Saudi Journal of Health Systems Research最新文献

{"title":"Evaluation of Team-Based Care Implementation in Primary Health Care Services in Saudi Arabia","authors":"A. N. Al-Zahrani, A. Aldahmashi, N. Radwan, N. Mahmoud, A. Alfaifi, Khalid Ibrahim Al-Abdulkareemf","doi":"10.1159/000530254","DOIUrl":"https://doi.org/10.1159/000530254","url":null,"abstract":"Introduction: Saudi Ministry of Health (MOH) is starting to transfer the delivery of primary health care (PHC) services from solo practice to team-based care (TBC) model. It is an important to understand factors that affect the integration of this new model of care in the early stage of implementation process to ensure adequate incorporation of this new intervention into the routine work in PHC centers. Normalization process theory (NPT) is a method that helps evaluate the integration of new interventions. Therefore, this study aimed to explain the integration of TBC model in PHC services and investigate the barriers that may hinder the implementation of this model through using NPT. Methods: A cross-sectional study was conducted in PHC centers of Saudi MOH 7 months after the implementation of TBC model. A systematic random sample technique was used to select participants from all Saudi regions. A NPT questionnaire was sent online to the participants to collect data. Results: The study revealed that cognitive participation construct represented the highest score (4.06 ± 0.74) followed by coherence (3.78 ± 0.87) and reflexive monitoring (3.75 ± 0.79) constructs. Collective action construct represented the lowest integration score (3.48 ± 0.68). Gender, years of work experience, and duration of applying TBC model were not significant factors affecting the mean integration scores of the four constructs of NPT. Conclusion: The study recorded good integration scores of the included health staff to TBC model. However, the study demonstrated some barriers that may hinder the implementation progress of the model including inadequate staff training, insufficient resources, and lack of feedback reports. Other recorded barriers are the staff perception that TBC model affects the nature of their work and disrupts the working relationship. Sufficient resources, adequate staff training with close supervision, and providing them with feedback reports regularly are recommended to support and improve the implementation of the TBC model in PHC services.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130305146","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":"Accreditation Impact on Quality of Healthcare Organization Services and Culture in a Tertiary Hospital in Saudi Arabia","authors":"Mohammed A. Babakkor, Waleed M. Kattan","doi":"10.1159/000529643","DOIUrl":"https://doi.org/10.1159/000529643","url":null,"abstract":"Introduction: While accreditation is thought to promote healthcare quality, a literature review revealed a scarcity of studies conducted in Saudi Arabia addressing the relationship between accreditation and better care quality and healthcare organization culture. Objectives: This research examined the accreditation effect on care quality and culture presented in King Abdullah Medical City (KAMC), as a healthcare organization, from the perspective of healthcare workers. Methods: The study design is a cross-sectional quantitative using anonymous and self-administered questionnaire for data collection from healthcare employees. The total number of participants was 218. Descriptive analysis was used, including means, range, and standard deviation. Also, the χ2 test was used for the association between the variables. Results: The result of the study showed that most of the dimensions associated with quality of care received high ratings. It revealed a significant beneficial association between employees’ perceptions of accreditation and quality of care across all these dimensions. The most dominant culture at KAMC was a group type demonstrated KAMC to be a personal environment. It revealed a strong relationship between employees’ views of the accreditation effect and a group culture type. Conclusion: This study’s findings matched those of a literature review that revealed a relation between accreditation and quality. Accreditation can help foster an organizational culture changing toward a culture that values skill development, cooperation, outcomes quality, and customer satisfaction. Accreditation processes have been found to promote a long-lasting and sustained improvement in quality of care and culture change. It demonstrated the crucial leadership influences in reaching this goal.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123340889","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":"COVID-19 Recovered Cases: Analysis of Patients’ Compliance with Precautionary Measures and Communication Protocol Application","authors":"Walid A. Al-Shroby, Maram E. Bin Dayel, Shahad H. Bin Osayl, Anwar M. Eldaw, Najla J. Alhraiwil","doi":"10.1159/000529645","DOIUrl":"https://doi.org/10.1159/000529645","url":null,"abstract":"Introduction: COVID-19-recovered cases’ compliance with precautionary measures employed by the health authorities is critical for prevention of virus spread and to combat the COVID-19 pandemic. This study aimed to assess the following amid COVID-19-recovered cases: (1) precautions’ compliance during and after the infection, (2) sources of information regarding precautions, and (3) Saudi MoH communication protocol with the infected cases. Methods: A descriptive phone-based cross-sectional survey was conducted on a national sample of COVID-19-recovered cases. Study participants were selected randomly from the National