Journal of pediatric rehabilitation medicine最新文献

{"title":"A pediatric rehabilitation therapy audit study: A brief report.","authors":"Amy Houtrow, Natalie Silverman, Matthew Mesoros, Kristyn Felman, Molly Fuentes, Alyson Stover, Gina McKernan","doi":"10.1177/18758894251341160","DOIUrl":"https://doi.org/10.1177/18758894251341160","url":null,"abstract":"<p><p>PurposeChildren with disabilities benefit from physical, occupational, and speech therapy, but families identify unmet needs for these services. The purpose of this study was to audit access to therapy services in a tri-state region. It was hypothesized that children who were publicly insured and children from minoritized identity groups would face greater access barriers and longer wait times than children covered by private insurance and non-minoritized White children.MethodsThis prospective audit study utilized callers who posed as mothers seeking outpatient therapy services for their child. Access difficulties were identified based on the number of phone calls required to obtain an appointment or determine if services would be obtained at all, as well as the number of days to the earliest available appointment.ResultsTherapy appointment access was a problem for 47.4% of simulated families. After 251 phone calls, 91 simulated families were able to schedule appointments in 76 clinics. Black and Hispanic simulated families had a harder time getting appointments, but days to appointment did not differ by telegraphed minoritized identity (F(3,88) = 1.474, p = .227).ConclusionSimulated families experienced substantial barriers to arranging therapy appointments with Black and Hispanic families experiencing more barriers than their White and Muslim peers.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251341160"},"PeriodicalIF":0.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078659","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":"Characteristics of pediatric patients with sports-related concussions: A single site retrospective review.","authors":"Jose A Cruz Ayala, Shahrukh Khan, Holly Monk, Emma Cole, Alison Smith, Scott Schultz, Lindsay Elliott, Jessica Zagory","doi":"10.1177/18758894251341146","DOIUrl":"https://doi.org/10.1177/18758894251341146","url":null,"abstract":"<p><strong>Purpose: </strong>Sports-related concussion (SRC) cases have increased among children in the last decade. Differences in concussion symptoms, presentation, and follow-up care exist when comparing demographics. The aim of this study was to explore SRC within the pediatric population.</p><p><strong>Methods: </strong>A retrospective chart review of patients ≤18 years old diagnosed with SRC at a New Orleans stand-alone children's hospital from January 2007 to December 2021 was performed. T-test and Fisher's exact test were used for relationship between outcomes and sports, demographics, setting, insurance, and follow-up care.</p><p><strong>Results: </strong>Children who sustained SRC at practice were more likely to be male (p = 0.0311) and younger (p < 0.0001). Cheerleading was more likely to have injuries during practice (p < 0.0001). Medicaid/uninsured patients were more likely to be referred from the emergency department (ED) (p = 0.001), have longer length of follow-ups (p = 0.0489), and have more missed appointments (p = 0.0062). However, the total number of follow-ups between insurance types did not differ (p = 0.3084).</p><p><strong>Conclusion: </strong>SRC incidence is situation and time dependent. Medicaid/uninsured patients are more likely to be evaluated at the ED, miss appointments, and have a longer length of follow-up to attain the same number of appointments. Exploring the nuances of SRC within this population will improve management and outcomes.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251341146"},"PeriodicalIF":0.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078673","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 national consensus-based framework on preferred assessments and interventions in current treatment for young people with acquired brain injury in Dutch rehabilitation centers.","authors":"Florian Allonsius, Arend de Kloet, Frederike van Markus-Doornbosch, Ingrid Rentinck, Suzanne Lambregts, Karin Huizing, Peter de Koning, Sandra Te Winkel, Christine Resch, Thea Vliet Vlieland, Menno van der Holst","doi":"10.1177/18758894251337581","DOIUrl":"https://doi.org/10.1177/18758894251337581","url":null,"abstract":"<p><strong>Purpose: </strong>Acquired brain injury (ABI) is prevalent among young people (4-25 years). When ABI-related problems persist, treatment in a rehabilitation center (RC) may be indicated. However, there is wide variability regarding the delivery of care across Dutch RCs, including assessments, interventions, and psychoeducational (PE) materials. The aim was to create a consensus-based framework with preferred assessments, interventions, and PE-materials to be used in pediatric ABI rehabilitation. A national framework could optimize the delivery of comparable care for this population.</p><p><strong>Methods: </strong>For this three-round Delphi study, healthcare professionals (physiatrists, psychologists, social workers, physical/occupational/speech/language therapists) from RCs providing care for young people with ABI were invited to participate. In the first two (online) rounds, currently used assessments/interventions/PE-materials were collected, stepwise-prioritized, subsequently listed per discipline, and classified per International Classification of Functioning (ICF) domain. Results from rounds one/two were discussed in a consensus meeting (in person), aiming to reach agreement on assessments/interventions/PE-materials in the national framework and how to use them in current practice.