Sri Lanka Journal of Bio-medical Informatics最新文献

{"title":"Application of blockchain technology to enhance data security of the medical records","authors":"B. Ranasinghe, R. Hewapathirana, V. H. W. Dissanayake","doi":"10.4038/sljbmi.v10i3.8070","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8070","url":null,"abstract":"Introduction: Blockchain is a rapidly evolving data security practice which employs a growing list of records linked using cryptographic hash of the block proceeding, a timestamp and transaction data. Electronic medical records (EMR) are gaining popularity in health sector. Most of these EMRs are based on relational databases. Data tampering is a known issue found in relational data base approach and it is fairly simple to alter a relational data base record with the administrative privileges. This research explores the potentials of blockchain technology with its resistant to modification of the data, as a tamper protection mechanism for medical records. Methods: A blockchain-based program was developed using Proof-of-Work, to maintain the integrity of the digital record independent of access permissions. This was preceded by a series of interviews with clinicians and EMR administers to understand the possible data tampering in association with paper-based and electronic medical records in the State health sector of Sri Lanka. The blockchain algorithm was applied to the Hospital Health Information Management System (HHIMS) clinical database. A security audit was used to assess the tamper-protection capabilities of the relational database. Results: It was possible to incorporate the blockchain algorithm to the relational database of Hospital HHIMS successfully. An independent blockchain-based data repository was created in association with the native data base of HHIMS. With this approach, a ‘block’ is being created for each new record added to HHIMS database. Hence, the blockchain generated was instrumental in verifying the authenticity of EMR transactions. Conclusion: With the increasing penetration of EMR in health sector, the integrity of the digital stored clinical data is becoming a vital necessity. In centralized database administration, possibility of tampering is high. Clinical data can be counted as ‘high risk’ for such occurrences. The blockchain technology found to be capable of making relational data base tamper-protected by verifying the authenticity of the transactions and data being stored in HHIMS.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133976966","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":"Cloud computing experience in state healthcare organisations of Sri Lanka","authors":"M. Piyasena, R. Hewapathirana","doi":"10.4038/sljbmi.v10i3.8072","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8072","url":null,"abstract":"Introduction: Cloud computing has the potential to restructure the way enterprises acquire, utilize and manage their requirements of computing resources efficiently and cost-effectively. This is true in health care organization in both the private and state sectors. However, health care service providers are traditionally considered to be slow technology adopters. For this cautious approach of slow adoption, there are numerous valid and obvious reasons i.e. security of patient data, cost of change, new technology not a primary focus. Therefore, this study carried out to find user concerns of cloud computing within the state health sector of Sri Lanka. Methods: A qualitative research method used. Non-probabilistic sampling technique was used as cloud computing is a new concept and awareness of cloud computing technologies still low even among ICT related staff. Results: Seven interviews carried out with those who were involved in health IT work in state health care organizations. The thematic areas appearing in cloud computing were; lack of knowledge in cloud computing technology, security, legal and privacy issues, political issues, computer misuse, disaster, theft of intellectual property, abuse of access privileges, data loss or damage and financial issues such as billing model.   Conclusions: In the Sri Lankan healthcare context, cloud computing adoption has not yet started widely. The attitude towards cloud computing is influenced by the security risk and privacy concerns where a lack of policy and legislation were considered major contributing factors. Vendor lock is not a major concern among users as users were not exposed to change in cloud providers. The most preferable cloud service model is a “platform as a service” and most preferable cloud deploying model is “a hybrid cloud”. However, the cost of the cloud is not a major barrier and the lack of knowledge among key actors on different modalities of cloud computing is a barrier to its adoption. Hence such barriers should be addressed appropriately to succeed in cloud service adoption for better digital health in the country. Furthermore, cloud computing should be considered strongly in digital health strategy and blueprint of the country.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125612438","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":"Review of guidelines related to the regulations on telehealth and internet-based prescribing from selected countries","authors":"Gumindu Garuka Kulatunga, R. Hewapathirana, R. Marasinghe, V. Dissanayake","doi":"10.4038/sljbmi.v10i3.8074","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8074","url":null,"abstract":"Introduction: Telehealth related services are spreading rapidly throughout many countries of the world.  