Journal of Doctoral Nursing Practice最新文献

{"title":"Monitoring Prediabetes Screening in Two Primary Care Offices in Rural Appalachia: A Quality Improvement Process.","authors":"Rebecca T Clark, Christine M Mullins, Jean C Hemphill","doi":"10.1891/JDNP-D-20-00027","DOIUrl":"10.1891/JDNP-D-20-00027","url":null,"abstract":"<p><strong>Background: </strong>One-third of the U.S. population has prediabetes, but 90% remain undiagnosed because healthcare providers are not screening for this condition.</p><p><strong>Objective: </strong>The purpose of this quality improvement project was to monitor prediabetes screening and identification, and implement evidence-based recommendations including registered dietician referral.</p><p><strong>Methods: </strong>This project involved using an evidence-based screening tool to measure individual risk of prediabetes. Aggregate data was collected to evaluate screening implementation, evidence-based recommendations offered by providers, and assess patient risk factors.</p><p><strong>Results: </strong>The percentage of patients at risk for prediabetes was 41.3% (<i>n</i> = 111). The most frequent risks were identified as overweight, history of hypertension, family history of type 2 diabetes mellitus (T2DM), and older age. Providers offered education on weight loss 68.5% (<i>n</i> = 76) and exercise 76.6% (<i>n</i> = 85) but referred 33.3% (<i>n</i> = 37) patients for nutrition education. The screening rates were 52.3% (<i>n</i> = 176) and 72.5% (<i>n</i> = 244) in clinics A and B respectively.</p><p><strong>Conclusions: </strong>A gap remains in using evidence-based recommendations to decrease risk of prediabetes. Prediabetes screening identified a greater percentage of persons in this population.</p><p><strong>Implications for nursing: </strong>There is a need for consistent practice of evidence-based recommendations. This project set the benchmark for future efforts to educate, encourage, and measure providers successes.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38758591","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":"Flipping the Classroom to Optimize Clinical Decision-Making in the Didactic Setting.","authors":"Karen Marie Arca-Contreras","doi":"10.1891/JDNP-D-20-00050","DOIUrl":"10.1891/JDNP-D-20-00050","url":null,"abstract":"<p><strong>Background: </strong>Deliberate inclusion of clinical decision-making nursing skills in the didactic setting will assist students in potentially making better patient care decisions. This can be optimized through use of the flipped learning andragogy. Flipped learning promotes an interactive classroom environment. It fosters teamwork and collaboration. Direct content instruction is the responsibility of students.</p><p><strong>Objective: </strong>This cohort pilot study investigated how the flipped and nonflipped approach to teaching impacted clinical decision-making and student participation.</p><p><strong>Methods: </strong>The Clinical Decision-Making in Nursing Scale (CDMNS) was administered to the students in the flipped classroom and the nonflipped classroom on week 1 and week 6. A student participation checklist was used to observe class activities at three separate intervals (baseline, mid-semester, and end-semester). A repeated measures analysis of covariance was conducted with Instruction Group as the between subjects factor (Flipped and Nonflipped) and Time (preinstruction and postinstruction) as the within subjects factor, and covarying age. The Time by the Instruction group was significant. The Flipped group showed an increase in Clinical decision-making scores (<i>p</i> < .001) after instruction while the Nonflipped group did not (<i>p</i> = .40).</p><p><strong>Results: </strong>The Flipped group (<i>n</i> = 24) showed an increase in Clinical decision-making scores (<i>p</i> < .001) after instruction while the Nonflipped group (<i>n</i> = 23) did not (<i>p</i> = .40). The Flipped classroom showed 100% participation at baseline, mid-semester, and end of semester. The Nonflipped classroom showed overall lower levels of participation, with 42%, 33%, and 39% at each point respectively.</p><p><strong>Conclusion/implications for nursing: </strong>Students who were taught using the flipped instruction were able to apply what they learned in relevant case studies, virtual simulations, and practice National Council Licensure Examination RN (NCLEX-RN) type questions. Through teamwork and collaboration, students had time to practice clinical decision-making skills. This was evident in the increased CDMNS scores and increased levels of participation over time in the flipped group when compared to the nonflipped group.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38758595","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":"The Impact of Nurse Education on Heart Failure Readmissions and Patient Education.","authors":"Kimberly Mattina, Beverly W Dabney, Mary Linton","doi":"10.1891/JDNP-D-19-00076","DOIUrl":"10.1891/JDNP-D-19-00076","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) has become a national concern, with approximately 5.7 million adults in the United States suffering from this life-altering disease. Improved education of these patients prior to discharge helps patients manage their disease adequately and reduce symptom exacerbations.</p><p><strong>Objective: </strong>This quality improvement initiative aimed to determine the effectiveness of an educational intervention in improving nurses' knowledge of HF discharge teaching and documentation of this education in patient charts.