</p><p><strong>Results: </strong>Seventy-four healthcare professionals from 12 RCs participated. After Delphi round one, 163 assessments, 39 interventions, and 64 PE-materials were collected. After round two, the selection was narrowed down to n = 51/n = 34/n = 28, respectively. After round three, consensus was reached on 37 assessments, 25 interventions (divided over all disciplines/classified per ICF domain), 27 PE-materials, as well as on the use of the framework by all participating RC to enhance clinical reasoning in current practice.</p><p><strong>Conclusion: </strong>A consensus-based national framework in ABI rehabilitation has been developed and is now available to optimize the delivery of care for young people with ABI across Dutch RCs.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251337581"},"PeriodicalIF":0.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016501","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":"Hospital experiences and medical traumatic stress in adults with spina bifida.","authors":"Ellen Fremion, Nora Deibler, Juliana Abel, Monique Ridosh","doi":"10.1177/18758894251333917","DOIUrl":"https://doi.org/10.1177/18758894251333917","url":null,"abstract":"<p><p>PurposeThis study examined hospital and emergency department (ED) experiences of adults with spina bifida (SB). It investigated the association between medical traumatic stress (MTS) and participant characteristics, anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and resiliency scores.MethodsAdults with SB who had a hospital or ED encounter within the last five years were recruited from a medical home clinic and completed a structured interview and validated questionnaires. Interview responses were characterized using qualitative theme analysis, questionnaires were scored using published guidelines, and MTS scores were reported per participant characteristic and emotional health questionnaire score counts and percentages.ResultsTwenty-five adults with SB were recruited, representing 37% of eligible patients. A majority of participants scored positive for at least one symptom cluster of MTS. No trends were noted within the demographic or SB data when compared to MTS scores. There was a trend of increased MTS symptom clusters associated with increased depression, anxiety, and PTSD, and a trend of decreased MTS symptom clusters associated with increased resilience. The narrative analysis yielded three distinct themes: negative hospital environment (sub-themes: feeling unheard, insufficient communication, care delays, and an uncomfortable adult healthcare environment), SB-related condition concerns and complications (sub-themes: adult providers lacking SB knowledge, multiple hospitalizations, pain, urology concerns, skin/bone infections, shunt/neurosurgery care, anxiety about needed procedures and illness severity, and MTS symptom clusters), and positive supports when in the hospital (sub-themes: self-advocacy, resilience, family support, positive patient/provider communication, and positive care outcome).ConclusionFurther research with a larger study population is necessary to draw significant conclusions about relationships between demographic and SB data, emotional health, and MTS. However, this study identified opportunities for improving healthcare experiences for this patient population, including facilitating communication, inquiring about potentially traumatic medical experiences, and promoting self-advocacy, self-efficacy, resilience, and familial support.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251333917"},"PeriodicalIF":0.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999412","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":"Maternal-fetal surgery for myelomeningocele longitudinal follow-up model: Mitigation of care fragmentation through care coordination and outcomes reporting.","authors":"Jonathan Castillo, Mary M Locastro, Romain Corroenne, Anjali Malhotra, Alexander Van Speybroeck, Grace Lai, Michael A Belfort, Magdalena Sanz Cortes, Heidi Castillo","doi":"10.1177/18758894251331335","DOIUrl":"https://doi.org/10.1177/18758894251331335","url":null,"abstract":"<p><p>PurposeFollowing the Global Health Symposium at the Spina Bifida World Congress in 2023, the purpose of this work is to provide a historical overview and a state-of-the-art update on the current global practice of myelomeningocele (MMC) closure and to highlight the importance of care coordination and outcomes reporting to mitigate care fragmentation through a multidisciplinary approach.MethodsPanelists from the Spina Bifida World Congress Global Health Symposium reviewed their institutions' history and experience with risk for fragmentation of care following prenatal repair and proposed solutions to address fragmentation of care.ResultsNew and rapidly evolving in-utero approaches to MMC repair are increasingly accessible for patients worldwide but bring more complexity to follow-up care. There is a consensus that unifying multidisciplinary practices and evaluations across institutions and countries will help make care coordination more comprehensive and longitudinal, and that meeting these standards may decrease care fragmentation.ConclusionRegardless of the open spina bifida repair technique, longitudinal follow-up must be established after fetal surgery, not only for the optimal care of individual patients but also to mitigate care fragmentation, transparently evaluate and compare techniques (for example, through the North American Fetal Therapy Network, the National Spina Bifida Patient Registry, etc.), engage health care professionals, and provide evidence-based multidisciplinary care.