PEC innovation最新文献

{"title":"Cross cultural adaptation and validation of audiovisual educational material for use in indigenous patients with rheumatoid arthritis","authors":"Joana Aguilar-Castillo ,&nbsp;Ingris Peláez-Ballestas ,&nbsp;José-Luis Montiel-Hernández ,&nbsp;Cairo Toledano-Jaimes ,&nbsp;Mario-Alberto Garza-Elizondo ,&nbsp;David Zepeda-González ,&nbsp;Diana-Lizbeth Gómez-Galicia","doi":"10.1016/j.pecinn.2024.100363","DOIUrl":"10.1016/j.pecinn.2024.100363","url":null,"abstract":"<div><h3>Background</h3><div>Culturally appropriate educational materials are necessary to improve health literacy among Indigenous populations. However, practically no such materials have been cross-culturally adapted and validated for Indigenous peoples based on compliance with efficacy components.</div></div><div><h3>Objective</h3><div>To perform a cross-cultural adaptation and validation of audiovisual educational materials for adult patients with rheumatoid arthritis belonging to Indigenous communities in Chiapas, Mexico.</div></div><div><h3>Methods</h3><div>Mixed-methods study consisting of three phases: 1) Spanish–Tzotzil translation and cross-cultural adaptation of seven previously designed and validated audiovisual educational materials; 2) qualitative validation; and 3) quantitative validation based on the efficacy components (attraction, understanding, induction to action, involvement, and acceptance). The information collected during the validation phases was recorded and transcribed for content analysis.</div></div><div><h3>Results</h3><div>A total of 31 patients with rheumatoid arthritis participated in the study. Patients had a mean age of 49 years, ≥5 years since disease onset, low adherence to pharmacological treatment (&lt;20%), and a high level of illiteracy (&gt;80%). After three versions of the educational material, where elements of cultural identification were added, the efficacy components increased significantly to reach scores higher than 90%. This suggests that culturally-adapted materials could promote greater patient participation in treatment.</div></div><div><h3>Conclusion</h3><div>This study shows the importance of cross-cultural adaptation in the design and validation of audiovisual educational materials for Indigenous populations; this aspect should be considered when implementing educational strategies for patients with chronic diseases.</div></div><div><h3>Innovation</h3><div>First educational audiovisual material translated and adapted from Spanish to Tzotzil, with a cultural sensitivity approach to achieve educational goals and improve therapeutic adherence.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safe sleep crib clinics: Promoting risk reduction strategies for sudden unexpected infant death","authors":"Carolyn R. Ahlers-Schmidt ,&nbsp;Christy Schunn ,&nbsp;Ashley M. Hervey ,&nbsp;Maria Torres","doi":"10.1016/j.pecinn.2024.100370","DOIUrl":"10.1016/j.pecinn.2024.100370","url":null,"abstract":"<div><h3>Objectives</h3><div>Safe Sleep Community Baby Showers (CBS) provide group education to reduce risk factors of sudden unexpected infant death (SUID). Based on CBS success, Safe Sleep Crib Clinics were developed to provide individual education. This study assessed Crib Clinic outcomes and differences in Crib Clinics compared to CBSs.</div></div><div><h3>Methods</h3><div>Certified Safe Sleep Instructors facilitated CBSs and/or Crib Clinics in their communities and collected participant data related to safe sleep, tobacco avoidance and breastfeeding. Crib Clinic data was compared pre- to post-test; post-test results were compared between Crib Clinics and CBSs.</div></div><div><h3>Results</h3><div>Crib Clinic attendees exhibited significant increases in intention to have infant follow safe sleep recommendations, avoid secondhand smoke and breastfeed (all <em>p</em> &lt; 0.001). Significant differences between Crib Clinic and CBS participants related to marital status, language, tobacco, education and insurance (all <em>p</em> &lt; 0.01). CBS and Crib Clinic participants differed on items related to sleep environment, breastfeeding and tobacco (all <em>p</em> = 0.05).</div></div><div><h3>Conclusions</h3><div>Overall Crib Clinics appear to be effective in increasing knowledge, intentions and confidence related to safe sleep, tobacco avoidance and breastfeeding. Crib Clinics may offer flexibility (e.g., time, format) that increases accessibility to safe sleep education for families.</div></div><div><h3>Innovation</h3><div>Results suggest the ability to shift education delivery method based on group size was important in both rural and urban settings.