JAACAP open最新文献

{"title":"A Randomized Clinical Trial of Technology-Enhanced Family-Focused Therapy for Youth in the Early Stages of Mood Disorders","authors":"David J. Miklowitz PhD ,&nbsp;Marc J. Weintraub PhD ,&nbsp;Megan C. Ichinose PhD ,&nbsp;Danielle M. Denenny PhD ,&nbsp;Patricia D. Walshaw PhD ,&nbsp;Catherine A. Wilkerson BS ,&nbsp;Samantha J. Frey BS ,&nbsp;Georga M. Morgan-Fleming BA ,&nbsp;Robin D. Brown BS ,&nbsp;John A. Merranko MA ,&nbsp;Armen C. Arevian MD, PhD","doi":"10.1016/j.jaacop.2023.04.002","DOIUrl":"10.1016/j.jaacop.2023.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>Family-focused therapy (FFT) is associated with enhanced outcomes in youth with bipolar and depressive disorders, but has not been evaluated in conjunction with mobile health tools. In symptomatic adolescents whose parents had histories of mood disorders, we examined whether the effects of telehealth-based FFT were augmented by mobile health apps that emphasized mood tracking and family coping skills.</p></div><div><h3>Method</h3><p>Participants (aged 13-19 years) had active mood symptoms and a parent with major depressive or bipolar disorder. Participants received 12 sessions in 18 weeks of telehealth FFT, with random assignment to (1) a mobile app (MyCoachConnect, MCC) that enabled mood tracking, reviews of session content, and text reminders to practice mood management and family communication skills (FFT-MCC); or (2) a mobile app that enabled mood tracking only (FFT-Track). Independent evaluators assessed youth every 9 weeks over 6 months on depressive symptoms (primary outcome), anxiety, and psychosocial functioning.</p></div><div><h3>Results</h3><p>Participants (N = 65; mean age 15.8 ± 1.6 years) significantly improved in depressive symptoms over 6 months (<em>F</em>_1,170 = 45.02, p &lt; .0001; ή² = 0.21, 95% CI = 0.11-0.31), but there were no effects of treatment condition or treatment by time interactions on depression scores. When secondary outcome measures were considered, the subgroup of youth with bipolar spectrum disorders showed greater improvements in anxiety and global functioning in FFT-MCC compared with FFT-Track.</p></div><div><h3>Conclusion</h3><p>Youth in the early stages of mood disorder may benefit from FFT enhanced by mobile health apps. Collaborations between researchers and information technologists on mobile app design and user experience may lead to increases in engagement among adolescents.</p></div><div><h3>Clinical trial registration information</h3><p>Technology Enhanced Family Treatment; <span>https://clinicaltrials.gov/</span><svg><path></path></svg>; NCT03913013.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 2","pages":"Pages 93-104"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41716104","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":"Scope","authors":"","doi":"10.1016/S2949-7329(23)00029-7","DOIUrl":"10.1016/S2949-7329(23)00029-7","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 2","pages":"Page A1"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49199898","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":"Modification of an Intervention to Improve Adherence in Adolescents and Young Adults With Bipolar Disorder","authors":"Larry F. Forthun PhD ,&nbsp;Martha Sajatovic MD ,&nbsp;Jennifer B. Levin PhD ,&nbsp;Melissa P. DelBello MD, MS ,&nbsp;Deionte Appling BA ,&nbsp;Michaela D. Broadnax BA ,&nbsp;Edna Fuentes-Casiano MSSA, LSW ,&nbsp;Raechel Cooley BA ,&nbsp;Carol E. Blixen PhD ,&nbsp;Avani C. Modi PhD","doi":"10.1016/j.jaacop.2023.04.001","DOIUrl":"10.1016/j.jaacop.2023.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Managing bipolar disorder (BD) is particularly challenging for adolescents and young adults (AYAs) ages 16 to 21. Few interventions exist that address self-management in AYAs with BD. Thus, this study aimed to modify the customized adherence enhancement behavioral intervention for AYAs through an iterative, patient-centered process.</p></div><div><h3>Method</h3><p>The Obesity-Related Behavioral Intervention Trials (ORBIT) model was used for intervention development. In phase 1a, adherence barriers and facilitators were identified to refine intervention content. Phase 1b occurred following curriculum modification to ensure that the modified intervention was relevant and usable by the target population. Data were collected via focus groups and interviews with AYAs with BD, parents, and providers. Transcripts were analyzed using directed content analysis.</p></div><div><h3>Results</h3><p>Phase 1a included focus groups/interviews with AYAs (n = 10), parents (n = 4), and providers (n = 9) who described the difficulties and successes in managing BD symptoms, improving adherence, and transitioning care from caregivers. Phase 1b included an advisory board composed of 8 phase 1a participants who provided feedback on modified session activities, module delivery, and curriculum. Phase 1b involved usability testing with new participants (n = 8), revealing the need for modifiable language based on developmental level, more engaging visual images, and confirmation that topics were salient to AYAs with BD.