Journal of substance use and addiction treatment最新文献

{"title":"Impact of telehealth, in-person, and hybrid care modalities on buprenorphine discontinuation among patients with opioid use disorder: A retrospective cohort study on commercially insured individuals","authors":"Jabed Al Faysal ,&nbsp;Md. Noor-E-Alam ,&nbsp;Gary J. Young ,&nbsp;Mohammad Yaseliani ,&nbsp;Amie J. Goodin ,&nbsp;Md Mahmudul Hasan","doi":"10.1016/j.josat.2025.209749","DOIUrl":"10.1016/j.josat.2025.209749","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid use disorder (OUD) is a leading cause of mortality in the United States. Buprenorphine is an effective treatment for OUD, but its benefits rely on sustained treatment retention. The expansion of telehealth and hybrid care models, particularly during the COVID-19 pandemic, provides an opportunity to improve retention. However, the comparative effectiveness of these care modalities on buprenorphine discontinuation across different treatment phases remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized IBM MarketScan Commercial Claims data from September 2019 to December 2022. The study included insured individuals aged ≥18 years diagnosed with OUD who initiated buprenorphine treatment between March 23, 2020, and December 31, 2021. Patients were stratified into telehealth, in-person, and hybrid care (initiating treatment via telehealth and receiving 51–75 % of visits in-person) groups. The primary outcome was buprenorphine discontinuation, defined as a gap of ≥30 days in prescription fills/refills during the 12-month follow-up. Discontinuation was assessed as two separate binary outcomes: (1) early-phase discontinuation, defined as a gap of ≥30 days within the first 3 months of treatment, and (2) late-phase discontinuation, defined as a gap of ≥30 days between months 4 and 12 among those who remained on treatment through the initial 3 months. Multivariable logistic regression models adjusted for covariates were applied for each outcome, and propensity score matching (PSM) was employed to minimize confounding.</div></div><div><h3>Results</h3><div>Among 10,783 patients (mean age 43.25 ± 12.62 years; 49.52 % female), those treated via telehealth were significantly less likely to discontinue buprenorphine during the early treatment phase compared to patients in both in-person and hybrid care groups (OR: 0.83, 95 % CI: 0.75–0.92). During the late treatment phase, patients receiving hybrid care had significantly lower odds of discontinuation compared to those receiving either telehealth or in-person care (OR: 0.73, 95 % CI: 0.62–0.86). These findings were consistent in both unmatched and matched analyses.</div></div><div><h3>Conclusions</h3><div>Telehealth was associated with improved early retention in buprenorphine treatment, while hybrid care models were more effective for long-term retention. The findings suggest that a phased approach, where telehealth is leveraged for treatment initiation and early retention, and when the patient continues via a hybrid model for long-term care, may optimize buprenorphine treatment outcomes.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209749"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531482","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":"Potential impact of peer support service on SUD treatment engagement following ED visits among Kentucky medicaid beneficiaries","authors":"Xiaoni Zhang ,&nbsp;Valerie Hardcastle ,&nbsp;Thuong Ho ,&nbsp;Gary Ozanich","doi":"10.1016/j.josat.2025.209746","DOIUrl":"10.1016/j.josat.2025.209746","url":null,"abstract":"<div><h3>Background</h3><div>Research indicates that peer support has a positive impact on patients with substance use disorders (SUD). Despite promising findings, integrating peer support into SUD treatment remains limited, particularly during the critical transition period between emergency department (ED) discharge and treatment initiation. This study examines the effectiveness of Kentucky-certified Peer Support Specialists (PSS) during that period within a Medicaid population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of beneficiaries with SUD who initiated treatment following an ED visit using Kentucky Medicaid claims data from July 1, 2022, to June 30, 2023. We assessed prior health conditions using 12-month lookback period (July 2021–June 2022). We then compared monthly engagement outcomes between beneficiaries who received PSS and those who did not.</div></div><div><h3>Results</h3><div>PSS was consistently associated with higher odds of treatment engagement across six months. In unadjusted logistic regression models, odds ratios (ORs) for the PSS group ranged from 1.75 (95 % CI: 1.45–2.09) to 4.17 (95 % CI: 3.53–4.91). Adjusted models accounting for age, sex, geographic location, and health conditions yielded ORs between 1.63 (95 % CI: 1.35–1.95) and 3.84 (95 % CI: 3.23–4.55).