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1دورية أكاديمية
المؤلفون: Messer, Laurel H.1, Bauza, Colleen2, Miller, Kellee M.3, Clements, Mark A.4, DeSalvo, Daniel J.5, Sherr, Jennifer6, Weinstock, Ruth S.7, Hood, Korey8, Laffel, Lori M.9
المصدر: Pediatric Diabetes. 9/15/2023, p1-10. 10p.
مصطلحات موضوعية: *CONTINUOUS glucose monitoring, *ENDOCRINOLOGY, *BLOOD sugar monitoring, *TYPE 1 diabetes, *DIABETES, *RISK assessment, *COMPARATIVE studies, *QUALITY of life, *DESCRIPTIVE statistics, *PATIENT education, *LONGITUDINAL method, *DISEASE risk factors, *ADULTS, *ADOLESCENCE
الشركة/الكيان: AMERICAN Diabetes Association 784510570
مستخلص: Objective. To evaluate patterns of continuous glucose monitor (CGM) use and perceptions of quality of life in adolescents/young adults with type 1 diabetes (T1D) after using CGM for up to 52 weeks in the CGM Intervention in Teens and Young (CITY) Adults randomized clinical trial (RCT). Subjects and Methods. Participants with T1D were initially randomized 1 : 1 to use of CGM or blood glucose meter (BGM) for 26 weeks. Following the RCT, participants in the BGM group initiated CGM (BGM–CGM cohort) and participants in the CGM group continued CGM (CGM–CGM cohort) for another 26 weeks. Problem Areas in Diabetes Survey-Pediatric Version (PAID-peds), Glucose Monitoring Satisfaction Survey (GMSS), Hypoglycemia Confidence Scale (HCS), Diabetes Technology Attitudes (DTA), Pittsburgh Sleep Quality Index (PSQI), Benefits of CGM, and Burdens of CGM were completed at baseline, 26 and 52 weeks. Results. In both cohorts, >70% of participants were wearing CGM > 5 days/week at 52 weeks; 5% discontinued CGM. The majority used the mobile app to receive glucose data. Adolescents (14 to <19 years) were more likely to use SHARE features than young adults (80% versus 41%). CGM–CGM participants had significantly higher scores on GMSS, DTA, and HCS at 52 weeks compared with baseline, and reported higher benefit and lower burden perceptions than at baseline. Similar results were observed for the BGM–CGM cohort. Conclusions. Improvements in self-reported measures were observed in adolescents and young adults using CGM. As CGM use is also associated with better glycemic control, utilizing CGM may contribute to improving both medical outcomes and emotional health. [ABSTRACT FROM AUTHOR]
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2دورية أكاديمية
المؤلفون: Prahalad, Priya, Maahs, David M.
المصدر: Diabetes Spectrum; Fall2023, Vol. 36 Issue 4, p299-305, 7p
مصطلحات موضوعية: CONTINUOUS glucose monitoring, ENDOCRINOLOGY, TEAMS in the workplace, DRUG delivery systems, BIOLOGICAL evolution, HEALTH services accessibility, BLOOD sugar monitoring, MEDICAL technology, TYPE 1 diabetes, BURDEN of care, HUMAN services programs, MEDICAL care use, QUALITY assurance, PSYCHOLOGICAL adaptation
مستخلص: Glucose monitoring is essential for the management of type 1 diabetes and has evolved from urine glucose monitoring in the early 1900s to home blood glucose monitoring in the 1980s to continuous glucose monitoring (CGM) today. Youth with type 1 diabetes struggle to meet A1C goals; however, CGM is associated with improved A1C in these youth and is recommended as a standard of care by diabetes professional organizations. Despite their utility, expanding uptake of CGM systems has been challenging, especially in minoritized communities. The 4T (Teamwork, Targets, Technology, and Tight Control) program was developed using a team-based approach to set consistent glycemic targets and equitably initiate CGM and remote patient monitoring in all youth with new-onset type 1 diabetes. In the pilot 4T study, youth in the 4T cohort had a 0.5% improvement in A1C 12 months after diabetes diagnosis compared with those in the historical cohort. The 4T program can serve as a roadmap for other multidisciplinary pediatric type 1 diabetes clinics to increase CGM adoption and improve glycemic outcomes. [ABSTRACT FROM AUTHOR]
