BMC digital health最新文献

{"title":"Healthy at Home for COPD: An Integrated Digital Monitoring, Treatment, and Pulmonary Rehabilitation Intervention.","authors":"Laurel O'Connor, Stephanie Behar, Seanan Tarrant, Pamela Stamegna, Caitlin Pretz, Biqi Wang, Brandon Savage, Thomas Scornavacca, Jeanne Shirshac, Tracey Wilkie, Michael Hyder, Adrian Zai, Shaun Toomey, Marie Mullen, Kimberly Fisher, Emil Tigas, Steven Wong, David D McManus, Eric Alper, Peter K Lindenauer, Eric Dickson, John P Broach, Vik Kheterpal, Apurv Soni","doi":"10.1186/s44247-024-00142-4","DOIUrl":"10.1186/s44247-024-00142-4","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is to demonstrate the feasibility of a multimodal, community-based intervention in treating acute COPD exacerbations.</p><p><strong>Results: </strong>Over 18 months, 1,333 patients were approached and 100 (7.5%) were enrolled (mean age 66, 52% female). Ninety-six participants (96%) remained in the study for the full enrollment period. Fifty-five (55%) participated in tele-pulmonary-rehabilitation. Participants wore the smartwatch for a median of 114 days (IQR 30-210) and 18.9 hours/day (IQR16-20) resulting in a median of 1034 minutes/day (IQR 939-1133). The rate at which participants completed scheduled survey instruments ranged from 78-93%. Nearly all participants (85%) performed COPD ecological momentary assessment at least once with a median of 4.85 recordings during study participation. On average, a 2.48-point improvement (p=0.03) in COPD Assessment Test Score was observed from baseline to study completion. The adherence and symptom improvement metrics were not associated with baseline patient activation measures.</p><p><strong>Conclusions: </strong>A multimodal intervention combining preventative care, symptom and biometric monitoring, and MIH services was feasible in adults living with COPD. Participants demonstrated high protocol fidelity and engagement and reported improved quality of life.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610448","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":"Feasibility of cognitive testing and ecological momentary assessments using smartphones in middle aged and older adults with insomnia.","authors":"Sara Ghadimi, Jason Ereso, Alexander J Kaula, Nick Taptiklis, Francesca Cormack, Cathy Alessi, Jennifer L Martin, Joseph M Dzierzewski, Arash Naeim, Sarah Kremen, Tue Te, Constance H Fung","doi":"10.1186/s44247-025-00158-4","DOIUrl":"10.1186/s44247-025-00158-4","url":null,"abstract":"<p><strong>Background: </strong>Older adults with insomnia who use benzodiazepine receptor agonists (BZAs) may be at increased risk of cognitive impairment. Cognitive testing outside of clinical settings may yield results that are more reflective of individuals' cognition in their natural environment, where they experience fluctuations in mental state (e.g. drowsiness). We assessed the feasibility of self-administered cognitive testing via smartphone apps for collecting in-moment, in-context data about a person's current state (ecological momentary assessment, EMA).</p><p><strong>Methods: </strong>Participants (<i>n</i> = 20; median age 66 years; 14 females, 18 white) aged ≥ 55 years who were recruited from a BZA deprescribing trial were invited to complete (over a 28 day period) daily drowsiness assessments on an EMA app (cued by smartwatch alerts) and weekly self-administered digit span (DGS) forward/backward (2 [minimum] - 9 [maximum]), verbal paired associates (VPA; 0 [best]-24 [worst] total errors), and cued delayed recall of VPA (VPA-DR; 0 [best] - 8 [worst] errors) tests on a cognitive app. We assessed the completion of EMA (0-28 days) and cognitive sessions (# of participants per # sessions completed). We performed thematic analysis of the participant interviews.</p><p><strong>Results: </strong>The median number of days that EMA was completed was 24.5. Twelve (60%) individuals participated in 4 sessions; 2 (10%) individuals participated in 3 sessions; 2 (10%) individuals participated in 2 sessions; and 4 (20%) individuals participated in 1 session. No drowsiness was reported 36% of the time, whereas 38% of the responses reflected feeling \"a little bit\" drowsy and 26% at least \"somewhat\" drowsy. Mean cognitive test scores were DGS-Forward = 7 (SD 1.3), DGS-Backward = 5.6 (SD 1.0), VPA total errors = 9.9 (SD 3.7), and VPA-DR = 2.2 (SD 1.9). Three themes emerged from the participant interviews: 1) concern for one's own cognitive abilities, 2) strategies employed for optimizing scores (including strategies that would invalidate results), and 3) ease of use of the applications.</p><p><strong>Conclusions: </strong>Our findings indicate that mobile cognitive tests and EMAs are feasible in this older population. Further work is needed to understand how scores are influenced by the setting, mood, and behaviors.