Enfermeria Intensiva最新文献

{"title":"Impacto de la implementación de un método de traspaso de información estandarizada interdisciplinar en sala de partos y unidad de cuidados obstétricos intermedios","authors":"E. Crespo-Mirasol RN, RM, MSc, PhD ,&nbsp;A. Llupià-García MD, MSc, PhD ,&nbsp;J. Bellart-Alfonso MD, MSc, PhD ,&nbsp;A. Peguero-Yus MD, MSc, PhD ,&nbsp;F. Figueras-Retuerta MD, MSc, PhD ,&nbsp;S. Hernández-Aguado MD, MSc, PhD","doi":"10.1016/j.enfi.2023.04.002","DOIUrl":"10.1016/j.enfi.2023.04.002","url":null,"abstract":"<div><h3>Aim</h3><p>This study aims to describe the implementation of the standard methodology for information transfer in the labour ward and Intermediate Obstetric Care Unit and to identify the impact of this implementation on the factors that act as facilitators and barriers in the procedure.</p></div><div><h3>Method</h3><p>Quasi-experimental pretest-posttest study without a control group in an Intermediate Obstetric Care Unit and delivery room of the Maternal-Fetal Medicine Service of a tertiary hospital in Barcelona. Healthcare staff self-completed an <em>ad hoc</em> questionnaire before and after implementing the standardised IDEAS methodology in the service during 2019 and 2020. Personal self-perception in the information transfer procedure was assessed. The Wilcoxon pairwise test was used for comparison before and after.</p></div><div><h3>Results</h3><p>The use of a standardised methodology has shown an impact on improving the transmission of information. Significant differences were detected before and after the intervention in the following dimensions: location, people involved, time period of the procedure, structured, orderly and clear, and sufficient time for questions (p<!--> <!-->&lt;<!--> <!-->0.001); while no differences were observed in: transmission to the referring professional, well-defined actions, and completion of a summary.</p></div><div><h3>Conclusions</h3><p>There are factors such as structural and organisational aspects and lack of time that hinder effective communication and therefore act as barriers to the transfer of information. The implementation of a methodology with the health professionals involved, the time and the appropriate space allows for the improvement of communication aspects in the multiprofessional team and, therefore, patient safety.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 5-12"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130114129","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":"Encuesta nacional sobre cambios en las políticas de comunicación, visitas y cuidados al final de la vida en las unidades de cuidados intensivos durante las diferentes olas de la pandemia de COVID-19 (estudio COVIFAUCI)","authors":"R.J. Fernández-Castillo PhDc, MSc, RN ,&nbsp;M.D. González-Caro RN ,&nbsp;F.J. Arroyo-Muñoz RN ,&nbsp;J. Garnacho-Montero PhD, MD","doi":"10.1016/j.enfi.2023.04.004","DOIUrl":"10.1016/j.enfi.2023.04.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The pandemic derived from the SARS-CoV-2 infection led to changes in care for both relatives and intensive care patients during the different waves of incidence of the virus. The line of humanization followed by the majority of the hospitals was seriously affected by the restrictions applied. As an objective, we propose to know the modifications suffered during the different waves of the SARS-CoV-2 pandemic in Spain regarding the policy of visits to patients in the ICU, monitoring at the end of life, and the use of new technologies of communication between family members, patients and professionals.</p></div><div><h3>Methods</h3><p>Multicenter cross-sectional descriptive study through a survey of Spanish ICUs from February to April 2022. Statistical analysis methods were performed on the results as appropriate. The study was endorsed by the Spanish Society of Intensive Nursing and Coronary Units.</p></div><div><h3>Results</h3><p>Twenty-nine percent of the units contacted responded. The daily visiting minutes of relatives dropped drastically from 135 (87.5-255) to 45 (25-60) in the 21.2% of units that allowed their access, improving slightly with the passing of the waves. In the case of bereavement, the permissiveness was greater, increasing the use of new technologies for patient-family communication in the case of 96.5% of the units.