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100370"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging human centered design to enhance clinician communication during pregnancy care: Overcoming language barriers with Spanish-speaking patients","authors":"Rose L. Molina ,&nbsp;Kasey Bellegarde ,&nbsp;Meghan Long ,&nbsp;Maria Bazan ,&nbsp;Rachel Moyal-Smith ,&nbsp;Ami Karlage ,&nbsp;Karen Schoenherr ,&nbsp;Lauren Spigel ,&nbsp;Amanda DiMeo ,&nbsp;Yessamin Pazos Herencia ,&nbsp;Saugata Chakraborty ,&nbsp;Jeanne-Marie Guise ,&nbsp;Asaf Bitton","doi":"10.1016/j.pecinn.2024.100366","DOIUrl":"10.1016/j.pecinn.2024.100366","url":null,"abstract":"<div><h3>Background</h3><div>Engaging patients in quality improvement and innovation projects is increasingly important, yet challenges persist with involving patients who speak languages other than English. This article presents design activities our team used to engage Spanish-speaking patients and cultural brokers.</div></div><div><h3>Objective</h3><div>To develop a clinician communication tool to enhance patient trust in pregnancy care clinicians, especially among minoritized populations who face language and cultural barriers, using human-centered design (HCD).</div></div><div><h3>Patient involvement and innovation</h3><div>We centered end-user experiences, including clinicians, Spanish-speaking patients, and Spanish-speaking cultural brokers, in our design process through multiple feedback sessions and modalities.</div></div><div><h3>Methods</h3><div>We used a HCD process to understand the problem, co-design a tool, and prepare for testing of a clinician tool. Design activities included a critical literature review, user interviews, design principles, solution sketching, rapid cycle feedback with subject matter experts, and field experience with pregnancy clinicians.</div></div><div><h3>Results</h3><div>We innovated on a widely used clinical communication tool, the Four Habits Model, and developed the Five Habits for Pregnancy Care to support pregnancy care clinicians in building trust by bridging cultural and language differences. We added an equity-focused habit “Pause and Reflect” to bookend the Four Habits. We refined the tool to meet different needs across pregnancy care visits based on feedback from 7 clinicians.</div></div><div><h3>Discussion</h3><div>We applied equity principles in a HCD process to understand a problem, co-design a tool, and prepare for testing by engaging with patients and cultural brokers in Spanish. Balancing the differing approaches for designers and researchers yielded important insights for enhancing equitable processes and outcomes in healthcare improvement.</div></div><div><h3>Practical value</h3><div>Communication tools designed with and for minoritized populations are critical for improving trust in all patient-clinician dyads during pregnancy care.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100366"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of positive and negative clinician communication in obstetrical visits from the perspectives of pregnant patients who use substances","authors":"Abisola Olaniyan ,&nbsp;Mary Hawk ,&nbsp;Dara D. Mendez ,&nbsp;Steven M. Albert ,&nbsp;Natalie Stern ,&nbsp;Sneha Patnaik ,&nbsp;Judy C. Chang","doi":"10.1016/j.pecinn.2025.100394","DOIUrl":"10.1016/j.pecinn.2025.100394","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the perceptions of pregnant patients who use substances regarding positive or negative clinician communication during obstetrical care.</div></div><div><h3>Methods</h3><div>We analyzed qualitative data from 85 semi-structured interviews with pregnant patients who reported or tested positive for substance use, which explored their interaction with obstetric providers during their first prenatal visit. This analysis focuses on patients' perceptions of negative versus positive clinician communication behaviors.</div></div><div><h3>Results</h3><div>Eighty-five participants described clinician communication behaviors they felt affected their feelings about the clinician and their willingness to talk about prenatal substance use and other sensitive topics. Negative behaviors included clinicians (1) expressing judgment, (2) rushing through the consultation and providing limited information to patients, and (3) using statements or behaviors that made patients feel dehumanized. Positive behaviors included clinicians (1) explicitly expressing care for the patient, (2) creating rapport by soliciting patient stories and building relationships, and (3) demonstrating attentive listening.</div></div><div><h3>Innovation</h3><div>To our knowledge, our study is the first to explore clinician communication behavior with a focus on prenatal substance use from the perspective of pregnant people using substances.</div></div><div><h3>Conclusion</h3><div>Our findings highlight pregnant patients' perspectives on communication patterns that could improve patient-clinician interactions and, in turn, maternal health care and outcomes.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100394"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lifestyle educational course as an adjunct to biologic administration in patients with severe asthma: A feasibility study","authors":"Joseph W. Lanario ,&nbsp;Drew Davies ,&nbsp;Lucy Cartwright ,&nbsp;Michael E. Hyland ,&nbsp;Matthew Masoli","doi":"10.1016/j.pecinn.2024.100364","DOIUrl":"10.1016/j.pecinn.2024.100364","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the feasibility and acceptability of adapting a psychoeducation course (Body Reprogramming) for severe asthma and finding suggestions for improvement.