ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses最新文献

{"title":"Expanding Access to Hearing Healthcare for Adults: How Interprofessional Collaboration Can Promote Care Equity From Clinics to Communities.","authors":"Sarah E Hughes, Clinton R Brenner, Bryan Facione, Erin J Ross, Carrie L Nieman, Michael M McKee, Devin L McCaslin, Milisa Manojlovich, Margaret I Wallhagen, Michael J Brenner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Age-related hearing loss (ARHL) is a prevalent yet often overlooked public health challenge that requires interprofessional teamwork and advocacy to implement evidence-based interventions. ARHL impacts quality of life, cognitive function, and social well-being, yet access to hearing care remains limited due partly due to socioeconomic disparities, stigma, and gaps in interprofessional collaboration. This paper explores strategies to expand equitable access to hearing healthcare through interprofessional collaboration, policy advocacy, and community outreach. Nurses, otolaryngologists, audiologists, primary care providers, and public health professionals play keys roles in integrating hearing screenings into routine care, facilitating timely interventions, and addressing disparities. By leveraging electronic health record prompts, social determinants of health screenings, and interdisciplinary teamwork, healthcare systems can improve early detection and intervention for ARHL. Strengthening nurse-physician communication and fostering interprofessional collaboration ensures that hearing loss is recognized and addressed as a critical component of patient-centered care. Beyond conventional clinical settings, community-based initiatives and policy reforms can further enhance access to hearing services. Expanding insurance coverage for hearing aids, advocating for inclusive healthcare policies, and fostering partnerships with local organizations can bridge existing gaps in care. Additionally, educational campaigns aimed at reducing stigma and increasing public awareness are essential for promoting the adoption of hearing interventions. By emphasizing collaborative approaches to hearing health, this article highlights the importance of addressing ARHL as a clinical and public health priority. A coordinated, equity-driven framework can expand access to care and reduce the long-term consequences of untreated hearing loss in aging adults.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"43 2","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181939","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":"Age-Related Hearing Loss: Evidence-Based Strategies for Early Detection and Management.","authors":"Sarah E Hughes, Clinton R Brenner, Alwyn T Pandian, Erin J Ross, Carrie L Nieman, Michael M McKee, Devin L McCaslin, David E Tunkel, Milisa Manojlovich, Margaret I Wallhagen, Michael J Brenner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Age-related hearing loss (ARHL) is common in older adults and has been linked to significant health and social challenges. These challenges include cognitive decline, depression, falls, and overall decreased quality of life. Despite its high prevalence, ARHL remains underdiagnosed and undertreated, partly due to its gradual onset, stigma, and lack of standardized screening and management protocols. This article provides a comprehensive overview of evidence-based strategies for the early detection and management of ARHL, with an emphasis on recent clinical practice guidelines where nurses are instrumental in leading quality improvement efforts. The multifactorial etiology of ARHL, encompassing genetic predispositions, environmental exposures, and physiological aging, is discussed alongside the health and socioeconomic impacts of untreated hearing loss, including cognitive decline and increased healthcare utilization. Routine screening and hearing assessments can be integrated into patient care visits for individuals aged 50 and above to improve early detection and opportunities for hearing loss management. Effective patient education involves individualized, culturally sensitive counseling that addresses the implications of untreated hearing loss and the benefits of early intervention, which can mitigate stigma and encourage proactive management. Assistive technologies such as consumer devices, hearing aids, and cochlear implants play a vital role in promoting hearing health in personalized care plans developed in collaboration with audiologists. Regular monitoring and follow-up are essential to assess adherence, address challenges, and adjust interventions. By adopting these evidence-based strategies, healthcare professionals can improve identification and management of age-related hearing loss, enhancing the overall health and quality of life for the aging population.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"43 2","pages":"26-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200974","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":"Creating Clarity Amid the Operating Room Clamor: A Mixed Methods Analysis of Noise-Related Barriers and Facilitators to Effective Communication.","authors":"Sarah E Hughes, Milisa Manojlovich, Clare E Jacobson, Devin L McCaslin, Michael M McKee, Dhruv Jain, Andrew S Bolze, Isabel J Hsu, Candice Stegink, Rishindra M Reddy, Kyle H Sheetz, Michael J Brenner","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The operating room is one of the noisiest healthcare environments, creating critical challenges for patient safety, team efficiency, and surgical outcomes. Operating room nurses, essential for patient care and team coordination, face unique risks from noise exposure and impaired communication, yet their challenges remain underexplored.