</p></div><div><h3>Conclusion</h3><p>Though sample sizes were small and not representative of the population of AYAs with BD, the ORBIT methodology informed the adaptation of the customized adherence enhancement intervention to improve adherence in AYAs with BD. Important next steps are to conduct a pilot randomized clinical trial of customized adherence enhancement for AYAs.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 2","pages":"Pages 80-92"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43316297","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":"Youth Who Have Lived in Alternative Care in Nigeria, Zambia, and Zimbabwe: Mental Health and Violence Outcomes in Nationally Representative Data","authors":"Sarah Elizabeth Neville PhD ,&nbsp;Oladoyin Okunoren MSW, LCSW ,&nbsp;Thomas M. Crea PhD","doi":"10.1016/j.jaacop.2023.05.002","DOIUrl":"10.1016/j.jaacop.2023.05.002","url":null,"abstract":"<div><h3>Objective</h3><p>We explore whether having previously lived in alternative care (foster, kinship, and/or residential care) is linked to sexual risk taking, mental health, and experiencing violence in Nigerian, Zambian, and Zimbabwean youth 13 to 17 years of age living in households with or without their biological parents, and we assess the utility and limitations of existing data.</p></div><div><h3>Method</h3><p>This study is a secondary analysis of nationally representative Violence Against Children Surveys (N = 6,405). Logistic regressions examined the effect of alternative care experience on the odds of poor outcomes, controlling for covariates including parental care status, orphanhood, and household assets.</p></div><div><h3>Results</h3><p>In both bivariate and multivariate analyses, having lived in alternative care in the last 5 years was associated with lowered odds of mental distress (odds ratio [OR] = 0.25, 95% CI = [0.10, 0.61], <em>p</em> = .002), and higher odds of sexual risk taking (OR = 1.70, 95% CI = [1.11, 2.59], <em>p</em> = .014), caregiver physical abuse (OR = 1.81, 95% CI = [1.30, 2.50], <em>p</em> &lt; .001), caregiver emotional abuse (OR = 1.75, 95% CI = [1.20, 2.54], <em>p</em> = .004), and peer violence (OR = 1.57, 95% CI = [1.09, 2.26], <em>p</em> = .015). It was not associated with suicidality, self-harm, or sexual assault after controlling for covariates.</p></div><div><h3>Conclusion</h3><p>Youth who have lived in alternative care in the last 5 years may benefit from programs that address violence, self-harm, and sexual risk taking behavior, even if they are now in families. To better understand children outside parental care, national data collection efforts should distinguish between residential and family-based care.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 2","pages":"Pages 141-150"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45430158","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":"Substance Use Disorders and Psychiatric Illness Among Transitional Age Youth Experiencing Homelessness","authors":"Colin W. Burke MD ,&nbsp;Elizabeth S. Firmin BA ,&nbsp;Sylvia Lanni BA ,&nbsp;Peter Ducharme MSW ,&nbsp;Maura DiSalvo MPH ,&nbsp;Timothy E. Wilens MD","doi":"10.1016/j.jaacop.2023.01.001","DOIUrl":"10.1016/j.jaacop.2023.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>Transitional age youth experiencing homelessness (TAY-EH) bear a high burden of substance use disorders (SUDs) and psychopathology. However, limited data exist on the co-occurrence and interactions between these diagnoses in this marginalized group. This study sought to identify rates of single and co-occurring SUDs and psychiatric diagnoses among a sample of TAY-EH and to investigate associations between psychopathology and prevalence and severity of SUDs in this group.</p></div><div><h3>Method</h3><p>TAY-EH accessing a low-threshold social service agency in a large metropolitan area completed psychosocial and diagnostic interviews to assess for SUDs and psychopathology. Analyses examined rates of single and co-occurring disorders and associations between burden of psychopathology and presence and severity of SUDs.</p></div><div><h3>Results</h3><p>The assessment was completed by 140 TAY-EH; the majority were youth of color (54% Black/African American, 16% Latinx), and 57% identified as male. Rates of single and co-occurring psychiatric disorders and specific SUDs (cannabis use disorder [CUD] and alcohol use disorder [AUD]) were notably high. An increasing number of psychiatric diagnoses was significantly associated with elevated CUD/AUD prevalence and severity. Mood, anxiety, attention-deficit/hyperactivity, and antisocial personality disorders were significantly associated with elevated CUD/AUD prevalence and severity, as was suicidality (all <em>p</em> &lt; .05).