Telemedicine journal and e-health : the official journal of the American Telemedicine Association最新文献

{"title":"Long-Term Effectiveness of Internet-Based Versus Traditional Cognitive Behavioral Therapy Across Psychiatric Disorders: A Systematic Review and Meta-Analysis.","authors":"Rūta Bakanaitė, Indrė Bakanienė, Ava Kanyeredzi","doi":"10.1177/15305627251358855","DOIUrl":"https://doi.org/10.1177/15305627251358855","url":null,"abstract":"<p><p><b>Background</b>: Internet-delivered cognitive behavioral therapy (iCBT) has become a promising alternative to face-to-face CBT, yet its long-term effectiveness across psychiatric disorders remains unclear. While numerous studies have examined short-term outcomes, it is essential to understand how iCBT compares with traditional CBT over extended periods and which conditions benefit most. <b>Methods</b>: A systematic search of PubMed, Embase, MEDLINE via EBSCO, PsycINFO via APA, Scopus, and Cochrane Library (CENTRAL) was conducted up to May 21, 2025. Randomized controlled trials (RCTs) comparing the long-term effects of iCBT and face-to-face CBT for depression, anxiety disorders, and eating disorders were included. The random-effects model was used to calculate the standardized mean difference (Hedges' g), and a chi-square test assessed adherence differences. <b>Results</b>: Eleven RCTs (1,272 participants) met the inclusion criteria. Pooled analysis showed no significant difference in long-term effectiveness between iCBT and face-to-face CBT (Hedges' g = -0.07, 95% CI: -0.36 to 0.21). Depressive disorders responded best to iCBT, while anxiety disorders showed mixed results, and eating disorders had the least favorable outcomes. Adherence was higher in face-to-face CBT (86.68%) than in iCBT (70.06%), with therapist-guided iCBT improving completion rates (79.09%) compared with self-guided formats (48.17%). <b>Conclusions:</b> iCBT is a promising alternative to traditional face-to-face CBT, demonstrating treatment effectiveness even in the long term. However, dropout rates are higher in iCBT, particularly in unguided formats, suggesting that therapist support may be crucial for ensuring participant adherence. Future research should optimize iCBT delivery, tailor it to specific disorders, and develop strategies to improve engagement.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652084","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":"Pandemic Telehealth Utilization Among Ambulatory Care Diabetes Patients Managed at an Urban Teaching Hospital in Washington, DC.","authors":"Jessica Lyons, Mary Awuonda, Daria Sinclair, Rakchhya Uprety, Faith Ogini, Carrie Crowther, Monika Daftary, Gail Nunlee-Bland","doi":"10.1089/tmj.2024.0468","DOIUrl":"https://doi.org/10.1089/tmj.2024.0468","url":null,"abstract":"<p><p><b>Objective:</b> The purpose of this study is to explore the prevalence of and factors associated with telehealth utilization in a medically underserved, ambulatory care diabetes population during COVID-19 pandemic. <b>Methods:</b> A retrospective chart review was conducted using electronic medical records from January 2020 to January 2021 at an ambulatory care diabetes clinic within an urban teaching hospital. Descriptive statistical analysis was conducted for all study variables. Simple and multiple logistic regression analyses were conducted to assess predictive factors of telehealth utilization during the COVID-19 pandemic. All statistical analysis was conducted using SPSS version 28 at an alpha level of 0.05. <b>Results:</b> A total of 325 patients were included in the study. The mean age of the study population was 58.2  ±  15.9 years, and the majority was female (67.6%) and Black/African American (92.6%). The average number of medications prescribed was 4.9 ± 2.6 medications, and the average A1C was 8.1% ± 2.4%. A high proportion of patients utilized telehealth (88.3%). Findings from the multivariable analysis showed that females were more likely to use telehealth compared to males, adjusting for other factors (OR_adjusted 2.14 (95% CI: 1.06-4.32). Ward, as a proxy for low income and high medically underserved status, was not a significant predictor of telehealth utilization (<i>p</i> = 0.89). <b>Conclusion:</b> Findings showed that telehealth was widely acceptable at the height of the COVID-19 pandemic even for participants who are low income and have high medically underserved status. Telehealth should continue to be championed as a viable option of care delivery for these vulnerable patients.