{"title":"Advances in the ecological validity of research on social cognition in schizophrenia: A systematic review of the literature","authors":"Alvaro Cavieres, Vanessa Acuña, Marcelo Arancibia, Camila Escobar","doi":"10.1016/j.scog.2024.100333","DOIUrl":"10.1016/j.scog.2024.100333","url":null,"abstract":"<div><h3>Introduction</h3><div>Ecologically valid assessments need to require tasks representative of real, everyday interactions between people in a social environment (i.e., verisimilitude) and to predict aspects of real-life performance in those same interactions (i.e., veridicality). To determine how researchers interested in social cognition among people with schizophrenia currently understand and apply ecological validity in their work, we conducted a systematic review of studies that had the ecological validity of their results as an explicit objective.</div></div><div><h3>Methods</h3><div>We performed the described systematic review following PRISMA guidelines.</div></div><div><h3>Results</h3><div>Of the 18 studies reviewed, only two defined <em>ecological validity</em>, 15 incorporated modifications to improve their verisimilitude, eight proposed analyses to examine their veridicality, and seven aimed to achieve both objectives.</div></div><div><h3>Conclusions</h3><div>Our systematic review suggests that very few published studies on social cognition among people with schizophrenia have explicitly defined <em>ecological validity</em>, and most have focused only on the verisimilitude of the tasks required while neglecting the veridicality of the results.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100333"},"PeriodicalIF":2.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446565","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}
Anna R. Knippenberg, Sabrina Yavari, Gregory P. Strauss
{"title":"Negative auditory hallucinations are associated with increased activation of the defensive motivational system in schizophrenia","authors":"Anna R. Knippenberg, Sabrina Yavari, Gregory P. Strauss","doi":"10.1016/j.scog.2024.100334","DOIUrl":"10.1016/j.scog.2024.100334","url":null,"abstract":"<div><div>Auditory hallucinations (AH) are the most common symptom of psychosis. The voices people hear make comments that are benign or even encouraging, but most often voices are threatening and derogatory. Negative AH are often highly distressing and contribute to suicide risk and violent behavior. Biological mechanisms underlying the valence of voices (i.e., positive, negative, neutral) are not well delineated. In the current study, we examined whether AH voice valence was associated with increased activation of the Defensive Motivational System, as indexed by central and autonomic system response to unpleasant stimuli. Data were evaluated from two studies that used a common symptom rating instrument, the Psychotic Symptom Rating Scale (PSY-RATS), to measure AH valence. Participants included outpatients diagnosed with SZ. Tasks included: Study 1: Trier Social Stress Task while heart rate was recorded via electrocardiography (<em>N</em> = 27); Study 2: Passive Viewing Task while participants were exposed to pleasant, unpleasant, and neutral images from the International Affective Picture System (IAPS) library while eye movements, pupil dilation, and electroencephalography were recorded (<em>N</em> = 25). Results indicated that negative voice content was significantly associated with: 1) increased heart rate during an acute social stressor, 2) increased pupil dilation to unpleasant images, 3) higher neural reactivity to unpleasant images, and 4) a greater likelihood of having bottom-up attention drawn to unpleasant stimuli. Findings suggest that negative AH are associated with greater Defensive Motivational System activation in terms of central and autonomic nervous system response.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100334"},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446566","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}
Philip D. Harvey , Richard S.E. Keefe , Peter Kallestrup , Sara J. Czaja , Hans Klein , William Horan
