I
nte
rna
t
io
na
l
J
o
urna
l o
f
Adv
a
nces in Applie
d Science
s
(
I
J
AAS)
Vo
l.
1
5
,
No
.
3
,
Sep
tem
b
er
20
2
6
,
p
p
.
9
1
1
~
9
2
0
I
SS
N:
2252
-
8
8
1
4
,
DOI
:
1
0
.
1
1
5
9
1
/ijaas
.
v
1
5
.
i
3
.
pp
911
-
9
2
0
911
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//ij
a
a
s
.
ia
esco
r
e.
co
m
Ethica
l issues
in
d
ig
ital menta
l heal
th
deliv
ery:
a co
mprehens
iv
e
sco
ping
review of
g
lo
ba
l challeng
es
Nurul Ai
n M
o
hd
Da
u
d,
H
a
ps
a
h M
d Y
us
o
f
,
No
ra
za
ni Ahm
a
d,
F
a
uzia
h M
o
hd
Sa
’
a
d,
Nurul H
a
s
y
im
a
h M
a
t
Ra
ni,
P
a
u K
ee
,
Nur
Sh
uh
a
na
M
o
h
d
Sa
ns
u
dd
i
n
D
e
p
a
r
t
me
n
t
o
f
G
u
i
d
a
n
c
e
a
n
d
C
o
u
n
se
l
l
i
n
g
,
F
a
c
u
l
t
y
o
f
H
u
ma
n
D
e
v
e
l
o
p
m
e
n
t
,
S
u
l
t
a
n
I
d
r
i
s
Ed
u
c
a
t
i
o
n
U
n
i
v
e
r
s
i
t
y
,
Ta
n
j
u
n
g
M
a
l
i
m
,
M
a
l
a
y
si
a
Art
icle
I
nfo
AB
S
T
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
Ap
r
29
,
2
0
2
5
R
ev
is
ed
May
30
,
2
0
2
6
Acc
ep
ted
J
u
n
17
,
2
0
2
6
Dig
it
a
l
tec
h
n
o
l
o
g
ies
a
re
b
e
c
o
m
in
g
i
n
c
re
a
sin
g
ly
i
n
teg
ra
ted
in
to
m
e
n
tal
h
e
a
lt
h
c
o
u
n
se
ll
i
n
g
.
Wh
il
e
e
x
p
a
n
d
in
g
t
h
e
b
o
u
n
d
a
ries
o
f
se
rv
ice
p
ro
v
isio
n
,
t
h
e
se
tec
h
n
o
l
o
g
ies
h
a
v
e
a
lso
ra
ise
d
n
u
m
e
ro
u
s
e
th
ica
l
c
h
a
ll
e
n
g
e
s
th
a
t
u
r
g
e
n
tl
y
n
e
e
d
c
larifica
ti
o
n
.
T
h
is
stu
d
y
c
o
n
d
u
c
ts
a
sc
o
p
in
g
re
v
iew
fo
ll
o
win
g
t
h
e
sta
n
d
a
rd
ize
d
m
e
th
o
d
o
lo
g
y
d
e
v
e
l
o
p
e
d
b
y
Ark
se
y
a
n
d
O’Malley
.
I
t
id
e
n
t
ifi
e
s
fiv
e
c
o
re
e
th
ica
l
c
h
a
ll
e
n
g
e
s
fa
c
i
n
g
p
ra
c
ti
ti
o
n
e
rs:
p
ri
v
a
c
y
a
n
d
d
a
t
a
se
c
u
rit
y
;
in
fo
rm
e
d
c
o
n
se
n
t
a
n
d
a
u
to
n
o
m
y
;
se
rv
ice
a
c
c
e
ss
ib
il
it
y
a
n
d
e
q
u
a
li
t
y
;
al
g
o
rit
h
m
ic
fa
irn
e
ss
a
n
d
b
ias
m
it
ig
a
ti
o
n
;
a
n
d
in
c
lu
si
v
e
n
e
ss
a
n
d
e
q
u
it
y
.
Ex
isti
n
g
c
o
m
p
a
ra
ti
v
e
a
n
a
l
y
se
s
sh
o
w
t
h
a
t
Wes
tern
c
o
u
n
tri
e
s,
in
c
lu
d
i
n
g
th
e
Un
it
e
d
S
tate
s
(US)
a
n
d
t
h
e
Un
it
e
d
Kin
g
d
o
m
(UK
)
,
h
a
v
e
m
a
tu
re
d
ig
it
a
l
m
e
n
tal
h
e
a
lt
h
re
g
u
lat
o
ry
fra
m
e
wo
rk
s.
I
n
c
o
n
tr
a
st,
n
o
n
-
Wes
tern
c
o
u
n
tri
e
s
g
e
n
e
ra
ll
y
fa
c
e
g
a
p
s
in
leg
a
l
p
r
o
tec
ti
o
n
s,
wh
ich
h
a
ve
c
re
a
ted
a
g
l
o
b
a
l
e
th
ica
l
d
iv
i
d
e
.
Art
ifi
c
ial
i
n
telli
g
e
n
c
e
(
AI
)
-
re
late
d
risk
s,
su
c
h
a
s
a
lg
o
rit
h
m
i
c
b
ias
a
n
d
lac
k
o
f
tran
sp
a
re
n
c
y
,
fu
r
th
e
r
e
x
a
c
e
rb
a
te
th
e
se
p
ro
b
lem
s.
Th
e
st
u
d
y
c
a
ll
s
o
n
p
o
li
c
y
m
a
k
e
rs
to
imp
ro
v
e
re
lev
a
n
t
re
g
u
lato
r
y
fra
m
e
wo
rk
s
a
n
d
re
q
u
ires
p
ra
c
ti
ti
o
n
e
rs t
o
re
c
e
iv
e
sp
e
c
ialize
d
e
th
ica
l
trai
n
in
g
.
K
ey
w
o
r
d
s
:
D
ata
p
r
iv
ac
y
Dig
ital m
en
tal
h
ea
lth
E
th
ical
is
s
u
es
I
n
f
o
r
m
ed
co
n
s
en
t
Sco
p
in
g
r
e
v
iew
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Nu
r
u
l A
in
Mo
h
d
Dau
d
Dep
ar
tm
en
t o
f
Gu
id
an
ce
a
n
d
C
o
u
n
s
ellin
g
,
Facu
lty
o
f
H
u
m
a
n
Dev
elo
p
m
e
n
t
Su
ltan
I
d
r
is
E
d
u
ca
tio
n
Un
iv
er
s
ity
3
5
9
0
0
T
an
ju
n
g
Ma
lim
,
Ma
lay
s
ia
E
m
ail:
n
u
r
u
l.a
in
@
f
p
m
.
u
p
s
i.e
d
u
.
m
y
1.
I
NT
RO
D
UCT
I
O
N
Fo
llo
win
g
th
e
C
OVI
D
-
1
9
p
an
d
em
ic,
th
e
p
en
etr
atio
n
r
at
e
o
f
g
lo
b
al
d
ig
ital
m
en
tal
h
ea
lth
ca
r
e
p
latf
o
r
m
s
h
as
r
is
en
s
u
b
s
tan
t
ially
.
T
elem
ed
icin
e,
m
o
b
ile
h
ea
lth
ap
p
licatio
n
s
,
an
d
ar
tific
ial
in
tellig
en
ce
(
AI
)
-
d
r
i
v
en
d
ia
g
n
o
s
tic
to
o
ls
h
av
e
co
m
p
letely
r
esh
ap
e
d
th
e
ac
ce
s
s
m
o
d
el
f
o
r
m
en
tal
h
ea
lth
s
er
v
ices.
Nev
er
th
eless
,
th
is
f
ield
s
till
co
n
f
r
o
n
ts
co
r
e
ch
allen
g
es
at
b
o
th
th
e
eth
ical
an
d
p
r
ac
tical
le
v
els:
wh
ile
W
ester
n
ju
r
is
d
ictio
n
s
,
in
clu
d
i
n
g
th
e
Un
ited
States
(
US)
an
d
t
h
e
E
u
r
o
p
ea
n
Un
i
o
n
(
E
U)
,
b
o
ast
m
atu
r
e
r
e
g
u
lato
r
y
f
r
am
ewo
r
k
s
s
u
ch
as
th
e
US
1
9
9
6
Hea
lth
I
n
s
u
r
a
n
ce
Po
r
tab
ilit
y
an
d
Acc
o
u
n
tab
ilit
y
Act
(
HI
PAA)
an
d
th
e
E
U’
s
g
en
er
al
d
ata
p
r
o
tectio
n
r
eg
u
l
atio
n
(
GDPR
)
,
n
o
n
-
W
ester
n
co
u
n
tr
ies
lik
e
Ma
lay
s
ia
a
n
d
So
u
th
Af
r
ica
s
u
f
f
er
f
r
o
m
s
ev
er
el
y
lag
g
i
n
g
r
e
g
u
lat
o
r
y
ca
p
a
city
.
T
h
is
p
a
p
er
a
r
g
u
e
s
th
at
lau
n
ch
in
g
g
lo
b
al
co
llab
o
r
ativ
e
d
ialo
g
u
e
is
a
n
ec
ess
ar
y
m
ea
s
u
r
e
to
ad
d
r
ess
th
e
f
u
n
d
am
en
tal
im
b
ala
n
ce
in
t
h
e
n
o
r
t
h
-
s
o
u
th
r
eg
u
lato
r
y
lan
d
s
ca
p
e.
Dig
ital
tech
n
o
lo
g
y
in
m
en
tal
h
ea
lth
,
th
er
ef
o
r
e
ex
is
tin
g
r
esear
ch
[
1
]
s
h
o
ws th
at
d
u
r
in
g
th
e
C
OVI
D
-
19
p
an
d
em
ic,
in
-
p
e
r
s
o
n
m
e
n
tal
h
ea
lth
s
er
v
ices
wo
r
ld
wid
e
wer
e
g
en
er
ally
r
estricte
d
,
an
d
th
r
ee
ty
p
es
o
f
d
ig
ital
to
o
ls
—
telem
ed
icin
e
p
r
o
g
r
am
s
,
m
o
b
ile
m
e
n
tal
h
ea
lth
ap
p
lic
atio
n
s
,
an
d
o
n
lin
e
co
u
n
s
ellin
g
p
latf
o
r
m
s
—
g
ain
ed
wid
esp
r
ea
d
u
s
e.
W
h
ile
th
ese
to
o
ls
g
r
ea
tly
im
p
r
o
v
e
d
s
er
v
ic
e
ac
ce
s
s
ib
ilit
y
,
th
e
p
r
esen
t
s
tu
d
y
f
i
n
d
s
th
at
th
is
s
h
if
t
h
as
b
r
o
u
g
h
t
n
ew
ch
al
len
g
es
to
p
r
o
tectin
g
th
e
c
o
n
f
id
e
n
t
iality
o
f
clien
ts
’
p
er
s
o
n
al
in
f
o
r
m
atio
n
,
ch
allen
g
es
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
1
4
I
n
t J Ad
v
Ap
p
l Sci
,
Vo
l.