: Copyright of Diabetes Spectrum is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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3دورية أكاديمية
المؤلفون: Albanese-O'Neill, Anastasia
المصدر: Diabetes Spectrum; Fall2023, Vol. 36 Issue 4, p288-298, 11p
مصطلحات موضوعية: CONTINUOUS glucose monitoring, TREATMENT of diabetes, ENDOCRINOLOGY, PROFESSIONAL practice, PEDIATRICS, DIABETES, MEDICAL care, HUMAN services programs, UNIVERSITIES & colleges, PATIENT education, TECHNOLOGY, MEDICAID
مصطلحات جغرافية: FLORIDA
الشركة/الكيان: AMERICAN Diabetes Association
مستخلص: This article describes the implementation of a diabetes technology educational program targeting continuous glucose monitoring (CGM) adoption that significantly increased utilization of CGM in the Division of Pediatric Endocrinology at the University of Florida. The author proposes that diabetes care and education specialists (DCESs) are uniquely positioned in the health care ecosystem to serve as diabetes technology champions. The article provides a step-by-step roadmap that DCESs and clinicians can use as they lead efforts to expand CGM adoption and durable use. [ABSTRACT FROM AUTHOR]
: Copyright of Diabetes Spectrum is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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4مؤتمر
المؤلفون: Cheng Yi Yuan, Bella Halim, Yee W. Kong, Jean Lu, Ralph Dutt-Ballerstadt, Peter Eckenberg, Ken Hillen, Anh Koski, Vlad Milenkowic, Emma Netzer, Varuni Obeyesekere, Solomon Reid, Catriona Sims, Sara Vogrin, Huan-Ping Wu, Thomas Seidl, David N. O’Neal
مصطلحات موضوعية: Medicine, Endocrinology, Nutrition and Dietetics not elsewhere classified, Health and Community Services, insulin cannula, continuous glucose monitoring, continuous glucose monitor-insulin set, feasibility study
الوصف: Supplemental material, sj-pptx-2-dst-10.1177_19322968241236771 for Combining an Electrochemical Continuous Glucose Sensor With an Insulin Delivery Cannula: A Feasibility Study by Cheng Yi Yuan, Bella Halim, Yee W. Kong, Jean Lu, Ralph Dutt-Ballerstadt, Peter Eckenberg, Ken Hillen, Anh Koski, Vlad Milenkowic, Emma Netzer, Varuni Obeyesekere, Solomon Reid, Catriona Sims, Sara Vogrin, Huan-Ping Wu, Thomas Seidl and David N. O’Neal in Journal of Diabetes Science and Technology
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5مؤتمر
المؤلفون: Cheng Yi Yuan, Bella Halim, Yee W. Kong, Jean Lu, Ralph Dutt-Ballerstadt, Peter Eckenberg, Ken Hillen, Anh Koski, Vlad Milenkowic, Emma Netzer, Varuni Obeyesekere, Solomon Reid, Catriona Sims, Sara Vogrin, Huan-Ping Wu, Thomas Seidl, David N. O’Neal
مصطلحات موضوعية: Medicine, Endocrinology, Nutrition and Dietetics not elsewhere classified, Health and Community Services, insulin cannula, continuous glucose monitoring, continuous glucose monitor-insulin set, feasibility study
الوصف: Supplemental material, sj-pptx-1-dst-10.1177_19322968241236771 for Combining an Electrochemical Continuous Glucose Sensor With an Insulin Delivery Cannula: A Feasibility Study by Cheng Yi Yuan, Bella Halim, Yee W. Kong, Jean Lu, Ralph Dutt-Ballerstadt, Peter Eckenberg, Ken Hillen, Anh Koski, Vlad Milenkowic, Emma Netzer, Varuni Obeyesekere, Solomon Reid, Catriona Sims, Sara Vogrin, Huan-Ping Wu, Thomas Seidl and David N. O’Neal in Journal of Diabetes Science and Technology
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6دورية أكاديمية
المؤلفون: Jancev, Milena, Vissers, Tessa A.C.M., Visseren, Frank L.J., van Bon, Arianne C., Serné, Erik H., DeVries, J. Hans, de Valk, Harold W., van Sloten, Thomas T.