{"title":"Migration of digital functional capacity assessments from device resident to cloud-based delivery: Development and convergent validity","authors":"Philip D. Harvey , Richard S.E. Keefe , Peter Kallestrup , Sara J. Czaja , Hans Klein , William Horan","doi":"10.1016/j.scog.2024.100331","DOIUrl":"10.1016/j.scog.2024.100331","url":null,"abstract":"<div><div>Decentralized clinical trials are leading to rapid changes in assessment technology, including an expansion of interest in remote delivery. As technology changes, some of the updates include migration to fully cloud-based software and data management, with attendant differences in hardware, response modalities, and modifications in the level of tester engagement. It is rare to see systematic descriptions of the process of migration and upgrading of technology-related assessments. We present comparative data on successive generations of two widely used functional capacity measures, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) and the Functional Capacity Assessment and Training System (FUNSAT). Four samples of healthy older individuals completed either the original device-resident, computer-administered versions, or cloud-based, tablet-delivered versions of these tasks. For the VRFCAT, performance and correlations with age were similar across versions, although performance was slightly (5 %) faster with iPad delivery. For the FUNSAT, performance and correlations with age and cognitive task scores were generally similar across versions for English Speakers, though there were some differences related to the testing language for the cloud-based version. These results support the feasibility of migrating digital assessments to cloud-based delivery and substantiate fundamental similarity across delivery strategies.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100331"},"PeriodicalIF":2.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000325/pdfft?md5=ca8c916199d8f0f564e82d512be874d7&pid=1-s2.0-S2215001324000325-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315339","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}
Aikaterini Poulou , Fotios Anagnostopoulos , Argiro Vatakis , Robert C. Mellon , Daniel R. Mueller
{"title":"The implementation and effectiveness of Integrated Psychological Therapy (IPT) in chronic middle-aged inpatients with schizophrenia","authors":"Aikaterini Poulou , Fotios Anagnostopoulos , Argiro Vatakis , Robert C. Mellon , Daniel R. Mueller","doi":"10.1016/j.scog.2024.100330","DOIUrl":"10.1016/j.scog.2024.100330","url":null,"abstract":"<div><h3>Introduction</h3><div>Cognitive rehabilitation is essential for schizophrenia treatment since it improves function. Moreover, the relationship between cognitive rehabilitation and functioning is significantly affected by negative symptoms and social cognition. Integrated Psychological Therapy (IPT) is a promising approach that integrates interventions in neurocognition, social cognition, and functional level. This study examines IPT's efficacy in chronic middle-aged inpatients.</div></div><div><h3>Methods</h3><div>A randomized controlled study involved 44 individuals with schizophrenia. Twenty-one IPT participants received 50 biweekly sessions and medication, while twenty-three control participants received treatment as usual/supportive therapy and pharmacotherapy. Pre- and post-intervention and six- and twelve-month follow-ups were arranged to assess neurocognition, social perception, psychopathology, and functioning using the Matrics Consensus Cognitive Battery, Social Perception Scale, Positive and Negative Syndrome Scale, and Global Assessment of Functioning.</div></div><div><h3>Results</h3><div>Speed of processing, attention/vigilance, overall composite, and neurocognitive composite scores improved significantly in the IPT group. Social Perception Scale performance improved in all areas after the intervention and persisted for 6 months. Positive, negative, and total psychopathology symptoms decreased significantly post-intervention and at the 12-month follow-up, whereas participants' functioning improved significantly.</div></div><div><h3>Conclusions</h3><div>Middle-aged chronic inpatients with schizophrenia may benefit from IPT in neurocognition, social perception, psychopathology, and functioning. This field of study may provide insight into schizophrenia treatment, hence further research is encouraged.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100330"},"PeriodicalIF":2.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000313/pdfft?md5=573f6f718b25b0f5042295b79275e95f&pid=1-s2.0-S2215001324000313-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310767","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}