</div></div><div><h3>Methods</h3><div>Severe asthma patients were recruited from a single centre and enrolled in an online group-based course. Each course consisted of four sessions: introduction to BR, stress, exercise, and diet. Participants were asked to complete questionnaires assessing HRQoL, mood, asthma and extra-pulmonary symptoms, pre/post course. Those who attended two or more sessions were invited to provide feedback in interviews.</div></div><div><h3>Results</h3><div>Twenty-eight participants took part in one of the five courses. Thirteen (46 %) attended all four sessions and were sent post-course questionnaires, eight participants (62 %) returned them. Twelve participants provided post course feedback, Themes included: The course as a time to reflect, Appreciation of the group-format, Impact of pre-existing knowledge on enjoyment of the course and Areas of improvement. Maintaining course size, clarification of the course aims and methods were identified as areas of improvement by participants.</div></div><div><h3>Conclusion</h3><div>An educational course focused on managing extra-pulmonary symptoms is feasible and of perceived benefit to patients with severe asthma.</div></div><div><h3>Innovation</h3><div>BR could be incorporated into a rehab programme for patients with severe asthma with significant extrapulmonary symptoms.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100364"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting healthier food choices through AI-tailored advice: A research agenda","authors":"Alain D. Starke ,&nbsp;Jutta Dierkes ,&nbsp;Gülen Arslan Lied ,&nbsp;Gloria A.B. Kasangu ,&nbsp;Christoph Trattner","doi":"10.1016/j.pecinn.2025.100372","DOIUrl":"10.1016/j.pecinn.2025.100372","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a research agenda to investigate the effectiveness of AI-tailored advice to support healthier home cooking. It aims to support healthier food choice in the context of hypertension, allergies, and sustainable diets.</div></div><div><h3>Methods</h3><div>We describe an agenda that has been formed between 2019 and 2022, through multiple rejected grant applications to the Research Council of Norway. We focus on the case of tailored recipe advice for individuals, formulating research questions and methods for three topics: “Acceptance of Personalized Food Advice”, “Algorithm and Interface AI: App Development”, and “Nutrition Modeling &amp; Clinical Trials”. The overall methodology focuses on mitigating health issues among individuals with hypertension.</div></div><div><h3>Conclusion</h3><div>The design of AI to support healthier home cooking should tap into computational principles, as well as (psychological) theories of behavioral change. The effectiveness of an AI-driven home cooking app can be evaluated in a clinical trial akin to ‘regular’ dietary intervention studies.</div></div><div><h3>Innovation</h3><div>The development of a research agenda requires an integrated effort between scientists from different domains, during both the development and writeup of ideas. The proposed project is innovative, as most food technology and AI approaches have yet to be tested in proper trials on changes in eating habits.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100372"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' emotional expressions and clinicians' responses in oncology – From recognition to exploration of concerns","authors":"Fernanda Bittencourt Romeiro ,&nbsp;Vanessa Garrido Pais ,&nbsp;Gerry Humphris ,&nbsp;Margarida Figueiredo-Braga","doi":"10.1016/j.pecinn.2025.100374","DOIUrl":"10.1016/j.pecinn.2025.100374","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to analyze patient's emotional expressions during the consultations and the responses of their oncologists to these expressions.</div></div><div><h3>Methods</h3><div>The study employed a mixed-method, observational, descriptive, and explanatory design. A total of 31 adult patients at different clinical stages, undergoing cancer treatment and 8 oncologists were included. Thirty-one routine outpatient oncology consultations were analyzed, after being transcribed and coded, using the Portuguese version of the Verona Coding Definitions of Emotional Sequences (VR-CoDES).</div></div><div><h3>Results</h3><div>The oncologists elicited and recognized patients' emotional concerns but they did not explore them in a way that encouraged patients to continue verbalizing their feelings. Oncologists provided more directive and guidance-oriented responses, focusing on cues related to physical pain and symptoms. Multilevel logistic regression analysis modeled the probability of oncologists' responses showing reduction of space in relation to patients' emotional cues/concerns, controlling for clustering and patients' clinical and socio-demographic variables. The type of cue and treatment influenced the oncologists' responses.