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251331335"},"PeriodicalIF":0.8,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000887","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":"Towards a successful teledance program for youth with cerebral palsy: A mixed-method study with the instructor's perspective.","authors":"Annie Pouliot-Laforte, Claire Cherrière, Margaux Hebinck, Jessica Tallet, Catherine Donskoff, Louis-Nicolas Veilleux, Martin Lemay, Maxime T Robert","doi":"10.1177/18758894251324317","DOIUrl":"https://doi.org/10.1177/18758894251324317","url":null,"abstract":"<p><p>PurposeDance is a leisure time physical activity (LTPA) known to improve motor, cognitive, and psychosocial functions in youth with cerebral palsy (CP). Online exercise or tele-programs are promising in overcoming the environmental barriers of accessibility to LTPA. To ensure successful implementation, it is necessary to identify limitations specific to dance in a pediatric population. The aim was to explore the perspectives of the main stakeholders, i.e., dance instructors and youth, to implement such a program.MethodsIn a mixed-method design, feasibility indicators were assessed by participation and retention rates, the Physical Activity Enjoyment Scale (PACES), and the Children's Effort Rating Table (CERT). Semi-structured interviews were conducted before and after the intervention with youth with CP [n = 15] and dance instructors [n = 3]. Interviews were analyzed with an inductive approach.ResultsParticipation and retention rates were 86.7% ± 10.7 and 100%, and the PACES and CERT average scores were 91% ± 11 and 3.7 ± 1.3, respectively. Four themes emerged from the interviews: 1) Technology; 2) Pedagogical Approach; 3) Participant's Environment; and 4) Social Relations.ConclusionThe teledance program is feasible and enjoyable, requiring minimal equipment and travel. However, there is a need to consider and provoke social interaction, to enhance the social and relational dimension of dance.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251324317"},"PeriodicalIF":0.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015497","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":"Reliability and validity of the Mini-Eating and Drinking Ability Classification System (Mini-EDACS) among Dutch preschoolers with cerebral palsy.","authors":"Floor van der Klift, Lynn B Orriëns, Bea Spek, Diane Sellers, Corrie E Erasmus, Karen van Hulst","doi":"10.1177/18758894251330469","DOIUrl":"https://doi.org/10.1177/18758894251330469","url":null,"abstract":"<p><p>PurposeThis study aimed to translate the English version of the Mini-Eating and Drinking Ability Classification System (Mini-EDACS) into Dutch and assess its psychometric properties and applicability among preschool-aged children with cerebral palsy (CP) in the Netherlands.MethodsForty-eight children with CP (18-36 months) were included. Inter-rater reliability of the Dutch version of the Mini-EDACS was assessed between two speech and language therapists (SLTs) and between two SLTs and parents. Construct validity was established by hypothesis testing regarding the expected strength of the correlation between Mini-EDACS level and sum score of (a) the Pediatric Eating Assessment Tool (PEDI-EAT-10) and (b) the Montreal Children's Hospital Feeding Scale (MCH-FS).ResultsThe level of agreement for Mini-EDACS level was almost perfect between SLTs (weighted kappa (k_w) = 0.83) and substantial between parents and SLTs (parents vs SLT-1: k_w= 0.77; parents vs SLT-2: k_w= 0.70).Kendall's tau-b correlation between Mini-EDACS and PEDI-EAT-10 was 0.66 (p < 0.001), slightly lower than hypothesized, and 0.52 (p < 0.001) between Mini-EDACS and MCH-FS, aligning with the hypothesis. Applicability was found to be good.ConclusionThe Dutch version of the Mini-EDACS showed sufficient inter-rater reliability, construct validity and applicability and can be used in clinical care in the Netherlands to promote unambiguous communication between healthcare professionals and parents.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251330469"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764251","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":"Global burden of chronic non-communicable diseases: Prenatal care and beyond, numerous challenges besiege investigation across the care continuum.","authors":"Jonathan Castillo, Judy K Thibadeau, Andrea Park, Tim Brei, Heidi Castillo","doi":"10.1177/18758894251331737","DOIUrl":"https://doi.org/10.1177/18758894251331737","url":null,"abstract":"<p><p>Recently, the National Institutes of Health (NIH) announced possible restructuring of indirect and administrative costs for funded research. Many entities have raised concern about the impacts that such funding restructuring may have on the future progress of biomedical investigation. The NIH has historically played a key role in research on relevant chronic conditions, including spina bifida and cerebral palsy. Such research funds have not only provided occasion for basic science investigational opportunities but also have allowed for enquiry into clinical, social, and environmental factors that impact disability-specific health outcomes, including those present in some of the world's most vulnerable communities. However, the journal's editorial board is nonetheless encouraged to see the growth and change of <i>Journal of Pediatric Rehabilitation Medicine</i> (JPRM), as the journal evolves from a special issue format to a collections format. The collections will serve as ever-growing \"homes\" for the latest research on childhood-onset physical disabilities and complex care needs, with the added benefit of greater accessibility and improved user interface. Furthermore, as reflected in this issue, <i>JPRM</i> will continue to offer a platform for research in multidisciplinary care of childhood disability throughout the lifespan as we weather the changes of time together as a committed global community of clinicians and investigators.