1
5
,
No
.
3
,
Sep
tem
b
er
2
0
2
6
:
911
-
9
2
0
912
th
at
ex
is
tin
g
eth
ical
f
r
am
ewo
r
k
ar
e
n
o
lo
n
g
e
r
ab
le
to
ad
d
r
ess
.
R
esear
ch
by
[
2
]
p
o
in
ts
o
u
t th
at
p
r
iv
ac
y
h
as lo
n
g
b
ee
n
a
co
r
e
eth
ical
p
r
in
cip
le
in
th
is
f
ield
,
an
d
ad
ap
tin
g
to
n
ew
tech
n
o
lo
g
ies
r
eq
u
ir
es
u
p
d
atin
g
p
r
iv
ac
y
m
ea
s
u
r
es
to
s
af
eg
u
ar
d
th
e
s
ec
u
r
ity
o
f
p
atie
n
ts
'
s
en
s
itiv
e
in
f
o
r
m
atio
n
an
d
s
tan
d
ar
d
i
ze
d
ata
p
r
o
ce
s
s
in
g
p
r
ac
tices.
C
u
r
r
en
tly
,
b
ig
d
ata
tech
n
o
lo
g
y
,
wh
ich
is
wid
ely
ad
o
p
te
d
ac
r
o
s
s
th
e
en
tire
in
d
u
s
tr
y
,
d
r
iv
es
th
e
lar
g
e
-
s
ca
le
co
llectio
n
o
f
p
er
s
o
n
al
in
f
o
r
m
atio
n
,
f
u
r
t
h
er
am
p
lify
in
g
p
r
i
v
ac
y
r
is
k
s
.
I
n
Ma
lay
s
ia,
wh
er
e
d
ata
p
r
o
tectio
n
r
e
g
u
latio
n
s
r
em
ai
n
in
co
m
p
lete,
lo
ca
l
p
atien
ts
'
d
ata
f
ac
e
ev
en
h
ig
h
er
s
ec
u
r
ity
r
is
k
s
,
m
ak
in
g
th
e
p
r
ac
tical
u
r
g
e
n
cy
o
f
th
is
eth
ic
al
is
s
u
e
in
cr
ea
s
in
g
ly
p
r
o
m
i
n
en
t
[
3
]
.
T
h
e
co
r
e
eth
ical
d
ilem
m
a
in
th
e
f
ield
o
f
d
ig
ital
m
en
tal
h
ea
lth
is
th
e
is
s
u
e
o
f
in
f
o
r
m
e
d
co
n
s
en
t.
T
r
ad
itio
n
al
f
ac
e
-
to
-
f
ac
e
c
o
u
n
s
ellin
g
h
as
estab
lis
h
ed
a
m
atu
r
e
in
f
o
r
m
ed
co
n
s
en
t
m
ec
h
a
n
is
m
th
r
o
u
g
h
d
i
r
ec
t
co
m
m
u
n
icatio
n
,
w
h
ich
ca
n
e
n
s
u
r
e
th
at
clien
ts
ar
e
awa
r
e
o
f
th
e
p
r
o
s
an
d
co
n
s
o
f
r
elev
an
t
s
er
v
ices.
T
h
is
well
-
estab
lis
h
ed
f
r
am
ewo
r
k
,
h
o
wev
er
,
o
n
ly
h
ig
h
lig
h
ts
th
e
b
r
an
d
-
n
ew
p
r
o
b
lem
s
em
er
g
in
g
i
n
d
ig
ital
s
ce
n
ar
io
s
.
Stu
d
y
[
4
]
p
o
in
ts
o
u
t
th
at
th
e
ter
m
s
o
f
s
er
v
ice
o
f
cu
r
r
en
t
d
ig
ital
m
en
tal
h
ea
lth
p
latf
o
r
m
s
ar
e
len
g
th
y
an
d
co
m
p
lex
,
a
n
d
t
h
e
v
ast
m
ajo
r
ity
o
f
clien
ts
ca
n
n
o
t
u
n
d
e
r
s
tan
d
th
e
co
n
te
n
t.
Stu
d
y
[
1
]
m
en
tio
n
s
th
at
in
s
u
f
f
icien
t
d
ig
ital
liter
ac
y
am
o
n
g
g
r
o
u
p
s
in
lo
w
-
r
eso
u
r
ce
s
ettin
g
s
f
u
r
th
er
am
p
lifie
s
th
is
r
is
k
;
s
tu
d
y
[
5
]
f
in
d
s
th
at
m
o
s
t
p
r
ac
titi
o
n
er
s
lack
f
o
r
m
al
tr
ai
n
in
g
to
a
d
d
r
ess
r
elev
an
t
eth
i
ca
l
ch
allen
g
es,
wh
ich
ca
n
ea
s
ily
tr
ig
g
er
v
ar
io
u
s
p
r
o
b
lem
s
.
Fo
r
th
is
r
ea
s
o
n
,
th
i
s
s
tu
d
y
p
r
o
p
o
s
es
th
at
th
e
tr
ain
in
g
an
d
s
u
p
p
o
r
t
s
y
s
tem
f
o
r
p
r
ac
t
itio
n
er
s
m
u
s
t
b
e
re
-
ev
alu
ated
to
f
u
lf
il
eth
ical
r
e
s
p
o
n
s
ib
ilit
ies
in
d
ig
ital
s
et
tin
g
s
.
I
n
f
o
r
m
e
d
co
n
s
en
t
in
th
e
f
ield
o
f
d
ig
ital
m
en
tal
h
ea
lth
is
a
c
o
r
e
eth
ical
ch
allen
g
e
th
at
u
r
g
e
n
tly
n
ee
d
s
clar
if
icatio
n
i
n
th
is
r
esear
c
h
ar
ea
.
T
r
ad
itio
n
al
f
ac
e
-
to
-
f
ac
e
p
s
y
c
h
o
lo
g
ical
c
o
u
n
s
ellin
g
,
w
h
ich
r
elies
o
n
d
ir
ec
t
co
m
m
u
n
icatio
n
,
h
as
d
ev
elo
p
ed
a
m
atu
r
e
g
u
ar
an
tee
m
ec
h
a
n
is
m
f
o
r
in
f
o
r
m
ed
co
n
s
en
t,
wh
ich
ca
n
e
n
s
u
r
e
th
at
s
er
v
ice
u
s
er
s
clea
r
ly
u
n
d
er
s
tan
d
all
b
en
ef
its
an
d
r
is
k
s
o
f
th
e
s
er
v
ices
th
ey
r
ec
eiv
e.
E
x
is
tin
g
r
esear
ch
s
h
o
w
s
th
at
th
is
m
ec
h
an
is
m
f
ac
es
m
u
ltip
le
im
p
ac
ts
in
d
ig
ital
s
ce
n
ar
io
s
:
p
o
in
ts
o
u
t
th
at
p
latf
o
r
m
r
u
les
h
av
e
in
h
er
en
t
f
laws
[
4
]
,
m
en
tio
n
s
th
at
g
ap
s
in
u
s
er
liter
ac
y
am
o
n
g
lo
w
-
r
eso
u
r
ce
g
r
o
u
p
s
will
am
p
lify
r
is
k
s
[
1
]
,
an
d
clar
i
f
ies
th
at
p
r
ac
titi
o
n
er
s
h
av
e
o
b
v
io
u
s
ca
p
ab
ilit
y
d
ef
icien
cies
[
5
]
.
I
n
r
esp
o
n
s
e
t
o
th
ese
is
s
u
es,
th
is
s
tu
d
y
p
r
o
p
o
s
es
to
o
p
tim
i
ze
th
e
tr
ain
in
g
an
d
s
u
p
p
o
r
t sy
s
tem
f
o
r
p
r
ac
titi
o
n
e
r
s
.
Data
p
r
iv
ac
y
a
n
d
s
ec
u
r
ity
ar
e
th
e
m
o
s
t
ce
n
tr
al
et
h
ical
co
n
c
er
n
s
in
th
e
f
ield
o
f
d
ig
ital
m
e
n
tal
h
ea
lth
co
u
n
s
ellin
g
.
Dr
awin
g
o
n
r
ese
ar
ch
f
r
o
m
[
6]
s
o
r
ts
o
u
t
g
lo
b
al
r
eg
u
lato
r
y
d
if
f
er
en
ce
s
:
th
e
U
S
HI
PAA,
th
e
E
U’
s
GDPR
,
Ma
lay
s
ia’
s
PD
PA
[
1
]
,
an
d
I
n
d
ia
’
s
lack
o
f
a
co
m
p
r
eh
en
s
iv
e,
s
p
ec
ialized
r
e
g
u
lato
r
y
s
y
s
tem
.
T
h
is
p
ap
er
p
r
o
p
o
s
es
th
at
th
e
p
o
p
u
la
r
izatio
n
o
f
telem
e
d
icin
e
will
am
p
lify
th
ese
lo
o
p
h
o
les,
cr
ea
tin
g
an
u
r
g
e
n
t
n
ee
d
to
in
tr
o
d
u
ce
a
d
ed
icate
d
d
ata
p
r
o
tectio
n
f
r
am
ewo
r
k
.
I
n
f
o
r
m
e
d
co
n
s
en
t,
wh
er
e
o
b
ta
in
in
g
in
f
o
r
m
e
d
co
n
s
en
t
in
d
ig
ital settin
g
s
is
a
co
m
p
lex
eth
ical
ch
allen
g
e.
I
ts
ef
f
ec
tiv
e
i
m
p
lem
en
tatio
n
is
h
in
d
e
r
ed
b
y
lo
w
d
ig
ital liter
ac
y
,
lan
g
u
ag
e
b
a
r
r
ier
s
,
an
d
c
u
m
b
er
s
o
m
e
leg
al
d
o
c
u
m
en
ts
,
an
d
r
is
k
s
ar
e
ev
en
h
ig
h
er
in
u
n
d
er
d
ev
elo
p
ed
r
eg
io
n
s
[
7
]
.
T
h
is
p
r
o
ce
s
s
ca
n
b
e
s
im
p
lifie
d
th
r
o
u
g
h
th
e
u
s
e
o
f
v
id
eo
s
an
d
in
f
o
g
r
ap
h
ics
[
3
]
.
