{"id":"https://openalex.org/W7118082011","doi":"https://doi.org/10.12775/qs.2025.49.67356","title":"A Review of Candida auris: Environmental Persistence and Evidence-Based Decontamination and Prevention Strategies","display_name":"A Review of Candida auris: Environmental Persistence and Evidence-Based Decontamination and Prevention Strategies","publication_year":2026,"publication_date":"2026-01-03","ids":{"openalex":"https://openalex.org/W7118082011","doi":"https://doi.org/10.12775/qs.2025.49.67356"},"language":"en","primary_location":{"id":"doi:10.12775/qs.2025.49.67356","doi":"https://doi.org/10.12775/qs.2025.49.67356","is_oa":true,"landing_page_url":"https://doi.org/10.12775/qs.2025.49.67356","pdf_url":"https://apcz.umk.pl/QS/article/download/67356/44950","source":{"id":"https://openalex.org/S4210230959","display_name":"Quality in Sport","issn_l":"2450-3118","issn":["2450-3118"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["ddh","erih-plus","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310317346","host_organization_name":"Kazimierz Wielki University in Bydgoszcz","host_organization_lineage":["https://openalex.org/P4310317346"],"host_organization_lineage_names":["Kazimierz Wielki University in Bydgoszcz"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality in Sport","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://apcz.umk.pl/QS/article/download/67356/44950","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5120643960","display_name":"Marta Krzy\u017caniak","orcid":"https://orcid.org/0009-0001-4125-7553","observed_orcids":["https://orcid.org/0009-0001-4125-7553"]},"institutions":[{"id":"https://openalex.org/I4387153159","display_name":"Szpital Morski im. PCK","ror":"https://ror.org/01akcbx94","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4387153159"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Marta Krzyzaniak","raw_affiliation_strings":["PCK Maritime Hospital in Gdynia, 1 Powstania Styczniowego Strett, 81-519 Gdynia, Poland"],"raw_orcid":"https://orcid.org/0009-0001-4125-7553","affiliations":[{"raw_affiliation_string":"PCK Maritime Hospital in Gdynia, 1 Powstania Styczniowego Strett, 81-519 Gdynia, Poland","institution_ids":["https://openalex.org/I4387153159"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5118636919","display_name":"Izabela Brynczka","orcid":"https://orcid.org/0009-0002-1527-5659","observed_orcids":["https://orcid.org/0009-0002-1527-5659"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Izabela Brynczka","raw_affiliation_strings":["Ludwik Rydygier Specialist Hospital,   1 Z\u0142ota Jesie\u0144 Street,  31-826 Krak\u00f3w, Poland"],"raw_orcid":"https://orcid.org/0009-0002-1527-5659","affiliations":[{"raw_affiliation_string":"Ludwik Rydygier Specialist Hospital,   1 Z\u0142ota Jesie\u0144 Street,  31-826 Krak\u00f3w, Poland","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120694460","display_name":"Klaudia Martyna Patrzyk\u0105t","orcid":"https://orcid.org/0009-0000-9440-5444","observed_orcids":["https://orcid.org/0009-0000-9440-5444"]},"institutions":[{"id":"https://openalex.org/I4405261599","display_name":"109 Szpital Wojskowy z Przychodni\u0105 w Szczecinie","ror":"https://ror.org/05j7wbb86","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4405261599"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Klaudia Martyna Patrzyk\u0105t","raw_affiliation_strings":["109 Military Hospital with Policlinic in Szczecin, Piotra Skargi 9-11 Street, 70-965 Szczecin, Poland"],"raw_orcid":"https://orcid.org/0009-0000-9440-5444","affiliations":[{"raw_affiliation_string":"109 Military Hospital with Policlinic in Szczecin, Piotra Skargi 9-11 Street, 70-965 Szczecin, Poland","institution_ids":["https://openalex.org/I4405261599"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120694461","display_name":"Zofia Gorzoch-Burduk","orcid":"https://orcid.org/0009-0001-6457-4105","observed_orcids":["https://orcid.org/0009-0001-6457-4105"]},"institutions":[{"id":"https://openalex.org/I4210131945","display_name":"University Clinical Centre","ror":"https://ror.org/02kyzv273","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4210131945"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Zofia Gorzoch- Burduk","raw_affiliation_strings":["University Clinical Center in Gda\u0144sk D\u0119binki 7 Street, 80-952 Gda\u0144sk, Poland"],"raw_orcid":"https://orcid.org/0009-0001-6457-4105","affiliations":[{"raw_affiliation_string":"University Clinical Center in Gda\u0144sk D\u0119binki 7 Street, 80-952 Gda\u0144sk, Poland","institution_ids":["https://openalex.org/I4210131945"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061013877","display_name":"Jacek