Elizabeth A. Kruse , Abhishek Saxena , Bridget J. Shovestul , Emily M. Dudek , Stephanie Reda , Jojo Dong , Arun Venkataraman , J. Steven Lamberti , David Dodell-Feder
{"title":"Training individuals with schizophrenia to gain volitional control of the theory of mind network with real-time fMRI: A pilot study","authors":"Elizabeth A. Kruse , Abhishek Saxena , Bridget J. Shovestul , Emily M. Dudek , Stephanie Reda , Jojo Dong , Arun Venkataraman , J. Steven Lamberti , David Dodell-Feder","doi":"10.1016/j.scog.2024.100329","DOIUrl":"10.1016/j.scog.2024.100329","url":null,"abstract":"<div><p>Individuals diagnosed with schizophrenia spectrum disorders (SSDs) often demonstrate alterations in the Theory of Mind Network (ToM-N). Here, in this proof-of-concept, single-arm pilot study, we investigate whether participants with an SSD (<em>N</em> = 7) were able to learn to volitionally control regions of the ToM-N (dorso/middle/ventromedial prefrontal cortex [D/M/VMPFC], left temporoparietal junction [LTPJ], precuneus [PC], right superior temporal sulcus [RSTS], and right temporoparietal junction [RTPJ]) using real-time fMRI neurofeedback (rtfMRI-NF). Region-of-interest analyses demonstrate that after neurofeedback training, participants were able to gain volitional control in the following ToM-N brain regions during the transfer task, where no active feedback was given: right temporoparietal junction, precuneus, and dorso/ventromedial prefrontal cortex (neurofeedback effect <em>Fs</em> > 6.17, <em>ps</em> < .05). These findings suggest that trained volitional control over the ToM-N is tentatively feasible with rtfMRI neurofeedback in SSD, although findings need to be replicated with more robust designs that include a control group and larger samples.</p></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"38 ","pages":"Article 100329"},"PeriodicalIF":2.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000301/pdfft?md5=b9df997a4f84a022a7a3050f119009b3&pid=1-s2.0-S2215001324000301-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142148638","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}
Jacopo Sapienza , Giulia Agostoni , Stefano Comai , Sofia Nasini , Stefano Dall'Acqua , Stefania Sut , Marco Spangaro , Francesca Martini , Margherita Bechi , Mariachiara Buonocore , Giorgia Bigai , Federica Repaci , Daniela Nocera , Chiara Ave , Carmelo Guglielmino , Federica Cocchi , Roberto Cavallaro , Giacomo Deste , Marta Bosia
{"title":"Neuroinflammation and kynurenines in schizophrenia: Impact on cognition depending on cognitive functioning and modulatory properties in relation to cognitive remediation and aerobic exercise","authors":"Jacopo Sapienza , Giulia Agostoni , Stefano Comai , Sofia Nasini , Stefano Dall'Acqua , Stefania Sut , Marco Spangaro , Francesca Martini , Margherita Bechi , Mariachiara Buonocore , Giorgia Bigai , Federica Repaci , Daniela Nocera , Chiara Ave , Carmelo Guglielmino , Federica Cocchi , Roberto Cavallaro , Giacomo Deste , Marta Bosia","doi":"10.1016/j.scog.2024.100328","DOIUrl":"10.1016/j.scog.2024.100328","url":null,"abstract":"<div><h3>Background</h3><p>In the last decade, the kynurenine pathway (KP) has gained attention in the pathogenesis of cognitive impairment in schizophrenia being at the croassroad between neuroinflammation and glutamatergic and cholinergic neurotransmission. However, clinical findings are scarse and conflicting, and the specific contributions of these two systems to the neurobiology of cognitive symptoms are far from being elucidated. Furthermore, little is known about the molecular underpinnings of non-pharmacological interventions for cognitive improvement, including rehabilitation strategies.</p></div><div><h3>Methods</h3><p>The current study examined 72 patients with schizophrenia, divided in two clusters depending on the severity of the cognitive impairment, with the aim to evaluate the impact of inflammatory biomarkers and KP metabolites depending on cognitive functioning. Moreover, we studied their possible link to the cognitive outcome in relation to sessions of cognitive remediation therapy (CRT) and aerobic exercise (AE) in a longitudinal arm of 42 patients.