D
i
g
i
t
a
l
co
m
p
e
t
en
c
y
,
th
i
s
s
tu
d
y
id
e
n
t
if
i
e
s
d
i
g
i
t
a
l
co
m
p
et
e
n
c
y
a
s
a
n
e
s
s
e
n
t
i
a
l
r
eq
u
ir
e
m
e
n
t
f
o
r
d
e
l
i
v
er
i
n
g
e
th
i
c
a
l
ly
s
o
u
n
d
o
n
l
i
n
e
m
en
t
a
l
h
e
a
l
th
s
e
r
v
i
c
e
s
.
P
r
a
c
t
i
t
io
n
e
r
s
m
u
s
t
b
e
p
r
o
f
i
c
i
e
n
t
w
i
th
d
i
g
i
t
a
l
p
l
a
t
f
o
r
m
s
an
d
ad
h
e
r
e
s
t
r
ic
t
l
y
t
o
p
r
o
f
e
s
s
i
o
n
a
l
e
th
i
c
a
l
s
t
an
d
a
r
d
s
[
5
]
.
H
o
w
ev
e
r
,
m
o
s
t
l
ac
k
f
o
r
m
a
l
t
r
a
i
n
in
g
in
t
h
i
s
ar
e
a
[
1
]
,
w
h
ic
h
l
e
ad
s
t
o
t
h
r
e
e
t
y
p
e
s
o
f
r
i
s
k
s
:
b
r
e
ac
h
es
o
f
co
n
f
i
d
en
t
i
a
l
i
t
y
,
c
o
m
m
u
n
i
c
a
t
i
o
n
er
r
o
r
s
,
a
n
d
u
n
c
l
ea
r
p
r
o
f
e
s
s
i
o
n
a
l
b
o
u
n
d
a
r
i
e
s
[
5
]
.
T
h
i
s
d
e
f
i
c
ie
n
cy
i
s
e
s
p
e
c
i
a
l
ly
ev
i
d
e
n
t
i
n
r
e
s
o
u
r
c
e
-
l
i
m
i
t
e
d
s
e
t
t
i
n
g
s
in
non
-
W
e
s
t
e
r
n
c
o
u
n
tr
i
e
s
[
1
]
.
T
h
is
s
tu
d
y
d
ef
in
es
d
i
g
ital
co
m
p
eten
ce
as
a
p
r
e
r
eq
u
is
ite
f
o
r
eth
ical
co
m
p
lian
ce
in
o
n
li
n
e
m
en
tal
h
ea
lth
s
er
v
ices,
wh
ich
r
e
q
u
ir
es
p
r
ac
titi
o
n
er
s
to
o
p
e
r
ate
d
i
g
ital
p
latf
o
r
m
s
p
r
o
f
icien
tly
a
n
d
s
t
r
ictly
u
p
h
o
ld
p
r
o
f
ess
io
n
al
eth
ics.
Ho
we
v
er
,
m
o
s
t
p
r
ac
titi
o
n
er
s
lack
f
o
r
m
al
tr
ain
in
g
in
th
is
f
ield
.
I
n
[
1
]
,
wh
ich
lead
s
to
t
h
r
ee
ty
p
es
o
f
r
is
k
s
:
b
r
ea
ch
es
o
f
co
n
f
id
en
tiality
,
c
o
m
m
u
n
icatio
n
er
r
o
r
s
,
a
n
d
u
n
clea
r
p
r
o
f
ess
io
n
al
b
o
u
n
d
ar
ies
[
5
]
.
T
h
is
d
ef
icien
cy
is
esp
ec
ially
p
r
o
m
in
en
t
in
n
o
n
-
W
ester
n
r
eso
u
r
ce
-
lim
ited
r
eg
i
o
n
s
[
1
]
.
Ma
in
tain
in
g
th
er
ap
e
u
tic
b
o
u
n
d
ar
ies,
p
r
ev
i
o
u
s
r
esear
ch
[
5
]
n
o
tes
th
at
co
m
p
ar
ed
t
o
tr
ad
itio
n
al
in
-
p
er
s
o
n
f
ac
e
-
to
-
f
ac
e
p
s
y
c
h
o
lo
g
ical
co
u
n
s
ellin
g
,
d
i
g
ital
p
s
y
ch
o
lo
g
ical
c
o
u
n
s
ellin
g
is
f
ar
m
o
r
e
lik
ely
to
tr
ig
g
er
eth
ical
r
is
k
s
d
u
e
t
o
b
l
u
r
r
ed
p
r
o
f
ess
io
n
al
b
o
u
n
d
a
r
ies.
A
ty
p
ical
ex
am
p
le
o
f
th
is
is
s
u
e
is
clien
ts
s
en
d
in
g
u
n
s
ch
ed
u
led
p
r
iv
ate
m
ess
ag
es
to
th
eir
co
u
n
s
ello
r
s
.
T
h
e
p
r
esen
t
s
tu
d
y
p
r
o
p
o
s
es
th
at
clea
r
co
m
m
u
n
icatio
n
g
u
id
elin
es
m
u
s
t
b
e
estab
lis
h
e
d
at
th
e
in
itial
s
tag
e
o
f
t
r
ea
tm
en
t.
C
u
ltu
r
al
a
n
d
co
n
te
x
tu
al
co
n
s
id
er
atio
n
s
,
th
is
s
tu
d
y
p
r
o
p
o
s
es
th
at
cu
ltu
r
al
an
d
co
n
tex
tu
al
f
ac
to
r
s
ex
ac
er
b
ate
th
e
eth
ical
ch
allen
g
es
o
f
d
ig
ital
m
en
tal
h
ea
lth
co
u
n
s
ellin
g
.
B
ased
o
n
s
am
p
les
f
r
o
m
n
o
n
-
W
ester
n
co
u
n
tr
i
es,
th
e
r
esear
ch
id
en
tifie
s
th
r
ee
co
r
e
p
r
o
b
lem
s
:
me
n
tal
illn
ess
-
r
elate
d
s
tig
m
a,
lan
g
u
ag
e
b
ar
r
ier
s
,
a
n
d
c
o
g
n
iti
v
e
d
if
f
er
en
ce
s
,
an
d
r
ec
o
m
m
en
d
s
th
at
p
r
ac
titi
o
n
er
s
ad
ju
s
t th
eir
p
r
ac
tices to
ad
a
p
t to
lo
ca
l c
u
ltu
r
al
c
o
n
tex
ts
[
1
]
.
2.
M
E
T
H
O
D
T
h
is
s
tu
d
y
ad
o
p
ts
th
e
s
co
p
in
g
r
ev
iew
m
eth
o
d
,
f
o
llo
win
g
t
h
e
f
r
am
ewo
r
k
p
r
o
p
o
s
ed
b
y
A
r
k
s
ey
an
d
O’
Ma
lley
[
8
]
.
I
t
co
v
er
s
b
o
th
ea
s
ter
n
an
d
wester
n
r
esear
ch
co
n
tex
ts
an
d
s
tr
ictly
ad
h
er
es
to
th
eir
f
iv
e
-
s
tag
e
p
r
o
ce
s
s
.
A
ll m
eth
o
d
o
l
o
g
ical
d
etails ar
e
lis
ted
in
T
ab
le
1
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Ad
v
Ap
p
l Sci
I
SS
N:
2252
-
8
8
1
4
E
th
ica
l iss
u
es in
d
ig
ita
l m
en
ta
l h
ea
lth
d
elive
r
y:
a
c
o
mp
r
eh
en
s
ive
…
(
N
u
r
u
l A
in
Mo
h
d
Da
u
d
)
913
T
ab
le
1
.
Fiv
e
-
s
tag
e
s
co
p
i
n
g
p
r
o
ce
s
s
No
S
t
a
g
e
s
D
e
scri
p
t
i
o
n
1
I
d
e
n
t
i
f
y
i
n
g
r
e
s
e
a
r
c
h
q
u
e
st
i
o
n
s
W
h
a
t
a
r
e
t
h
e
e
t
h
i
c
a
l
c
h
a
l
l
e
n
g
e
s
o
f
d
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
serv
i
c
e
s?
W
h
a
t
a
r
e
t
h
e
c
o
r
e
a
t
t
r
i
b
u
t
e
s
o
f
e
x
i
s
t
i
n
g
l
i
t
e
r
a
t
u
r
e
i
n
t
h
e
f
i
e
l
d
o
f
d
i
g
i
t
a
l
men
t
a
l
h
e
a
l
t
h
e
t
h
i
c
s
?
2
I
d
e
n
t
i
f
y
i
n
g
r
e
l
e
v
a
n
t
st
u
d
i
e
s
A
c
o
m
p
r
e
h
e
n
si
v
e
sea
r
c
h
w
a
s
c
o
n
d
u
c
t
e
d
u
si
n
g
S
c
o
p
u
s
a
n
d
W
e
b
o
f
S
c
i
e
n
c
e
(
W
O
S
)
,
u
t
i
l
i
z
i
n
g
s
e
a
r
c
h
t
e
r
ms
,
su
c
h
a
s
“
d
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
e
t
h
i
c
s
”,
“
d
a
t
a
p
r
i
v
a
c
y
”,
“
i
n
f
o
r
me
d
c
o
n
se
n
t
”,
“
t
e
l
e
h
e
a
l
t
h
”,
a
n
d
“
A
I
i
n
me
n
t
a
l
h
e
a
l
t
h
”.
3
S
t
u
d
y
se
l
e
c
t
i
o
n
I
n
c
l
u
s
i
o
n
c
r
i
t
e
r
i
a
f
o
c
u
se
d
o
n
e
m
p
i
r
i
c
a
l
st
u
d
i
e
s,
t
h
e
o
r
e
t
i
c
a
l
p
a
p
e
r
s,
a
n
d
r
e
v
i
e
w
s
a
d
d
r
e
ssi
n
g
e
t
h
i
c
a
l
i
ss
u
e
s
i
n
d
i
g
i
t
a
l
me
n
t
a
l
h
e
a
l
t
h
c
o
u
n
s
e
l
l
i
n
g
.
O
n
l
y
En
g
l
i
s
h
-
l
a
n
g
u
a
g
e
p
a
p
e
r
s
p
u
b
l
i
sh
e
d
b
e
t
w
e
e
n
2
0
1
9
a
n
d
2
0
2
4
w
e
r
e
i
n
c
l
u
d
e
d
.
B
o
o
k
c
h
a
p
t
e
r
s
a
n
d
b
o
o
k
s
w
e
r
e
e
x
c
l
u
d
e
d
.