Proper guidance on the provision of these services is essential to provide quality healthcare. Internet-based prescribing is an important component of telehealth services. If allowed, Internet-based prescribing must be done within a proper regulatory framework. Method: Guidelines related to the regulation of telehealth services, from registration of physicians to practice medicine to delivery of medicine to patient through internet-based prescriptions were identified through a web-based search using standard medical/ health databases. These documents were reviewed and comparatively analysed. Results: 14 regulatory guidelines were identified. They were from countries/ states with established digital health ecosystems such as Australia, Canada (country wide and for the states of British Columbia and Ontario), Denmark, France, New Zealand, Portugal, Singapore, United Kingdom, United states of America (for the states of California, Maine, North Carolina and Washington). The guidelines were related to the practice of Telemedicine including internet-based prescribing. These guidelines were uniform in relation to the following: any medical prescription was valid, if it is prescribed /issued by a health professional with a licence to prescribe;  there was no distinction between ‘telemedicine license’ and the standard ‘medical license’; in cross border practice, the physicians were required to have a licence to practice medicine in the country where the patient was a resident, at the time of care; general requirements needed to start telehealth services [ensuring that telehealth was appropriate to the situation; ensuring that there was a pre-established relationship with the patient in case of prescription of controlled medications; ensuring that the physician was able to access sufficient patient information prior to prescribing; training of physicians on providing the telehealth service]; ensuring that valid informed consent can be obtained; ensuring the privacy and confidentiality of patient data; ensuring that the patient knows the physician’s identity, qualifications, and where he is providing the service from.; ensuring that the patients know the limitations of telehealth methodology; ensuring that patient identify can be confirmed prior to the consultation; ensuring that suitable distance diagnostic devises are used, and ensuring that medical records are retained. Conclusion: The above-mentioned guidelines would be useful in developing a telehealth regulatory framework for Sri Lanka.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132773882","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":"Limitations in Electronic prescribing in Sri Lankan context: a qualitative study","authors":"M. Ariyaratne","doi":"10.4038/sljbmi.v10i3.8067","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8067","url":null,"abstract":"Introduction: The process of creating medical prescriptions by hand using a pen and paper is influenced by the knowledge, experience, guidelines and regulations. When the same activity is attempted using e-prescription software, user interface and system design limitations can impose additional restrictions. Such additional restrictions limit the freedom to adhere to all possible patterns found in paper-based prescriptions disturbing the workflow and the outputs.  The objective of the research was to identify the limitations in e-prescribing and to propose improvements. Methods: A multistage integrated evaluation was conducted to identify the limitations. The first stage was the identification of the work process of paper-based prescription generation and patterns of the outputs. The second stage consisted of an anonymous online questionnaire to capture the usability data of each identified case. The third stage was a semi-structured interview among the Sri Lankan electronic prescribers to capture the capability of electronic prescribing to address the identified use cases. Results: The data model for the Dictionary of Medicines and Devices (dm+d) of National Health Services, UK was used to model seven different use cases which were explained by activity diagrams, component diagrams and test cases at the first stage. During the second stage of the online questionnaire, all the use cases identified were found to be used during the generation of paper-based prescriptions. The thematic analysis of semi-structured interviews revealed that e-prescribing fails in some identified use cases.  Conclusions: Some Electronic Health Record Systems used in Sri Lanka are currently not fit enough to cater to certain identified use cases of prescription generation. The limitations need to be recognized and corrected before the development of unintentional trends among Sri Lankan e-prescribers.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133361579","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":"Process simulation using non-clinical-data to optimize clinical care in the State Health Sector","authors":"M. P. W. Sahabandu, R. Hewapathirana, A. Jayatilleke","doi":"10.4038/sljbmi.v10i3.8066","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8066","url":null,"abstract":"Introduction: Sri Lanka is a developing country, the resources in health sector is limited. This is particularly true in Outpatient Departments (OPD) and Preliminary Care Units (PCU). This can be overcome by utilizing available resources efficiently by identifying bottle necks in care delivery process. Process simulation is a popular approach used worldwide for similar purposes. Non–clinical–data in health sector i.e. waiting time and service delivery time could be used as variables in this approach. The objective of the study was to design a process simulation based on non-clinical-data for optimization of emergency care medical services in the state sector health institutions in Sri Lanka. Methodology: An analysis of the current first contact care systems in the Accident and Orthopaedic Service (AOS) of the National Hospital of Sri Lanka and PCU at Base Hospital, Panadura was carried out to identify the temporal dimension of resource allocation for time-domain simulation. Process simulation & modelling was done in the AOS by using Arena® software. Results: Congestion was observed in the OPD - AOS in the morning hours. This was mainly at the X-ray department, as 85% of total OPD patients were directed to take X-rays. There was no reduction in waiting time observed by increasing the number of doctors or pharmacists. However, there was a reduction of waiting time (from 97 minutes to 1 minute) observed by increasing X-ray stations from one to two. Conclusions: Process simulation can be used to identify the delays in the clinical care pathway and hence, to allocate & utilize resources effectively & efficiently in hospital settings.   