</p></div><div><h3>Results</h3><p>Neuroinflammation appeared to exert a more pronounced influence on cognition in patients exhibiting a higher cognitive functioning, contrasting with the activation of the KP, which had a greater impact on individuals with a lower cognitive profile. Cognitive improvements after the treatments were negatively predicted by levels of TNF-α and positively predicted by the 3-hydroxykynurenine (3−HK)/kynurenine (KYN) ratio, an index of the kynurenine-3-monooxygenase (KMO) enzyme activity.</p></div><div><h3>Conclusion</h3><p>Overall, these findings add novel evidence on the biological underpinnings of cognitive impairment in schizophrenia pointing at a differential role of neuroinflammation and KP metabolites in inducing cognitive deficits depending on the cognitive reserve and predicting outcomes after rehabilitation.</p></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"38 ","pages":"Article 100328"},"PeriodicalIF":2.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000295/pdfft?md5=54248f45278f1be63d6fe3c4e9270e2f&pid=1-s2.0-S2215001324000295-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088850","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}
Reut Komemi , Hana Tubenbaltt , Eiran V. Harel , Mor Nahum , Lena Lipskaya-Velikovsky
{"title":"Ecological virtual reality-based cognitive remediation among inpatients with schizophrenia: A pilot study","authors":"Reut Komemi , Hana Tubenbaltt , Eiran V. Harel , Mor Nahum , Lena Lipskaya-Velikovsky","doi":"10.1016/j.scog.2024.100326","DOIUrl":"10.1016/j.scog.2024.100326","url":null,"abstract":"<div><p>Schizophrenia presents a considerable clinical challenge due to limited progress in promoting daily-life functioning among diagnosed individuals. Although cognitive remediation (CR) has emerged as a promising approach to improving cognitive and functional outcomes in schizophrenia, its effectiveness among inpatients and within hospital environments—where opportunities to practice skills in real-world contexts are limited—remains unclear. Here, we aimed to establish the feasibility and initial efficacy of a short, ecological virtual reality-based CR training (CR-EVR) in acute mental health inpatient settings. Efficacy was assessed at four levels: training engagement, near transfer, far transfer, and ecological transfer. Twenty-three inpatients with schizophrenia (Male: 33.3 ± 8.5; 4 Female) completed 8, 20-min CR-EVR sessions, with exercises training the cognitive abilities of inhibition, planning, working memory, shifting, self-initiation, persistence, and attention. Their cognitive functioning, schizophrenia symptoms, functional capacity, and participation in occupations were evaluated pre- and post-training to address four levels of effectiveness. Of the recruited participants, 25.8 % dropped out. Inpatients who completed the full protocol reported high rates of satisfaction (1-not satisfied; 5-very satisfied)) from the intervention (Median = 4, IQR:3.5–5). Post-training, significant improvements were found in the trained cognitive components (intervention engagement: −6.58 < t/Z < 2.02, <em>p</em> < .05), general cognitive functioning (−2.59 < t/Z < 2.29, <em>p</em> < .05), functional capacity (<em>t</em> = −2.9, p < .05), and diversity of participation in everyday activities (<em>t</em> = −3.36, p < .05). This preliminary study suggests that CR-EVR may be a feasible and practical tool to enhance cognitive and ecological outcomes in short-stay acute inpatient settings. Subject to further research, such intervention may be considered an add-on to current practices that promote recovery and health among inpatient populations.</p></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"38 ","pages":"Article 100326"},"PeriodicalIF":2.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000271/pdfft?md5=f5789124689b40f14b3d8fb575785eef&pid=1-s2.0-S2215001324000271-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088849","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}
Narissa Byers, Sarah MacIsaac, Kate MacGregor, Veronica Whitford