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00158-4.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555984","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":"Comparative validity assessment of three android step counter applications; a semi-structured laboratory-based study.","authors":"Uchechukwu Martha Chukwuemeka, Arinze Damian Nnalue, Sochima Johnmark Obiekwe, Fatai Adesina Maruf, Anthony Chinedu Anakor, Monday Omoniyi Moses, Chinedum Amaechi, Uchenna Prosper Okonkwo, Ifeoma Adaigwe Amaechi","doi":"10.1186/s44247-025-00159-3","DOIUrl":"10.1186/s44247-025-00159-3","url":null,"abstract":"<p><strong>Background: </strong>Step counting stands out as a highly practical and widely utilised method for assessing an individual's level of physical activity (PA). Although the progress of step counting has undergone a significant transformation in recent times, the need to validate PA applications (apps) is even more pressing to ensure their accuracy. This study aimed to compare the criterion validity of Pacer, Pedometer by ITO Technologies Inc., and Google Fit in measuring step counts in semi-structured laboratory-based conditions.</p><p><strong>Method: </strong>This comparative experimental study involved 50 students who were fitted with Android phones running the three step counting applications (Pedometer, Pacer and Google Fit) simultaneously while they walked a 30-m walkway at a normal and fast pace during which a video of their walking was recorded with Techno Pouvoir 4 Pro running Android version 11. The steps in the recorded videos served as the criterion compared with the steps recorded by the apps and were counted only when the foot is lifted off the ground and placed in a new location. They were counted independently by two reviewers, who recounted where their level of agreement was more than 3 steps until their report was not more than 2 steps different. The Spearman's correlation was used for a relationship, while Mean Absolute Percentage Error (MAPE) and Bland plot were for validity testing at an Alpha level of 0.05.</p><p><strong>Result: </strong>While there was no significant difference in step counts among the three apps, a significant difference was found between the steps recorded by the apps and those counted by the video criterion during normal-paced walking but not for fast-paced walking (<i>p</i> > 0.05). The MAPEs for the three applications were moderate, with Google Fit showing 6.6% for normal pace walking and Pedometer and Pacer showing 9.2%. For fast-paced walking, the MAPE was lower at 5.4% across all three applications.</p><p><strong>Conclusion: </strong>Our findings suggest that a pedometer, Pacer and Google Fit could be used as outcome measures in a general population for counting steps, but Google Fit might be a better step counter when normal pace walking is assessed. However, the study's relatively short duration may have overlooked variations in the applications'performance across different conditions over a longer period; hence, future studies should consider comparing the validity of these applications for a longer duration and among diverse populations.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602408","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":"Using night shift worker and employee health stakeholder perspectives to inform the development of Arcashift^tm, a digital precision circadian medicine intervention for shift work disorder.","authors":"Paige Coyne, Matthew B Jennings, Sara Santarossa, Dana Murphy, Maya Zreik, Helena Bryans, Christopher Drake, Olivia Walch, Philip Cheng","doi":"10.1186/s44247-025-00167-3","DOIUrl":"https://doi.org/10.1186/s44247-025-00167-3","url":null,"abstract":"<p><strong>Background: </strong>More than a quarter of night shift workers (NSWs) have symptoms severe enough to meet diagnostic criteria for Shift Work Disorder (SWD). This study sought to understand the experiences of both NSWs and employee health stakeholders (EHSs) to inform the design of an effective digital precision circadian medicine intervention for NSWs experiencing SWD.</p><p><strong>Methods: </strong>NSWs (<i>N</i> = 20) participated in virtual focus groups (<i>N</i> = 5) and were asked about their experiences with night shift work, desired components of a digital intervention for SWD, and feedback on a potential digital precision circadian medicine intervention (i.e., Arcashift™) for SWD. Eligibility criteria: fixed night schedule for 6 + months, diagnosed with SWD, and aged 18-50 years. EHSs (<i>N</i> = 5) participated in virtual 1-on1 interviews, where they were asked about what motivations, goals, and return-on-investments (ROIs) mattered with regards to investing in a digital intervention for NSWs. Focus groups and interviews were digitally recorded and transcribed. Combined transcript reflexive thematic analysis was conducted to identify themes.