Contraception最新文献

{"title":"Awareness and perceptions related to self-managed abortion in Ohio after Dobbs.","authors":"Katlynn McFarland, Maria F Gallo, Mikaela H Smith, Abigail Norris Turner, Danielle Bessett","doi":"10.1016/j.contraception.2025.110941","DOIUrl":"10.1016/j.contraception.2025.110941","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to analyze awareness and perceptions related to self-managed abortion in Ohio after Dobbs and subsequent changes in Ohio abortion law.</p><p><strong>Study design: </strong>We analyzed data from the most recent wave (September 2022 to August 2023) of the Ohio Survey of Women, a cross-sectional survey of a population representative sample of women aged 18-44 years in Ohio (full sample N = 2473). Our variables of interest were awareness of self-managed medication abortion (SMMA) and perceptions of self-managed abortion (SMA). Respondents were considered to have awareness of SMMA if they reported having heard of pills they can buy and use at home to conduct an abortion without going to a clinic or consulting a doctor. All respondents were also asked to indicate methods that they understand to mean SMA.</p><p><strong>Results: </strong>A plurality (41.6%) of respondents were aware of SMMA. Non-Hispanic Black and non-Hispanic Asian women had less awareness of SMMA compared to non-Hispanic White women (prevalence ratio [PR] = 0.72, 95% CI, 0.54-0.95 and PR = 0.45, 95% CI, 0.26-0.77, respectively). When compared with women who hold a bachelor's degree or higher educational level, women with less than a high school education, those with a high school degree, and those with only some college had less awareness of SMMA (respectively, PR = 0.58, 95% CI, 0.36-0.94; PR = 0.71, 95% CI, 0.58-0.86; PR = 0.78, 95% CI, 0.68-0.88). About 30.3% of women identified Plan B, and 24.4% indicated herbs as methods of SMA.</p><p><strong>Conclusions: </strong>The findings highlight disparities in awareness of SMMA abortion in adult, reproductive-aged women in Ohio.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110941"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026831","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":"Provider-imposed restrictions on contraceptive use in Western Kenya.","authors":"Stephanie Chung, Brooke Bullington, Emilia Goland, Dickens O Onyango, Leigh Senderowicz, Abigael Mwanyiro, Claire W Rothschild, Ben Wekesa, Brian Frizzelle, Ginger Golub, Katherine Tumlinson","doi":"10.1016/j.contraception.2025.110937","DOIUrl":"10.1016/j.contraception.2025.110937","url":null,"abstract":"<p><strong>Objective: </strong>Contraceptive providers unnecessarily restrict contraceptive use or inappropriately apply medical eligibility criteria for a variety of reasons, including knowledge gaps, personal bias, or fear of legal or social consequences. As prevalence of these restrictions is unknown, this analysis aims to document current patterns of provider-imposed restrictions on contraceptive methods at public facilities in Western Kenya and assess novel questions on medical restrictions.</p><p><strong>Study design: </strong>We surveyed 345 family planning providers across all 137 public healthcare facilities in Kisumu County, Kenya in 2022. The survey asked about non-clinically-indicated provider restrictions placed on six contraceptive methods, including sociodemographic and medical restrictions on contraceptive use. We use descriptive statistics to present the self-reported proportion of providers who impose incorrect sociodemographic or medical restrictions and use Chi-squared tests to explore associations with provider gender, age, time since last family planning training, and facility level.</p><p><strong>Results: </strong>We find that providers commonly imposed sociodemographic restrictions on female permanent contraception and intrauterine devices, with fewer providers inappropriately restricting women seeking oral contraceptive pills, implants, injections, or male condoms. Few providers reported accurately applying weight, blood pressure, or breastfeeding related medical eligibility criteria, with many inappropriately restricting hormonal methods. Weight was the most common reason for restriction, with 50% of providers reportedly applying inappropriate weight-based restrictions to oral contraceptive pills, 60% to injectables, and 40% to implants.</p><p><strong>Conclusions: </strong>Provider bias and inappropriate medical restrictions limit women's contraceptive choice in Kenya. More research is needed to address inappropriate provider restrictions, especially around patient age, weight, and partner consent.</p><p><strong>Implications: </strong>We find that providers are applying biased and/or inappropriate medical restrictions to contraceptive methods in Kisumu, Kenya, especially around patient weight. More research is needed to understand why many providers are applying medical eligibility criteria incorrectly, and how this impacts women's contraceptive choices.