Puzio","orcid":"https://orcid.org/0009-0001-9832-8527","observed_orcids":["https://orcid.org/0009-0001-9832-8527"]},"institutions":[{"id":"https://openalex.org/I75124487","display_name":"Gda\u0144sk Medical University","ror":"https://ror.org/019sbgd69","country_code":"PL","type":"education","lineage":["https://openalex.org/I75124487"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Julia Puzio","raw_affiliation_strings":["Medical University of Gda\u0144sk  Marii Sk\u0142odowskiej-Curie 3a Street, 80-210 Gda\u0144sk, Poland"],"raw_orcid":"https://orcid.org/0009-0001-9832-8527","affiliations":[{"raw_affiliation_string":"Medical University of Gda\u0144sk  Marii Sk\u0142odowskiej-Curie 3a Street, 80-210 Gda\u0144sk, Poland","institution_ids":["https://openalex.org/I75124487"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120643959","display_name":"Paula Marcinkowska","orcid":"https://orcid.org/0009-0000-6913-8831","observed_orcids":["https://orcid.org/0009-0000-6913-8831"]},"institutions":[{"id":"https://openalex.org/I75124487","display_name":"Gda\u0144sk Medical University","ror":"https://ror.org/019sbgd69","country_code":"PL","type":"education","lineage":["https://openalex.org/I75124487"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Paula Marcinkowska","raw_affiliation_strings":["Medical University of Gda\u0144sk  Marii Sk\u0142odowskiej-Curie 3a Street, 80-210 Gda\u0144sk, Poland"],"raw_orcid":"https://orcid.org/0009-0000-6913-8831","affiliations":[{"raw_affiliation_string":"Medical University of Gda\u0144sk  Marii Sk\u0142odowskiej-Curie 3a Street, 80-210 Gda\u0144sk, Poland","institution_ids":["https://openalex.org/I75124487"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120643961","display_name":"Micha\u0142 Jezierski","orcid":"https://orcid.org/0009-0000-0185-4065","observed_orcids":["https://orcid.org/0009-0000-0185-4065"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Micha\u0142 Jezierski","raw_affiliation_strings":["University Clinical Hospital in Pozna\u0144; Przybyszewskiego 49 Street, 60-355 Pozna\u0144, Poland;"],"raw_orcid":"https://orcid.org/0009-0000-0185-4065","affiliations":[{"raw_affiliation_string":"University Clinical Hospital in Pozna\u0144; Przybyszewskiego 49 Street, 60-355 Pozna\u0144, Poland;","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120695098","display_name":"Kinga Popielarska","orcid":"https://orcid.org/0009-0009-7797-5301","observed_orcids":["https://orcid.org/0009-0009-7797-5301"]},"institutions":[{"id":"https://openalex.org/I75124487","display_name":"Gda\u0144sk Medical University","ror":"https://ror.org/019sbgd69","country_code":"PL","type":"education","lineage":["https://openalex.org/I75124487"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Kinga Popielarska","raw_affiliation_strings":["Medical University of Gda\u0144sk  Marii Sk\u0142odowskiej-Curie 3a Street, 80-210 Gda\u0144sk, Poland"],"raw_orcid":"https://orcid.org/0009-0009-7797-5301","affiliations":[{"raw_affiliation_string":"Medical University of Gda\u0144sk  Marii Sk\u0142odowskiej-Curie 3a Street, 80-210 Gda\u0144sk, Poland","institution_ids":["https://openalex.org/I75124487"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034660042","display_name":"Ewelina Nowicka","orcid":"https://orcid.org/0009-0004-1782-0416","observed_orcids":["https://orcid.org/0009-0004-1782-0416"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ewelina Nowicka","raw_affiliation_strings":["University Clinical Hospital in Pozna\u0144; Przybyszewskiego 49 Street, 60-355 Pozna\u0144, Poland;"],"raw_orcid":"https://orcid.org/0009-0004-1782-0416","affiliations":[{"raw_affiliation_string":"University Clinical Hospital in Pozna\u0144; Przybyszewskiego 49 Street, 60-355 Pozna\u0144, Poland;","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5016773614","display_name":"Kamila Wr\u00f3blewska","orcid":"https://orcid.org/0009-0002-8459-4792","observed_orcids":["https://orcid.org/0009-0002-8459-4792"]},"institutions":[{"id":"https://openalex.org/I4210094198","display_name":"University Clinical Hospital In Bialystok","ror":"https://ror.org/00j1phe22","country_code":"PL","type":"healthcare","lineage":["https://openalex.org/I4210094198"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Kamila Wr\u00f3blewska","raw_affiliation_strings":["University Clinical Hospital in Bia\u0142ystok Marii Sk\u0142odowskiej-Curie 24a Street, 15-276 Bia\u0142ystok, Poland"],"raw_orcid":"https://orcid.org/0009-0002-8459-4792","affiliations":[{"raw_affiliation_string":"University Clinical Hospital in Bia\u0142ystok Marii Sk\u0142odowskiej-Curie 24a Street, 15-276 Bia\u0142ystok, Poland","institution_ids":["https://openalex.org/I4210094198"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.00673833,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"49","issue":null,"first_page":"67356","last_page":"67356"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11000","display_name":"Infection