</p><p><strong>Objective: </strong>To assess hearing challenges and communication barriers in operating room teams from nurses' perspectives, with implications for patient safety and interventions.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Methods: </strong>An electronic survey was distributed to operating room personnel, examining hearing difficulties, communication barriers, and current solutions using multiple-choice, Likert-scale, and open-ended formats. Quantitative and qualitative data were analyzed via descriptive statistics and summative thematic analysis.</p><p><strong>Results: </strong>Among 225 participants, 51 were nurses (23%), with 25% reporting hearing loss, 63% no hearing loss, and 12% uncertain. All nurses with baseline hearing loss reported auditory challenges in the operating room, while half without hearing loss reported frequent struggles during surgery (p<.0021). Nurses with > 5 years' operating room exposure had over 5-fold risk of hearing loss (95% confidence interval: 1.3-21.2; p=0.028). Noise from suction devices, alarms, and music hindered communication. Self-accommodations included asking for repetition (62%) and modifying the environment (32%). Nearly all respondents (96%) emphasized improving communication, supporting ambient noise reduction, technology, or behavioral interventions like closed-loop communication.</p><p><strong>Conclusions: </strong>Operating room nurses, central to surgical safety and team efficiency, are disproportionately impacted by noise-related communication challenges. Their dual role positions them to lead the implementation of targeted noise mitigation and communication strategies, driving critical improvements in the surgical environment.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"43 2","pages":"15-25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200975","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":"Advancing Educational Equity for Children with Hearing Loss: Celebrating the 50^th Anniversary of the Individuals with Disability Education Act (IDEA).","authors":"Clinton R Brenner, Alwyn T Pandian, Sarah E Hughes, Casey J Stach, Ellen S Thomas, Anita F Vereb, Terence K Pleasant, Erin M Khang, Kris Estheimer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Individuals with Disabilities Education Act has been pivotal in securing necessary accommodations, specialized instruction, and assistive technologies, thereby promoting educational equity. Despite these advances, children with hearing differences continue to face significant barriers in early identification, intervention, and inclusion, necessitating the continuous advocacy and involvement of interdisciplinary professionals in educational and healthcare settings. Nurses are instrumental in bridging healthcare and education, facilitating early detection of hearing differences through newborn screenings and routine school assessments. They have a role in coordinating medical and educational services and advocating for individualized accommodations that enhance learning experiences. However, inconsistent screening policies and lack of awareness among parents, educators, and pediatricians about early indicators of hearing differences persist represent barriers to timely intervention. This article also explores the broader social determinants affecting access to resources and interventions for children with hearing differences, such as socioeconomic disparities and insurance coverage. It advocates for stronger policies and resources to address these inequities and calls for an expanded role of nurses in promoting comprehensive educational access. As IDEA continues to evolve, there is an ongoing need for innovative approaches, including the integration of advanced technologies and interdisciplinary collaboration, to ensure that all children with hearing differences can achieve their full academic potential and quality of life.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"43 2","pages":"40-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200973","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":"From Ramsay Hunt to Parotid Cancer: A Case Report.","authors":"Meredith H Cummings, Kai-Lin You, Marci L Nilsen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosis of head and neck malignancies remains challenging given the complexity and heterogeneity of the organs and involved anatomical features. Additionally, the presenting symptoms of head and neck cancer may often be vague, mimicking symptoms of less serious illnesses. The following case highlights these challenges. The patient presented to his primary care physician with right facial paralysis involving difficulty closing his eye, as well as intermittent right ear pain. The patient was referred to neurology for a workup to diagnose Lyme Disease or Ramsay Hunt Auricularis. The patient was initially diagnosed with and treated for Ramsay Hunt Auricularis. Despite the treatment, the