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610907","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":"Telehealth Buprenorphine Initiation for Opioid Use Disorder Among American Indian and Alaska Native Veterans, April 2017-March 2023.","authors":"Cole Haskins, Amber B Amspoker, Annette Walder, Julianna Hogan, Anthony Ecker, Jan Lindsay, Jay Shore","doi":"10.1089/tmj.2025.0038","DOIUrl":"https://doi.org/10.1089/tmj.2025.0038","url":null,"abstract":"<p><p><b>Objective:</b> To determine whether buprenorphine initiation among American Indian and Alaska Native (AI/AN) Veterans increased with expanded telehealth-prescribing abilities during the COVID-19 pandemic. <b>Methods:</b> This cohort study used the Veterans Health Administration medical record system, including 1,761 AI/AN Veterans with a new opioid use disorder (OUD) diagnosis. Exclusion criteria included buprenorphine receipt in the 3 months before diagnosis and methadone use. Primary exposures included time of diagnosis (3 years before vs. during COVID-19 pandemic, April 1, 2020-March 31, 2023), rurality, and telehealth-only versus in-person encounters. Covariates included age, gender, marital status, Deyo-Charlson Comorbidity Index, and psychiatric comorbidities. The primary outcome was buprenorphine initiation, defined by prescription at/after OUD diagnosis. <b>Results:</b> Of 1,761 AI/AN Veterans with OUD, the mean age was 53.8, 58.5% urban residing, and 37.5% married. Depressive (62.8%) and alcohol use disorders (38.9%) were common. The pre-COVID-19 cohort had more in-person opioid encounters (59.8% vs. 35.7%). Buprenorphine was more frequently prescribed in the pre-COVID-19 cohort (18.5% vs. 12.9%). In the adjusted main-effects model, neither time nor rurality was associated with initiation, but in-person encounters were (odds ratio [OR] = 6.09; 95% confidence interval [CI]: 4.24-8.76). Rurality × time effect modification revealed rural Veterans were more likely to initiate buprenorphine than urban Veterans during the pandemic (OR = 1.81, 95% CI: 1.10-2.99). <b>Conclusions:</b> Unadjusted buprenorphine initiation rates decreased during COVID-19 but were ultimately unexplained by time, with only in-person encounters associated with initiation, compared with telehealth alone. Urban Veterans saw a decline, while rural rates remained stable, likely due to less reliance on in-person care. AI/AN Veteran OUD disparities necessitate telehealth optimization and provider education.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602829","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":"Telehealth Research in France: A 20-Year Bibliometric Study from 2004 to 2023.","authors":"Robin Ohannessian, Paul Martin Gousset, Jean-Pascal Piermé, Julie Salomon","doi":"10.1089/tmj.2025.0078","DOIUrl":"https://doi.org/10.1089/tmj.2025.0078","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine research in France remains relatively underexplored, with a notable absence of comprehensive literature reviews or bibliometric analyses guiding research prioritization and funding allocation for public health interests. The objective of this study is to provide a comprehensive overview of telehealth research in France, elucidating its current trends and primary funding sources. <b>Methods:</b> A bibliometric analysis was conducted spanning a 20-year period from January 1, 2004, to December 31, 2023, using six open-access databases, including the Ministry of Health of France (public research funding), Health Data Hub (research protocols from France), Clinicaltrials.gov (global repository of research protocols), PubMed (scientific publications), Theses.fr (PhD database in France), and DUMAS (master's and doctorate theses database in France). <b>Results:</b> The French Ministry of Health funded 41 telehealth research projects between 2009 and 2022, amounting to €15 million, which constituted 1.1% of all projects funded during this period. 279 study protocols were identified on ClinicalTrials.gov, peaking in 2021 with 58 protocols (20.8%), representing 5.8% of worldwide protocols. Public hospitals provided most of the funding (66%), with 18% coming from the industry. A total of 1,254 publications related to telehealth were identified in PubMed, representing 2.5% of worldwide telehealth publications. <b>Discussions:</b> This is the first study in France and Europe to describe the trends in telehealth research over a 20-year period. Telehealth research in France started in the early 2000s, had a linear growth between 2011 and 2021, peaked during the COVID-19 pandemic, and decreased in 2022 and 2023. All types of telehealth interactions were covered, and funding came mostly from public sources. Funding for telehealth research was however limited and should be increased in France.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602830","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":"Trends in Remote Patient Monitoring Before and After the COVID-19 Public Health Emergency Declaration in the United States: A Comparison Between Rural/Urban and Racial/Ethnic Group.","authors":"Ruchira Mahashabde, Ambrish A Pandit, Mahip Acharya, Mir M Ali, Cari A Bogulski, Hari Eswaran, Corey J Hayes","doi":"10.1089/tmj.2025.0071","DOIUrl":"https://doi.org/10.1089/tmj.2025.0071","url":null,"abstract":"<p><p><b>Background:</b> This study assesses the trend in remote patient monitoring (RPM) utilization among Medicare beneficiaries in the United States with differing rural/urban and racial/ethnic statuses. <b>Methods:</b> Using Medicare fee-for-service claims from January 2018 to December 2020, monthly rates of