, males were better users of alcohol hand gel overall. Employment group: the highest use was amongst female visitors with display 1 (51.6%). Displays had least influence on male doctors (44% with display 1, 10% with display 3). Conclusion: We recommend the use of prominently placed posters and gel dispensers in hospital foyers.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114664657","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 : 2008-09-01DOI: 10.1177/1469044608094720
P. Cryer, T. Cooper
Since July 2007 the Department of Health (DH) in England and the NHS Purchasing and Supply Agency (NHS PASA) have been working jointly and have developed the HCAI Technology Innovation Programme, which has been formally acknowledged in the DH HCAI strategy for 2008 — Clean Safe Care (DH, 2008). Funding has been made available to support the programme as part of the Comprehensive Spending Review for 2008-09. This paper provides an overview of the programme including the predicted benefits and outcomes. The actual outcomes from the programme will be published as academic papers in a range of journals, including the journal of the Infection Prevention Society.
{"title":"HCAI Technology Innovation Programme — Helping to get evidence into practice","authors":"P. Cryer, T. Cooper","doi":"10.1177/1469044608094720","DOIUrl":"https://doi.org/10.1177/1469044608094720","url":null,"abstract":"Since July 2007 the Department of Health (DH) in England and the NHS Purchasing and Supply Agency (NHS PASA) have been working jointly and have developed the HCAI Technology Innovation Programme, which has been formally acknowledged in the DH HCAI strategy for 2008 — Clean Safe Care (DH, 2008). Funding has been made available to support the programme as part of the Comprehensive Spending Review for 2008-09. This paper provides an overview of the programme including the predicted benefits and outcomes. The actual outcomes from the programme will be published as academic papers in a range of journals, including the journal of the Infection Prevention Society.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122111170","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 : 2008-09-01DOI: 10.1177/1469044608093936
D. Talon, L. Excoffon, M. Tiv, Alexis Pinçon, H. Gbaguidi-Haore, Xavier Bertrand
To investigate the environmental contamination of rooms of patients colonised with meticillin resistant Staphylococcus aureus (MRSA), we conducted a prospective study during a five month period in a French university hospital. Environmental samples were taken once per week for each MRSA included patient, until the patient was discharged. The surfaces swabbed were the covers, the lifting pole, the bed bars, the table and the trolley. A 500-litre air sample was collected with an impactor air sampler, and a Petri dish was left open in the room for two hours. The aims of the study were to assess the impact of nasal decolonisation and dressing changes on the day of sampling on environmental contamination of the room. Thirty patients were included in this study. In total, 37.5% of the rooms tested positive: surface samples were positive in 11.8% of cases (39/320), and air samples were positive in 17.9% of cases (23/128). Much higher levels of contamination were observed on days on which dressings were changed, in the absence of nasal decolonisation with mupirocin. This study shows that the environment is often contaminated in the rooms of patients with MRSA. Our results are consistent with the findings of other studies suggesting that the environment may play an important role in the persistence of hospital epidemics, and that this contamination should be taken into account in the organisation and delivery of care and in evaluations of preventive measures.
{"title":"Environmental reservoirs of meticillin resistant Staphylococcus aureus in patients' rooms: Potential impact on care practices","authors":"D. Talon, L. Excoffon, M. Tiv, Alexis Pinçon, H. Gbaguidi-Haore, Xavier Bertrand","doi":"10.1177/1469044608093936","DOIUrl":"https://doi.org/10.1177/1469044608093936","url":null,"abstract":"To investigate the environmental contamination of rooms of patients colonised with meticillin resistant Staphylococcus aureus (MRSA), we conducted a prospective study during a five month period in a French university hospital. Environmental samples were taken once per week for each MRSA included patient, until the patient was discharged. The surfaces swabbed were the covers, the lifting pole, the bed bars, the table and the trolley. A 500-litre air sample was collected with an impactor air sampler, and a Petri dish was left open in the room for two hours. The aims of the study were to assess the impact of nasal decolonisation and dressing changes on the day of sampling on environmental contamination of the room. Thirty patients were included in this study. In total, 37.5% of the rooms tested positive: surface samples were positive in 11.8% of cases (39/320), and air samples were positive in 17.9% of cases (23/128). Much higher levels of contamination were observed on days on which dressings were changed, in the absence of nasal decolonisation with mupirocin. This study shows that the environment is often contaminated in the rooms of patients with MRSA. Our results are consistent with the findings of other studies suggesting that the environment may play an important role in the persistence of hospital epidemics, and that this contamination should be taken into account in the organisation and delivery of care and in evaluations of preventive measures.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128332381","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 : 2008-09-01DOI: 10.1177/1469044608093959
S. Wiseman, Gawesh Jawaheer, P. Kostkova, G. Madle
{"title":"Editorial: Specialist Digital Libraries — National Resource for Infection Control (NRIC) — Information overload or underload? (www.nric.org.uk)","authors":"S. Wiseman, Gawesh Jawaheer, P. Kostkova, G. Madle","doi":"10.1177/1469044608093959","DOIUrl":"https://doi.org/10.1177/1469044608093959","url":null,"abstract":"","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124901409","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 : 2008-09-01DOI: 10.1177/1469044608095540
A. McLaughlin, J. Canavan, E. Adams, R. Mcdonagh, H. Brar, Gerard J. Fitzpatrick, M. Donnelly
Our aim was to assess, for the first time, the know-ledge and perception of meticillin resistant Staphylococcus aureus (MRSA) among the general public and a group of hospital visitors. Five hundred and forty five participants completed the survey, 24 (4.4%) had not heard of MRSA and were excluded from further analysis; 345 members of the public and 176 hospital visitors remained. Twenty four (4.4%) of the public and two of the hospital visitors had a personal history of MRSA and thus formed a discrete group. The majority of participants thought that MRSA transmission could be reduced by hand washing. MRSA evoked a strong emotive response, 61% agreeing they would be angry and 80.9% agreeing that they would feel fearful if diagnosed with MRSA. The public are generally knowledgeable about MRSA but most agreed that they would feel angry and afraid by its diagnosis. Future public education campaigns on MRSA should be aware of this response.
{"title":"A survey of MRSA awareness and knowledge among the general public and patients' visitors","authors":"A. McLaughlin, J. Canavan, E. Adams, R. Mcdonagh, H. Brar, Gerard J. Fitzpatrick, M. Donnelly","doi":"10.1177/1469044608095540","DOIUrl":"https://doi.org/10.1177/1469044608095540","url":null,"abstract":"Our aim was to assess, for the first time, the know-ledge and perception of meticillin resistant Staphylococcus aureus (MRSA) among the general public and a group of hospital visitors. Five hundred and forty five participants completed the survey, 24 (4.4%) had not heard of MRSA and were excluded from further analysis; 345 members of the public and 176 hospital visitors remained. Twenty four (4.4%) of the public and two of the hospital visitors had a personal history of MRSA and thus formed a discrete group. The majority of participants thought that MRSA transmission could be reduced by hand washing. MRSA evoked a strong emotive response, 61% agreeing they would be angry and 80.9% agreeing that they would feel fearful if diagnosed with MRSA. The public are generally knowledgeable about MRSA but most agreed that they would feel angry and afraid by its diagnosis. Future public education campaigns on MRSA should be aware of this response.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133716093","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}
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