</p></div><div><h3>Conclusion</h3><p>This study reveals a complex overlay of SUDs and psychopathology facing TAY-EH, with a significant association between co-occurring psychopathology and severity of CUD/AUD. To the authors’ knowledge, this is the first study to examine associations between specific psychopathology and severity of SUDs among TAY-EH. Further research into the mechanistic and temporal links between these conditions is needed to inform tailored treatment interventions.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 1","pages":"Pages 3-11"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47178700","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":"Psychiatric Diagnoses and Treatment in Nine- to Ten-Year-Old Participants in the ABCD Study","authors":"Kelly A. Duffy BS ,&nbsp;Raghu Gandhi MD ,&nbsp;Chloe Falke BS ,&nbsp;Andrea Wiglesworth MA ,&nbsp;Bryon A. Mueller PhD ,&nbsp;Mark B. Fiecas PhD ,&nbsp;Bonnie Klimes-Dougan PhD ,&nbsp;Monica Luciana PhD ,&nbsp;Kathryn R. Cullen MD","doi":"10.1016/j.jaacop.2023.03.001","DOIUrl":"10.1016/j.jaacop.2023.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>Psychiatric disorders commonly emerge before adulthood. Identification and intervention may vary significantly across populations. A large population-based study was leveraged to estimate the prevalence of psychiatric disorders and treatments and evaluate predictors of treatment in children ages 9 and 10 in the United States.</p></div><div><h3>Method</h3><p>Cross-sectional data from the Adolescent Brain Cognitive Developmental (ABCD) Study were analyzed. The Schedule for Affective Disorders and Schizophrenia for School-Age Children–Computerized version (K-SADS-COMP) was used to estimate clinical diagnoses, and the Child Behavior Checklist (CBCL) was used to assess internalizing and externalizing psychopathology. Parents reported on prescription medications and other mental health interventions. Prevalence rates of K-SADS diagnoses and treatments were calculated. Logistic regression analyses estimated associations between clinical and sociodemographic predictors (sex at birth, race, ethnicity, income, education, urbanicity) and treatments.</p></div><div><h3>Results</h3><p>The most common K-SADS diagnoses were anxiety disorders, followed by attention-deficit/hyperactivity disorder, and oppositional defiant disorder. Attention-deficit/hyperactivity disorder and depression diagnoses predicted stimulant and antidepressant medication use, respectively. Bipolar and attention-deficit/hyperactivity disorder diagnoses also predicted antidepressant medications, outpatient treatment, and psychotherapy. The odds of reporting specific treatments varied by sex, ethnic and racial identities, urbanicity, and income.</p></div><div><h3>Conclusion</h3><p>Expected rates of K-SADS-based psychiatric symptoms are present in the ABCD sample at ages 9 and 10, with treatment patterns broadly mapping onto psychopathology in expected ways. However, important variations in reported treatment utilization across sociodemographic groups were observed, likely reflecting societal and cultural influences. Findings are considered in the context of potential mental health disparities in US children.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 1","pages":"Pages 36-47"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47873606","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":"Open Science for Child and Adolescent Psychiatry","authors":"Manpreet K. Singh MD, MS,&nbsp;Warren Y.K. Ng MD, MPH","doi":"10.1016/j.jaacop.2022.10.001","DOIUrl":"10.1016/j.jaacop.2022.10.001","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42152650","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":"Metformin for Overweight and Obese Children With Bipolar Spectrum Disorders Treated With Second-Generation Antipsychotics (MOBILITY): Protocol and Methodological Considerations for a Large Pragmatic Randomized Clinical Trial","authors":"Jeffrey A. Welge PhD ,&nbsp;Christoph U. Correll MD ,&nbsp;Michael T. Sorter MD ,&nbsp;Victor M. Fornari MD, MS ,&nbsp;Thomas J. Blom MS ,&nbsp;Adam C. Carle PhD, MA ,&nbsp;Bin Huang PhD ,&nbsp;Christina C. Klein PhD, MPH ,&nbsp;Melissa P. DelBello MD","doi":"10.1016/j.jaacop.2023.03.004","DOIUrl":"10.1016/j.jaacop.2023.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>Youth with bipolar spectrum disorders may experience improved mood stability when treated with second generation antipsychotics (SGAs); however, SGAs are associated with unhealthy weight gain and adverse metabolic effects. Metformin may mitigate this weight gain but is rarely prescribed by community mental health practitioners. Its long-term efficacy, safety, and acceptability in usual care, and factors that might moderate these effects, are unknown. The Metformin for Overweight and Obese Children and Adolescents with Bipolar Spectrum Disorders Treated with Second Generation Antipsychotics (MOBILITY) trial aims to fill these gaps. We present the design and analytic plan of this multi-site, open-label, randomized trial.