Rehab A Mohamed, Doaa Mazen Abdel-Salam, Heba M. Galal, Ohoud Mohammed F Alsahli, Alhanof Ahmed Althari, Batool Meshal Alorayyidh, Reema Hamad A ALHarbi, Zainab Mohammed M Almohammed
{"title":"Metabolic Control and Its Correlates among Diabetic Patients in Aljouf Region, Saudi Arabia: A Cross-Sectional study","authors":"Rehab A Mohamed, Doaa Mazen Abdel-Salam, Heba M. Galal, Ohoud Mohammed F Alsahli, Alhanof Ahmed Althari, Batool Meshal Alorayyidh, Reema Hamad A ALHarbi, Zainab Mohammed M Almohammed","doi":"10.5742/mewfm.2023.95256191","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256191","url":null,"abstract":"Background: Throughout the world, diabetes, and its consequences, constitutes a serious problem for public health. Metabolic control can reduce the risk of diabetes complications. The present study aims to determine diabetic metabolic control among diabetic patients in the Aljouf region, Saudi Arabia, and its association with family function, depression, and other sociodemographic and clinical data. Methods: A cross-sectional study was conducted among 279 diabetic patients attending the diabetic center in a specialized hospital in Aljouf Region, Saudi Arabia. A structured anonymous questionnaire was distributed to the targeted population during a direct interview. Results: The present study showed that HbA1c was 7% among 86% of the participants. Regarding lipid profile, abnormal HDL, LDL, triglycerides, and cholesterol levels were detected among 39.4%, 41.2%, 68.5%, and 50.2% of the participants, respectively. Severe depression and severe family dysfunction were detected among 22% and 6% of the participants, respectively. Increasing age was associated with higher LDL levels and diabetes duration was associated with higher HbA1c levels in patients with diabetes. Conclusion: The study concluded that family function and depression do not directly affect diabetic patients’ diabetes metabolic control and the study showed a high prevalence of uncontrolled HbA1c levels and dyslipidemia among the study participants. Further investigation into the variables underlying the control of diabetes is required to further enhance patient outcomes because many people are still failing to meet the metabolic control objectives. Keywords: Metabolic control; Depression; Family function; Diabetes mellitus; Saudi Arabia","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640461","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 screen time on Children’s Behaviour","authors":"Mohammed Al Naima","doi":"10.5742/mewfm.2023.95256194","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256194","url":null,"abstract":"As more of their leisure time is spent with screens such as iPhones, tablets, computer games, and television, parents, health experts, and educators are concerned about the impact of screen time on children’s well-being. Excessive screen usage has a negative impact on the verbal, emotional, and physical growth of children. Because children and teenagers are naturally drawn to screens, the aim is to teach them how to use them responsibly. Screens may help promote self-esteem and give numerous chances for learning and growth when used with good screen objectives and abilities. Children, especially those above the age of three, respond to interactive programming that is entertaining, suited to them, and stimulates imitation or participation. Dynamic video games may encourage light-to-moderate or acceptable physical exercise in the near future. Families and child care providers may include more physical activity into daily routines by using fun, age-appropriate exercise (e.g., yoga or dance) and fitness apps or videogames. As a result of these concerns, parents are being advised to limit their children’s screen time on a daily basis, with particular time constraints for children and a general guideline to minimize screen time in teenagers. Key words: screen time, children's behaviour","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640460","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}
Waad A. Alotaibi, Shahad A. Alotiabi, Tareq J. Alanezi
{"title":"Neonatal Tetanus: case report in Saudi Arabia","authors":"Waad A. Alotaibi, Shahad A. Alotiabi, Tareq J. Alanezi","doi":"10.5742/mewfm.2023.95256200","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256200","url":null,"abstract":"Aims: This paper aims to investigate a case of neonatal tetanus in Saudi Arabia, studying the different factors leading to infection, role and protocols used in hospital in diagnosis and management of the case. Methods: A medical profile of neonatal case confirmed for neonatal tetanus was collected and studied, in addition to collecting literature reviews about epidemiology, diagnosis and management. Results: A newborn 7-day old girl with poor socioeconomical status and poor aseptic delivery had been admitted to hospital with symptoms of jerky repetitive movement and history of decreased feeding and poor sucking for one day. Laboratory tests, cranial computed tomography (CT) and lumbar puncture were performed, all of them with normal results. She was hospitalized on 12 November, 2019 in an environment free of sensorial stimuli in the Pediatric Intensive Care Unit (PICU), with assisted ventilation. The patient was treated with metronidazole 30mg/kg/day, ampicillin 150 mg/kg/day, and cefotaxime 