</div><div>Subgroup analysis by sex showed that females receiving PSS had ORs ranging from 1.50 (95 % CI: 1.10–2.05) to 3.77 (95 % CI: 2.80–5.07), while males showed ORs from 1.70 (95 % CI: 1.43–2.14) to 4.22 (95 % CI: 3.43–5.22). Among those with one health condition, PSS effects ranged from Month 1 (OR = 1.41, 95 % CI: 1.03–1.95) to a peak in Month 2 (OR = 4.51, 95 % CI: 3.32–6.13). For those with two conditions, effects increased from Month 1 (OR = 1.76, 95 % CI: 1.33–2.34) to a peak in Month 3 (OR = 4.21, 95 % CI: 3.25–5.45). In the group with three or more conditions, ORs started at 2.49 (95 % CI: 1.43–4.32) and remained high through Month 6 (OR = 3.46, 95 % CI: 2.18–5.48).</div></div><div><h3>Conclusions</h3><div>Peer support services are associated with the increased likelihood of SUD engagement in Kentucky Medicaid enrollees. Subgroup findings by gender and health complexity highlight its broad effectiveness. These results support expanding access to peer support in Medicaid policy and practice.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209746"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512901","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":"“All it's gonna tell you is if it has fentanyl or not:” Perceptions of fentanyl and drug checking among first responders and people who use drugs","authors":"Brenda Y. Goh ,&nbsp;Emily C. Williams ,&nbsp;Courteney Wettemann ,&nbsp;Callan E. Fockele ,&nbsp;Tessa Frohe ,&nbsp;Grover Williams ,&nbsp;Nathan Holland ,&nbsp;Rachel E. Rourke ,&nbsp;Robert Pitcher ,&nbsp;Thea Oliphant-Wells ,&nbsp;Jenna van Draanen","doi":"10.1016/j.josat.2025.209747","DOIUrl":"10.1016/j.josat.2025.209747","url":null,"abstract":"<div><h3>Introduction</h3><div>Fentanyl contamination in the unregulated drug supply contributes to high rates of opioid overdose among people who use drugs (PWUD). Drug checking is a harm reduction strategy that provides PWUD with information about the contents of their substances. Although drug checking has broad utility, this study focused specifically on drug checking to test for fentanyl, with a particular emphasis on fentanyl test strips (FTS) and point-of-care testing at community service organizations. This study assessed first responders and PWUDs' perceptions of fentanyl, drug checking, and associated implementation suggestions.</div></div><div><h3>Methods</h3><div>The risk environment framework and community-engaged methods guided the study. First responders and PWUD were recruited using convenience sampling from first responder agencies and community service locations, respectively, in King County, WA. The study conducted semi-structured interviews with first responders (<em>n</em> = 32; law enforcement officers, paramedics, emergency medical services, firefighters, etc.) and PWUD (<em>n</em> = 13) until data saturation. A group of academically trained and peer-based researchers with lived experiences of substance use analyzed the data using a thematic analysis approach.</div></div><div><h3>Results</h3><div>First responders and PWUD discussed the fentanyl-saturated drug use landscape and the amplification of PWUDs' overdose risk. Preferences for fentanyl among PWUD varied, ranging from a preference for it, to willingness to use it, to strong aversion. Most first responders expressed concerns about post-overdose FTS distribution, viewing it as ineffective in promoting safer use behaviors and inconsistent with their workflow and provider role. People who use fentanyl perceived drug checking to be of low relevance due to fentanyl's ubiquity, while PWUD who were trying to avoid it cited numerous barriers, including low availability, trust in sellers, limitations of FTS, and lack of information or connections.</div></div><div><h3>Conclusions</h3><div>The study found low support for drug checking for fentanyl and first responders' distribution of FTS. Drug checking may have the most utility for PWUD who were trying to avoid fentanyl; however, its potential benefits may not be fully realized until structural barriers to access and use are addressed. Caution should be exercised to not promote drug checking as a universal tool and place the onus of addressing fentanyl contamination on PWUD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209747"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512899","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":"Evaluation of a primary care-based Medication for Opioid Use Disorder (MOUD) program in a fully-integrated federally qualified health center","authors":"Karen Howard ,&nbsp;Pamela Stover ,&nbsp;Andrew Suchocki","doi":"10.1016/j.josat.2025.209744","DOIUrl":"10.1016/j.josat.2025.209744","url":null,"abstract":"<div><h3>Introduction</h3><div>Clackamas Health Centers (CHC), a public sector Federally Qualified Health Center in Oregon, has been providing medication for opioid use disorder (MOUD) in a low-barrier, harm reduction model for over a decade. CHC also provides a unique pathway for criminal justice-involved patients to receive MOUD treatment. CHC's primary care-based treatment program has seen substantial growth since it began; however, a comprehensive review has never been completed.</div></div><div><h3>Methods</h3><div>A mixed-methodology program evaluation was undertaken to determine if the CHC MOUD program is providing effective low-barrier care. Outcomes for this evaluation included retention rate, opioid-free urine drug screen (UDS) results, patient and provider satisfaction, and patient improvement in quality of life.