</p></div><div><h3>Conclusions</h3><p>The family of patients admitted to the ICU during the different waves of the COVID-19 pandemic have suffered restrictions on visits and a change from face-to-face to virtual communication techniques. Access times were reduced to minimum levels during the first wave, recovering with the advance of the pandemic but never reaching initial levels. Despite the implemented solutions and virtual communication, efforts should be directed towards improving the protocols for the humanization of healthcare that allow caring for families and patients whatever the healthcare context.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 35-44"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348827","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":"Monitorización de la glucemia en el paciente crítico adulto: tipo de muestra y método de análisis. Revisión sistemática y metanálisis","authors":"S. Arias-Rivera PhDc, MSN, RN ,&nbsp;M. Raurell-Torredà PhD, MSN, RN ,&nbsp;R.J. Fernández-Castillo PhDc, MSN, RN ,&nbsp;C. Campos-Asensio BPharm, MLS ,&nbsp;I.J. Thuissard-Vasallo MsC, PhD ,&nbsp;C. Andreu-Vázquez PhD, MsC, MvD ,&nbsp;M.E. Rodríguez-Delgado MsC, RN","doi":"10.1016/j.enfi.2023.02.003","DOIUrl":"10.1016/j.enfi.2023.02.003","url":null,"abstract":"<div><h3>Introduction</h3><p>The clinical guideline for the management of sepsis recommends using arterial blood samples for glycaemic control. A multicentre study in 86 Spanish intensive care units revealed that 85.4% of these used capillary puncture.</p></div><div><h3>Objective</h3><p>To analyse the reliability of glycaemia by comparing different blood samples (arterial, venous, capillary) and instruments (glucometers, gasometers, central laboratory). Secondarily, to estimate the effect of confounding variables and the performance of measuring instruments as determined by different quality standards.</p></div><div><h3>Methodology</h3><p>Systematic review and meta-analysis with search in PubMed, CINAHL and Embase databases in September-2021 and September-2022, with no time or language limits. Grey literature sources: DART-Europe, OpenGrey and Google Scholar. Results summarised by qualitative (description of results, study characteristics) and quantitative (meta-analysis to assess standardised mean difference) synthesis. Methodological quality of articles assessed with Quality Assessment of Diagnostic Accuracy Studies-2. Protocol: <span>https://osf.io/</span><svg><path></path></svg> DOI 10.17605/OSF.IO/T8KYP.</p></div><div><h3>Results</h3><p>A total of 32 articles and 5451 patients were included. No discrepancies were obtained between arterial glucometer vs. laboratory samples (bias [95%CI]: 0.01 [−0.12 to 0.14] mg/dL). In contrast, arterial samples with a gasometer did significantly overestimate (bias [95%CI]: 0.12 [0.01 to 0.24] mg/dL). The same trend is seen in capillaries with a glucometer, although not significantly (bias [95%CI]: 0.07 [−0.02 to 0.15] mg/dL). There is discrepancy between studies on the effect of haematocrit and acid-base balance. The greatest consensus is on the poor agreement of glucometer with capillary vs. laboratory samples in the presence of shock and vasopressor support, renal failure or during vitamin C treatment.</p></div><div><h3>Conclusions</h3><p>The evidence to date recommends the use of arterial blood with a blood glucose meter for better reliability of glycaemic analysis and less effect of possible confounding variables, frequently present in the critically ill adult patient.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 45-72"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000238/pdfft?md5=8f132a3d100503d60140f427897322de&pid=1-s2.0-S1130239923000238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127576925","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":"El hambre invisible en la Unidad de Cuidados Intensivos. Estrategias de Cuidado y Consideraciones Esenciales","authors":"Ignacio Zaragoza-García","doi":"10.1016/j.enfi.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2024.01.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 1-4"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139549557","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":"Nurses’ perceptions of the obstacles and supportive behaviors of end-of-life care in intensive care units","authors":"Majd T. Mrayyan ,&nbsp;Nijmeh Al-Atiyyat ,&nbsp;Ala Ashour ,&nbsp;Ali Alshraifeen ,&nbsp;Abdullah Algunmeeyn ,&nbsp;Sami Al-Rawashdeh ,&nbsp;Murad Sawalha ,&nbsp;Abdallah Abu Khait ,&nbsp;Imad Alfayoumi ,&nbsp;Mohammad Sayaheen ,&nbsp;Mohammad Odeh","doi":"10.1016/j.enfi.2023.04.006","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.04.006","url":null,"abstract":"<div><h3>Purpose</h3><p>This study examined the Jordanian registered nurses’ perceptions of the obstacles and supportive behaviors of End-of-Life Care in Intensive Care Units and examined the differences in the concepts based on the samples’ demographics.