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110937"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056204","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":"Society of Family Planning Research Practice Support: Researcher and institutional review board considerations for sexual and reproductive health research with minor adolescents.","authors":"Maureen K Baldwin, April J Bell, Andrea J Hoopes, Subasri Narasimhan, Mary A Ott","doi":"10.1016/j.contraception.2025.110935","DOIUrl":"10.1016/j.contraception.2025.110935","url":null,"abstract":"<p><p>This guidance document provides sexual and reproductive health (SRH) researchers, Institutional Review Boards (IRBs), research ethics committees, and funders with the knowledge and tools necessary for the appropriate inclusion of minor adolescents in SRH research. We provide an overview of the importance of explicit inclusion of adolescent minors in sexual and reproductive health research. We interpret ethical guidelines for researchers and IRBs. We urge researchers to avoid using age 18 as a cutoff for research inclusion since, in many jurisdictions, youth less than age 18 may provide self-consent for SRH care and research. We describe options for waiver of parental consent, waiver of signed consent, and Certificate of Confidentiality, when needed for protection of privacy or confidentiality. We define routine clinical care for adolescent minors to aid determinations about minimal risk research. Finally, we promote a research consent environment that considers developmental capacity for understanding research participation. Inclusion of adolescent minors in research is crucial to promote health equity and reproductive justice.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110935"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058536","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":"Motivations to use a novel hormonal male contraceptive: Perspectives from male contraceptive clinical trial participants.","authors":"Jessica D Gipson, Marta Bornstein, Andrew Duong, Brian T Nguyen","doi":"10.1016/j.contraception.2025.110932","DOIUrl":"10.1016/j.contraception.2025.110932","url":null,"abstract":"<p><strong>Objective: </strong>Most existing studies on men's willingness to use novel hormonal male contraceptives (HMCs) rely on survey data and focus on the hypothetical use of HMCs. The aim of this in-depth, qualitative study was to elicit the perspectives of HMC clinical trial participants - men who have actually used an HMC - to describe their motivations for using HMCs.</p><p><strong>Study design: </strong>In 2017-18 we conducted 30 in-depth, semi-structured interviews with a sample of men who participated in early-stage HMC clinical trials in Los Angeles or Seattle to explore their experiences with and motivations for trialing a HMC. Using thematic analysis, we analyzed deidentified transcripts using deductive and inductive codes, summarizing key themes using a socioecological framework.</p><p><strong>Results: </strong>Participants averaged 35 years old (range: 22-52) and were ethnically and sociodemographically diverse. Men's motivations for using an HMC centered on societal-level factors (i.e., concerns regarding 'overpopulation' and responsible childbearing), partnership factors (concerns regarding entrapment; desire to share in contraceptive responsibility), and individual-level factors (i.e., contraceptive options that maximized pleasure and intimacy; beliefs in men's contraceptive and bodily autonomy).</p><p><strong>Conclusions: </strong>This study provides the first U.S.-based, in-depth qualitative insights from men who have used HMCs. Men's motivations for participating in HMC clinical trials and wanting to use novel male contraceptives are both numerous and multi-faceted, supporting prevailing survey data on men's willingness to use them once on the market. These data offer insights on how male contraceptives could be marketed to the general public.</p><p><strong>Implications: </strong>Men's motivations vary with respect to participation in hormonal male clinical trials and desire to use HMCs when they become available. All of these motivations - from the broader, societal level, to the individual and partnership level - are critical to assessing the demand for and subsequent marketing of HMCs.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110932"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002612","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":"Future reproductive outcomes and contraceptive access in the first year postpartum after non-receipt of postpartum permanent contraception.","authors":"Jonas J Swartz, Tracy Truong, Maria I Rodriguez, Geeta K Swamy, Keisha Bentley-Edwards, Kavita S Arora, Emily Chen, Nicola Young, Esmé D Trahair, Megan Happ, Kamryn Locklear, Alaattin Erkanli, Evan R Myers","doi":"10.1016/j.contraception.2025.110933","DOIUrl":"10.1016/j.contraception.2025.110933","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to compare pregnancy, contraceptive uptake, and health care utilization in the 365 days following delivery, between those who requested and did not receive permanent contraception and those who requested other types of postpartum contraception.</p><p><strong>Study design: </strong>This was a retrospective cohort study of 1412 patients among 5688 delivering in 2018 at one health system. Our primary outcome was pregnancy within 365 days postpartum and we compared 207 individuals who requested and did not receive permanent contraception, with 956 who requested other types of contraception. Secondary outcomes included care utilization and contraceptive uptake in the year postpartum.</p><p><strong>Results: </strong>Individuals with unfulfilled permanent contraception requests had similar incidence of pregnancy by 365 days postpartum as those planning other types of contraception (9.2% vs 8.6%, p = 0.79), a difference which persisted after adjusting for parity and insurance type. Those with unfulfilled requests returned for postpartum care somewhat less frequently (58.5% vs 66.1%, p = 0.04) but were more likely to use more effective contraception (35.3% vs 17.6%, p < 0.001).