المساهمون: Interne Geneeskunde Vasculaire, Circulatory Health, MS Interne Geneeskunde
مصطلحات موضوعية: CGM, Continuous glucose monitoring, Glycaemic control, Meta-analysis, Systematic review, Type 2 Diabetes, Internal Medicine, Endocrinology, Diabetes and Metabolism
الوصف: Aims/hypothesis: Continuous glucose monitoring (CGM) is increasingly used in the treatment of type 2 diabetes, but the effects on glycaemic control are unclear. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the effect of CGM on glycaemic control in adults with type 2 diabetes. Methods: We performed a systematic review using Embase, MEDLINE, Web of Science, Scopus and ClinicalTrials.gov from inception until 2 May 2023. We included RCTs investigating real-time CGM (rtCGM) or intermittently scanned CGM (isCGM) compared with self-monitoring of blood glucose (SMBG) in adults with type 2 diabetes. Studies with an intervention duration <6 weeks or investigating professional CGM, a combination of CGM and additional glucose-lowering treatment strategies or GlucoWatch were not eligible. Change in HbA1c and the CGM metrics time in range (TIR), time below range (TBR), time above range (TAR) and glycaemic variability were extracted. We evaluated the risk of bias using the Cochrane risk-of-bias tool version 2. Data were synthesised by performing a meta-analysis. We also explored the effects of CGM on severe hypoglycaemia and micro- and macrovascular complications. Results: We found 12 RCTs comprising 1248 participants, with eight investigating rtCGM and four isCGM. Compared with SMBG, CGM use (rtCGM or isCGM) led to a mean difference (MD) in HbA1c of −3.43 mmol/mol (−0.31%; 95% CI −4.75, −2.11, p<0.00001, I2=15%; moderate certainty). This effect was comparable in studies that included individuals using insulin with or without oral agents (MD −3.27 mmol/mol [−0.30%]; 95% CI −6.22, −0.31, p=0.03, I2=55%), and individuals using oral agents only (MD −3.22 mmol/mol [−0.29%]; 95% CI −5.39, −1.05, p=0.004, I2=0%). Use of rtCGM showed a trend towards a larger effect (MD −3.95 mmol/mol [−0.36%]; 95% CI −5.46 to −2.44, p<0.00001, I2=0%) than use of isCGM (MD −1.79 mmol/mol [−0.16%]; 95% CI −5.28, 1.69, p=0.31, I2=64%). CGM was also associated with an increase in TIR (+6.36%; 95% ...
وصف الملف: application/pdf
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7دورية أكاديمية
مصطلحات موضوعية: Management of Diabetes Mellitus and Hypoglycemia, Endocrinology, Diabetes and Metabolism, Medicine, Health Sciences, Machine Learning in Healthcare and Medicine, Health Information Management, Health Professions, Metabolic Syndrome and Cardiovascular Disease, Continuous Glucose Monitoring, Diabetes, Glucose Metabolism, Type 1 Diabetes, Heart Disease Prediction, Meal, Diabetes mellitus, Type 2 diabetes, Gradient boosting, Multilayer perceptron, Boosting machine learning, Blood glucose monitoring, Internal medicine, Artificial neural network, Computer science, Artificial intelligence, Random forest, Endocrinology
الوصف: Type 2 Diabetes, a metabolic disorder disease, is becoming a fast growing health crisis worldwide. It reduces the quality of life, and increases mortality and health care costs unless managed well. After-meal blood glucose level measure is considered as one of the most fundamental and well-recognized steps in managing Type 2 diabetes as it guides a user to make better plans of their diet and thus control the diabetes well. In this paper, we propose a data-driven approach to predict the 2 h after meal blood glucose level from the previous discrete blood glucose readings, meal, exercise, medication, & profile