</p></div><div><h3>Methods</h3><p><span>A cross-sectional and comparative study was conducted using a convenience sample of 230 Intensive Care Unit registered nurses in Jordan. Data were analyzed descriptively, and differences were measured using the independent sample </span><em>t</em><span>-test, the one-way Analysis of Variance, and Scheffe’s post hoc test.</span></p></div><div><h3>Results</h3><p>The registered nurses’ scored moderately on obstacles (74.98 ± 14.54) and supportive behaviors (69.22 ± 4.84). The commonly perceived obstacle and supportive behaviors to End-of-Life Care in Intensive Care Units s were reported. The perceived obstacles differ based on the registered nurses’ certification as an Intensive Care Units nurse (3.04 ± 0.58 vs. 2.74 ± 0.49, p = 0.008), type of Intensive Care Unit (3.28 ± 0.34 vs. 2.86 ± 0.62, p &lt; 0.001), type of facility (3.16 ± 0.59 vs. 2.77 ± 0.61, p &lt; 0.001), number of beds in the unit (3.07 ± 0.48 vs. 2.69 ± 0.48, p = 0.020), and the number of hours worked per week (3.06 ± 0.56 vs. 2.81 ± 0.60, p = 0.005). In contrast, supportive behaviors only differ based on the registered nurses’ age (3.22 ± 0.69 vs. 2.90 ± 0.64, p = 0.019).</p></div><div><h3>Conclusions</h3><p>The common End-of-Life Care perceived obstacle in Intensive Care Units was the lack of nursing education and training regarding the studies concept, which warrants immediate intervention such as on-job training. The common End-of-Life Care perceived supportive behavior in Intensive Care Units was when family members accepted that the patient was dying when nurses offered support to family members; motivational interventions are needed to sustain such behavior. Differences in the perceived obstacles and supportive behaviors should be leveraged for the benefit of patients, nurses, and hospitals.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 23-34"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139549556","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":"Eficacia y seguridad de un compuesto de ácidos grasos hiperoxigenados en la mejora de la microcirculación de la púrpura fulminante en pacientes pediátricos con sepsis: estudio piloto","authors":"G. Pérez-Acevedo RN, PNP, MSc, PhD(c) ,&nbsp;A. Bosch-Alcaraz PhD, RN, PNP, MSc ,&nbsp;J.E. Torra-Bou PhD, RN, MSc","doi":"10.1016/j.enfi.2023.04.003","DOIUrl":"10.1016/j.enfi.2023.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Purpura fulminans (PF) is a serious complication of sepsis resulting from a set of alterations characterised by the development of ecchymotic haemorrhagic lesions and skin necrosis.</p></div><div><h3>Aim</h3><p>To analyse the efficacy and safety of the topical application of HOFA compound, in the cutaneous microcirculation of PF lesions in paediatric patients affected by sepsis<strong>.</strong></p></div><div><h3>Material and methods</h3><p>A prospective quasi-experimental pre-test/post-test single-group conducted in a Paediatric Intensive Care Unit of a third level hospital was performed. Paediatric patients aged 0-18 years with sepsis were included. Somatic oximetry values were measured before and after application of HOFAs every 4<!--> <!-->hours over the first three days of the patients’ hospitalisation. Patient's socio-demographic and clinical variables and somatic oximetry by placing a sensor for measuring tissue perfusion on the area with PF were determined.</p></div><div><h3>Results</h3><p>Four patients were recruited, with a median age of 98 months. The purpuric lesions measured were mainly located on both feet and hands and, in two patients, also on the lateral malleoli and calves of both lower extremities. A total of 225 measurements were obtained, with mean pre-intervention scores of 71.17<!--> <!-->±<!--> <!-->15.65% versus 73.68<!--> <!-->±<!--> <!-->14.83% post-intervention. Statistical significance (p<!--> <!-->&lt;<!--> <!-->0.001) was observed upon comparison of the pre- and post-intervention measurements.</p></div><div><h3>Conclusions</h3><p>Early and continued application of HOFAs in the management of sepsis-induced PF is an effective and safe practice in the cases analysed. In more than half of the episodes analysed, an increase in tissue microcirculation was observed after the application of HOFAs, with no adverse events.