</div></div><div><h3>Conclusions</h3><div>Communication skills training focused on the ability to better explore patients' emotions may help oncologists to provide more explicit and empathetic responses that validate the emotional content expressed during consultations. <em>Practice Implications:</em> Oncologists do not use the same responses as a standard with patients, thus adjusting them individually.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100374"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we offering palliative care and employing shared decision making in the neonatal intensive care unit? A 10-year retrospective chart review","authors":"Sawyer Karabelas-Pittman ,&nbsp;Helen Coo ,&nbsp;Hannah Lee ,&nbsp;Christine C. Moon ,&nbsp;Gillian MacLean","doi":"10.1016/j.pecinn.2025.100375","DOIUrl":"10.1016/j.pecinn.2025.100375","url":null,"abstract":"<div><h3>Objective</h3><div>Perinatal palliative care (PPC) supports families with a fetal diagnosis of a life-limiting condition or who are facing preterm labour at the limits of viability. Shared decision making (SDM) is the gold standard approach in PPC. The objectives of this study were to describe the Neonatal Intensive Care Unit (NICU) team's involvement in PPC and the extent of SDM at an academic hospital in southeastern Ontario, and the frequency with which PPC was offered, accepted and received for live births.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed charts for births from January 2010–January 2020 where a life-limiting condition (LLC) had been prenatally diagnosed or there was threatened preterm labour (TPTL) at the limits of viability. Frequency distributions were used to summarize the NICU team's involvement, extent of SDM, and data related to PPC provision.</div></div><div><h3>Results</h3><div>The LLC group included 73 patients. The NICU team was consulted for 26 (36 %). Among the 10 consults that involved decision making, SDM was documented in 9 instances (90 %). PPC was offered to 9 of 60 LLC families (15 %) with a live birth and was accepted by 8 (89 %). The TPTL Group included 112 patients. Seventy (62 %) received a consult with the NICU team. SDM was documented in 34 of 39 consults (87 %) that involved decision making. PPC was offered to 28 of 90 families (31 %) who experienced a live birth and was accepted by 16 (57 %).</div></div><div><h3>Conclusion</h3><div>Our results demonstrate the need for standardized consultation and palliative care referral protocols to advance access to and quality of neonatal end-of-life care.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100375"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning from brilliant failures","authors":"Annemiek J Linn,&nbsp;Nanon Labrie","doi":"10.1016/j.pecinn.2025.100383","DOIUrl":"10.1016/j.pecinn.2025.100383","url":null,"abstract":"","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100383"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissemination, adaptation, and uptake of patient-facing materials to improve care coordination in primary care","authors":"Claire E. O'Hanlon ,&nbsp;Jenny M. Barnard ,&nbsp;Danielle E. Rose ,&nbsp;Susan E. Stockdale ,&nbsp;Evelyn T. Chang ,&nbsp;Elizabeth M. Yano ,&nbsp;David A. Ganz","doi":"10.1016/j.pecinn.2025.100386","DOIUrl":"10.1016/j.pecinn.2025.100386","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to improve patients' experience of care coordination by promoting the uptake of patient-facing tools with evidence of sustained use in Veterans Affairs (VA) primary care clinics. We disseminated tools, adapted and improved tools in response to feedback, and tracked real-world uptake.</div></div><div><h3>Methods</h3><div>We conducted outreach to leadership and frontline providers at local, regional, and national levels. We collaborated with frontline providers and veteran patients using human-centered design approaches to guide tool adaptation. We assessed dissemination and real-world uptake through website analytics and QR code tracking.</div></div><div><h3>Results</h3><div>Tools included paper pamphlets that explained care processes, provided contact information, and answered frequently asked questions. Feedback resulted in use of larger fonts; pictures and colors; less dense text; and QR codes. Discussions led to development of new tools addressing current challenges coordinating care with VA-paid community providers. We observed substantial uptake (&gt;2000 tool page views, &gt;3000 QR code accesses).</div></div><div><h3>Conclusion</h3><div>Simple patient-facing tools are valuable to patients and frontline providers as evidenced by voluntary uptake despite competing demands.</div></div><div><h3>Innovation</h3><div>Tools with evidence of sustained uptake were adapted to address current challenges with navigating care and care coordination among VA and non-VA providers. QR codes enabled tracking of real-world uptake.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100386"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}