</p><p><strong>Methods: </strong>This project was conducted at a Magnet-recognized acute care hospital with 39 critical care step-down beds. Twenty-nine nurses employed on the step-down unit participated in the educational intervention. Pre/post nurse knowledge and chart review data were analyzed.</p><p><strong>Results: </strong>There was a statistically significant increase in the percentage of patients receiving HF education from unit nurses from preintervention 77.0% (<i>n</i> = 81) to postintervention 96.4% (<i>n</i> = 138) (<i>p</i> < .001). There was also a statistically significant increase in the mean number of days patients were educated from 1.64 to 2.58 days (<i>p</i> < .001). Nurse knowledge also increased from pretest (69.7%) to posttest scores (100%) (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>Providing HF educational opportunities enhanced nurse knowledge and increased their documentation of HF education in patient charts.</p><p><strong>Implications for nursing: </strong>Nurse educators may use the study results to improve nurse education and practices aimed at reducing HF readmissions.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38758590","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":"Establishing a Telehealth Program in Primary Care for the Treatment of Opioid Use Disorder.","authors":"Katherine J Coulter,&nbsp;Mary F Hintzsche","doi":"10.1891/JDNP-D-19-00068","DOIUrl":"https://doi.org/10.1891/JDNP-D-19-00068","url":null,"abstract":"<p><strong>Background: </strong>More than 130 Americans die from opioid overdose each day. To address the opioid epidemic, opioid treatment programs are in place to treat substance use disorder. These programs have seen an influx of patients and are not able to accommodate the number of patients. Primary care practices can help with the crisis by providing an office-based opioid treatment (OBOT) program.</p><p><strong>Objective: </strong>To describe the necessary steps and considerations to put in place for implementing a telehealth OBOT program. Establishing a telehealth program for patients controlled on medication-assisted treatment can improve access to care, improve patient compliance, and redirect the workflow of the family practice.</p><p><strong>Methodos: </strong>After a literature review of established OBOT programs, state and federal laws, Medicare and reimbursement policies, a telehealth opioid treatment program was designed for private primary care practice.</p><p><strong>Conclusions: </strong>Primary care practices can should implement an office based opioid treatment program via telehealth to improve workflow and accessibility to care.</p><p><strong>Implications for nursing: </strong>To offer improved access to care for patients with opioid addiction and seamless workflow in the office-based setting, primary care practices should consider establishing their telehealth OBOT program based on the following recommendations.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"207-215"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724243","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":"Evidence-Based Approaches for Prescribing Psychotropic Medications in Individuals With Autism Spectrum Disorders.","authors":"Lisa Alberts","doi":"10.1891/JDNP-D-20-00001","DOIUrl":"https://doi.org/10.1891/JDNP-D-20-00001","url":null,"abstract":"<p><strong>Background: </strong>Treating children and adults with autism spectrum disorders (ASDs) is challenging, whether for mental health concerns, underlying healthcare conditions, or a variety of behavioral challenges, such as self-injury, aggression, or irritability.</p><p><strong>Objective: </strong>This article highlights evidence-based approaches to inform prescribing practices in treating children and adults with ASDs and mental health or behavioral challenges.</p><p><strong>Methods: </strong>Current and historical literature focusing on treating individuals with ASDs using psychotropic medications was analyzed.</p><p><strong>Results: </strong>Psychotropic medications may not be the best choice for treating individuals with ASDs and mental health or behavioral challenges. Inappropriate use of psychotropic medications in this population can cause significant side effects and lead to long-term health related issues.</p><p><strong>Conclusions: </strong>Prescribers should use evidence-based approaches when treating this population.</p><p><strong>Implications for nursing: </strong>Nurse practitioners are likely to encounter patients with ASDs in their practice. Understanding special considerations in prescribing for this population is highly relevant and important to improve health outcomes.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"216-223"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724244","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":"The Consequences of Cannabis Use: A Review of Self-Reported Use and Experiences Among College Students.","authors":"Anna Castaneda Tabet,&nbsp;Delia G Meyer,&nbsp;Crystal Carrisalez,&nbsp;Jennifer Martinez,&nbsp;Richard Paul Diaz","doi":"10.1891/JDNP-D-19-00082","DOIUrl":"https://doi.org/10.1891/JDNP-D-19-00082","url":null,"abstract":"<p><strong>Background: </strong>Healthy People 2020 has introduced a new initiative focused on adolescent health, ages 10-17, and young adults, ages 18-25, due to health and social problems starting or peaking during these years. The initiative focuses on decreasing such problems including substance use. Cannabis is one of the most popular illegal substances used among young adults for recreation in the United States. Multiple consequences of cannabis use are well documented in the literature including the development of medical problems, developmental delays, and social issues. Furthermore, academic success is linked to overall health outcomes.