beneficiaries utilizing RPM per 100,000 beneficiaries enrolled in both Medicare Parts A and B were calculated. Comparative interrupted time series models delineated differences in level and trend of RPM utilization between beneficiaries with differing rural/urban status, race/ethnicity, and race/ethnicity as stratified by rural/urban status using March 2020, the start of COVID-19 public health emergency (PHE) in the United States, as interruption time. <b>Results:</b> RPM utilization increased from 2 to 240 RPM claims per 100,000 Medicare beneficiaries from January 2018 to December 2020. Urban beneficiaries experienced a 24.20 RPM user-level change per month at the start of PHE. Trend difference for urban versus rural beneficiaries increased by 7.85 RPM users per month before and after the start of PHE (<i>p</i> < 0.0001). The trend difference for non-Hispanic Black versus White beneficiaries significantly increased by 12.43 RPM users per 100,000 beneficiaries per month after declaration of PHE (<i>p</i> < 0.0001). Similarly, the trend difference for beneficiaries of Hispanic and of other races significantly increased by 7.48 and 16.93 RPM users per 100,000 beneficiaries per month, respectively, after the declaration of the PHE (<i>p</i> < 0.0001 for both). Trends for racial/ethnic minorities stratified by rural/urban status were similar to the overall trends by racial/ethnic group. <b>Discussion:</b> Inequities in RPM utilization exist and were exacerbated by the COVID-19 pandemic. Targeted interventions are needed to increase RPM utilization broadly, particularly among rural residents.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556561","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":"Improving Autism Detection Through Telemedicine in China: A Comparative Analysis of Multitool-Combined Screening Protocols.","authors":"Weiqin Wang, Zhongling Liu, Dan Wu, Xiaoyan Qiu, Yichen Li, Lingyan Chen, Jihua Zhang, Shasha Wang, Yuan Tian, Yuanyuan Zhang, Daqian Zhu, Jiaojiao Song, Jinjin Chen","doi":"10.1089/tmj.2025.0065","DOIUrl":"https://doi.org/10.1089/tmj.2025.0065","url":null,"abstract":"<p><p><b>Background:</b> Autism spectrum disorder (ASD) prevalence is rising globally, yet traditional face-to-face screening faces challenges, especially during COVID-19. Telemedicine offers a viable alternative for remote ASD detection. Telemedicine offers a promising alternative for remote ASD screening. This study aimed to enhance ASD screening efficiency through telemedicine by integrating multiple early screening tools and comparing their combined efficacy in China. <b>Methods:</b> A cross-sectional, observational, multicenter study was conducted in three districts of Shanghai, utilizing a telemedicine system, the Early Childhood Development Screening, which includes the Warning Signs Checklist for Screening Psychological, Behavioral, and Developmental Problems of Children (WSC), the Early Behavioral Markers of Autism-Five No's behavior, and section A of the Modified Checklist for Autism in Toddlers-23 (CHAT-23-A). Children aged 18 to 36 months were screened, and the Childhood Autism Rating Scale was used as a diagnostic tool. The study evaluated the sensitivity, specificity, and screening performance of these tools individually and in combination. <b>Results:</b> A total of 1,102 valid cases were screened with an effective rate of 83.30%. The WSC and the Five No's demonstrated high sensitivity (90.9%), while the CHAT-23-A showed higher specificity (88.6%) but lower sensitivity (63.6%). In parallel testing, the combination of WSC and Five No's maintained high sensitivity but reduced specificity. Serial testing improved specificity to 97.6% with the triple test but at the cost of lower sensitivity. The area under the receiver operating characteristic curve and the Youden index were highest for the WSC and Five No's combination in serial testing. <b>Conclusions:</b> The study presents a novel ASD screening combination protocol with good sensitivity and specificity, validated through a telemedicine system. This protocol is expected to enhance the accuracy and efficiency of early ASD screening, improving long-term prognoses for children and contributing to their healthy development.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546869","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":"Staying in Your Lane-Perhaps Change Lanes!","authors":"Charles R Doarn","doi":"10.1089/tmj.2025.0154","DOIUrl":"10.1089/tmj.2025.0154","url":null,"abstract":"","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"807"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288151","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":"Intensive Remote Onboarding to Improve Digital Health Access Among Safety-Net Patients During a Pandemic: An Implementation Study.","authors":"Asha S Choudhury, Anupama G Cemballi, Delphine S Tuot, George Su, Triveni DeFries, Shobha Sadasivaiah, Neda Ratanawongsa, Courtney R Lyles","doi":"10.1089/tmj.2024.0452","DOIUrl":"https://doi.org/10.1089/tmj.2024.0452","url":null,"abstract":"<p><p><b>Objective:</b> The