</p><p><strong>Results: </strong>The reflexive thematic analysis produced three themes. The first theme, <i>the trials and tribulations of night shift work</i>, related to the physical, mental, and emotional tolls related to working the night shift and resulted from problem-focused discussions with NSWs about what it is like to work the night shift. Subthemes included: <i>physically and mentally draining, the world runs on daytime hours, and lack of respect and consideration</i>. The remaining two themes, <i>thrown to the wolves</i> and <i>shifting towards an app</i>, were the result of shifting focus group conversations with NSWs and interviews with EHSs towards solution-focused thinking by presenting a digital precision circadian medicine intervention (i.e., Arcashift™) through which NSWs' SWD could be improved.</p><p><strong>Conclusion: </strong>This study represents a strong preliminary step toward the development of an app for the intervention of SWD. There is a critical need for a real-world intervention for SWD, and stakeholders were optimistic about the potential of an app to help address SWD. Future work is needed to assess the extent to which the proposed app, informed by these stakeholder insights, is able to improve outcomes for employees and ROIs for EHSs.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00167-3.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755183","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":"The completeness, accuracy and impact on alerts, of wearable vital signs monitoring in hospitalised patients.","authors":"Anthony J Wilson, Alexander J Parker, Gareth B Kitchen, Andrew Martin, Lukas Hughes-Noehrer, Mahesh Nirmalan, Niels Peek, Glen P Martin, Fiona C Thistlethwaite","doi":"10.1186/s44247-025-00151-x","DOIUrl":"https://doi.org/10.1186/s44247-025-00151-x","url":null,"abstract":"<p><strong>Background: </strong>Use of wearable vital signs sensors (WVSSs) to monitor hospitalised patients is growing but uncertainty exists about how such sensors should be adopted into existing practice. The aim of this observational study was to determine the completeness of data capture and accuracy of measurements recorded by a suite of WVSSs. The implications of using such measurements to derive early warning scores was also assessed.</p><p><strong>Methods: </strong>Adult inpatients with Covid-19 wore four WVSSs recording heart rate/respiratory rate (HR/RR), oxygen saturation (SpO₂), axillary temperature and blood pressure (BP). Wearable vitals were paired with traditional vitals (measured by nurses) recorded concurrently. The accuracy of the wearable vitals was assessed using traditional vitals as the reference. National early warning (NEWS2) scores were calculated using wearable and traditional vitals.</p><p><strong>Results: </strong>Forty-eight patients were monitored for 204 days with the sensors. Median sensor wear was 3.9(IQR:1.7-5.9), 3.9(IQR:1.6-5.9) and 3.8(IQR:0.9-5.9) days for HR/RR, temperature and SpO₂ respectively. The BP cuff was worn for median 1.9(IQR:0.9-3.8) days in 33 patients. Length of hospital stay was 8(IQR:6-13) days. Completeness of data capture was 84% for HR/RR, 98% for temperature, 72% for SpO₂ and 36% for BP.There were 1633 HR, 1614 RR, 1412 temperature, 1294 SpO₂ and 59 BP wearable-traditional measurement pairs. 59.7% of HR pairs were within ± 5 bpm, 38.5% of RR pairs within ± 3breaths/min, 24.4% of temperature pairs within ± 0.3℃, 32.9% of SpO₂ pairs within ± 2% and 39.0% of BP pairs within ± 10 mmHg. Agreement between wearable and traditional RRs was poor at high RRs.In a ward setting, 613 NEWS2 scores were calculated using wearable-traditional HR, RR, temperature and SpO₂ pairs. The median NEWS2_traditional was 1(IQR:1-2) and the median NEWS2_wearable was 4(IQR:3-6). Using traditional NEWS2 alerts as a reference, 86% (225/262) of wearable NEWS2 5 + alerts and 89% (82/92) of wearable NEWS2 7 + alerts were false positives.</p><p><strong>Conclusions: </strong>Agreement between vital signs recorded by wearable sensors and concurrent traditional vitals is poor. In this context, data from wearable sensors should not be used in existing track and trigger systems.</p><p><strong>Trial registration: </strong>The COSMIC-19 study was registered with clinicaltrials.gov (registration: NCT04581031, date of registration: Oct 6th 2020).</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00151-x.