4
D
a
t
a
e
x
t
r
a
c
t
i
o
n
a
n
d
a
n
a
l
y
si
s
S
e
l
e
c
t
e
d
s
t
u
d
i
e
s
w
e
r
e
a
n
a
l
y
z
e
d
u
s
i
n
g
a
s
t
r
u
c
t
u
r
e
d
Ex
c
e
l
sh
e
e
t
c
a
p
t
u
r
i
n
g
v
a
r
i
a
b
l
e
s
,
su
c
h
a
s
y
e
a
r
o
f
p
u
b
l
i
c
a
t
i
o
n
,
c
o
u
n
t
r
y
,
p
o
p
u
l
a
t
i
o
n
,
s
t
u
d
y
d
e
s
i
g
n
,
k
e
y
e
t
h
i
c
a
l
i
ss
u
e
s,
a
n
d
r
e
c
o
m
me
n
d
a
t
i
o
n
s.
Th
e
ma
t
i
c
a
n
a
l
y
s
i
s
w
a
s
u
se
d
t
o
c
a
t
e
g
o
r
i
z
e
t
h
e
st
u
d
i
e
s
i
n
t
o
f
i
v
e
mai
n
e
t
h
i
c
a
l
a
r
e
a
s.
5
C
o
l
l
a
t
i
n
g
a
n
d
s
u
mm
a
r
i
z
i
n
g
r
e
su
l
t
s
F
i
n
d
i
n
g
s
w
e
r
e
r
e
o
r
g
a
n
i
z
e
d
i
n
t
o
t
h
e
mes
a
n
d
su
b
t
h
e
mes
i
d
e
n
t
i
f
i
e
d
t
h
r
o
u
g
h
t
h
e
ma
t
i
c
a
n
d
c
o
m
p
a
r
a
t
i
v
e
a
n
a
l
y
ses
t
o
p
r
e
se
n
t
a
r
o
b
u
st
d
i
sc
u
ss
i
o
n
o
f
e
t
h
i
c
a
l
c
h
a
l
l
e
n
g
e
s
i
n
d
i
g
i
t
a
l
me
n
t
a
l
h
e
a
l
t
h
c
o
u
n
se
l
l
i
n
g
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
O
v
er
v
iew
o
f
s
t
ud
y
s
elec
t
io
n a
nd
cha
ra
ct
er
is
t
ics
T
h
e
p
r
o
ce
s
s
was c
o
n
d
u
cte
d
u
s
in
g
th
e
f
iv
e
-
s
tag
e
s
co
p
in
g
p
r
o
ce
s
s
.
A
to
tal
o
f
3
7
r
ec
o
r
d
s
wer
e
o
b
tain
ed
f
r
o
m
t
h
e
W
o
S
d
atab
ase
,
1
2
8
f
r
o
m
Sco
p
u
s
,
an
d
2
7
6
f
r
o
m
E
R
I
C
(
n
=
4
4
1
)
.
Af
ter
r
e
m
o
v
in
g
2
2
d
u
p
licate
en
tr
ies,
th
is
s
tu
d
y
co
m
p
leted
m
u
ltip
le
r
o
u
n
d
s
o
f
s
cr
ee
n
in
g
,
an
d
u
ltima
tely
,
2
0
s
tu
d
ies
m
et
th
e
in
clu
s
io
n
cr
iter
ia.
T
h
ese
elig
ib
le
s
tu
d
ie
s
co
v
er
1
0
co
u
n
tr
ies,
with
th
e
US
r
an
k
in
g
f
ir
s
t
with
6
in
c
lu
d
ed
s
tu
d
ies.
T
h
e
n
u
m
b
er
o
f
r
elev
an
t p
u
b
licatio
n
s
r
o
s
e
s
h
ar
p
ly
af
te
r
2
0
2
0
,
r
ea
ch
in
g
a
p
ea
k
o
f
5
p
u
b
licatio
n
s
in
2
0
2
3
.
T
h
is
tr
en
d
s
tem
s
f
r
o
m
t
h
e
C
OVI
D
-
1
9
p
an
d
em
ic,
wh
ich
ac
c
eler
ated
th
e
p
r
o
m
o
tio
n
o
f
d
ig
i
tal
m
en
tal
h
ea
lth
to
o
ls
.
T
h
is
s
tu
d
y
r
e
v
iews
th
e
2
0
in
clu
d
ed
s
tu
d
ies
in
d
ig
ital
m
e
n
tal
h
ea
lth
.
Sco
p
i
n
g
r
e
v
iew
an
al
y
s
is
s
h
o
ws
th
at
th
ese
s
tu
d
ies
ar
e
g
eo
g
r
a
p
h
ically
co
n
ce
n
tr
ated
in
h
ig
h
-
in
c
o
m
e
W
ester
n
co
u
n
tr
ies,
an
d
th
eir
p
u
b
licatio
n
d
ates
ar
e
c
o
n
ce
n
t
r
ated
b
etwe
en
2
0
2
0
a
n
d
2
0
2
4
.
Dr
awin
g
o
n
th
e
ju
d
g
m
en
t
s
p
r
esen
ted
in
[
1
]
an
d
[
9
]
,
th
e
C
OVI
D
-
1
9
p
a
n
d
em
ic
h
as
ca
taly
ze
d
r
elev
an
t
e
th
ical
is
s
u
es
to
s
h
if
t
f
r
o
m
b
ein
g
laten
t
to
u
r
g
en
t.
Pre
v
io
u
s
f
r
am
ewo
r
k
s
th
at
r
elied
o
n
W
ester
n
r
eg
u
lato
r
y
s
y
s
tem
s
,
s
u
ch
as
HI
PAA
an
d
GD
PR
,
ca
n
n
o
t
ad
ap
t
to
th
e
leg
al,
in
f
r
astru
ctu
r
e,
an
d
c
u
ltu
r
al
co
n
te
x
ts
o
f
n
o
n
-
W
ester
n
s
ettin
g
s
.
T
h
is
s
tu
d
y
ex
tr
ac
t
s
f
iv
e
m
ajo
r
eth
ical
th
em
es,
an
d
t
h
eir
co
r
r
esp
o
n
d
i
n
g
r
elatio
n
s
h
i
p
s
ar
e
o
r
g
an
ize
d
in
T
a
b
le
2
,
wh
ich
will
b
e
a
n
aly
ze
d
in
d
ep
t
h
in
s
u
b
s
eq
u
en
t sectio
n
s.
3
.
2
.
T
hem
a
t
ic
f
ind
ing
s
a
nd
dis
cu
s
s
io
n
T
h
is
s
tu
d
y
u
s
es
th
em
atic
an
al
y
s
is
to
ex
tr
ac
t
f
iv
e
co
r
e
r
esear
ch
th
em
es:
p
r
iv
ac
y
an
d
d
ata
s
ec
u
r
ity
;
in
f
o
r
m
e
d
co
n
s
en
t
an
d
au
to
n
o
m
y
;
s
er
v
ice
ac
ce
s
s
ib
ilit
y
a
n
d
eq
u
ity
;
alg
o
r
ith
m
ic
f
air
n
ess
an
d
b
ias
;
an
d
in
clu
s
iv
en
ess
an
d
eq
u
ity
.
Pro
ce
ed
in
g
in
p
h
ases
u
n
d
er
a
n
i
n
teg
r
ated
a
n
aly
tical
f
r
am
ewo
r
k
,
th
e
s
tu
d
y
f
ir
s
t
r
ep
o
r
ts
co
r
e
f
in
d
in
g
s
f
o
r
ea
ch
in
d
iv
id
u
al
t
h
em
e,
th
e
n
in
ter
p
r
ets
th
ese
f
in
d
in
g
s
with
in
s
cien
tific
an
d
r
e
g
u
lato
r
y
co
n
tex
ts
.
T
h
is
ap
p
r
o
ac
h
ca
n
clar
if
y
th
e
in
ter
n
al
co
n
n
ec
tio
n
s
with
in
th
e
r
esear
ch
f
ield
an
d
g
en
er
ate
in
s
ig
h
ts
f
o
r
r
ef
er
en
ce
b
y
p
o
licy
an
d
p
r
ac
ti
ce
.
3
.
2
.
1
.
P
riv
a
c
y
a
nd
da
t
a
s
ec
u
rit
y
T
h
e
s
y
s
tem
atic
r
ev
iew
c
o
n
d
u
cted
f
o
r
th
is
s
tu
d
y
in
t
h
e
f
ield
o
f
d
ig
ital
m
en
tal
h
ea
lth
i
n
clu
d
ed
a
to
tal
o
f
2
0
r
elev
an
t
s
tu
d
ies.
Statis
tical
an
aly
s
is
f
o
u
n
d
t
h
at
p
r
iv
ac
y
an
d
d
ata
s
ec
u
r
ity
ar
e
th
e
m
o
s
t
f
r
eq
u
e
n
tly
m
en
tio
n
ed
et
h
ical
co
n
ce
r
n
s
in
th
e
f
ield
.
Fiv
e
d
e
d
icate
d
s
tu
d
ies
co
v
er
e
d
f
o
u
r
ty
p
es
o
f
s
ce
n
ar
io
s
,
in
clu
d
i
n
g
o
n
lin
e
p
s
y
ch
o
th
e
r
ap
y
[
1
0
]
a
n
d
wea
r
ab
le
s
cr
ee
n
in
g
[
1
1
]
,
[
1
2
]
,
a
n
d
r
em
o
te
m
en
tal
h
ea
lth
s
er
v
ices
d
u
r
in
g
th
e
p
an
d
em
ic
[
1
3
]
,
with
th
e
co
r
e
co
n
f
licts
b
ein
g
th
e
lar
g
e
v
o
l
u
m
e
o
f
s
en
s
itiv
e
d
ata
co
llected
y
et
in
s
u
f
f
icien
t
co
r
r
esp
o
n
d
in
g
p
r
o
tectio
n
,
as
well
as in
co
n
s
is
ten
t g
o
v
er
n
an
c
e
s
tan
d
ar
d
s
ac
r
o
s
s
d
if
f
er
e
n
t ju
r
is
d
ictio
n
s
.
T
h
is
s
tu
d
y
f
ir
s
t
d
r
aws
o
n
ex
is
tin
g
r
esear
ch
to
o
r
g
an
ize
a
n
d
o
u
tlin
e
th
r
ee
c
o
r
e
in
ter
n
ati
o
n
a
l
m
ed
ical
d
ata
r
eg
u
lato
r
y
f
r
am
ewo
r
k
s
:
th
e
US
HI
PAA,
th
e
E
U’
s
GDPR
,
an
d
th
e
Un
ited
Kin
g
d
o
m
(
UK)
’
s
Natio
n
al
Hea
lth
Ser
v
ice
(
NHS)
en
cr
y
p
t
io
n
r
u
les
[
1
]
.
I
t
th
en
cites
m
u
lt
ip
le
US
m
ed
ical
d
ata
s
ec
u
r
ity
in
cid
en
ts
r
ec
o
r
d
ed
in
[
1
4
]
,
in
wh
ich
m
illi
o
n
s
o
f
m
ed
ical
r
ec
o
r
d
s
wer
e
leak
e
d
.