Control in Healthcare","score":0.9208999872207642,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11000","display_name":"Infection Control in Healthcare","score":0.9208999872207642,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10150","display_name":"Antifungal resistance and susceptibility","score":0.07010000199079514,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12744","display_name":"Medical Device Sterilization and Disinfection","score":0.002899999963119626,"subfield":{"id":"https://openalex.org/subfields/2404","display_name":"Microbiology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/candida-auris","display_name":"Candida auris","score":1.0},{"id":"https://openalex.org/keywords/environmental-disinfection","display_name":"environmental disinfection","score":0.8790000081062317},{"id":"https://openalex.org/keywords/multidrug-resistant-fungi","display_name":"multidrug-resistant fungi","score":0.6600000262260437},{"id":"https://openalex.org/keywords/intensive-care-unit","display_name":"intensive care unit","score":0.7049999833106995},{"id":"https://openalex.org/keywords/infection-control","display_name":"infection control","score":0.8360000252723694},{"id":"https://openalex.org/keywords/chlorine-based-disinfectants","display_name":"chlorine disinfectants","score":0.8180000185966492},{"id":"https://openalex.org/keywords/hydrogen-peroxide-vapor","display_name":"hydrogen peroxide vapor","score":0.7609999775886536},{"id":"https://openalex.org/keywords/uv-c-disinfection","display_name":"UV-C disinfection","score":0.8230000138282776},{"id":"https://openalex.org/keywords/quaternary-ammonium-salts","display_name":"quaternary ammonium compounds","score":1.0},{"id":"https://openalex.org/keywords/disinfection-efficacy","display_name":"disinfectant efficacy","score":0.7279999852180481}],"concepts":[{"id":"https://openalex.org/C2909786013","wikidata":"https://www.wikidata.org/wiki/Q26816853","display_name":"Candida auris","level":3,"score":0.626800000667572},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5795999765396118},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.5236999988555908},{"id":"https://openalex.org/C166888038","wikidata":"https://www.wikidata.org/wiki/Q4118322","display_name":"Infection control","level":2,"score":0.44449999928474426},{"id":"https://openalex.org/C2781221799","wikidata":"https://www.wikidata.org/wiki/Q73984","display_name":"Disinfectant","level":2,"score":0.44369998574256897},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.4228000044822693},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.4113999903202057},{"id":"https://openalex.org/C2776436953","wikidata":"https://www.wikidata.org/wiki/Q5163215","display_name":"Consistency (knowledge bases)","level":2,"score":0.3287999927997589},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.3278000056743622},{"id":"https://openalex.org/C2987315675","wikidata":"https://www.wikidata.org/wiki/Q1773974","display_name":"Disease control","level":2,"score":0.2777000069618225},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.27469998598098755},{"id":"https://openalex.org/C89423630","wikidata":"https://www.wikidata.org/wiki/Q7193","display_name":"Microbiology","level":1,"score":0.26429998874664307}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.12775/qs.2025.49.67356","doi":"https://doi.org/10.12775/qs.2025.49.67356","is_oa":true,"landing_page_url":"https://doi.org/10.12775/qs.2025.49.67356","pdf_url":"https://apcz.umk.pl/QS/article/download/67356/44950","source":{"id":"https://openalex.org/S4210230959","display_name":"Quality in Sport","issn_l":"2450-3118","issn":["2450-3118"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["ddh","erih-plus","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310317346","host_organization_name":"Kazimierz Wielki University in Bydgoszcz","host_organization_lineage":["https://openalex.org/P4310317346"],"host_organization_lineage_names":["Kazimierz Wielki University in Bydgoszcz"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality in Sport","raw_type":"journal-article"},{"id":"doi:10.12775/qs.2026.49.67356","doi":"https://doi.org/10.12775/qs.2026.49.67356","is_oa":true,"landing_page_url":"https://doi.org/10.12775/qs.2026.49.67356","pdf_url":null,"source":{"id":"https://openalex.org/S4210230959","display_name":"Quality in Sport","issn_l":"2450-3118","issn":["2450-3118"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["ddh","erih-plus","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310317346","host_organization_name":"Kazimierz Wielki University in