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031485","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":"Implementation evaluation of biometric fingerprint scanning for monitoring HIV care engagement: acceptability, feasibility, and fidelity among peripartum women living with HIV in Lilongwe, Malawi.","authors":"Wiza Kumwenda, Sophie Lazar, Shaphil Wallie, Madelyn Frey, Denzel Matiya, Michael Owino, Victor Mwapasa, Mina Hosseinipour, Angela M Bengtson","doi":"10.1186/s44247-025-00162-8","DOIUrl":"10.1186/s44247-025-00162-8","url":null,"abstract":"<p><strong>Background: </strong>Sustained HIV care engagement is essential for pregnant women living with HIV (PWLHIV) on lifelong antiretroviral therapy (ART). However, transferring clinics, missed HIV visits, and disengagement from HIV care can make monitoring engagement challenging. This study evaluated the acceptability, feasibility, and fidelity of a biometric fingerprint scanning (BFS) system to monitor women's engagement in HIV care across a network of large, urban clinics in Malawi using a cloud-based BFS system. Differences in BFS coverage compared to the standard of care monitoring (SOC) system were also examined.</p><p><strong>Methods: </strong>PWLHIV aged ≥18 years, attending their first antenatal visit, and residing in Lilongwe District, Malawi, were enrolled and followed through 9-months postpartum at 5 clinics. An implementation evaluation survey was administered at 9-month postpartum to evaluate BFS acceptability and feasibility. BFS recorded attendance at each study and routine HIV visit, with daily data uploads to facilitate participant identification across sites. SOC attendance data were abstracted for fidelity assessment and comparison of BFS coverage. Descriptive statistics assessed acceptability, feasibility, and fidelity. Using the Conceptual framework of Implementation Fidelity, the composite score for the four fidelity aspects (Coverage, Consistency, Duration, Content) was calculated and categorized as \"high\" (≥ 80%), \"moderate\" (50%-79%), and \"low adherence\" (<50%). Chi-square tests and Poisson regression with generalized estimating equations and robust variance were used to assess differences in BFS coverage, with statistical significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Of 399 participants, 91% completed a 9-month postpartum visit. Acceptability was high, with 83% comfortable using BFS and 98% finding it easy to use. Feasibility was high, with 99% recommending it. Fidelity was moderate, with a composite score of 68%. BFS was operational for 88% of 612 working days, used consistently at a median of 50% (IQR 30, 70) of HIV visits, and 75% of participants reported using it as trained. BFS captured 52% of 3,554 visits compared to 48% with SOC (PR = 1.06, 95% CI: 1.04-1.09).</p><p><strong>Conclusion: </strong>BFS was acceptable and feasible for monitoring HIV visits across clinics, showing better coverage compared to the SOC system despite moderate fidelity. Further research is needed to identify barriers and facilitators to BFS implementation.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s44247-025-00162-8.</p>","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"3 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499627","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":"Potential sources of inaccuracy in the Apple watch series 4 energy expenditure estimation algorithm during wheelchair propulsion","authors":"Marius Lyng Danielsson, Roya Doshmanziari, Berit Brurok, M. Wouda, J. Baumgart","doi":"10.1186/s44247-024-00101-z","DOIUrl":"https://doi.org/10.1186/s44247-024-00101-z","url":null,"abstract":"","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801601","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":"From an idea to the marketplace: identifying and addressing ethical and regulatory considerations across the digital health product-development lifecycle","authors":"E. Largent, Jason Karlawish, Anna Wexler","doi":"10.1186/s44247-024-00098-5","DOIUrl":"https://doi.org/10.1186/s44247-024-00098-5","url":null,"abstract":"","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"47 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141805081","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":"Efficacy of digital interventions on physical activity promotion in individuals with noncommunicable diseases: an overview of systematic reviews","authors":"Mohammadhossein Kardan, Andres Jung, Mehvish Iqbal, Saeed Keshtkar, W. Geidl, Klaus Pfeifer","doi":"10.1186/s44247-024-00097-6","DOIUrl":"https://doi.org/10.1186/s44247-024-00097-6","url":null,"abstract":"","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814209","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":"Software symptomcheckR: an R package for analyzing and visualizing symptom checker triage performance","authors":"Marvin Kopka, Markus A. Feufel","doi":"10.1186/s44247-024-00096-7","DOIUrl":"https://doi.org/10.1186/s44247-024-00096-7","url":null,"abstract":"","PeriodicalId":72426,"journal":{"name":"BMC digital health","volume":"33 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815432","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}