</div></div><div><h3>Results</h3><div>Data collected from July 1, 2022 to December 31, 2022 showed a 6-month retention rate of 85 % (<em>N</em> = 186). Urine drug screens were opioid-negative for 91 % of samples examined (<em>N</em> = 222). Patients reported positive lifestyle changes after receiving MOUD treatment, demonstrated by Treatment Effectiveness Assessment scores. Medical providers surveyed (<em>N</em> = 9) felt satisfied in their work treating patients with opioid use disorder and patients (<em>N</em> = 24) reported satisfaction with the care they were receiving in the MOUD program.</div></div><div><h3>Conclusion</h3><div>While data on primary care-based MOUD models is sparse, this evaluation has shown similar or better results than those noted in other studies on outcomes such as retention and urine drug screen results. These data can help demonstrate the effectiveness of fully-integrated MOUD programs in primary care, as well as establishing a baseline for treatment outcomes and future program evaluation.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209744"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512900","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 effect of craving on retention and treatment switching under buprenorphine-naloxone and methadone models of care for non-heroin opioid use disorder: Exploratory analyses from a pragmatic, randomized controlled trial","authors":"Christina McAnulty ,&nbsp;Gabriel Bastien ,&nbsp;Anita Abboud ,&nbsp;Arash Bahremand ,&nbsp;Omar Ledjiar ,&nbsp;M. Eugenia Socias ,&nbsp;Bernard Le Foll ,&nbsp;Louis-Christophe Juteau ,&nbsp;Didier Jutras-Aswad ,&nbsp;for the OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse","doi":"10.1016/j.josat.2025.209743","DOIUrl":"10.1016/j.josat.2025.209743","url":null,"abstract":"<div><h3>Introduction</h3><div>Though opioid agonist therapies are the mainstay of treatment for opioid use disorder, treatment retention remains suboptimal. Improved prediction of who will remain in treatment could lead to improved treatment outcomes. Whether craving predicts reduced retention in treatment remains debated. We performed analyses to determine whether craving predicted treatment attrition or treatment switching in people with non-heroin opioid use disorder initiating opioid agonist therapy.</div></div><div><h3>Methods</h3><div>Our data came from the OPTIMA trial - a pan-Canadian, pragmatic, open-label, randomized controlled trial that compared a flexible, early take-home buprenorphine/naloxone model of care (<em>n</em> = 137) to standard treatment with methadone (<em>n</em> = 132) for non-heroin opioid use disorder over a period of 24 weeks. We performed Cox proportional hazards regression to conduct survival analyses of time (days) to treatment attrition, and time to switch to another treatment, with craving as a time-varying covariate, controlling for assigned treatment group, lifetime history of heroin use and province. Craving was measured at baseline, week 2, 6, 10, 14, 18, 22 using the Brief Substance Craving Scale.</div></div><div><h3>Results</h3><div>We found that craving predicted both treatment drop out and treatment switching. A 1-point increase in craving was associated with a 15.3 % increase of risk of dropping out of the study (HR = 1.153, 95 % CI = 1.065 to 1.248, <em>p</em> &lt; 0.001) and with a 11.5 % increase of risk of switching treatment (HR = 1.115, 95 % CI = 1.016 to 1.225, <em>p</em> = 0.022).</div></div><div><h3>Conclusions</h3><div>Craving predicted both treatment attrition and treatment switching in people receiving buprenorphine/naloxone or methadone models of care for non-heroin opioid use disorder. These findings highlight the importance of targeting and better addressing craving during treatment with opioid agonist therapies.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209743"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509852","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":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(25)00113-4","DOIUrl":"10.1016/S2949-8759(25)00113-4","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"175 ","pages":"Article 209734"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253367","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":"Association between buprenorphine adherence for opioid use disorder and clinical events and healthcare spending among older patients","authors":"Olajumoke A. Olateju ,&nbsp;Mina Shrestha ,&nbsp;J. Douglas Thornton","doi":"10.1016/j.josat.2025.209740","DOIUrl":"10.1016/j.josat.2025.209740","url":null,"abstract":"<div><h3>Background</h3><div>Buprenorphine adherence in older adults with opioid use disorder (OUD) remains underexplored. This study investigated the associations between buprenorphine adherence and risks of opioid overdose, hospitalization, and healthcare spending among older adults to help inform practice and policy.