150mg/kg/day. Sedation was maintained with midazolam 6mic/kg/min. Also, we started on muscle relaxation pancuronium 0.1 mg /kg/hr. and Magnesium sulfate. Besides that, we administered human immunoglobulin IM (500 IU), as well as one dose of tetanus toxoid. During hospital admission the condition of the patient was much improved. On 19 December 2019 the patient was extubated and started with baclofen and physiotherapy. Conclusion: This case indicates that non-sterile delivery by non-practical attendants are the biggest cause of neonatal tetanus along with mothers unimmunized against tetanus. However, in the rarest of incidence of neonatal tetanus, physicians should be prepared to suspect, diagnose and treat neonatal tetanus and ensure clear and clean delivery of newborns. A combination of antibiotics and muscular relaxants are used to manage neonatal tetanus. Key words: neonatal tetanus, case report, Saudi Arabia","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640459","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}
Afaf Farouq Alzahrani, Nada Abdulfattah Abdulaal, Ahmed Salah A.M. Ahmed
{"title":"Prevalence and Risk Factors of Pregnancy-Related Anxiety: A Systematic Review","authors":"Afaf Farouq Alzahrani, Nada Abdulfattah Abdulaal, Ahmed Salah A.M. Ahmed","doi":"10.5742/mewfm.2023.95256195","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256195","url":null,"abstract":"Background: Pregnancy is a unique period of life that can overwhelm an expectant mother with experiences of psychological ambivalence, concretized by emotional disturbances, sudden transitions from exhaustion to exaltation, or even mixed anxiety. Objective: To determine the prevalence of pregnancy-related anxiety and its associated factors among pregnant women. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A structured literature review was carried out using the component of the PICO framework. The literature search was conducted in Medline, Ovid, Embase, Google Scholar, and PubMed. A combination of relevant search terms was used. Electronic searches were supplemented by manual searches of references of included studies and review articles. The duplicate citations were identified and removed. Results: A total of 69 articles were identified through the searches, while 13 articles met the inclusion criteria. The characteristics and results of included studies were discussed, regarding the study design, screening tools, prevalence, onset, and risk factors of pregnancy-related anxiety. Conclusions: Anxiety disorders are common during pregnancy. There is wide variability in its measurement, with a subsequently wide range in reported prevalence rates. Several risk factors are associated with pregnancy-related anxiety, such as younger age, low income, past history of stillbirth, unwanted pregnancy, current comorbidity, or mental illness. Key words: Pregnancy, anxiety, onset, prevalence, risk factors, systematic review, PRISMA.","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640656","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}
Mohammed Ali Alkahmous, Anisah Zead T. Alyahya, Abdullah Nasser Almansour, Maha turki Aldhfeeri, Amal Abdullah Alsanari, Shwog Eissa Yehya Fagehi
{"title":"Assessment of Vaccination Rates and Barriers in Family Medicine Practices: A Cross-sectional Study","authors":"Mohammed Ali Alkahmous, Anisah Zead T. Alyahya, Abdullah Nasser Almansour, Maha turki Aldhfeeri, Amal Abdullah Alsanari, Shwog Eissa Yehya Fagehi","doi":"10.5742/mewfm.2023.95256192","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256192","url":null,"abstract":"Background: Vaccination is a crucial tool in publichealth for preventing the spread of infectious diseases. Understanding the factors influencing vaccine acceptance and addressing barriers to vaccination are essential in promoting vaccine uptake and achieving population-level protection. Methodology: This study examined the demographic factors, vaccination rates, and barriers to vaccination among 385 participants. The participants were categorized based on age, gender, marital status, having children, monthly income, educational level, occupation, and nationality. Data on willingness to vaccinate, completion of the vaccination course, and barriers to vaccination were collected through surveys. Results: The study found that 80% of participants expressed their willingness to take the COVID-19 vaccine. Factors included age, having children, monthly income, and educational level, influenced vaccine acceptance. Participants in the 18-25 years age group showed the highest willingness to vaccinate (85%), while those with higher incomes and higher educational levels also demonstrated higher rates of acceptance. Several barriers to vaccination were identified, including fear of vaccination, concerns about vaccine safety, and accessibility issues. Conclusion: This study highlights the importance of vaccination and provides valuable insights into the demographic factors, vaccination rates, and barriers to vaccination. The findings emphasize the need for targeted interventions to address specific concerns and improve accessibility to vaccines. By addressing these barriers, public health authorities can enhance vaccine acceptance and achieve widespread vaccination coverage, thereby mitigating the impact of infectious diseases on public health. Key words: Vaccination rates, Barriers","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640651","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}