information of Type 2 diabetes patients. To the best of our knowledge, this is the first attempt to use discrete blood glucose readings for 2 h after meal blood glucose level prediction using data-driven models. In this study, we have collected data from five prediabetic and diabetic patients in free living conditions for six months. We have presented comparative experimental study using different ... : مرض السكري من النوع 2، وهو مرض اضطراب التمثيل الغذائي، أصبح أزمة صحية سريعة النمو في جميع أنحاء العالم. فهو يقلل من نوعية الحياة، ويزيد من تكاليف الوفيات والرعاية الصحية ما لم تتم إدارتها بشكل جيد. يعتبر قياس مستوى السكر في الدم بعد الوجبة أحد الخطوات الأساسية والمعترف بها جيدًا في إدارة مرض السكري من النوع 2 لأنه يوجه المستخدم لوضع خطط أفضل لنظامه الغذائي وبالتالي السيطرة على مرض السكري بشكل جيد. في هذه الورقة، نقترح نهجًا قائمًا على البيانات للتنبؤ بمستوى الجلوكوز في الدم بعد ساعتين من الوجبة من قراءات الجلوكوز المنفصلة السابقة في الدم، والوجبة، والتمارين الرياضية، والأدوية، ومعلومات الملف الشخصي لمرضى السكري من النوع 2. على حد علمنا، هذه هي المحاولة الأولى لاستخدام قراءات الجلوكوز المنفصلة في الدم لمدة ساعتين بعد الوجبة للتنبؤ بمستوى الجلوكوز في الدم باستخدام نماذج تعتمد على البيانات. في هذه الدراسة، جمعنا بيانات من خمسة مرضى مصابين بداء السكري ومرضى السكري في ظروف معيشية مجانية لمدة ستة أشهر. لقد قدمنا دراسة تجريبية مقارنة باستخدام نماذج التعلم الآلي الشائعة المختلفة بما في ذلك انحدار ناقلات الدعم، ...
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8دورية أكاديمية
المؤلفون: Ayoub Ali Alshaikh, Faisal Saeed Al-Qahtani, Saif Aboud M. Alqahtani, Ahmad Ali AlFarhan, Ali Mushabbab Al Nuwayhidh, A.M. Madkhali, Renad Alqahtani, Abdullah F. Alasmari, Abdulaziz Saeed Alserhani, Hatim Ahmed Alqubaisi, Ziyad Saad Saeed Aldawh, Abdurrahman Elfulaty Ahmad, Ramy Mohamed Ghazy
مصطلحات موضوعية: Self-Management of Diabetes in Adults, Endocrinology, Diabetes and Metabolism, Medicine, Health Sciences, Management of Diabetes Mellitus and Hypoglycemia, Epidemiology and Implications of Multimorbidity in Healthcare, Epidemiology, Diabetes, Self-Management, Continuous Glucose Monitoring, Type 1 Diabetes, Self-efficacy, Diabetes mellitus, Glycemic, Glycated hemoglobin, Internal medicine, Cohort, Diabetes management, Depression economics, Physical therapy, Type 2 diabetes, Psychology, FOS Psychology, Endocrinology, Economics, Psychotherapist, Macroeconomics
الوصف: Background Self-efficacy is a popular psychological concept that refers to an individual's perception or belief in his ability to perform specific actions. This study aimed to assess the predictive value of self-efficacy, measured using the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEM6S) questionnaire, for diabetes management and overall well-being in patients with diabetes. Subject and methods An anonymous online cross-sectional study was conducted to evaluate the self-efficacy of diabetic patients in the Asser region of Saudi Arabia. The participants were requested to upload their most recent glycated hemoglobin A1C (HbA1C) measurements taken in the last three months, which helped in the accurate categorization of their diabetes as either controlled or uncontrolled. We used the valid Arabic version of the SEM6S and WHO-5 well-being questionnaires to assess patient self-efficacy and well-being. Results A cohort of 342 patients was enrolled in the study, 67.25% were married, their mean age ... : الكفاءة الذاتية هي مفهوم نفسي شائع يشير إلى تصور الفرد أو إيمانه بقدرته على أداء أفعال محددة. تهدف هذه الدراسة إلى تقييم القيمة التنبؤية للكفاءة الذاتية، التي تم قياسها باستخدام استبيان الكفاءة الذاتية لإدارة مقياس 6 عناصر