On
th
is
b
asis
,
th
e
s
tu
d
y
a
r
g
u
es
th
at
ex
is
tin
g
r
eg
u
lato
r
y
r
u
les
ca
n
n
o
t
g
u
a
r
a
n
tee
d
ata
s
ec
u
r
ity
wh
en
r
elied
o
n
alo
n
e
,
an
d
t
h
er
e
is
an
u
r
g
e
n
t
n
ee
d
to
estab
lis
h
a
s
u
p
p
o
r
tin
g
co
m
p
lian
ce
f
r
am
ewo
r
k
.
T
h
is
s
tu
d
y
f
u
r
t
h
er
f
in
d
s
th
at
th
e
p
r
iv
ac
y
r
is
k
s
o
f
m
en
tal
h
ea
lth
m
ed
ical
d
ata
ar
e
f
ar
h
ig
h
e
r
th
an
t
h
o
s
e
in
r
o
u
tin
e
m
ed
ical
s
ce
n
ar
io
s
.
T
ak
in
g
Ma
lay
s
ia’
s
cu
r
r
en
t
p
er
s
o
n
al
d
ata
p
r
o
tectio
n
ac
t
as
an
ex
am
p
le,
th
e
co
u
n
tr
y
o
n
ly
h
as
a
g
en
er
al
-
p
u
r
p
o
s
e
d
ata
p
r
o
tectio
n
f
r
am
ew
o
r
k
,
with
n
o
s
p
ec
iali
ze
d
r
u
les
f
o
r
h
ig
h
ly
s
en
s
itiv
e
m
en
tal
h
ea
lth
d
ata.
T
h
is
g
ap
is
n
o
t
a
p
u
r
el
y
tech
n
ic
al
is
s
u
e;
it
will
tr
ig
g
e
r
a
lo
s
s
o
f
p
atien
t
tr
u
s
t,
w
h
ich
i
n
t
u
r
n
u
n
d
er
m
in
es
t
h
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
1
4
I
n
t J Ad
v
Ap
p
l Sci
,
Vo
l.
1
5
,
No
.
3
,
Sep
tem
b
er
2
0
2
6
:
911
-
9
2
0
914
v
er
y
f
o
u
n
d
atio
n
o
f
m
e
n
tal
h
e
alth
s
er
v
ices.
Fo
r
th
is
r
ea
s
o
n
,
th
e
s
tu
d
y
p
r
o
p
o
s
es
th
at
p
r
iv
a
cy
p
r
o
tectio
n
m
u
s
t
in
teg
r
ate
th
r
ee
c
o
r
e
d
im
e
n
s
io
n
s
: p
atien
t tr
u
s
t,
tr
ea
tm
en
t e
f
f
ec
tiv
en
ess
,
an
d
eq
u
itab
le
ac
ce
s
s
to
m
ed
ical
ca
r
e.
T
ab
le
2
.
C
h
ar
tin
g
th
e
d
ata
No
A
u
t
h
o
r
Y
e
a
r
F
i
n
d
i
n
g
K
e
y
e
t
h
i
c
a
l
c
h
a
l
l
e
n
g
e
S
u
b
-
t
h
e
me
Th
e
m
e
1
S
k
o
r
b
u
r
g
e
t
a
l
.
[
1
5
]
2
0
2
4
Et
h
i
c
s
o
f
A
I
a
n
d
p
a
r
t
i
c
i
p
a
t
o
r
y
r
e
se
a
r
c
h
i
n
men
t
a
l
h
e
a
l
t
h
A
I
d
e
c
i
si
o
n
-
ma
k
i
n
g
v
s.
p
a
t
i
e
n
t
a
u
t
o
n
o
my
A
u
t
o
n
o
m
y
i
n
AI
I
n
f
o
r
med
c
o
n
se
n
t
a
n
d
a
u
t
o
n
o
my
2
K
r
e
t
z
sc
h
m
a
r
e
t
a
l
.
[
1
6
]
2
0
1
9
P
e
r
sp
e
c
t
i
v
e
s
o
f
y
o
u
n
g
p
e
o
p
l
e
o
n
m
e
n
t
a
l
h
e
a
l
t
h
c
h
a
t
b
o
t
s
U
ser t
r
u
s
t
a
n
d
d
e
c
i
s
i
o
n
-
ma
k
i
n
g
a
u
t
o
n
o
my
Tr
u
st
a
n
d
a
u
t
o
n
o
my
i
n
c
h
a
t
b
o
t
s
I
n
f
o
r
med
c
o
n
se
n
t
a
n
d
a
u
t
o
n
o
my
3
N
e
b
e
k
e
r
e
t
al
.
[
1
7
]
2
0
1
9
Et
h
i
c
s
i
n
A
I
-
su
p
p
o
r
t
e
d
d
i
g
i
t
a
l
h
e
a
l
t
h
r
e
sea
r
c
h
I
n
f
o
r
med
c
o
n
se
n
t
a
n
d
p
r
i
v
a
c
y
i
n
A
I
r
e
se
a
r
c
h
I
n
f
o
r
med
c
o
n
se
n
t
i
n
A
I
r
e
sea
r
c
h
I
n
f
o
r
med
c
o
n
se
n
t
a
n
d
a
u
t
o
n
o
my
4
B
i
r
k
e
t
a
l
.
[
1
8
]
2
0
2
1
V
a
l
u
e
a
c
r
o
s
s
u
ser
e
x
p
e
r
i
e
n
c
e
a
n
d
d
a
t
a
o
w
n
e
r
sh
i
p
d
o
ma
i
n
s
D
a
t
a
p
r
i
v
a
c
y
a
n
d
o
w
n
e
r
sh
i
p
O
w
n
e
r
sh
i
p
o
f
d
a
t
a
I
n
f
o
r
med
c
o
n
se
n
t
a
n
d
a
u
t
o
n
o
my
5
H
a
ssem
a
n
d
La
h
e
r
[
3
]
2
0
2
2
Ev
a
l
u
a
t
i
o
n
o
f
e
t
h
i
c
a
l
g
u
i
d
e
l
i
n
e
s
i
n
o
n
l
i
n
e
men
t
a
l
h
e
a
l
t
h
s
c
r
e
e
n
i
n
g
C
o
n
f
i
d
e
n
t
i
a
l
i
t
y
a
n
d
d
a
t
a
h
a
n
d
l
i
n
g
i
n
o
n
l
i
n
e
s
c
r
e
e
n
i
n
g
s
P
r
i
v
a
c
y
i
n
o
n
l
i
n
e
scree
n
i
n
g
P
r
i
v
a
c
y
a
n
d
d
a
t
a
sec
u
r
i
t
y
6
S
k
o
r
b
u
r
g
a
n
d
F
r
i
e
se
n
[
1
3
]
2
0
2
1
Et
h
i
c
a
l
a
n
d
e
p
i
s
t
e
m
i
c
c
o
n
c
e
r
n
s
i
n
d
i
g
i
t
a
l
me
n
t
a
l
h
e
a
l
t
h
d
u
r
i
n
g
C
O
V
I
D
-
19
B
a
l
a
n
c
i
n
g
r
a
p
i
d
r
e
sp
o
n
se
a
n
d
e
t
h
i
c
a
l
r
i
g
o
r
d
u
r
i
n
g
c
r
i
s
e
s
D
i
g
i
t
a
l
h
e
a
l
t
h
r
e
sp
o
n
s
e
P
r
i
v
a
c
y
a
n
d
d
a
t
a
sec
u
r
i
t
y
7
S
t
o
l
l
e
t
a
l
.
[
1
0
]
2
0
2
0
Et
h
i
c
a
l
c
o
n
c
e
r
n
s i
n
o
n
l
i
n
e
p
sy
c
h
o
t
h
e
r
a
p
y
M
a
i
n
t
a
i
n
i
n
g
c
o
n
f
i
d
e
n
t
i
a
l
i
t
y
a
n
d
i
n
f
o
r
me
d
c
o
n
se
n
t
o
n
l
i
n
e
O
n
l
i
n
e
p
sy
c
h
o
t
h
e
r
a
p
y
P
r
i
v
a
c
y
a
n
d
d
a
t
a
sec
u
r
i
t
y
8
C
h
i
a
u
z
z
i
e
t
a
l
.
[
1
1
]
2
0
2
0
Te
l
e
me
n
t
a
l
h
e
a
l
t
h
c
h
a
l
l
e
n
g
e
s
d
u
r
i
n
g
t
h
e
C
O
V
I
D
-
1
9
e
r
a
P
r
i
v
a
c
y
a
n
d
d
a
t
a
se
c
u
r
i
t
y
i
n
v
i
d
e
o
c
o
n
s
u
l
t
a
t
i
o
n
s
P
r
i
v
a
c
y
i
n
t
e
l
e
me
n
t
a
l
h
e
a
l
t
h
P
r
i
v
a
c
y
a
n
d
d
a
t
a
sec
u
r
i
t
y
9
O
’
Le
a
r
y
e
t
a
l
.
[
1
2
]
2
0
2
4
U
si
n
g
w
e
a
r
a
b
l
e
s fo
r
men
t
a
l
h
e
a
l
t
h
s
c
r
e
e
n
i
n
g
i
n
c
h
i
l
d
r
e
n
P
r
i
v
a
c
y
a
n
d
a
c
c
u
r
a
c
y
i
n
w
e
a
r
a
b
l
e
d
a
t
a
f
o
r
c
h
i
l
d
r
e
n
P
r
i
v
a
c
y
i
n
w
e
a
r
a
b
l
e
s
P
r
i
v
a
c
y
a
n
d
d
a
t
a
sec
u
r
i
t
y
10
C
o
g
h
l
a
n
e
t
a
l
.
[
1
9
]
2
0
2
3
Et
h
i
c
a
l
c
o
n
c
e
r
n
s wi
t
h
men
t
a
l
h
e
a
l
t
h
c
h
a
t
b
o
t
s
Tr
a
n
s
p
a
r
e
n
c
y
a
n
d
a
c
c
o
u
n
t
a
b
i
l
i
t
y
i
n
c
h
a
t
b
o
t
r
e
c
o
m
me
n
d
a
t
i
o
n
s
Tr
a
n
s
p
a
r
e
n
c
y
i
n
c
h
a
t
b
o
t
s
A
l
g
o
r
i
t
h
m
i
c
f
a
i
r
n
e
ss a
n
d
b
i
a
s
11
M
c
C
r
a
d
d
e
n
e
t
a
l
.