Rofayda Mansour Ahmad Rofayda Mansour Ahmad, Rahaf Masoud D Albalawi, Nouf Salem Albalawi, Nawaf Farhan Alghamdi, Naif Ibrahim Alzahrani, Zahraa Hussain Aljeshi, Hanan Ali Atafi, Hotoon Kamel Alghaythee, Alyaa Mohammed Izaldin Haider, Zainab Esameldeen Abujamal, Alhanouf Radhyan Alruwili, Majed Mohammad Qaysi
{"title":"Autism Spectrum Disorders in Children","authors":"Rofayda Mansour Ahmad Rofayda Mansour Ahmad, Rahaf Masoud D Albalawi, Nouf Salem Albalawi, Nawaf Farhan Alghamdi, Naif Ibrahim Alzahrani, Zahraa Hussain Aljeshi, Hanan Ali Atafi, Hotoon Kamel Alghaythee, Alyaa Mohammed Izaldin Haider, Zainab Esameldeen Abujamal, Alhanouf Radhyan Alruwili, Majed Mohammad Qaysi","doi":"10.5742/mewfm.2023.95256197","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256197","url":null,"abstract":"Background: Autism Spectrum Disorders (ASDs) describe a category of neurodevelopmental disorders in which individuals experience difficulties of social interaction and age-appropriate play and struggle to establish healthy peer interactions at their stage of development. This study will address the various aspects of Autism in children including clinical symptoms, evaluation, diagnosis and widely used medication or care. Methodology: The search strategy involved utilizing two primary sources for obtaining relevant literature: Google Scholar and PubMed. The inclusion criteria comprised articles published in peer-reviewed journals, written in English, and focusing on ASD in children. Studies with diverse designs, including experimental, observational, and review studies, were considered. Results: While children with autism spectrum disorders share many characteristics with children that have other developmental disorders and can benefit from many of the same educational strategies, they pose specific challenges for families, teachers, and others who collaborate with them. A deficiency in non-verbal and verbal communication requires a great deal of effort and ability, including in teaching basic knowledge. Special challenges in social interaction (e.g.,joint attention) may require more individual instruction than most children to gain and retain their children’s attention. Furthermore, ordinary social interactions between peers do not typically take place without active preparation and ongoing adult structuring in the child’s environment. Conclusion: The lack of traditional friendships and peer relationships influences child motivation structures and the sense of experience. Adequate social experiences can be some of the most challenging and valuable lessons a child with autism spectrum disorders can learn. Keywords: ASD (Autism Spectrum Disorders), QOL (Quality Of Life), neurodevelopmental conditions, PA (Physical Activity), DSM, ICD","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640657","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":"Mental Health program integration into Primary Health Care: Results of a Project Implemented at Yarmouk Health Care Center & Capital Health Primary Care Center, Kuwait","authors":"Huda Alduwaisan, Aseel Omran Al-Sabbrei, Maryam AL-Khamees, Nusaiba Alkanderi, Doaa Khalifa Hussein, Amani AlSaqabi, Waris Qidwai","doi":"10.5742/mewfm.2023.95256193","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256193","url":null,"abstract":"Objective: World Health Organization (WHO) identified a gap in meeting mental health care needs in the health services. To bridge this gap, at Yarmouk Primary Health Care Center and Capital Health District area in Kuwait, it was decided to implement a best practice model, for integrating mental health services into primary health care services in Kuwait. Methodology: Implementation of the best practice model, for integrating mental health services into primary care services in Kuwait’s health system was initiated in 2008. It involved the integration of cost–effective, feasible evidence-based interventions for mental health conditions in Primary Health Care (PHC) and other priority health programs. It envisioned a mental health component in PHC, to enhance access to mental health care and improve identification and treatment rates for priority mental disorders, to provide holistic care for particularly disabling comorbid physical and mental health problems, and to engage in mental health promotion. Results: The program was initiated in 12 primary mental health care clinics in the Capital Health District area in Kuwait. Two hundred (200) Family Physicians and General Practitioners, were trained in psychiatric integration within the primary health care system. Regular evaluation of the performance of physicians working in primary mental health clinics in the program was ensured. Periodic evaluation of psychiatric patient visits in the Primary mental health clinics was conducted for quality improvement. Mental health awareness days and educational sessions were organized. Discussion: A practice model for integrating mental health services into primary care was developed in Kuwait, involving stakeholders. Its favorable impact on mental health in the community is undergoing scrutiny. Limitations such as human resource shortage and, movement of trained physicians from primary care to other administrative departments