</p><p><strong>Objective: </strong>The aim of this study was to explore cannabis use and knowledge of consequences among college students at a university in southwest Texas.</p><p><strong>Method: </strong>Secondary analysis of survey results from students at a small, private university. The Core Alcohol and Drug Survey, a self-report questionnaire, was utilized to measure alcohol and drug usage, attitudes, perceptions, and opinions regarding drug and alcohol usage. The survey was distributed to all 6,537 undergraduate students. The survey results were collected over a 3-month period and provided to the authors for interpretation.</p><p><strong>Results: </strong>Eighty-two survey responses were received. Analysis indicated that 24.7% of the students used marijuana in the past year, and 16% had used cannabis within 30 days of the survey. Of the respondents surveyed, 13.3% reported they used cannabis occasionally and 38.7% reported they used cannabis regularly. Furthermore, survey results indicated that 12.7% of respondents reported some of the consequences from cannabis use experienced within the past year included public misconduct, such as fighting, arguing, and vandalism. In addition, 13.9% reported having experienced serious personal problems due to cannabis use at least once during the past year including injuries, suicidal thoughts, and sexual assault. Reported attitudes and perceptions of cannabis use include 13.3% perceived great risk associated with cannabis use. Moreover, 62.3% of respondents believe that their friends would disapprove of cannabis use. A negative correlation was identified between cannabis use within the previous 30 days and low grades.</p><p><strong>Conclusion: </strong>The consequences of cannabis use are well documented in the literature, yet cannabis remains a popularly used illegal substance among college students. Despite experiencing known consequences of cannabis use, much of the sample reported regular use of the substance.</p><p><strong>Implications for practice: </strong>Results of the study may be used to improve education and interventions aimed at reducing cannabis use among college students. In addition, providers may use the information to provide patient education at routine visits.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"229-234"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38726122","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":"Depression and Glycemic Control in the Primary Care Setting: An Overview for Primary Care Providers.","authors":"Elisa Laird,&nbsp;Meaghan Maydick,&nbsp;Brayden Kameg","doi":"10.1891/JDNP-D-19-00008","DOIUrl":"https://doi.org/10.1891/JDNP-D-19-00008","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus and depression are frequently comorbid health conditions. Outcomes are generally poorer when the two diseases states co-occur, including the risk of long-term complications, quality of life, mortality, and associated healthcare costs.</p><p><strong>Objective: </strong>The purpose of this article is to review the relationship between type 2 diabetes mellitus and depression, as well as to provide recommendations on the integration of their management in primary care.</p><p><strong>Methods: </strong>Utilizing PubMed and CINAHL, a literature review was completed to identify research pertaining to comorbid depression and diabetes. Reference lists of identified articles were also explored for relevance.</p><p><strong>Results: </strong>There is evidence demonstrating the relationship between diabetes and depression, and a myriad of screening tools and treatment options that can be implemented within the primary care setting.</p><p><strong>Conclusions: </strong>Based on current evidence, it is recommended that mood symptoms should be addressed as part of standard diabetes care in the primary care setting, and patients diagnosed with depression should be screened for diabetes.</p><p><strong>Implications for nursing: </strong>Addressing both depression and diabetes are within the primary care scope of practice. The call to primary care providers to holistically, collaboratively, and simultaneously improve the outcomes of these comorbid conditions is now.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"202-206"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724242","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":"Antibiotic Stewardship Through Standardized Diagnosis and Treatment of Small Bowel Bacterial Overgrowth in Pediatric Patients With Short Bowel Syndrome Reduces Antibiotic Exposure and Improves Cost of Health Care.","authors":"Christie Heinzman,&nbsp;Conrad Cole","doi":"10.1891/JDNP-D-19-00080","DOIUrl":"https://doi.org/10.1891/JDNP-D-19-00080","url":null,"abstract":"<p><strong>Background: </strong>Small bowel bacterial overgrowth (SBBO) is difficult to diagnose in pediatric patients with short bowel syndrome due to the invasive nature of the gold standard testing. Alternative testing methods also have barriers leaving providers to diagnose clinically. This has led to antibiotic overprescribing in this population. An algorithm for SBBO identification and standardized treatment is proposed.