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we utilized the Merative MarketScan® Database (2017–2019) to identify Medicare Advantage enrollees with OUD who initiated buprenorphine and were retrospectively followed for 180 days. We classified patients as adherent (Proportion of Days Covered ≥0.80) or non-adherent to buprenorphine. We balanced baseline characteristics between groups using an inverse probability treatment weighting approach. We then evaluated the associations between adherence and the risks of opioid overdose and all-cause hospitalization using discrete-time survival and Cox proportional hazards models respectively. Finally, we estimated differences in healthcare spending between adherent and non-adherent patients using generalized linear models.</div></div><div><h3>Results</h3><div>The cohort included 631 patients (379 [60 %] male; mean (SD) age:67 [2.8] years). Among them, 437 (69 %) were adherent to buprenorphine. Patients with a history of chronic pain, mental health disorders, and diabetes were less likely to adhere while higher average daily doses of buprenorphine were associated with increased adherence. Adherence was associated with reduced risks of opioid overdose (HR:0.76; 95%CI:0.59–0.93) and hospitalization (HR:0.55; 95%CI:0.42–0.73). Healthcare spending among adherent patients was $40,200 [95%CI:$54,712-25,687]) lower than in non-adherent patients. These findings were consistent across robustness and sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Buprenorphine adherence was associated with reduced risks of opioid overdose, hospitalization, and healthcare spending in the overall population of older individuals with OUD. Enhancing adherence to buprenorphine should be prioritized in OUD treatment strategies among this population.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209740"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287490","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":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(25)00112-2","DOIUrl":"10.1016/S2949-8759(25)00112-2","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"175 ","pages":"Article 209733"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253366","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":"Association of state medicaid prescription cap policies with trajectories of buprenorphine use for opioid use disorder","authors":"Patience M. Dow ,&nbsp;Miriam George ,&nbsp;Landon D. Hughes ,&nbsp;Corinne Roma ,&nbsp;Theresa I. Shireman ,&nbsp;Julie M. Donohue ,&nbsp;Lisa Peterson ,&nbsp;Jaclyn M.W. Hughto","doi":"10.1016/j.josat.2025.209739","DOIUrl":"10.1016/j.josat.2025.209739","url":null,"abstract":"<div><h3>Background</h3><div>Buprenorphine and other medications for opioid use disorder (OUD) can reduce opioid-related morbidity and mortality. It is unknown whether state Medicaid prescription cap policies that restrict the monthly number of covered prescription fills affect the duration of buprenorphine use.</div></div><div><h3>Objective</h3><div>To identify trajectories of buprenorphine use and determine the association of caps with trajectory group membership among individuals with OUD.</div></div><div><h3>Methods</h3><div>Using 10 states' Medicaid claims data from 2010 to 2015, we employed group-based trajectory models to identify patterns of buprenorphine fills over 12 months. We conducted multinomial logistic regression to estimate the association of cap policies with buprenorphine trajectory group membership, adjusting for individual- and state-level covariates.</div></div><div><h3>Results</h3><div>Among 69,306 Medicaid enrollees with OUD who initiated buprenorphine, 16.9 % resided in states with caps. The mean age was 36.2 (SD = 9.8) years and 59.2 % were female. We identified five trajectories: consistent use (40.9 %), delayed discontinuation (14.5 %), early discontinuation (26.4 %), gradually declining use (9.5 %), and rebounding use (8.8 %). Caps were associated with greater risk of membership in the early discontinuation group (adjusted relative risk ratio = 1.47, 95%CI = 1.36,1.59, referent = consistent use). Younger age, male sex, Black race, Hispanic ethnicity, non-opioid substance use disorder, history of acute care utilization were also positively associated with early discontinuation.</div></div><div><h3>Conclusions</h3><div>Medicaid cap policies were associated with increased likelihood of early discontinuation and other trajectories of inconsistent buprenorphine use relative to states without these policies. Medicaid's prominence as a payer for OUD treatment and 12 states' continued implementation of caps warrant safeguards to ensure cap policies do not undermine buprenorphine access.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209739"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276936","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":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(25)00107-9","DOIUrl":"10.1016/S2949-8759(25)00107-9","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"174 ","pages":"Article 209728"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241753","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}