COVID-19 pandemic exacerbated disparities in digital health access critical to care delivery. San Francisco Health Network aimed to enroll safety-net patients onto a patient portal with a remote onboarding workflow. <b>Methods:</b> We used a standardized workflow to assess interest in enrollment and provide technical support. Calls from December 2020 to February 2021 were to English-speaking adults with enrollment codes. Outreach expanded March-June 2021 to Spanish speakers and patients without codes after an updated workflow enabled video identity verification and provision of new codes. <b>Results:</b> Of 274 eligible patients, 49% (78/160) of those called were reached. While 62% (48/78) were interested, 20% ultimately enrolled. Barriers included lack of smart devices, internet, and familiarity with videoconferencing. <b>Discussion:</b> Safety-net patients have high interest in portals but experienced obstacles to enrollment, despite intensive remote support. Health systems must recognize portals as central to patient care and devote additional resources to inclusive onboarding.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":"31 7","pages":"919-923"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532876","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":"Assessment of Equitable Use of Virtual Care in Pediatric Specialized Care.","authors":"Robin D Deliva, Kyle Tsang, Parham Manafzadehtabriz, Ashley Graham, Rebecca Comrie, Mark R Palmert","doi":"10.1089/tmj.2025.0059","DOIUrl":"https://doi.org/10.1089/tmj.2025.0059","url":null,"abstract":"<p><p><b>Objective</b>: Telemedicine and broadly, virtual care are established modes of health care delivery but may present unintended barriers to access. We assessed postpandemic ambulatory care provision to determine whether marginalized areas were underrepresented among virtual visits. <b>Methods</b>: We retrospectively analyzed 396,624 ambulatory visits (January 2022 through December 2023), using patient demographics and the Ontario Marginalization Index to compare virtual (78% electronic health record-integrated video) and in-person visits across the domains of residential instability, material deprivation, dependency, and ethnic concentration. Logistic regression was used to compare virtual to in-person visits, adjusting for age, sex, and geographic location. <b>Results</b>: We found higher virtual care utilization for children in remote areas (41% [OR: 1.72 {1.66-1.78}]) and progressively higher virtual care utilization across age groups. Virtual care use for children aged 1-12 was 27% (OR: 1.57 [1.53-1.62]); for adolescents aged 12-16 was 33% (OR: 2.02 [1.96-2.09]); and for those over 16 years was 38% (OR: 2.56 [2.49-2.64]), compared to infants (19%). Indices of residential instability, dependency, and material deprivation had minimal impact on access to virtual care; however, areas with high ethnic concentrations had significantly fewer virtual visits compared to the least ethnically concentrated areas (26.1% vs. 35.0%; adjusted OR: 0.65 [0.63-0.67]). Each quintile increase in marginalization within the ethnic concentration index was associated with an 11% decrease in the odds of a virtual visit. <b>Conclusions</b>: Virtual care use was higher for those at greater distance but lower in ethnically concentrated areas. Further investigation of strategies targeting language barriers, technological literacy, and cultural beliefs is warranted.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500336","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":"Geospatial Analysis of Telemedicine Physicians in the United States.","authors":"Ryan J Crowley, Jag S Lally, David M Kline, Amanda M Bunting","doi":"10.1089/tmj.2025.0160","DOIUrl":"https://doi.org/10.1089/tmj.2025.0160","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine can increase care access and may be particularly helpful for rural patients. We sought to conduct a geospatial analysis of telemedicine physicians in the United States with attention to urban-rural and specialty-level differences. <b>Methods:</b> We used the Doctors and Clinicians national downloadable file. We assessed urban-rural differences in telemedicine physician density, categorized by Rural-Urban Continuum Codes. We analyzed telemedicine physician distribution using spatial clustering and choropleth graphs. <b>Results:</b> Our cohort comprised 660,537 physicians, of whom 136,462 (20.7%) offered telemedicine services. Physicians offering telemedicine services were less likely to practice in rural environments (<i>p</i>-value < 0.001) than nontelemedicine physicians. There were clusters of low telemedicine physician density in the South. <b>Discussion:</b> Telemedicine physicians were less likely to practice in rural areas, which may exacerbate health care disparities. Targeted interventions to increase telemedicine accessibility in rural and underserved areas should be pursued.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500337","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}