</p><p><strong>Objective: </strong>Standardize SBBO identification and treatment in pediatric short bowel syndrome.</p><p><strong>Methods: </strong>1-year retrospective chart review and literature review.</p><p><strong>Results: </strong>Final analysis of 146 admissions revealed diagnostic and antibiotic prescribing inconsistencies. In total, 28% (<i>n</i> = 41) received antibiotics for SBBO including those who continued home antibiotic (<i>n</i> = 27), those prescribed an antibiotic based on clinical suspicion (<i>n</i> = 12), and those prescribed an antibiotic based on duodenal aspirate (<i>n</i> = 2). In 10.2% (<i>n</i> = 15) patients, antibiotics were prescribed without clear clinical indication resulting in 342 antibiotic exposed days and $24,000 in prescription costs.</p><p><strong>Conclusion: </strong>Clinical research is greatly needed as it relates to SBBO. In the meantime, the proposed algorithm guides providers through diagnosis and treatment decision-making. Thoughtful antibiotic prescribing is key to optimizing outcomes while minimizing adverse effects of antibiotics.</p><p><strong>Implications for nursing: </strong>The algorithm empowers nursing to minimize antibiotic overuse through collaborative teamwork.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"187-194"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724240","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":"An Interprofessional Pain Diary in Transitional Care: A Feasibility Project.","authors":"Desirri L Arneson,&nbsp;Darla C Coss,&nbsp;Lisa P Rovick,&nbsp;Patricia Finch Guthrie","doi":"10.1891/JDNP-D-19-00075","DOIUrl":"https://doi.org/10.1891/JDNP-D-19-00075","url":null,"abstract":"<p><strong>Background: </strong>Understanding pain perceptions in older adults is important for pain management. An interprofessional team conducted a feasibility project to examine whether a pain diary designed for older adults in a transitional care unit offered a more holistic description of the pain experience.</p><p><strong>Objectives: </strong>The project was designed to: (a) Develop a pain diary, (b) Examine patient usability, (c) Determine feasibility of the diary in workflow, and (d) Examine outcomes of diary entries and satisfaction surveys.</p><p><strong>Methods: </strong>Three rapid change cycles assisted in developing and implementing the diary.</p><p><strong>Results: </strong>Five patients followed for 32 days during implementation wrote simple narratives and rated their pain (<i>M = 2-5.3)</i> on 11-point pain rating scales. Themes from narrative responses were <i>medicated relief and alternative methods, finding a balance between motion and activity, emotional burden of pain</i>, and the <i>importance of feeling supported by the health-care team</i>. Patients and staff completed satisfaction questionnaires indicating enhanced communication.</p><p><strong>Conclusions: </strong>The diary was feasible for patients and staff to use and has potential as an effective interprofessional tool for pain management.</p><p><strong>Implications for nursing: </strong>The pain diary provides the interprofessional team an opportunity to understand the patient experience and provide holistic care.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"195-201"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724241","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":"Students' Perceptions of the Value of Learning the Skill Sets of a DNP-Prepared Nurse: An Exploratory Study.","authors":"Meigan Robb,&nbsp;Diane F Hunker","doi":"10.1891/JDNP-D-20-00002","DOIUrl":"https://doi.org/10.1891/JDNP-D-20-00002","url":null,"abstract":"<p><strong>Background: </strong>Students enter doctor of nursing practice (DNP) programs with varying interests and professional experiences. Little is known about how this impacts learning.</p><p><strong>Objective: </strong>To explore if differences existed in students' perceptions of task values related to learning the skill sets of a DNP-prepared nurse.</p><p><strong>Methods: </strong>Students were sent a link to a 17-item electronic survey consisting of demographic questions and nine statements based on competencies as outlined in <i>The Essentials of Doctoral Education for Advanced Nursing Practice</i> (American Association of Colleges of Nursing [AACN], 2006). Students ranked the statements in order of perceived value of performing after program completion.</p><p><strong>Results: </strong>Mean rankings of task values demonstrated the advanced practice registered nurse (APRN) group (<i>n</i> = 32) identified the most valuable skill as \"suggest an evidence-based change in professional practice based on the findings of published research articles and professional practice experience.\" The non-APRN group (<i>n</i> = 10) reported \"work collaboratively with other non-nursing healthcare professionals to improve patient and population health outcomes.\"</p><p><strong>Conclusions: </strong>Students' perceptions of the value of learning the skill sets vary amongst APRNs and non-APRNs, and are shaped by past professional experiences and future role demands.</p><p><strong>Implications for nursing: </strong>Findings provide faculty with knowledge that can be used to tailor teaching and engagement strategies.</p>","PeriodicalId":40310,"journal":{"name":"Journal of Doctoral Nursing Practice","volume":"13 3","pages":"224-228"},"PeriodicalIF":0.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38724245","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}