[
2
0
]
2
0
2
3
P
r
o
mi
se
o
f
A
I
i
n
p
sy
c
h
i
a
t
r
y
a
n
d
a
ss
o
c
i
a
t
e
d
e
t
h
i
c
a
l
i
ss
u
e
s
En
s
u
r
i
n
g
f
a
i
r
n
e
ss
a
n
d
t
r
a
n
s
p
a
r
e
n
c
y
i
n
A
I
mo
d
e
l
s
Tr
a
n
s
p
a
r
e
n
c
y
i
n
A
I
p
sy
c
h
i
a
t
r
y
A
l
g
o
r
i
t
h
m
i
c
f
a
i
r
n
e
ss a
n
d
b
i
a
s
12
A
r
b
a
n
a
s
[
2
1
]
2
0
2
4
I
mp
a
c
t
o
f
c
h
a
t
b
o
t
s
l
i
k
e
C
h
a
t
G
P
T
i
n
p
sy
c
h
i
a
t
r
i
c
c
a
r
e
Tr
u
st
a
n
d
o
v
e
r
-
r
e
l
i
a
n
c
e
o
n
a
u
t
o
m
a
t
e
d
c
h
a
t
b
o
t
s
Tr
u
st
i
n
c
h
a
t
b
o
t
s
A
l
g
o
r
i
t
h
m
i
c
f
a
i
r
n
e
ss a
n
d
b
i
a
s
13
M
o
r
c
h
e
t
a
l
.
[
2
2
]
2
0
2
0
Et
h
i
c
a
l
g
u
i
d
e
l
i
n
e
s
f
o
r
A
I
i
n
su
i
c
i
d
e
p
r
e
v
e
n
t
i
o
n
Et
h
i
c
a
l
u
s
e
o
f
A
I
i
n
c
r
i
t
i
c
a
l
i
n
t
e
r
v
e
n
t
i
o
n
s
Et
h
i
c
s
i
n
A
I
su
i
c
i
d
e
p
r
e
v
e
n
t
i
o
n
A
l
g
o
r
i
t
h
m
i
c
f
a
i
r
n
e
ss a
n
d
b
i
a
s
14
V
i
l
a
z
a
a
n
d
M
c
C
a
s
h
i
n
[
2
3
]
2
0
2
1
Et
h
i
c
s
o
f
c
h
a
t
b
o
t
a
u
t
o
m
a
t
i
o
n
i
n
me
n
t
a
l
h
e
a
l
t
h
t
h
e
r
a
p
y
B
a
l
a
n
c
i
n
g
a
u
t
o
m
a
t
i
o
n
w
i
t
h
h
u
m
a
n
c
a
r
e
F
a
i
r
n
e
ss
i
n
c
h
a
t
b
o
t
t
h
e
r
a
p
y
A
l
g
o
r
i
t
h
m
i
c
f
a
i
r
n
e
ss a
n
d
b
i
a
s
15
M
a
r
t
i
n
e
t
a
l
.
[2
4]
2
0
2
1
D
e
v
e
l
o
p
m
e
n
t
o
f
d
i
g
i
t
a
l
p
h
e
n
o
t
y
p
i
n
g
t
o
o
l
s
i
n
men
t
a
l
h
e
a
l
t
h
P
r
i
v
a
c
y
i
n
c
o
n
t
i
n
u
o
u
s
mo
n
i
t
o
r
i
n
g
a
n
d
d
a
t
a
c
a
p
t
u
r
e
D
i
g
i
t
a
l
p
h
e
n
o
t
y
p
i
n
g
I
n
c
l
u
s
i
v
i
t
y
a
n
d
f
a
i
r
n
e
ss
16
V
a
l
e
n
t
i
n
e
e
t
a
l
.
[
2
5
]
2
0
2
3
U
ser a
u
t
o
n
o
m
y
v
s
a
l
g
o
r
i
t
h
m
-
d
r
i
v
e
n
r
e
c
o
m
me
n
d
a
t
i
o
n
s
M
e
n
t
a
l
h
e
a
l
t
h
a
p
p
s
r
e
c
o
m
me
n
d
a
t
i
o
n
s
M
e
n
t
a
l
h
e
a
l
t
h
a
p
p
s
I
n
c
l
u
s
i
v
i
t
y
a
n
d
f
a
i
r
n
e
ss
17
P
a
v
e
z
e
t
a
l
.
[
2
6
]
2
0
2
3
Et
h
i
c
s
o
f
c
a
r
e
i
n
marg
i
n
a
l
i
z
e
d
c
o
mm
u
n
i
t
i
e
s
u
si
n
g
d
i
g
i
t
a
l
t
o
o
l
s
En
s
u
r
i
n
g
i
n
c
l
u
s
i
v
i
t
y
a
n
d
f
a
i
r
n
e
ss i
n
d
i
g
i
t
a
l
i
n
t
e
r
v
e
n
t
i
o
n
s
D
i
g
i
t
a
l
i
n
c
l
u
si
o
n
I
n
c
l
u
s
i
v
i
t
y
a
n
d
f
a
i
r
n
e
ss
18
F
a
i
ss
n
e
r
e
t
a
l
.
[
2
7
]
2
0
2
4
Et
h
i
c
a
l
a
n
a
l
y
s
i
s
o
f
d
e
p
r
e
ss
i
o
n
d
e
t
e
c
t
i
o
n
v
i
a
smar
t
p
h
o
n
e
a
p
p
s
P
r
e
v
e
n
t
i
n
g
e
p
i
s
t
e
m
i
c
i
n
j
u
st
i
c
e
i
n
p
a
ssi
v
e
t
r
a
c
k
i
n
g
a
p
p
s
S
martp
h
o
n
e
a
p
p
s
I
n
c
l
u
s
i
v
i
t
y
a
n
d
f
a
i
r
n
e
ss
19
A
l
k
u
r
e
i
s
h
i
e
t
a
l
.
[
2
8
]
2
0
2
1
D
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
e
t
h
i
c
s
d
u
r
i
n
g
C
O
V
I
D
-
19
Eq
u
i
t
a
b
l
e
a
c
c
e
ss t
o
d
i
g
i
t
a
l
men
t
a
l
h
e
a
l
t
h
t
o
o
l
s
D
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
A
c
c
e
ss
i
b
i
l
i
t
y
a
n
d
e
q
u
a
l
i
t
y
20
C
a
l
l
a
r
d
e
t
a
l
.
[
2
9
]
2
0
2
2
M
e
n
t
a
l
h
e
a
l
t
h
i
n
u
n
i
v
e
r
si
t
i
e
s
u
n
d
e
r
d
i
g
i
t
a
l
c
a
p
i
t
a
l
i
sm
I
mp
a
c
t
o
f
c
a
p
i
t
a
l
i
sm
o
n
s
t
u
d
e
n
t
men
t
a
l
h
e
a
l
t
h
a
n
d
c
a
r
e
D
i
g
i
t
a
l
c
a
p
i
t
a
l
i
sm
A
c
c
e
ss
i
b
i
l
i
t
y
a
n
d
e
q
u
a
l
i
t
y
3
.
2
.
2
.
I
nfo
rm
ed
co
ns
ent
a
nd
a
uto
no
m
y
T
h
is
s
tu
d
y
r
ev
iews
f
o
u
r
ex
is
tin
g
eth
ical
s
tu
d
ies
in
d
ig
ital
m
en
tal
h
ea
lth
s
er
v
ices.
T
h
e
s
e
s
tu
d
ies
u
n
if
o
r
m
ly
id
en
tif
y
in
f
o
r
m
ed
co
n
s
en
t
an
d
u
s
er
au
to
n
o
m
y
as
co
r
e
eth
ical
ch
allen
g
es
f
o
r
th
e
r
ea
l
-
wo
r
ld
d
ep
lo
y
m
e
n
t
o
f
s
u
c
h
s
er
v
ices.
T
h
is
s
tu
d
y
ca
teg
o
r
izes
two
ty
p
es
o
f
p
r
o
b
lem
-
tr
i
g
g
er
in
g
s
ce
n
ar
io
s
:
th
e
f
ir
s
t
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Ad
v
Ap
p
l Sci
I
SS
N:
2252
-
8
8
1
4
E
th
ica
l iss
u
es in
d
ig
ita
l m
en
ta
l h
ea
lth
d
elive
r
y:
a
c
o
mp
r
eh
en
s
ive
…
(
N
u
r
u
l A
in
Mo
h
d
Da
u
d
)
915
in
v
o
lv
es
th
e
lack
o
f
in
-
p
er
s
o
n
n
o
n
-
v
er
b
al
cu
es
in
tr
ad
itio
n
al
r
em
o
te
c
o
u
n
s
ellin
g
,
an
d
th
e
s
ec
o
n
d
en
co
m
p
ass
es
th
r
ee
ty
p
es
o
f
r
is
k
s
d
e
r
iv
ed
f
r
o
m
in
tellig
en
t
s
er
v
ice
ca
r
r
ier
s
.
T
h
is
s
tu
d
y
f
u
r
th
er
cites
th
e
ch
atb
o
t
s
tu
d
y
f
r
o
m
r
ef
er
en
ce
[
1
6
]
,
th
e
AI
r
esear
c
h
p
latf
o
r
m
s
tu
d
y
f
r
o
m
r
e
f
er
en
ce
[
1
5
]
,
an
d
th
e
co
n
clu
s
io
n
s
p
r
esen
ted
in
[
1
8
]
t
o
co
r
r
o
b
o
r
ate
th
e
p
er
v
asiv
en
ess
o
f
th
ese
p
ain
p
o
in
ts
.
T
h
is
s
tu
d
y
b
r
ea
k
s
th
r
o
u
g
h
th
e
tr
ad
itio
n
al
lim
itatio
n
o
f
f
o
cu
s
in
g
s
o
lely
o
n
p
r
o
ce
d
u
r
al
co
m
p
lian
ce
,
ex
p
an
d
i
n
g
th
e
b
o
u
n
d
ar
y
o
f
th
e
r
esear
ch
’
s
s
ig
n
if
ican
ce
.
Dr
awin
g
o
n
th
e
v
iews
o
f
s
ch
o
lar
[
3
0
]
,
it
p
r
o
p
o
s
es
th
at
in
f
o
r
m
e
d
co
n
s
en
t
in
d
i
g
ital
co
n
tex
ts
s
h
o
u
ld
m
o
v
e
b
ey
o
n
d
th
e
o
n
e
-
tim
e
p
r
o
ce
s
s
lim
ited
to
in
itial
r
eg
is
tr
atio
n
,
an
d
b
e
r
ec
o
n
s
tr
u
cted
as
a
co
n
tin
u
o
u
s
d
ialo
g
u
e
th
at
iter
ate
s
in
s
y
n
c
with
in
-
u
s
e
tech
n
o
l
o
g
ies
an
d
tr
ea
tm
en
t
m
o
d
els.