Saudi Health Electronic Surveillance Network (HESN) database. The study questionnaire included (1) sociodemographic, (2) questions that assessed compliance and source of knowledge about COVID-19 precautionary measures, (3) questions about the MoH communication protocol. Results: Of the 484 participants, there were 363 (75%) males and 89.7% were Saudis. Most respondents (85.3%) went for COVID-19 testing because they had symptoms either with or without confirmed case contact. About 70% of respondents adhered to quarantine from being tested positive for COVID-19. Cases commitment to precautionary measures did not change after recovery among 44.8%, while nearly 40% their commitment was increased compared to time before infection. The MoH communication protocol was conducted with satisfactory levels in relation to time of first contact, frequency, asking about list of contacts, and advising to download Tetamman application and its regular update. Females had lower levels of commitment to the precautionary measures after recovery and lower use of the MoH 937 call centre services during infection compared to males with p values of 0.036–0.014, respectively. Conclusion: A high level of compliance with COVID-19 precautionary measures was exhibited by COVID-19-recovered cases during and after recovery with moderate use of the MoH 937 call centre services and low-level awareness about MoH online guide.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128519605","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":"Challenges of Telemedicine Implementation in Patients with Cardiovascular Diseases: Insight from a Single Center during COVID-19 Lockdown","authors":"A. Aljizeeri, Mohammed A Alfurayh, Ghadah Saad Alduhaimi, G. I. Alhussin, Malak Emad Alabdulkareem, Ahmed Sharahili, Mouath A Alturaymi, Amjad M Ahmed, S. M. Alyousif, Mousa Alali Alfaris, A. Alsaileek","doi":"10.1159/000529370","DOIUrl":"https://doi.org/10.1159/000529370","url":null,"abstract":"Introduction Telemedicine is a desirable option for healthcare in Saudi Arabia. The challenges of telemedicine in cardiovascular care in Saudi Arabia are not known. The COVID-19 pandemic offered an unprecedented opportunity to identify real-life challenges of telemedicine in Saudi Arabia. We sought to identify the challenges of telemedicine among patients with cardiovascular diseases using the experience of the COVID-19 pandemic. Methods This is a cross-sectional survey-based study through a self-filled questionnaire. The questionnaire included demographic data, type of cardiovascular disease, and difficulties faced by the patients during the COVID-19 lockdown. Results 394 (60% male, mean age 51.4 ± 19.3 years) participated in the study. 30.3% had valve diseases, 26.4% had heart failure, and 24.1% had coronary artery disease. 45.6% reported difficulty with telemedicine during COVID-19 lockdown. Among those who have difficulties, almost half of the participants had difficulty with the cancellation of telemedicine appointments, and 15.5% had difficulty in getting medications. Conclusion Cancellation of telemedicine appointments and getting the medications were cardiovascular patients' main challenges during the COVID-19 lockdown. Telemedicine is a feasible option for the follow-up of chronic cardiovascular diseases. Therefore, it should be implemented to increase the availability of specialized cardiovascular care over a wide geographical area.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132103339","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":"Visual Cue to Reduce False No-Show Registration in Riyadh Primary Healthcare: A Randomized Controlled Trial","authors":"Muath A. Aldosari, Bader S. Batarfi, Moyser Z. Al-Mullah, Abdulatif A. Binjassas, Sara T. Alshammari, S. Alsuhaibani, May S. BinBaz","doi":"10.1159/000529006","DOIUrl":"https://doi.org/10.1159/000529006","url":null,"abstract":"Introduction: Preliminary field visits to the Saudi Ministry of Health’s primary healthcare centers (PHCs) confirmed a proportion of prior reported no-show appointments to be false due to staff registering patient arrivals inappropriately. We sought to investigate whether visual cue reminders would prime the staff to register patients properly. Methods: A randomized controlled trial was conducted in 2019 involving 35 PHCs in Riyadh, Saudi Arabia. Visual posters were installed in the intervention PHCs wherever patient arrivals were registered. The primary outcome was patient no-show appointments. Staff who registered appointment arrivals were observed and interviewed. Multilevel logistic regression analyzed the change in no-shows across an intervention group and a control group. Results: The intervention group had lower odds ratio (OR) of no-shows than the control group, although not significantly (OR 0.81, 95% confidence interval [CI] = 0.50–1.31). The period during Ramadan saw fewer no-shows than pre-Ramadan (OR 1.60, 95% CI = 1.55–1.66). Compared to family medicine appointments, no-shows were higher for the smoking cessation clinic (OR 3.95, 95% CI = 3.43–4.54), dental appointments (OR 2.14, 95% CI = 1.97–2.32), and vaccine appointments (OR 1.31, 95% CI = 1.27–1.35). Qualitative analysis shows that PHCs’ appointment processing was arbitrary without a unified structure. Conclusion: The reduction in no-show rates using visual cues was not significant. However, certain confounders, if not addressed prior to intervention implementation, can lead to cognitive overload and burnout, inviting unwanted behavior. Further implications are discussed.