{"title":"Schizotypal traits and their relationship to reading abilities in healthy adults","authors":"Narissa Byers, Sarah MacIsaac, Kate MacGregor, Veronica Whitford","doi":"10.1016/j.scog.2024.100327","DOIUrl":"10.1016/j.scog.2024.100327","url":null,"abstract":"<div><p>Schizotypal traits (i.e., personality characteristics that range from mild eccentricities to more pronounced schizophrenia-like perceptions, thought patterns, and behaviours) have been associated with a variety of cognitive impairments, including difficulties in language processing. Although these difficulties span several aspects of language (e.g., semantic processing, verbal fluency, visual word recognition), it is unclear whether reading abilities are also affected. Thus, the current study employed the Schizotypal Personality Questionnaire (SPQ) – Brief (<span><span>Raine and Benishay, 1995</span></span>) to examine how schizotypal traits impact both word-level and text-level reading skills (using a battery of standardized assessments) in a sample of healthy young adults. We found some evidence that higher schizotypal traits, specifically, increased Disorganized factor scores (reflecting aberrant thinking, communication patterns, and behaviour), were associated with reduced word-level reading abilities. However, this finding did not remain significant after correcting for multiple comparisons. Overall, our study suggests that reading may be another aspect of language affected by schizotypal traits, although additional research (with greater power) is needed to further explore and confirm this finding.</p></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"38 ","pages":"Article 100327"},"PeriodicalIF":2.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2215001324000283/pdfft?md5=52f9bb18ed09f85b970ebc9d0e3fbca8&pid=1-s2.0-S2215001324000283-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142077028","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}
Qi Zhou , Yue Zheng , Xiaodong Guo , Yi Wang , Chengcheng Pu , Chuan Shi , Xin Yu
{"title":"Abnormal hedonic process in patients with stable schizophrenia: Relationships to negative symptoms and social functioning","authors":"Qi Zhou , Yue Zheng , Xiaodong Guo , Yi Wang , Chengcheng Pu , Chuan Shi , Xin Yu","doi":"10.1016/j.scog.2024.100325","DOIUrl":"10.1016/j.scog.2024.100325","url":null,"abstract":"<div><h3>Background</h3><p>Anhedonia is a deficit of dynamic reward process, and a large proportion of schizophrenia patients continue to experience anhedonia even during the stable phase. However, few studies have examined the multiple aspects of performance in reward processing in patients with stable schizophrenia and evidence suggests that physical and cognitive effort may involve different neural mechanisms.</p></div><div><h3>Methods</h3><p>Parallel measures of effort-based expenditure for reward tasks (EEfRT) and self-report questionnaires of pleasure were applied in 61 patients with stable schizophrenia (SSZ) and 46 healthy controls (HCs), and percentages of hard task choices (HTC%) were used to assess motivation in reward processing. Negative symptoms, neurocognitive and social function were evaluated in SSZ patients, and associations with performance in reward tasks were explored.</p></div><div><h3>Results</h3><p>SSZ patients reported more severe consummatory and anticipatory anhedonia and social anhedonia. HTC% in reward tasks of SSZ patients were significantly lower than that of HCs, especially in cognitive-effort tasks. HTC% in cognitive tasks were correlated with motivation and pleasure dimension of negative symptoms, whereas HTC% in physical tasks were associated with expression dimension. Anticipatory anhedonia and negative symptoms were correlated with Personal and Social Performance Scale (PSP) scores.</p></div><div><h3>Conclusion</h3><p>Patients with stable schizophrenia have social anhedonia, physically consummatory and anticipatory anhedonia and reduced reward motivation. They are less willing to make cognitive effort than physical effort for reward. The different associations of physical and cognitive effort with negative symptoms indicate physical and cognitive effort may represent disparate neuropsychological processes. Anticipatory anhedonia is closely related to social functioning.</p></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"38 ","pages":"Article 100325"},"PeriodicalIF":2.3,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221500132400026X/pdfft?md5=c801f7f5adb9cd59c786d5464ea50ad2&pid=1-s2.0-S221500132400026X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142058528","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}