Implementation of this process can be advantageous in developing countries like Sri Lanka, where there are limited financial resources.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122327345","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":"Review of literature for health information security on Sri Lankan health","authors":"R. Ranwala","doi":"10.4038/sljbmi.v10i3.8069","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8069","url":null,"abstract":"Introduction: A large number of government health institutions in Sri Lanka are using Health Information Systems at present. However, there is no national-level health information security policy or privacy protection legislation in the country to regulate health information security and privacy. The objective of this study was to identify the current policies and acts related to health information security and privacy in Sri Lanka. Methods: A literature search was carried out in PubMed and google scholar databases. Grey literature is also included in the search, such as Health Ministry publications. Following keywords/ search terms were used:  Information Security Policy in Sri Lanka, Information Security Act in Sri Lanka, Health Information Security, Health Data privacy. Results: There were no specific documents on health information security and privacy in Sri Lankan context. However, nine documents published by the ministry of health were related to health information. Except for the National Policy on health information, other documents have limited description on security-related areas such as data storage, information disclosure, patient privacy and patient consent. Data/Information Security, Client Privacy, Confidentiality and ethics were addressed with few strategies including fair information practices, Anonymity and Pseudo anonymity and empowering health care recipients in The National Policy on Health information. In addition, there are some general e-laws and policies related to electronic data which can be partially linked to information management in the health sector. Conclusions: Most of the available documents only briefly address security and privacy issues.  However, when a legal value has been given to electronic information systems, it helps to restrict information misuse and promotes authorized use of personal health data. As there is no specific policy or acts to safeguard health information security and privacy there is an urgent requirement to develop policy documents and guidelines addressing issues like data ownership, data localization and data sharing.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123303160","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":"Knowledge about the right to information act of Sri Lanka among the trainees of postgraduate institute of medicine of Sri Lanka","authors":"I. Ihalagama, C. A. D. M. N. C. Kolambage, P. V. A. I. Gunawardena, S. D. Siriwardane","doi":"10.4038/sljbmi.v10i3.8078","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8078","url":null,"abstract":"Introduction: Right to Information Act (RTI) of Sri Lanka implemented in 2016, describes the rights and level of access to information in the public authorities in the country. In the healthcare sector, information plays a major role; persuading health care providers to be conscious of the contents of the Act. The purpose of this survey was to assess the level of knowledge and to get recommendations on methods to improve awareness on RTI act among the trainees of the Postgraduate Institute of Medicine (PGIM). Methods: An electronic questionnaire was distributed among all the trainees currently attached to the PGIM. The questionnaire included 16 questions, covering the main components of the Act. Marks were allocated according to the level of knowledge and feedback was given at the end of the questionnaire. Results: Out of 116 Participants (Response rate – 10.1%) responded to the online questionnaire, the highest number of participants were from General Medical specialties (18%). Other participants were from Biomedical Informatics (17%), General Surgical specialties (16%), Gynaecology and Obstetrics (7%), Pathology (5%) and Medical Administration (4%) streams. The average point score was 47%. The points ranged from 6% (only one answer is correct) to 94% (only one answer is wrong). The results of the survey show an inadequate knowledge, considering the direct questions based on the Act (Only 43% correct answers). In contrast, scenario-based questions recorded higher scores (61% correct answers). Furthermore, 96% of the participants believed that there should be an awareness program regarding RTI. Conclusion: There is a knowledge gap pertaining to the contents of the RTI act among the PGIM trainees. This needs to be addressed with knowledge sharing sessions based on the needs of the trainees as it will be important in their career pathway.