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251331737"},"PeriodicalIF":0.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730537","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":"Satisfactory long-term functional and radiological outcomes following hip reconstructive surgery in children with cerebral palsy.","authors":"Kathleen Montpetit, Souad Rhalmi, Mathieu Lalumiere, Noémi Dahan-Oliel, Doron Keshet, Dan Epstein, Reggie Hamdy","doi":"10.1177/18758894251316072","DOIUrl":"https://doi.org/10.1177/18758894251316072","url":null,"abstract":"<p><p>PurposeThis study aimed to evaluate long-term functional and radiological outcomes as well as parents' perception of change and overall satisfaction following hip reconstructive surgery in children with cerebral palsy (CP).MethodsMedical charts of children between three and 18 years of age with CP who had surgery between 1993 and 2014 by the same surgeon were reviewed. The study sample consisted of 44 children (Gross Motor Function Classification System levels I-V) aged 2-18 years representing 60 hips. Mean follow-up was 8.4 years [1.8-17.5]. A final follow-up evaluation was held to obtain post-operative anteroposterior pelvic radiographs and administer patient-reported outcomes to the caregivers.ResultsCare and Comfort Hypertonicity Questionnaire scores showed that 74-79% of caregivers reported no difficulty post-surgery in terms of child's pain or discomfort during position changes, when participating in general activities, or during sleep. The Lower Extremity Parent-Rated Change Form showed that 58-76% of caregivers reported a better status in their child's overall health, leg function, activity level, and pain post-surgery. Seventy-six percent of the caregivers indicated satisfaction with the overall changes since the surgery. For the 45 hips with both pre-operative and follow-up radiological outcomes, migration percentage improved significantly (p < 0.001) by 36.7%, and there was a 62.2% increase in the number of hips that were located post-operatively compared to pre-operatively. Acetabular coverage improved significantly (p < 0.001) from non-covered to covered in 46.7% of the hips and Shenton's line improved significantly (p < 0.001) from non-intact to intact in 66.7% of the hips.ConclusionHip reconstructive surgery improved long-term functional and radiological outcomes, as well as quality of life for children and caregivers, while changes were perceived as satisfactory to the families. Evaluating pain, function, and satisfaction is important to measure the impact of hip reconstructive surgery on daily life.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251316072"},"PeriodicalIF":0.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669805","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":"Immersive virtual reality rehabilitation after lower limb surgery in paediatric patients.","authors":"Ivan Phelan, Alicia Carrion-Plaza, Penny Jayne Furness, Jack Parker, Nicolas Nicolaou, Paul Dimitri","doi":"10.1177/18758894241313093","DOIUrl":"10.1177/18758894241313093","url":null,"abstract":"<p><p>PurposePatients who have undergone lower limb surgery require rehabilitation to regain movement and function in the affected leg. Unfortunately, physical rehabilitation can be painful, reducing compliance and recovery. This feasibility study aimed to demonstrate that immersive virtual reality (IVR) applications can provide potential benefits of anxiety reduction and pain distraction for children during gait rehabilitation, increased engagement and enjoyment, and improved perceived walking quality.MethodsThis study included 15 children aged 11-16 who required weight-bearing rehabilitation following lower limb surgery. A mixed methods (quantitative and qualitative) approach and a multidirectional perspective (patients, parents and physiotherapists) were adopted to measure. Changes in anxiety (General Anxiety Disorder-7) and pain (visual analogue scale) before and after the intervention were assessed. Qualitative data were collected through interviews with children, their parents, and physiotherapists, focusing on their experiences, satisfaction, perceived effectiveness, and acceptability of the IVR intervention.ResultsResults demonstrated that IVR for rehabilitation after lower limb surgery in children (1) reduced anticipatory anxiety; (2) reduced the level of pain experienced during gait rehabilitation; (3) improved rehabilitation, such that children were walking more than expected and with better quality; (4) increased confidence; (5) made rehabilitation more enjoyable; and (6) was delivered via a system that was easy to learn and accept.ConclusionThis rehabilitation IVR is the first product of its class for paediatric lower limb postoperative rehabilitation. These preliminary results will inform improvements to the system in a future multi-site study with a large calculated sample size to demonstrate its clinical effectiveness and safety in acquiring medical device markings and adoption.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":"18 1","pages":"30-41"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735703","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}