للأمراض المزمنة (SEM6S)، لإدارة مرض السكري والرفاهية العامة لدى مرضى السكري. الموضوع والطرق تم إجراء دراسة مستعرضة عبر الإنترنت مجهولة الهوية لتقييم الكفاءة الذاتية لمرضى السكري في منطقة آسر في المملكة العربية السعودية. طُلب من المشاركين تحميل أحدث قياسات الهيموغلوبين السكري A1C (HbA1C) التي تم أخذها في الأشهر الثلاثة الماضية، مما ساعد في التصنيف الدقيق لمرض السكري لديهم على أنه إما خاضع للرقابة أو غير خاضع للرقابة. استخدمنا النسخة العربية الصالحة من استبياني الرفاه SEM6S و WHO -5 لتقييم الكفاءة الذاتية للمريض ورفاهيته. النتائج تم تسجيل مجموعة من 342 مريضًا في الدراسة، وكان 67.25 ٪ منهم متزوجين، وكان متوسط أعمارهم 43.17 ± 17.61 عامًا، و 52.69 ٪ حصلوا على مستوى جامعي أو تعليم عالٍ. من بين المشاركين، أظهر 46.0 ٪ رفاهية، بينما أبلغ 24.9 ٪ عن ضعف الرفاهية، بما في ذلك 9.4 ٪ تم تحديدهم على أنهم ...
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9دورية أكاديمية
المؤلفون: Sajid Saleem, Areeba Fareed, Sohail Akhtar, Saeed M. Farhat, Amira Mohamed Taha, Aymar Akilimali
مصطلحات موضوعية: Management of Diabetes Mellitus and Hypoglycemia, Endocrinology, Diabetes and Metabolism, Medicine, Health Sciences, Management of Diabetes Mellitus and Cardiovascular Risk, Pancreatic Islet Dysfunction and Regeneration, Surgery, Continuous Glucose Monitoring, Diabetes, Type 1 Diabetes, Type 2 Diabetes, Glucose Control, Insulin glargine, Glycemic, Cochrane Library, Meta-analysis, Insulin, Internal medicine, Hypoglycemia, Type 2 diabetes, Diabetes mellitus, Systematic review, Randomized controlled trial, MEDLINE, Endocrinology, Political science, FOS Political science, Law, FOS Law
الوصف: Diabetes affects millions of people globally, despite treatment options, adherence and other factors pose obstacles. Once-weekly Insulin Icodec, a novel basal Insulin analog with a week-long half-life, offers potential benefits, enhancing convenience, adherence, and quality of life for improved glycemic control. This systematic review and meta-analysis aimed to assess the efficacy and safety of once-weekly Insulin Icodec compared to once-daily Insulin Glargine U-100 in individuals with type II diabetes (T2D).A comprehensive literature search was conducted using PubMed, and Cochrane Library databases before September 2023 to identify relevant Randomized control trials (RCTs) with no language restrictions following PRISMA guidelines. The Cochrane risk-of-bias tool was used for quality assessment. All statistical analyses were conducted using RevMan (version 5.4; Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014).Four RCTs published from 2020 to 2023 with a cumulative sample size of 1035 ... : يصيب مرض السكري ملايين الأشخاص على مستوى العالم، على الرغم من خيارات العلاج والالتزام وعوامل أخرى تشكل عقبات. يوفر برنامج Insulin Icodec مرة واحدة أسبوعيًا، وهو نظير أنسولين أساسي جديد له عمر نصف لمدة أسبوع، فوائد محتملة، مما يعزز الراحة والالتزام ونوعية الحياة لتحسين التحكم في نسبة السكر في الدم. تهدف هذه المراجعة المنهجية والتحليل التلوي إلى تقييم فعالية وسلامة ترميز الأنسولين Icodec مرة واحدة أسبوعيًا مقارنةً بالأنسولين Glargine U -100 مرة واحدة يوميًا في الأفراد المصابين بداء السكري من النوع الثاني (T2D). تم إجراء بحث شامل في الأدبيات باستخدام قواعد بيانات PubMed و Cochrane Library قبل سبتمبر 2023 لتحديد تجارب التحكم العشوائية ذات الصلة (RCTs) مع عدم وجود قيود لغوية تتبع إرشادات PRISMA. تم استخدام أداة كوكرين لمخاطر التحيز لتقييم الجودة. تم إجراء جميع التحليلات الإحصائية باستخدام RevMan (الإصدار 5.4 ؛ كوبنهاغن: مركز كوكرين الشمالي، تعاون كوكرين، 2014). تم تضمين أربع تجارب عشوائية مضبوطة نُشرت من عام 2020 إلى عام 2023 بحجم عينة تراكمي قدره 1035. كشف متوسط الفرق المجمع (MD) عن TIR أطول بنسبة 4.68 ٪ (٪) مع ...