</p><p><strong>Conclusions: </strong>We report future pregnancy incidence among those with unfulfilled permanent contraception similar to patients not requesting permanent contraception. Patients had relatively high rates of postpartum visits and use of highly-effective contraception, demonstrating the value of these services.</p><p><strong>Implications: </strong>Policies facilitating access to contraception and postpartum follow up could help reduce the risk of future pregnancy, even among those unable to access preferred contraception at the time of delivery.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110933"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015207","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":"Learning from medication abortion: Repeat doses of misoprostol after mifepristone for early pregnancy loss management.","authors":"Fatoumata Bah, Robin Wallace, Angel M Foster, Libby Wetterer, Melissa Grant, Cari Sietstra","doi":"10.1016/j.contraception.2025.110934","DOIUrl":"10.1016/j.contraception.2025.110934","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110934"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059552","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":"Pharmacy deserts: A complexity that worsens contraception access in the United States.","authors":"Natalie DiPietro Mager, Theresa Schroeder Hageman, David R Bright","doi":"10.1016/j.contraception.2025.110931","DOIUrl":"10.1016/j.contraception.2025.110931","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110931"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061528","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":"Hormonal contraception after use of ulipristal acetate as emergency contraception: A systematic review.","authors":"Emily M Snyder, Kathryn M Curtis, Antoinette T Nguyen, Ananya Tadikonda, Katherine Kortsmit, Lauren B Zapata, Maura K Whiteman","doi":"10.1016/j.contraception.2025.110898","DOIUrl":"10.1016/j.contraception.2025.110898","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review literature on whether hormonal contraception following ulipristal acetate (UPA) for emergency contraception decreases the effectiveness of either drug.</p><p><strong>Study design: </strong>We searched multiple databases through December 2022 for studies assessing the interaction between UPA and hormonal contraception. The primary outcome was contraceptive effectiveness, measured by pregnancy rates or proxy measures (e.g., ovarian activity). We extracted and summarized findings from identified studies, assessed risk of bias for each study, and determined certainty of evidence for all outcomes.</p><p><strong>Results: </strong>Four studies met inclusion criteria; all had low risk of bias. Two studies assessed whether UPA use affected the ability of oral contraceptives (OCs) to inhibit ovulation; no differences were observed in ovarian activity when starting OCs 1 day after UPA compared with starting OCs 1 day after placebo. Two studies assessed whether OC use affected the ability of UPA to delay ovulation; both studies observed higher proportions of ovulation when UPA was followed by OC use versus delayed or no OC use. One study assessed ovulation risk when UPA was taken after missed OCs, followed by immediate versus delayed OC resumption; no ovulations occurred within the first 5 days after UPA administration in either group, but there was greater risk of ovulation beyond 5 days with delayed versus immediate OC resumption.</p><p><strong>Conclusions: </strong>While there is no evidence that UPA affects the ability of hormonal contraception to inhibit ovulation, hormonal contraception use immediately or soon after UPA may decrease UPA's ability to delay ovulation. The certainty of evidence ranged from moderate to very low.</p><p><strong>Implications: </strong>If a patient desires hormonal contraception after UPA, an interaction can be avoided by delaying initiation or resumption of hormonal contraception. The risk of pregnancy due to decreased UPA effectiveness with immediate hormonal contraception should be balanced against the risk of subsequent pregnancy due to delay or non-start of hormonal contraception.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110898"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789415","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":"Society of Family Planning clinical recommendation: Prevention of infection after abortion and pregnancy loss.","authors":"Terri Cheng, Nimisha Kumar, Laura Laursen, Sharon L Achilles, Matthew F Reeves","doi":"10.1016/j.contraception.2025.110895","DOIUrl":"10.1016/j.contraception.2025.110895","url":null,"abstract":"<p><p>This Clinical Recommendation serves as a revision to the Society of Family Planning's 2010 Prevention of infection after induced abortion guidance. It examines infection risk, identifiable risk factors, and prophylactic measures for the prevention of infection associated with procedural and medication management of abortion and pregnancy loss to make evidence-based recommendations for the clinical care of patients. The following are the Society of Family Planning's recommendations: We recommend clinicians test and treat patients for gonorrhea and chlamydia at the time of abortion if there is (1) high clinical suspicion, (2) a positive diagnosis, or (3) the pregnant individual is under 25 years old and due for routine screening according to Centers for Disease Control and Prevention's guidelines; clinicians should not delay abortion while awaiting diagnosis or treatment (GRADE 1C). We recommend against screening for bacterial vaginosis before abortion (GRADE 1C). Since the rate of infection is low for