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126541805","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":"Building trust in health information systems","authors":"V. Dissanayake","doi":"10.4038/SLJBMI.V4I2.6242","DOIUrl":"https://doi.org/10.4038/SLJBMI.V4I2.6242","url":null,"abstract":"Trust is defined in dictionaries as a firm belief in the reliability, truth, or ability of someone or something. The eHospital Dompe Project has been highlighted as a success story of ICT implementation in the Sri Lankan health care sector. In this issue of the Journal, the project manager of the eHospital Dompe Project describes how they have used Information and Communication Technology (ICT) to build trust in the health care delivered at the hospital by enhancing the hospital workflow and making the hospital work ‘smarter’ (2) . What has been achieved at District Hospital, Dompe should be an eye opener for the entire health care sector in Sri Lanka. One must recognise however that one can do more to build trust in health care. Without trust patients may not access health services at all, or disclose all medically relevant information. Trust in appropriate disclosure of information, referred to as communication trust, is an important attribute of all that goes into building trust in health care. It allows individuals and organisations to share information, to tell the truth, and to admit mistakes while at the same time maintaining the confidentiality of information disclosed. Two articles in this issue of the Journal deal with issues related to building communication trust. In the first article Jayawardena highlights security, privacy and confidentiality issues related to electronic health information systems. (Editorial truncated at 250 words)","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128675769","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":"Negotiating privacy, confidentiality and security issues pertaining to electronic medical records in Sri Lanka: A comparative legal analysis","authors":"Harshani Menaka Ratnayake","doi":"10.4038/SLJBMI.V4I2.5859","DOIUrl":"https://doi.org/10.4038/SLJBMI.V4I2.5859","url":null,"abstract":"Introduction Sri Lanka is set to adapt electronic medical records (EMR) at an ever increasing rate in the coming decade. However, handling of EMRs pose considerable legal challenge in relation to its privacy and confidentiality, quality of records and tort based liability. While the Sri Lankan legislation recognise electronic records as legally valid in most instances, it does not provide sufficient legal backing when it comes to sensitive personal health data. Methodology This paper adapts a comparative method of legal research. The author believes this to be an appropriate methodology for answering the research questions as it is primarily used for the purpose of “promotion of mutual understanding by acquiring knowledge of foreign legal systems”. Findings The paper recognizes that the existing Sri Lankan legislation does not provide for sensitive personal data such as EMR. However, the Sri Lankan legislation has already established the legal validity of electronic records. The paper discusses various legislations from the US including the Health Insurance Portability and Accountability Act (HIPAA) of 1996, The Patient Safety and Quality Improvement Act (PSQIA) of 2005 and Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 as reference legislation. It also discusses the Data Protection Act of 1998 in the UK and the EU Directives as reference legislation for establishing a legal framework for Sri Lanka that would address the needs of EMRs. Recommendations Following the legal analysis, the paper proposes a way forward in adapting suitable legislations from the ones discussed. Some of these adaptations include defining the criteria in which a valid legal record can be established, the creation of the role data controller, laying down a clear framework in which personal health data can be shared, defining the criteria that should be met when using EMR for research, measures to encourage the adaption of EMRs and the standards set forth and the necessity to amend the Computer Crimes Act to include specific provisions to deal with crimes involving EMRs. Conclusion The paper concludes by stating the need to obtain wider consensus from all relevant stakeholders before such legislation is implemented and that the same should not hinder the IT industry which can promote the efficiency of the country’s health care system.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121915854","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 systematic literature review of Security, Privacy and Confidentiality of patient information in Electronic Health Information Systems","authors":"A. Jayawardena","doi":"10.4038/SLJBMI.V4I2.5740","DOIUrl":"https://doi.org/10.4038/SLJBMI.V4I2.5740","url":null,"abstract":"Introduction The evolution of medicine during the past few decades has resulted in electronic transformation of patient records which experienced multiple problems such as security, privacy and confidentiality of patient’s information. Security, privacy and confidentiality are potentially major problems in electronic health records and no system currently available in the world is 100% secure. The objectives of this study were to describe the major issues related to security, privacy and confidentiality of electronic health information systems and computer based patient record systems and to describe methods currently used to overcome those issues by reviewing published articles. Method These articles were identified by searching the PubMed online electronic bibliographic database [www.ncbi.nih.gov/pubmed] for articles published between January 2000 and January 2013 using the keywords security, privacy, confidentiality, electronic health information systems, and computer based patient record systems. 25 articles were selected for this review after a screening process from among 236 articles identified after the PubMed search. Results All 25 articles (100%) had identified that security, privacy, and confidentiality were major problems with Electronic Health Records. None of them were 100% secure and only two (8%) were Health Insurance Portability and Accountability Act (HIPAA) compliant. Conclusion Safeguarding the security, privacy and confidentiality is a major problem in electronic health records and a major challenge for governments. However, studies on the security, privacy and confidentiality issues were not conclusive. Alternative approaches considering social, cultural and governmental factors may be needed to be taken into account to deal with the security, privacy and confidentiality issues. Normal 0 false false false EN-US X-NONE X-NONE","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131707956","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}