in the Ministry of Health (MOH), coupled with a lack of relevant data and the need for better coordination between stakeholders, were identified. Issues regarding electronic health records, patient confidentiality, and quality of services were identified. Stigma related to mental health issues resulted in a delay in implementing the integration. Conclusion: With increasing psychiatric illnesses and a lack of adequate specialized mental health services, addressing this issue at the primary care level offers an attractive cost-effective option to deal with the crisis. Keywords: Mental Health, Primary Health Care, Integration, Health system, Family Physician","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"374 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640458","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 systematic review of interventions to improve medication adherence in family medicine patients","authors":"Abdullah Salih Alrashidi, Hassan Dhafer Hassan Alasmari, Abdulaziz Muteb Alshammari, Khaled Saleh Alrashedi","doi":"10.5742/mewfm.2023.95256199","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256199","url":null,"abstract":"Background: Medication non-adherence poses a significant challenge in healthcare, leading to suboptimal treatment outcomes. This systematic review aims to evaluate the effectiveness of different interventions in improving medication adherence. Methodology: A comprehensive search was conducted to identify relevant studies. Inclusion criteria encompassed interventions targeting medication adherence and reporting quantitative measures of adherence outcomes. The selected studies were assessed for quality, and data were extracted for analysis. Results: The review included a total of 14 studies. Interventions involving tailored phone calls or educational materials did not yield significant improvements in medication adherence. Conversely, interventions such as face-to-face counseling sessions and self-management programs showed promise in improving adherence. Nurse-led interventions and pharmacist-led consultations did not demonstrate significant improvements. Similarly, interventions involving stroke physician specialist assessments, behavioral feedback, medication reviews, and motivational interviewing did not yield significant improvements. A pooled analysis of various interventions across different healthcare settings showed a moderate but not statistically significant difference in medication adherence. Conclusion: The findings from this systematic review suggest that interventions tailored to individual patient characteristics and involving personalized support and education show promise in improving medication adherence. However, interventions relying solely on tailored phone calls, educational materials, nurse-led care, pharmacist-led consultations, stroke physician specialist assessments, behavioral feedback, medication reviews, or motivational interviewing may not consistently improve adherence. Keywords: Medication Adherence, Patient Compliance, Family Medicine, Education, Behavioral Modification.","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640654","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":"Fever – Common symptom with uncommon Diagnosis in UK Primary Care – A Case report","authors":"M. A. Qureshi, Aktharuz Zaman","doi":"10.5742/mewfm.2023.95256127","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256127","url":null,"abstract":"A case study presenting with fever with an uncommon diagnosis in UK Primary Care. Key words: fever, rare diagnosis, delayed onset falciparum malaria infection","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75902743","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}
K. Mathew, Shaik Shaheen, Prince Christopher Rajkumar Honest
{"title":"APRI and FIB-4 - a simple predictor of fibrosis in NAFLD/NASH at the primary care level - A case report","authors":"K. Mathew, Shaik Shaheen, Prince Christopher Rajkumar Honest","doi":"10.5742/mewfm.2023.95256144","DOIUrl":"https://doi.org/10.5742/mewfm.2023.95256144","url":null,"abstract":"The importance of simple investigations like platelets, AST (Aspartate aminotransferase) and ALT (Alanine aminotransferase) when managing patients with NAFLD (non-alcoholic fatty liver disease) and NASH (non-alcoholic steatohepatitis) in primary care should not be overlooked, as this would predict the progression to fibrosis and cirrhosis. A better control of diabetes, metabolic syndrome and the reduction of bodyweight at an early stage when the APRI (AST to Platelet ratio index) and/or FIB-4 score is significant, would have delayed/aborted the progression to fibrosis and cirrhosis is highlighted by this case report. Physicians in primary care should be aware of the significance of low platelet count and high AST (a ‘red flag’) in a case of NAFLD and NASH, and should provide intense control of diabetes, obesity and metabolic syndrome followed by a referral to a gastroenterologist/hepatologist at an early stage. Key words: Primary Care, General Practice, NASH, NAFLD, FIB-4, APRI, Red flag, low platelet, cirrhosis, primary prevention","PeriodicalId":23895,"journal":{"name":"World Family Medicine Journal /Middle East Journal of Family Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86767553","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}