patient suffered two falls from a loss of consciousness. The cardiologist consulted in the emergency department noted no cardiac etiology. Ultimately, a Computerized Tomography scan and additional imaging revealed a parotid lesion, and the patient was diagnosed with salivary gland carcinoma. The tumor was encircling the internal carotid artery and was subsequently deemed inoperable. No distant metastases were noted. The patient was treated with concurrent chemoradiation using carboplatin and paclitaxel, and leuprolide for androgen receptor-positive cancer. The patient completed this treatment and continues leuprolide every three months. His most recent Positron Emission Tomography scan revealed no evidence of residual disease or recurrent/metastatic disease. The patient still experiences significant long-term treatment effects, such as lymphedema, trismus, and peripheral neuropathy, for which he undergoes rehabilitation services. This unique case is a prime example of the complicated diagnosis and treatment trajectories for patients with head and neck cancer. Frequent follow-up and long-term multidisciplinary care are essential to manage symptoms associated with treatment for all individuals with head and neck cancers.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"42 2","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058647","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":"Post-extubation Assessment of Laryngeal Symptoms and Severity (PALSS) in the Intensive Care Unit: Protocol of a Prospective Cohort Study.","authors":"Vinciya Pandian, Sai Phani Sree Cherukuri, Mounica Koneru, Vidyadhari Karne, Farbod Zahedi Tajrishi, Swetha Aloori, Pooja Kota, Victor Dinglas, Elizabeth Colantuoni, Lee Akst, Alexander T Hillel, Dale M Needham, Martin B Brodsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>The Post-extubation Assessment of Laryngeal Symptoms and Severity (PALSS) study systematically evaluates patient symptoms related to endotracheal intubation with mechanical ventilation, assesses laryngeal injury and voice function after extubation, and develops a screening tool to identify patients with clinically important, post-extubation laryngeal injury.</p><p><strong>Design: </strong>Single-center, prospective observational cohort study conducted in 6 intensive care units (ICU).</p><p><strong>Methods: </strong>Patients ≥18 years old who are orally intubated and mechanically ventilated in an ICU and meet eligibility criteria will undergo flexible laryngoscopy, with a sample size goal of 300 completed laryngoscopies. Primary outcome measures include signs and symptoms of laryngeal injury, including voice symptoms and alterations in swallowing, measured using the Laryngeal Hypersensitivity Questionnaire-Acute and Voice Symptom Scale questionnaires respectively. Data will be collected within 72 hours post-extubation and at 7-day follow-up or hospital discharge (whichever occurs first). Data will be analyzed using descriptive statistics, regression models, and predictive modeling using machine learning.</p><p><strong>Discussion: </strong>The findings of this study will describe the clinical signs and symptoms of laryngeal injury post-extubation.</p><p><strong>Conclusion: </strong>The PALSS study will provide insights for future studies that explore laryngeal injuries using flexible laryngoscopy after endotracheal intubation.</p><p><strong>Implications for patient care: </strong>Identifying signs and symptoms of laryngeal injury after endotracheal intubation will facilitate the development of a screening tool that will assist in early identification of post-extubation laryngeal injury, and aid in decreasing short- and long-term complications of endotracheal intubation.</p><p><strong>Reporting method: </strong>SPIRIT.</p><p><strong>Patient or public contribution: </strong>Patients were study participants; and family members provided informed consent when the patient lacked decision-making capacity.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"42 1","pages":"8-21"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543551","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":"Unlocking Silent Suffering: Addressing the Otorhinolaryngologic Needs of Incarcerated Persons Through Carceral Health Education.","authors":"Yena Kang, Payge Barnard, Gabriella VanAken, Vinciya Pandian, Michael Brenner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mass incarceration in the United States presents major healthcare challenges, and otorhinolaryngology-related needs within carceral settings are underrecognized. Public health crises, as exemplified by the COVID-19 pandemic which led to over 3,000 deaths among incarcerated individuals, can intensify disparities. Both acute otorhinolaryngology conditions, such as craniomaxillofacial trauma, impending airway compromise, and life-threatening infection, as well as more chronic conditions such as cancer, sinusitis, or ear infections can lead to impaired quality of life, disability, or preventable mortality. Incarcerated individuals experience substantial healthcare disparities, which are driven by intrinsic individual and carceral facility factors such as resource scarcity, structural barriers, limited self-advocacy, and social determinants of health, as well as extrinsic factors related to societal misconceptions, inadequate