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126762151","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":"COVID-19 Stigma Correlates with Burnout among Healthcare Workers: Evidence from Healthcare Workers Practicing in Saudi Arabia","authors":"Omar S. Alnahdi, Faisal A. Albuqaytah, N. Alotaibi, Marwah Afeef, Z. Natto, Razin H. Subahi","doi":"10.1159/000528564","DOIUrl":"https://doi.org/10.1159/000528564","url":null,"abstract":"Introduction COVID-19-related stigma is the level of stigma associated with being involved with the pandemic. It has been reported that a significant number of healthcare workers experienced anxiety, depression, stigmatization, physical violence, harassment during the COVID-19 pandemic; even the families of the healthcare workers were victims of discrimination and stigmatization. The aim of our study was to determine the prevalence of COVID-19-related stigma among the healthcare workers in Saudi Arabia and to assess the COVID-19-related stigma, its associated factors, and burnout correlate. Methods Web-based, self-administered questionnaire has been sent to healthcare workers' official emails through the internal communication department in the targeted hospitals. It includes the COVID-19-related stigma-validated scale “E16-COVID19-S” and two questions relative to the full Maslach Burnout Inventory assessing the burnout. The required sample is 377 based on the sample size calculation with a response rate of 50%. Results A total of 407 responses were received from the targeted population. Of them, 49.4% scored high on the COVID-19-related stigma scale. The correlation between the COVID-19-related stigma and burnout was found to be moderately positive and statistically significant (rs = 0.515, p= <0.001). Conclusion It has been found that gender, workplace capacity, ever taking COVID-19 test during the pandemic had a significant impact on scoring high on the COVID-19-related stigma scale. Moreover, there is a correlation between being stigmatized during the pandemic and being burned out.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114557843","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":"A Qualitative Study Investigating the Current Practices, Obstacles, and Needs of Enteral Nutrition Support among Registered Dietitians Managing Non-Critically Ill Hospitalized Patients in Riyadh, Saudi Arabia","authors":"Fatimah F Alsoqeah, Rabaa A Alyumni, Nawaf W. Alruwaili, K. Aldubayan","doi":"10.1159/000528652","DOIUrl":"https://doi.org/10.1159/000528652","url":null,"abstract":"Introduction: Despite the wide availability of international guidelines that direct enteral nutrition practices, no recommendations or guidelines are tailored specifically for the unique healthcare environment in Saudi Arabia. Specifically tailored national guidelines are considered essential evidence that should be developed and followed. However, understanding the current practices, local needs, and gaps is important to facilitate the process of developing a practical national guideline. Methodology: In this qualitative study, focus groups using a structured interview technique were conducted to gain an in-depth understanding of the current enteral nutrition practices and related needs/obstacles from 24 registered dietitians handling non-critically ill patients. The recorded sessions were transcribed, and then themes were identified via coding analysis. In addition, the inter-rater agreement of the data’s themes was evaluated. Results: Five focus group sessions that consisted of 24 participants (3 males and 21 females) working in private and governmental hospitals (18 governmental and 6 private) in Riyadh city were conducted. Ten enteral nutrition practice-related themes for non-critically ill patients were identified via coding analysis, in addition to four obstacle-related themes and four need-related themes. Conclusion: Non-critically ill patients represent the most significant majority of hospitalized patients. Therefore, it is recommended for the relevant regulatory authorities to develop national enteral nutrition guidelines and policies that guarantee consistent and sustainable care, along with improving the health outcomes for this population.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114937017","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":"Physicians’ Perceptions of Dietitians’ Services and Roles in Riyadh, Kingdom of Saudi Arabia","authors":"Alhanouf S. Alsamani, K. Aldubayan, Yara Almuhtadi, A. Aladel","doi":"10.1159/000528453","DOIUrl":"https://doi.org/10.1159/000528453","url":null,"abstract":"Introduction: Nutrition is a fundamental part of living a healthy lifestyle and is well-recognized in the prevention and treatment of several illnesses. The physicians’ collaboration according to their perception regarding the nutrition services and dietitian roles is important for optimal healthcare management. However, gaps exist in the knowledge and understanding of how the dietitian is perceived by physicians. To the researchers’ knowledge, this is the first study to assess the physicians’ perceptions regarding the role and services of dietitians in Riyadh city. Method: A cross-sectional study was conducted by using an anonymous self-administered online-based survey to investigate physicians’ perceptions regarding the role and services of dietitians. In addition to demographics, the questionnaire consisted of 20 statements that covered five domains of the dietitians’ scope of practice (Medical Nutrition Therapy, Legislation and Policy, Research and Interventions, Community Programs, and Sports Nutrition). A total of 407 participants were recruited between February and March 2021. Male and female medical physicians with different professional degrees