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 13-22"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130239923000585/pdfft?md5=567974bc275f28e851488639087fe473&pid=1-s2.0-S1130239923000585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116334987","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":"¿Movilizamos de forma activa y temprana durante la ventilación mecánica a los pacientes ingresados en una unidad de cuidados intensivos?","authors":"A. González-Castro PhD, MD ,&nbsp;R. Ferrero-Franco RN ,&nbsp;C. Blanco-Huelga MD","doi":"10.1016/j.enfi.2023.03.001","DOIUrl":"10.1016/j.enfi.2023.03.001","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"35 1","pages":"Pages 73-74"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126108654","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":"Efectos adversos relacionados con la administración de norepinefrina por accesos venosos periféricos cortos: una revisión de alcance","authors":"J. García-Uribe RN, MSc ,&nbsp;D. Lopera-Jaramillo RN, MSc ,&nbsp;J. Gutiérrez-Vargas Bióloga, PhD ,&nbsp;A. Arteaga-Noriega RN, MSc, PhD ,&nbsp;O.A. Bedoya RN, MSc, PhD","doi":"10.1016/j.enfi.2022.09.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2022.09.001","url":null,"abstract":"<div><p>Peripheral administration of norepinephrine is restricted due to the association of extravasation with tissue necrosis.</p></div><div><h3>Method</h3><p>scoping review with the objective of describing the adverse effects related to the administration of norepinephrine through short peripheral venous access and the characteristics of drug administration in patients hospitalized in ICU, surgery, and emergency services.</p></div><div><h3>Results</h3><p>12 studies with heterogeneous characteristics by size and type of population were included. The proportion of complications associated with peripheral norepinephrine administration was less than 12% in observational studies and it was less than 2% in those that used doses less than 0.13<!--> <!-->μg/kg/min, and concentrations less than 22.3<!--> <!-->μg/ml. The main associated complication was extravasation and there were no cases of tissue necrosis at the venipuncture site, some extravasation cases were treated with phentolamine, terbutaline or topical nitroglycerin. The drug administration time ranged between 1-528<!--> <!-->hours with a weighted mean of 2.78<!--> <!-->h.</p></div><div><h3>Conclusion</h3><p>The main adverse effect was extravasation, no additional complications occurred, phentolamine and terbutaline seem to be useful, and its availability is a necessity. It is essential for the nursing staff to carry out a close assessment and comprehensive care in patients receiving norepinephrine by peripheral route.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 218-226"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775555","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":"Incidencia de úlceras por presión secundarias al decúbito prono en pacientes ingresados en unidades de cuidados intensivos por SARS-CoV-2","authors":"E. Pérez-Juan RN ,&nbsp;M. Maqueda-Palau RN ,&nbsp;C. Feliu-Roig RN ,&nbsp;J.M. Gómez-Arroyo RN ,&nbsp;D. Sáez-Romero RN ,&nbsp;A. Ortiz-Monjo RN","doi":"10.1016/j.enfi.2022.12.001","DOIUrl":"https://doi.org/10.1016/j.enfi.2022.12.001","url":null,"abstract":"<div><p>The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces.</p></div><div><h3>Objectives</h3><p>To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals.</p></div><div><h3>Methods</h3><p>Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0.</p></div><div><h3>Results</h3><p>A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48<!--> <!-->h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p<!--> <!-->=<!--> <!-->0.002), location (p<!--> <!-->&lt;<!--> <!-->0.001) and median duration of hours per PD episode (p<!--> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusions</h3><p>The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.</p></div>","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 176-185"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775546","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":"Oral care with chlorhexidine: One size does not fit all","authors":"M. Llaurado-Serra RN, MSc, PhD ,&nbsp;E. Afonso RN, MSC ,&nbsp;J. Mellinghoff RN, BSc (Hons.), MSc ,&nbsp;E. Conoscenti RN, MNSc ,&nbsp;M. Deschepper PhD","doi":"10.1016/j.enfi.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.enfi.2023.03.002","url":null,"abstract":"","PeriodicalId":43993,"journal":{"name":"Enfermeria Intensiva","volume":"34 4","pages":"Pages 227-228"},"PeriodicalIF":1.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71775557","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}