education of healthcare providers on carceral healthcare, and underdeveloped care systems. To address these issues, a comprehensive approach is needed, incorporating experiential learning, bias reduction, and trust building. Early clinical exposure, enhanced public health education, and community outreach efforts are conducive to cultivating structural competence and relevant skills. Carceral health initiatives can thus raise awareness and enhance the healthcare of incarcerated individuals. Healthcare professionals can expand their roles to advocate for equitable care, prioritize rehabilitation over punishment, and support individuals upon reentry into society. Healthcare professionals in otorhinolaryngology, play a pivotal role in addressing the needs of incarcerated individuals, with nurses, physicians, and allied health stakeholders working together. Education, advocacy, and compassionate care provide the basis for a more equitable and humane carceral healthcare system that upholds the dignity and well-being of all individuals.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"41 4","pages":"14-22"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001554","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":"Otolaryngology Nurses' Awareness of Clinical Practice Guidelines.","authors":"Helene J Krouse","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical practice guidelines (CPG) are developed to inform clinical decision-making and standardize care based on scientific evidence, benefits and harms of treatment, and patient preferences to achieve optimal health outcomes. This survey study explored the level of awareness of otorhinolaryngology (ORL) nurses in using CPGs in clinical practice. The study sought to answer the following: (1) How aware are ORL nurses of CPGs developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF)? (2) Which CPGs are most widely identified by ORL nurses? and (3) Do ORL nurses perceive that AAO-HNSF guidelines can benefit their practice? An online survey was developed, piloted, and launched to all eligible registered nurse SOHN members in October 2015. A total of 146 nurses (29%) completed the survey. Over 60% of respondents were in nursing for more than 20 years, 20% were in ORL for 5 years or less, and 40% worked in the hospital, 25% were aware of one or less of the guidelines, with 75% aware of 2 or more specialty guidelines. Nurses were most aware of the tracheostomy care (64%), tonsillectomy in children (47%), and tympanostomy tubes in children (46%) guidelines. The majority of ORL nurses was aware of specialty CPGs and used them to help guide their clinical practice on a regular basis. They also perceived support by their organizations to engage in evidence-based practice. Increasing nurses' awareness and knowledge of CPGs will likely increase guideline use and advance clinical practices based on these recommendations. Strategies to enhance evidence-based guideline recommendations into practice will also be discussed.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"35 1","pages":"6-12"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36866640","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":"Early Detection and Aggressive Management of Otologic Pathologies in Children with Down Syndrome.","authors":"Jessica Hoffner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 13-year-old boy with Down syndrome (DS) presents to the pediatric otolaryngologist after being lost to follow-up for several years. The child is accompanied by his stepmother, who has recently been granted full custody together with his father. The stepmother states that the child's mother was non-compliant with his medical care and now, as she describes it, they are \"playing catch-up.\" According to his stepmother, he has a history of recurrent ear infections and had tympanostomy tubes inserted in the past (date(s) unknown). The child has several other co-morbidities including severe obstructive sleep apnea (OSA), premature ventricular beats and possible hypothyroidism. He receives services in school for his speech and language delays in addition to regular physical and occupational therapy. The child was referred by his pediatrician who initially sent him for an audiological evaluation after failing a hearing test in the office. The child's audiogram is consistent with bilateral, severe mixed sensorineural (SNHL) and conductive hearing loss (CHL) and reveals small canal volumes consistent with bilateral middle ear effusions (MEE). The physical exam also reveals bilateral MEE and possible cholesteatoma in the right ear, consistent with chronic otitis media. This case highlights the need for early education of families in the primary care setting when the diagnosis of DS is made, in order to ensure that the child receives adequate care to maximize developmental potential and quality of life.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"35 1","pages":"19-28"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36866641","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":"Membership in Professional Nursing Organizations.","authors":"Helene J Krouse","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":"35 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36866639","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}