who worked in Riyadh city were eligible to be included in the study. A cross-tabulation test was used to determine the difference among physicians regarding their perceptions of dietitians’ services and roles. Results: For all of the 20 statements that demonstrated dietitians’ services and roles, the mean score was classified as “strongly agree” with a mean of 4.33 (SD ± 0.541). There was a statistically significant relationship between physicians’ perceptions according to their nutritional background and two statements regarding dietitians’ clinical roles. In addition, there was also a statistically significant relationship between physicians’ perceptions who are not working in academia and three statements regarding dietitians’ clinical and nonclinical roles. Conclusions: This study’s findings support the importance of dietitians’ services in the healthcare setting as a multidisciplinary approach and recommend expanding dietitians’ employment opportunities outside the healthcare setting. Additionally, this study emphasizes incorporating nutrition education for physicians and demonstrates physicians’ understanding of nutrition as a discipline.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123886942","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":"Global Actions on Climate Change: The Health System Focus – A Systematic Review","authors":"H. Dinar","doi":"10.1159/000528427","DOIUrl":"https://doi.org/10.1159/000528427","url":null,"abstract":"Introduction: It is now crystal clear that weather change is not just a fact but a circumstance that threatens to be extremely destructive. It has a quantifiable negative impact on human well-being, physical and mental health. Therefore, this review was conducted with an aim to study the global actions on climatic changes with a special focus on health of the population, health systems, and their preparedness. Methods: The writing of this systematic review followed the guidance of PRISMA checklist. Extensive literature research was conducted at the sources of information which included MEDLINE (PubMed interface), and Google Scholar, to identify articles discussing the role of climatic change and its impacts. Results: It was found that many challenges to health sector are posed by the climatic changes; therefore, public health preparedness and response should be upgraded through strategy adaptation, risk mitigation, and assessment measures. Conclusion: Discoveries on key health changes and climatic indicators aimed toward informed decisions by policy makers about policy programs implementation, detect evidence gaps, and better recognition of the barriers in achieving the health system adaptability and resilience, thereby maximizing the health problems caused by climate change around the globe.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123761177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Beneficiaries’ Satisfaction with Access to Health Care and Barriers within the Health Delivery System in Saudi Arabia","authors":"S. Alqutub","doi":"10.1159/000527562","DOIUrl":"https://doi.org/10.1159/000527562","url":null,"abstract":"Introduction: Health care system navigation and communication with the providers are the barriers to health care access. Recently, a new health care model with the provider’s reform mechanism was introduced in Saudi Arabia. The national goal of financial reform is to provide Saudi nationals, residents, and visitors with timely access to health care. This study aimed to assess the long-term beneficiaries’ satisfaction with access to health care and explore the influencing factors and barriers, including cost and communication with the providers and probable solutions. Methods: In this cross-sectional self-administered online survey, we used the validated “6A,” namely, affordability, acceptability, adequacy, accessibility, availability, and awareness (30 items) of perceived access to health care questionnaire. The primary outcome variable was the overall satisfaction with access to health care among the long-term beneficiaries and caregivers. Demographic variables were used as predictors of the level of satisfaction. Results: A total of 118 health care long-term beneficiaries completed the questionnaires. The mean age of the participants was 49 years. Most participants were beneficiaries from the Ministry of Health (n = 62; 52.5%). Only 42 participants (35.6%) reported a high level of satisfaction. Low satisfaction level was mainly reported by non-Saudi, retired males living in big cities. Similarly, those who paid the health care services in cash reported a significantly low level of satisfaction. Moreover, the level of satisfaction was significantly associated with insurance coverage. Discussion: The first application of the “6A” perceived access to health care questionnaire in Saudi Arabia identified that 35.6% were poorly satisfied with access to health care. However, the rate is lower than that reported in six European countries, which ranged from 53% to 55%. Since after 4 years of health reform, payment methods for health services were identified as a significant predictor of variation in the mean scores of accesses to health care. Further national-level studies exploring access to health care are needed on long-term beneficiaries who are retired and those who live in rural and remote areas. In future health sector reform and health system research, addressing unaffordable to pay services is required.","PeriodicalId":214470,"journal":{"name":"Saudi Journal of Health Systems Research","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128437643","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}