nonprocedural abortion and the number needed to treat is high, coupled with inherent risks associated with antibiotic use, we recommend against the use of universal antibiotic prophylaxis in the setting of medication abortion, medication management of early pregnancy loss, or self-managed abortion (GRADE 1C). We recommend universal antibiotic prophylaxis for patients undergoing procedural abortion across all gestational durations (GRADE 1A). For procedural management of pregnancy loss, we recommend antibiotic prophylaxis (GRADE 1A). We recommend clinicians initiate antibiotic prophylaxis for procedural abortion and procedural management of pregnancy loss before instrumentation to maximize efficacy (GRADE 1B). Antibiotics should be given with adequate time for absorption, but data on the optimal timing for prophylaxis are lacking. In the setting of osmotic cervical dilator use, there is insufficient evidence to recommend for or against routine antibiotic prophylaxis before osmotic cervical dilator placement. We recommend discontinuing antibiotic prophylaxis after the procedure is completed (GRADE 1B). We recommend a single dose of doxycycline 200 mg orally or azithromycin 500 mg orally before a procedural abortion or procedural management of pregnancy loss (GRADE 1B). Metronidazole is a second-line option as it has evidence to suggest a prophylactic effect despite being less effective than doxycycline or azithromycin against aerobic bacteria. We recommend against the use of fluoroquinolones for prophylaxis in the setting of procedural abortion or procedural management of pregnancy loss due to the increased risk of side effects and complications (GRADE 1B). There is insufficient evidence to recommend for or against vaginal preparation with a local antiseptic solution or to recommend a specific vaginal preparation regimen before procedural abortion or procedural management of pregnancy loss.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110895"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743913","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":"Society of Family Planning Clinical Recommendation: Management of undesired pregnancy of unknown location and abortion at less than 42 days of gestation.","authors":"Siripanth Nippita, Catherine Cansino, Alisa B Goldberg, Neena Qasba, Katharine White, Vinita Goyal, Angeline Ti, Christy Boraas","doi":"10.1016/j.contraception.2025.110865","DOIUrl":"10.1016/j.contraception.2025.110865","url":null,"abstract":"<p><p>Pregnancy of unknown location is a condition in which a pregnancy test is positive, but no intrauterine or extrauterine pregnancy is visualized using transvaginal ultrasonography. We recommend using standardized nomenclature and definitions to describe intrauterine pregnancy (IUP), probable IUP, pregnancy of unknown location (PUL), probable ectopic pregnancy (probable EP), and ectopic pregnancy (EP) (Best Practice). Among abortion-seeking patients found to have a PUL, the incidence of EP is 4% to 8%. We recommend clinical judgment in assessing the risk for EP in the setting of PUL; the absence of an intrauterine gestational sac (GS) or yolk sac should not delay care (GRADE 1B). In asymptomatic individuals with an undesired PUL who prefer to proceed with immediate treatment (medication or procedural management without delay) and have a low risk of EP, as determined by the clinician based on history, symptoms, and all other available data, we recommend medication management with mifepristone and misoprostol or procedural management via uterine aspiration and clear plans for ensuring pregnancy resolution in a timely fashion (GRADE 1B). While both medication and procedural management of undesired PUL are associated with earlier pregnancy resolution and identification of EP, the two main risks of inadequate follow-up include ongoing pregnancy and missing or delaying a subsequent diagnosis of EP. For individuals with PUL choosing immediate treatment with medication management, we recommend clinicians obtain a baseline serum quantitative human chorionic gonadotropin (hCG) at the time of medication provision to aid in diagnosis and follow-up (GRADE 1A). Following medication management of PUL with mifepristone and misoprostol, we suggest a repeat serum quantitative hCG level, with pregnancy resolution defined as either a 50% decline or greater at 48 to 72 hours after misoprostol or an 80% decline or greater at 7 days after mifepristone or 5 to 10 days after misoprostol (GRADE 2B). We recommend against direct extrapolation of follow-up recommendations from no-test abortion clinical protocols to individuals with a documented PUL treated with mifepristone and misoprostol, given the higher risk of EP among individuals with a known PUL (GRADE 1C). When uterine aspiration is performed at less than 42 days of gestation, including for individuals with PUL or probable IUP, and both chorionic villi and GS are not visualized, we recommend repeat ultrasonography (if an IUP or probable IUP was seen initially), serum quantitative hCG follow-up, or both (GRADE 1B). When both chorionic villi and GS are not visualized after uterine aspiration and serial serum hCG follow-up is warranted, we recommend testing on the day of the procedure and 24 to 72 hours later, with pregnancy resolution defined as greater than 50% decline 24 hours after aspiration, greater than 70% by 48 hours, or greater than 80% by approximately 72 hours (GRADE 1B).</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110865"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694641","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}