T
h
is
ar
g
u
m
e
n
t
r
ef
u
te
s
th
e
d
o
m
in
an
t
cu
r
r
en
t
m
ain
s
tr
ea
m
p
r
ac
tice
th
at
tr
ea
ts
in
f
o
r
m
ed
co
n
s
en
t
as
a
one
-
tim
e
ev
e
n
t
—
th
at
is
,
th
e
len
g
th
y
ter
m
s
o
f
s
er
v
ice
th
at
u
s
er
s
click
to
ag
r
ee
to
w
ith
o
u
t
an
y
g
en
u
in
e
u
n
d
er
s
tan
d
i
n
g
[
1
4
]
.
T
h
is
p
r
o
b
lem
is
p
ar
ticu
lar
ly
ac
u
te
in
lo
w
-
r
eso
u
r
ce
s
ettin
g
s
,
wh
er
e
li
m
ited
d
ig
ital
liter
ac
y
an
d
lan
g
u
a
g
e
b
ar
r
ier
s
f
u
r
t
h
e
r
u
n
d
er
m
i
n
e
th
e
p
r
ac
tical
s
ig
n
if
ican
ce
o
f
th
e
co
n
s
en
t
p
r
o
ce
s
s
[
7
]
.
W
h
ile
m
u
ltime
d
ia
in
f
o
r
m
ed
co
n
s
en
t
to
o
ls
with
em
b
ed
d
e
d
v
id
eo
s
an
d
in
f
o
g
r
ap
h
ics
alr
ea
d
y
ex
is
t
[
3
]
,
t
h
eir
on
-
th
e
-
g
r
o
u
n
d
ad
o
p
tio
n
r
ate
r
em
ain
s
v
er
y
lo
w.
Fro
m
a
cr
it
ical
p
er
s
p
ec
tiv
e,
th
is
p
ap
er
ar
g
u
es
th
at
in
f
o
r
m
ed
co
n
s
en
t
in
d
i
g
ital
h
ea
lth
co
n
tex
ts
h
as
b
ec
o
m
e
in
v
alid
,
d
ir
e
ctly
u
n
d
e
r
m
in
in
g
u
s
er
au
t
o
n
o
m
y
.
A
s
tu
d
y
[
3
1
]
n
o
tes
th
at
u
s
er
s
lack
u
n
d
e
r
s
tan
d
in
g
o
f
t
h
e
s
co
p
e
o
f
u
s
e,
s
h
ar
in
g
,
an
d
co
m
m
er
cializa
tio
n
o
f
th
eir
p
er
s
o
n
al
h
ea
l
th
d
ata,
a
n
d
a
r
e
th
u
s
u
n
ab
le
to
m
a
k
e
tr
u
l
y
in
f
o
r
m
ed
m
ed
ical
d
ec
is
io
n
s
.
I
n
[
3
2
]
,
p
r
o
p
o
s
e
r
ep
lacin
g
tr
ad
itio
n
al
all
-
or
-
n
o
th
in
g
co
n
s
en
t
ag
r
ee
m
en
ts
with
g
r
an
u
l
ar
,
u
s
er
-
co
n
t
r
o
lled
d
ec
is
io
n
-
m
ak
in
g
r
ig
h
ts
o
v
e
r
p
er
s
o
n
al
d
ata
s
h
ar
in
g
.
T
h
is
p
a
p
er
ad
d
s
th
at
d
ig
ital
h
ea
lth
r
e
g
u
lato
r
y
f
r
am
ewo
r
k
s
r
eq
u
ir
e
i
ter
ativ
e
u
p
d
ates
to
m
an
d
ate
th
e
r
o
llo
u
t o
f
s
u
itab
ly
ad
ap
ted
,
d
y
n
a
m
ic,
an
d
ea
s
y
-
to
-
u
n
d
er
s
tan
d
in
f
o
r
m
e
d
co
n
s
en
t m
ec
h
an
is
m
s
.
3
.
2
.
3
.
Serv
ice
a
cc
ess
ibi
lity
a
nd
equa
lity
T
wo
in
d
ep
en
d
en
t
s
tu
d
ies
f
o
c
u
s
ed
o
n
d
ig
ital
m
e
n
tal
h
ea
lth
s
er
v
ices
[
2
9
]
,
[
2
8
]
p
o
in
t
o
u
t
th
at
a
co
r
e
eth
ical
p
ar
ad
o
x
e
x
is
ts
in
th
is
f
ield
:
wh
ile
th
ese
tech
n
o
lo
g
ies
h
av
e
th
e
p
o
ten
tial
to
r
ea
ch
p
r
ev
io
u
s
ly
u
n
d
er
s
er
v
e
d
y
o
u
th
,
r
u
r
al
c
o
m
m
u
n
ities
,
an
d
ec
o
n
o
m
ically
d
is
ad
v
an
tag
ed
g
r
o
u
p
s
,
th
ey
m
ay
in
s
tead
ex
ac
er
b
ate
ex
is
tin
g
h
ea
lth
d
is
p
ar
ities
.
E
x
is
tin
g
r
esear
ch
[
2
8
]
d
r
aws
o
n
em
p
ir
ical
d
ata
co
llected
d
u
r
i
n
g
th
e
C
OVI
D
-
19
p
an
d
em
ic
to
co
n
f
ir
m
th
at
a
lack
o
f
s
tab
le
in
ter
n
et,
s
u
itab
l
e
d
ev
ices,
o
r
n
ec
ess
ar
y
d
ig
ita
l
liter
ac
y
ex
clu
d
es
ce
r
tain
g
r
o
u
p
s
f
r
o
m
ac
ce
s
s
in
g
v
ar
io
u
s
d
ig
ital
s
er
v
ices.
T
h
is
s
tu
d
y
f
o
cu
s
es
o
n
th
e
i
n
t
er
s
ec
tio
n
o
f
d
ig
ital
in
eq
u
ality
a
n
d
d
ig
ital
m
en
ta
l
h
ea
lth
,
b
u
ild
s
o
n
th
e
estab
lis
h
ed
r
esear
ch
lin
ea
g
e
in
th
e
f
ield
o
f
d
ig
ital
in
eq
u
ality
,
an
d
cites
th
e
d
ef
i
n
itio
n
o
f
d
i
g
ital
in
eq
u
ality
p
r
o
p
o
s
ed
in
[
3
3
]
,
wh
ich
f
r
am
es
d
ig
ital
in
eq
u
ality
as
co
v
er
in
g
th
r
ee
d
im
en
s
io
n
s
:
ac
ce
s
s
,
s
k
ills
,
an
d
u
s
ag
e.
T
h
ese
d
im
en
s
io
n
s
to
g
eth
er
wo
r
s
en
th
e
d
e
v
elo
p
m
e
n
tal
d
is
ad
v
an
tag
es
o
f
m
ar
g
in
alize
d
g
r
o
u
p
s
,
an
d
wh
en
p
r
o
jecte
d
o
n
to
th
e
m
e
n
tal
h
ea
lth
co
n
tex
t,
th
ey
cr
ea
te
a
s
u
p
p
ly
-
d
em
an
d
m
is
m
atch
:
th
e
g
r
o
u
p
s
th
at
n
ee
d
s
er
v
ices
m
o
s
t
ar
e
th
e
least
ab
le
to
ac
ce
s
s
d
ig
ital
m
en
tal
h
ea
lth
s
u
p
p
o
r
t.
I
n
[
3
4
]
n
o
tes
th
at
in
teg
r
atin
g
u
n
iv
er
s
al
d
esig
n
in
t
o
d
ig
ital
m
en
tal
h
ea
lth
p
latf
o
r
m
s
ca
n
o
n
ly
r
ed
u
ce
s
o
m
e
ac
ce
s
s
b
ar
r
ier
s
,
an
d
ca
n
n
o
t
r
eso
lv
e
s
tr
u
ctu
r
al
b
ar
r
ie
r
s
in
lo
w
-
an
d
m
id
d
le
-
in
co
m
e
co
u
n
tr
ies
s
u
ch
as
p
o
v
er
ty
,
g
eo
g
r
ap
h
ic
is
o
latio
n
,
an
d
g
a
p
s
in
d
ig
ital
in
f
r
astru
ctu
r
e.
B
u
il
d
in
g
o
n
th
e
to
p
i
cs
o
f
p
r
iv
ac
y
an
d
in
f
o
r
m
e
d
co
n
s
en
t
e
x
p
lo
r
e
d
in
o
u
r
team
’
s
p
r
io
r
p
u
b
licatio
n
s
,
th
is
s
tu
d
y
id
en
tifie
s
th
at
g
r
o
u
p
s
with
lo
w
d
ig
ital
liter
ac
y
f
ac
e
d
u
al
r
is
k
s
:
s
u
f
f
er
i
n
g
p
r
i
v
ac
y
v
i
o
latio
n
s
an
d
b
ein
g
u
n
a
b
le
to
p
r
o
v
id
e
v
alid
in
f
o
r
m
ed
co
n
s
en
t.
T
h
is
s
tu
d
y
ca
lls
f
o
r
et
h
ical
f
r
am
e
wo
r
k
s
in
th
is
f
ield
t
o
ad
o
p
t
an
in
ter
s
ec
tio
n
al
p
er
s
p
ec
tiv
e
to
r
ec
o
g
n
ize
th
e
d
is
p
r
o
p
o
r
tio
n
ate
h
a
r
m
th
at
o
v
er
lap
p
in
g
v
u
ln
e
r
ab
ilit
ies in
f
lict o
n
s
p
ec
if
ic
p
o
p
u
latio
n
s
.
3
.
2
.
4
.
Alg
o
rit
hm
ic
f
a
irness
a
nd
bia
s
T
h
is
r
ev
iew
in
clu
d
es
a
to
tal
o
f
f
iv
e
eth
ical
s
tu
d
ies,
cited
as
[
1
9
]
–
[
2
3
]
,
th
at
h
ig
h
lig
h
te
d
th
e
is
s
u
es
o
f
alg
o
r
ith
m
ic
f
air
n
ess
an
d
b
ias
in
AI
-
d
r
iv
en
m
e
n
tal
h
ea
lth
tech
n
o
lo
g
ies.
T
h
ese
s
tu
d
ies
r
ea
ch
a
co
n
s
is
ten
t
co
n
s
en
s
u
s
:
n
o
n
-
r
e
p
r
esen
tativ
e
tr
ain
in
g
d
ata
w
ill
tr
ig
g
er
s
y
s
tem
ic
b
ias
ac
r
o
s
s
th
r
e
e
co
r
e
ca
teg
o
r
ies
o
f
ap
p
licatio
n
s
:
m
en
tal
h
ea
lt
h
d
iag
n
o
s
is
,
ch
atb
o
t
th
er
a
p
y
,
an
d
s
u
icid
e
r
is
k
ass
es
s
m
en
t,
in
d
icatin
g
th
at
non
-
r
e
p
r
esen
tativ
e
tr
ain
in
g
d
a
ta
ca
n
p
r
o
d
u
ce
s
y
s
tem
ic
b
iases
.