Bydgoszcz","host_organization_lineage":["https://openalex.org/P4310317346"],"host_organization_lineage_names":["Kazimierz Wielki University in Bydgoszcz"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality in Sport","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.12775/qs.2025.49.67356","doi":"https://doi.org/10.12775/qs.2025.49.67356","is_oa":true,"landing_page_url":"https://doi.org/10.12775/qs.2025.49.67356","pdf_url":"https://apcz.umk.pl/QS/article/download/67356/44950","source":{"id":"https://openalex.org/S4210230959","display_name":"Quality in Sport","issn_l":"2450-3118","issn":["2450-3118"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":["ddh","erih-plus","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310317346","host_organization_name":"Kazimierz Wielki University in Bydgoszcz","host_organization_lineage":["https://openalex.org/P4310317346"],"host_organization_lineage_names":["Kazimierz Wielki University in Bydgoszcz"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Quality in Sport","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.98580002784729}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7118082011.pdf","grobid_xml":"https://content.openalex.org/works/W7118082011.grobid-xml"},"referenced_works_count":5,"referenced_works":["https://openalex.org/W2538799985","https://openalex.org/W2953331870","https://openalex.org/W3082785035","https://openalex.org/W4281633644","https://openalex.org/W4387996253"],"related_works":["https://openalex.org/W7133780014","https://openalex.org/W4281633644","https://openalex.org/W2796969235","https://openalex.org/W7126164241","https://openalex.org/W4410959190","https://openalex.org/W4414981343","https://openalex.org/W4292260214","https://openalex.org/W7139034489","https://openalex.org/W4415214753","https://openalex.org/W7128595106"],"abstract_inverted_index":{"Background.":[0],"Candida":[1,60],"auris":[2,61,99],"is":[3,138,181],"an":[4],"emerging,":[5],"multidrug-resistant":[6],"fungal":[7],"pathogen":[8],"ofsignificant":[9],"public":[10,81],"health":[11,82],"concern.":[12],"Noted":[13],"for":[14,35],"its":[15],"environmental":[16,51],"persistence":[17],"and":[18,57,67,108,141,148,156],"hightransmissibility,":[19],"it":[20],"poses":[21],"a":[22,47,177],"substantial":[23],"threat":[24],"in":[25,54,62,132],"healthcare":[26],"settings,":[27],"particularly":[28,122],"inintensive":[29],"care":[30],"units,":[31],"driving":[32],"the":[33,55,90,149],"need":[34],"specific":[36,133],"infection":[37],"control":[38,58],"protocols.":[39],"Aim.":[40],"The":[41],"aim":[42],"of":[43,50,59,89,151],"this":[44],"study":[45],"was":[46],"comparative":[48,87,117],"analysis":[49,88,118],"disinfectionmethods":[52],"used":[53],"prevention":[56],"various":[63],"countries":[64],"andhealthcare":[65],"facilities.Material":[66],"methods.":[68],"This":[69],"review":[70],"analyzed":[71],"literature":[72],"from":[73],"2016-2025,":[74],"sourcedfrom":[75],"databases":[76],"such":[77],"as":[78,113],"PubMed,":[79],"alongside":[80],"guidelines":[83],"andepidemiological":[84],"reports.":[85],"A":[86,116],"selected":[91],"data":[92],"wasconducted.":[93],"Results.":[94],"Disinfection":[95],"strategies":[96],"against":[97,162],"C.":[98],"primarily":[100],"recommend":[101],"chlorine-":[102],"andhydrogen":[103],"peroxide-based":[104,157],"agents,":[105],"with":[106],"UV-C":[107],"vaporized":[109],"hydrogen":[110],"peroxide":[111],"(VHP)noted":[112],"supplementary":[114],"measures.":[115],"revealed":[119],"significantinternational":[120],"divergence,":[121],"regarding":[123],"quaternary":[124],"ammonium":[125],"compounds(QACs),":[126],"which":[127],"are":[128,159,166],"largely":[129],"restricted":[130],"except":[131],"contexts":[134],"like":[135],"India.":[136],"Overallefficacy":[137],"highly":[139],"variable":[140],"dependent":[142],"on":[143],"disinfectant":[144],"selection,":[145],"workflow,":[146],"stafftraining,":[147],"consistency":[150],"protocol":[152],"implementation.":[153],"Conclusions.":[154],"Chlorine-":[155],"disinfectants":[158],"most":[160],"effective":[161],"C.auris,":[163],"while":[164],"QACs":[165],"discouraged":[167],"despite":[168],"their":[169],"localized":[170],"use.":[171],"To":[172],"counter":[173],"variabilityin":[174],"international":[175],"guidelines,":[176],"unified":[178],"regulatory":[179],"framework":[180],"recommended.":[182],"Keyrecommendations":[183],"include":[184],"standardizing":[185],"procedures,":[186],"enhancing":[187],"staff":[188],"training,":[189],"andmaintaining":[190],"strict":[191],"surveillance.":[192],"Further":[193],"research,":[194],"including":[195],"hospital":[196],"case":[197],"studies,":[198],"isneeded":[199],"due":[200],"to":[201],"insufficient":[202],"current":[203],"data.":[204]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-01-03T00:00:00"}