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10دورية أكاديمية
المؤلفون: Ignacio Hormazábal‐Aguayo, Jacinto Muñoz-Pardeza, José Francisco López‐Gil, Nidia Huerta‐Uribe, María Jesús Chueca-Guindulain, Sara Berrade‐Zubiri, Estefanía Sánchez, Mikel Izquierdo, Yasmín Ezzatvar, Antônio García‐Hermoso
مصطلحات موضوعية: Management of Diabetes Mellitus and Hypoglycemia, Endocrinology, Diabetes and Metabolism, Medicine, Health Sciences, Promotion of Healthy Lifestyles in Young Adults, General Health Professions, Health Professions, Mobile Health Interventions and Applications, Type 1 Diabetes, Diabetes, Continuous Glucose Monitoring, Health Apps, Physical Activity, Glycemic, Psychological intervention, Type 1 diabetes, mHealth, Usability, Randomized controlled trial, Motivational interviewing, Family medicine, Physical therapy, Diabetes mellitus, Nursing, FOS Health sciences, Endocrinology, Surgery, Human–computer interaction, Computer science
الوصف: Introduction The use of new technologies presents an opportunity to promote physical activity, especially among young people with type 1 diabetes (T1DM), who tend to be less active compared to their healthy counterparts. The aim of this study is to investigate the impact of a personalized resistance exercise program, facilitated by the Diactive-1 App, on insulin requirements among children and adolescents diagnosed with T1DM. Methods and analysis A minimum of 52 children and adolescents aged 8-18 years, who were diagnosed with T1DM at least 6 months ago, will be randomly assigned to either a group engaging in an individualized resistance exercise program at least 3 times per week over a 24-week period or a waiting-list control group. The primary outcome will be the daily insulin dose requirement. The secondary outcomes will include glycemic control, cardiometabolic profile, body composition, vascular function, physical fitness, 24-hour movement behaviors, diet, and psychological parameters. The usability of ... : مقدمة يمثل استخدام التقنيات الجديدة فرصة لتعزيز النشاط البدني، خاصة بين الشباب المصابين بداء السكري من النوع الأول (T1DM)، الذين يميلون إلى أن يكونوا أقل نشاطًا مقارنة بنظرائهم الأصحاء. الهدف من هذه الدراسة هو التحقيق في تأثير برنامج تمرين المقاومة الشخصي، الذي ييسره تطبيق Diactive -1، على متطلبات الأنسولين بين الأطفال والمراهقين الذين تم تشخيص إصابتهم بـ T1DM. الأساليب والتحليل سيتم تعيين ما لا يقل عن 52 طفلاً ومراهقًا تتراوح أعمارهم بين 8 و 18 عامًا، والذين تم تشخيص إصابتهم بمرض السكري من النوع الأول قبل 6 أشهر على الأقل، بشكل عشوائي إما لمجموعة تشارك في برنامج تمرين مقاومة فردي 3 مرات على الأقل أسبوعيًا على مدار 24 أسبوعًا أو مجموعة مراقبة قائمة الانتظار. ستكون النتيجة الأولية هي متطلبات جرعة الأنسولين اليومية. ستشمل النتائج الثانوية التحكم في نسبة السكر في الدم، وملف التمثيل الغذائي للقلب، وتكوين الجسم، ووظيفة الأوعية الدموية، واللياقة البدنية، وسلوكيات الحركة على مدار 24 ساعة، والنظام الغذائي، والمعلمات النفسية. سيتم أيضًا تقييم قابلية استخدام التطبيق. الأخلاقيات والنشر تم منح الموافقة الأخلاقية لإجراء ...
النص الكامل