</p></div><div><h3>Method</h3><p>Patients will be randomized to either metformin plus brief healthy diet and exercise education (MET+LIFE) or to LIFE alone. Up to 1637 patients will be followed for up to 2 years at 64 community and academic mental health treatment facilities. Patients may switch between treatment arms during follow-up.</p></div><div><h3>Discussion</h3><p>Pragmatic trials place few burdens and constraints on participating patients, families, and clinicians. This flexibility will allow MOBILITY to obtain long-term follow-up in a large, diverse sample, but produces analytic challenges. MOBILITY’s flexible design has the potential to generate several novel methodological issues that we address. Some patients randomized to LIFE will fail to lose weight, and therefore metformin initiation contrary to the randomization may result from weight gain. Adherence to medications, SGAs, and lifestyle recommendations as well as satiety are potential time-varying mediators, moderators, or confounders of the effect of metformin. Adherence to metformin and SGAs may be positively correlated; therefore, a beneficial effect of metformin on weight could be obscured by the known SGA adverse effect on body weight. However, such correlation could facilitate causal inference by providing indirect information about unknown metformin adherence among patients who did not receive it. A perceived protective effect of metformin could potentially lead to risk compensation, with poorer diet and activity among those receiving metformin. We discuss limitations of traditional statistical approaches and summarize an advanced methodology (“Targeted Learning”) that addresses some of these limitations.</p></div><div><h3>Clinical trial registration information</h3><p>Metformin for Overweight &amp; OBese ChILdren and Adolescents With BDS Treated With SGAs (MOBILITY); <span>https://clinicaltrials.gov/</span><svg><path></path></svg>; NCT02515773.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 1","pages":"Pages 60-73"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45785860","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":"The Coronavirus Impact Scale: Construction, Validation, and Comparisons in Diverse Clinical Samples","authors":"Joel Stoddard MD, MAS ,&nbsp;Elizabeth Reynolds PhD ,&nbsp;Ruth Paris PhD, LICSW ,&nbsp;Simone P. Haller PhD ,&nbsp;Sara B. Johnson PhD, MPH ,&nbsp;Jodi Zik MD ,&nbsp;Eliza Elliotte BS ,&nbsp;Mihoko Maru PhD, LCSW, MA ,&nbsp;Allison L. Jaffe BS ,&nbsp;Ajitha Mallidi BA ,&nbsp;Ashley R. Smith PhD ,&nbsp;Raquel G. Hernandez MD, MPH ,&nbsp;Heather E. Volk PhD ,&nbsp;Melissa A. Brotman PhD ,&nbsp;Joan Kaufman PhD","doi":"10.1016/j.jaacop.2023.03.003","DOIUrl":"10.1016/j.jaacop.2023.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>This report is of the construction and initial psychometric properties of the Coronavirus Impact Scale in multiple large and diverse samples of families with children and adolescents. The scale was established to capture the impact of the coronavirus pandemic during its first wave. Differences in impact between samples and internal structure within samples were assessed.</p></div><div><h3>Method</h3><p>A total of 572 caregivers of children and adolescents or expecting mothers in diverse clinical and research settings completed the Coronavirus Impact Scale. Samples differed in regard to developmental stage, background, inpatient/outpatient status, and primary research or clinical setting. Model free methods were used to measure the scale’s internal structure and to determine a scoring method. Differences between samples in specific item responses were measured by multivariate ordinal regression.</p></div><div><h3>Results</h3><p>The Coronavirus Impact Scale demonstrated good internal consistency in a variety of clinical and research populations. Across the groups studied, single, immigrant, predominantly Latinx mothers of young children reported the greatest impact of the pandemic, with noteworthy effects on food access and finances reported. Individuals receiving outpatient or inpatient care reported greater impacts on health care access. Elevated scores on the Coronavirus Impact Scale were positively associated with measures of caregiver anxiety and both caregiver- and child-reported stress at a moderate effect size.</p></div><div><h3>Conclusion</h3><p>The Coronavirus Impact Scale is a publicly available scale with adequate psychometric properties for use in measuring the impact of the coronavirus pandemic in diverse populations.</p></div>","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 1","pages":"Pages 48-59"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9719727","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":"Scope","authors":"","doi":"10.1016/S2949-7329(23)00013-3","DOIUrl":"https://doi.org/10.1016/S2949-7329(23)00013-3","url":null,"abstract":"","PeriodicalId":73525,"journal":{"name":"JAACAP open","volume":"1 1","pages":"Page A1"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699099","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}