I
n
ad
d
itio
n
,
[
2
2
]
also
p
r
o
p
o
s
es
th
at
alg
o
r
ith
m
ic
er
r
o
r
s
in
s
u
icid
e
p
r
ev
e
n
tio
n
s
c
en
ar
io
s
co
n
s
titu
te
life
-
or
-
d
ea
th
-
lev
el
eth
ical
r
is
k
s
.
T
h
is
s
tu
d
y
s
tates
at
th
e
o
u
ts
et
th
at
th
e
cu
r
r
en
t
f
ie
ld
o
f
m
ed
ic
al
AI
s
u
f
f
er
s
f
r
o
m
a
s
ev
er
e
tr
a
n
s
p
ar
en
cy
d
ef
icit.
R
esear
ch
er
s
[
1
9
]
,
[
2
0
]
p
r
o
p
o
s
es
th
at
th
e
b
lack
-
b
o
x
n
atu
r
e
o
f
AI
al
g
o
r
ith
m
s
wea
k
en
s
ac
co
u
n
tab
ilit
y
m
ec
h
an
is
m
s
an
d
im
p
ed
es
p
h
y
s
ician
s
an
d
p
atien
ts
f
r
o
m
e
v
alu
atin
g
th
e
b
asis
o
f
au
t
o
m
at
ed
m
ed
ical
a
d
v
ice.
I
n
[
2
1
]
s
u
p
p
lem
e
n
ts
th
is
lin
e
o
f
r
esear
ch
b
y
id
e
n
tify
in
g
n
e
w
r
is
k
s
in
m
en
tal
h
ea
lth
ca
r
e
s
ce
n
ar
io
s
,
p
o
in
tin
g
o
u
t
th
at
ch
atb
o
ts
ar
e
ea
s
ily
m
is
u
s
ed
in
co
n
tex
ts
th
at
r
eq
u
ir
e
h
u
m
an
clin
ical
ju
d
g
m
en
t.
I
n
[
2
3
]
f
u
r
th
er
q
u
esti
o
n
wh
eth
er
a
u
to
m
ated
co
g
n
itiv
e
b
eh
av
io
r
al
th
er
a
p
y
ca
n
m
ee
t
t
h
e
eth
ical
s
tan
d
ar
d
s
o
f
ca
r
e.
T
h
is
s
tu
d
y
p
o
in
ts
o
u
t
th
at
AI
u
s
ed
in
m
e
d
ical
s
ce
n
ar
io
s
at
th
e
cu
r
r
en
t stag
e
s
u
f
f
er
s
f
r
o
m
a
s
ev
e
r
e
lack
o
f
tr
an
s
p
ar
en
cy
.
E
x
is
tin
g
r
esear
ch
[
1
9
]
an
d
[
2
0
]
h
as
n
o
ted
th
at
th
is
is
s
u
e
u
n
d
er
m
in
es
ac
co
u
n
tab
ilit
y
m
ec
h
a
n
is
m
s
an
d
m
ay
also
g
iv
e
r
is
e
to
r
is
k
s
,
i
n
clu
d
in
g
t
h
e
m
is
u
s
e
o
f
m
en
t
al
h
ea
lth
ch
atb
o
ts
[
2
1
]
an
d
e
th
ical
v
io
latio
n
s
in
au
to
m
ated
co
g
n
itiv
e
th
er
a
p
y
[
2
3
]
.
T
h
ese
f
in
d
in
g
s
ar
e
p
ar
tic
u
lar
ly
co
n
ce
r
n
in
g
w
h
en
v
iew
ed
th
r
o
u
g
h
th
e
le
n
s
o
f
g
lo
b
al
h
ea
lth
eq
u
it
y
.
Dr
awin
g
o
n
th
e
wo
r
k
p
r
esen
ted
in
[1
]
,
[
3
5
]
,
th
is
s
tu
d
y
p
r
o
p
o
s
es
th
at
m
en
tal
h
ea
lth
AI
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
1
4
I
n
t J Ad
v
Ap
p
l Sci
,
Vo
l.
1
5
,
No
.
3
,
Sep
tem
b
er
2
0
2
6
:
911
-
9
2
0
916
tr
ain
ed
o
n
d
ata
f
r
o
m
W
ester
n
p
o
p
u
latio
n
s
will
s
y
s
tem
atica
lly
d
is
to
r
t
th
e
p
s
y
ch
o
l
o
g
ic
al
p
r
esen
tatio
n
s
o
f
in
d
iv
id
u
als
f
r
o
m
n
o
n
-
W
ester
n
cu
ltu
r
al
b
ac
k
g
r
o
u
n
d
s
.
E
x
is
tin
g
tech
n
ical
a
p
p
r
o
ac
h
es,
in
c
lu
d
in
g
d
if
f
er
e
n
tial
p
r
iv
ac
y
an
d
f
ed
e
r
ated
lear
n
in
g
,
ca
n
o
n
ly
r
eso
lv
e
p
a
r
t
o
f
th
i
s
p
r
o
b
lem
.
On
ly
b
y
ad
v
an
cin
g
th
e
d
iv
er
s
if
icatio
n
o
f
d
atasets
an
d
em
b
e
d
d
in
g
c
u
ltu
r
al
s
en
s
itiv
ity
ca
n
th
e
in
e
q
u
ality
th
at
AI
m
a
y
am
p
lify
b
e
elim
in
ated
,
an
d
cu
ltu
r
al
ad
ap
tatio
n
is
a
n
ec
ess
ar
y
p
r
e
r
eq
u
is
ite
to
ac
h
iev
e
th
is
g
o
al.
3
.
2
.
5
.
I
nclus
iv
it
y
a
nd
f
a
irnes
s
P
r
e
v
i
o
u
s
s
t
u
d
i
e
s
,
i
n
c
l
u
d
i
n
g
[
1
9
]
,
[
2
5
]
–
[
2
7
]
,
[
2
4
]
,
a
l
l
f
o
cu
s
o
n
in
c
l
u
s
i
o
n
an
d
e
q
u
i
t
y
in
th
e
f
i
e
ld
o
f
d
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
th
,
a
n
d
an
al
y
z
e
t
h
e
te
c
h
n
o
lo
g
i
ca
l
g
a
in
s
a
n
d
lo
s
s
e
s
o
f
d
if
f
er
e
n
t
p
o
p
u
la
t
i
o
n
g
r
o
u
p
s
a
cr
o
s
s
t
h
r
e
e
m
a
j
o
r
d
i
m
en
s
i
o
n
s
.
Am
o
n
g
th
e
s
e
,
t
h
e
f
i
n
d
i
n
g
s
o
f
t
h
r
e
e
s
u
b
-
s
t
u
d
i
e
s
a
r
e
p
a
r
t
i
cu
l
a
r
ly
cr
i
t
i
c
a
l
:
in
s
t
u
d
y
[
2
4
]
n
o
t
e
t
h
a
t
co
n
t
in
u
o
u
s
d
ig
i
t
a
l
p
h
en
o
ty
p
in
g
to
o
l
s
c
a
r
r
y
p
r
i
v
a
c
y
r
i
s
k
s
,
a
n
d
a
r
g
u
e
th
a
t
t
h
e
d
e
s
i
g
n
o
f
s
u
c
h
t
o
o
l
s
m
u
s
t
b
a
l
an
c
e
c
l
in
i
c
a
l
u
ti
l
i
t
y
a
n
d
p
er
s
o
n
a
l
a
u
to
n
o
m
y
;
i
n
s
t
u
d
y
[
2
5
]
f
i
n
d
t
h
a
t
r
e
co
m
m
e
n
d
a
t
i
o
n
s
y
s
t
e
m
s
f
o
r
m
e
n
t
a
l
h
e
a
l
th
a
p
p
l
i
c
a
t
io
n
s
p
r
i
o
r
i
t
i
z
e
u
s
er
e
n
g
a
g
e
m
en
t
m
e
t
r
i
c
s
,
wh
i
c
h
in
a
d
v
e
r
te
n
t
ly
n
a
r
r
o
w
t
h
e
s
c
o
p
e
o
f
u
s
e
r
s
’
av
a
i
l
ab
l
e
tr
e
a
tm
e
n
t
o
p
ti
o
n
s
;
in
s
t
u
d
y
[
2
6
]
,
f
r
o
m
an
o
p
p
o
s
in
g
p
er
s
p
e
c
t
iv
e
,
p
r
o
p
o
s
e
a
n
e
t
h
i
c
s
o
f
c
a
r
e
,
a
r
g
u
i
n
g
t
h
a
t
d
ig
i
t
a
l
i
n
c
l
u
s
io
n
d
e
s
i
g
n
s
f
o
r
m
ar
g
in
a
l
i
z
ed
g
r
o
u
p
s
m
u
s
t
c
en
t
e
r
em
p
a
t
h
y
a
n
d
c
u
l
tu
r
a
l
r
e
s
p
o
n
s
i
v
en
e
s
s
.
E
x
i
s
t
i
n
g
r
e
s
e
a
r
c
h
h
a
s
i
d
e
n
t
if
i
e
d
th
r
ee
ca
t
e
g
o
r
i
e
s
o
f
f
a
ir
n
e
s
s
r
i
s
k
s
i
n
t
h
e
cr
o
s
s
-
cu
l
t
u
r
a
l
a
p
p
l
i
ca
t
i
o
n
o
f
d
ig
i
t
a
l
m
e
n
ta
l
h
e
a
l
t
h
t
o
o
l
s
:
i
n
s
tu
d
y
[
3
6
]
p
o
in
t
s
o
u
t
t
h
a
t
m
o
s
t
s
u
c
h
t
o
o
l
s
ar
e
d
e
v
e
lo
p
ed
b
a
s
e
d
o
n
W
e
s
t
e
r
n
m
e
n
t
a
l
h
ea
l
t
h
f
r
am
e
w
o
r
k
s
,
an
d
c
an
n
o
t
ad
a
p
t
to
t
h
e
co
r
e
e
x
p
e
r
i
en
c
e
s
o
f
n
o
n
-
W
e
s
t
e
r
n
g
r
o
u
p
s
,
i
n
c
l
u
d
i
n
g
th
e
i
r
e
x
p
r
e
s
s
i
o
n
s
o
f
d
i
s
t
r
e
s
s
an
d
h
e
lp
-
s
e
ek
i
n
g
b
e
h
av
i
o
r
s
;
i
n
s
t
u
d
y
[
2
7
]
f
i
n
d
th
a
t
p
a
s
s
i
v
e
s
e
l
f
-
t
r
ac
k
in
g
a
p
p
l
i
c
a
t
io
n
s
u
s
e
d
f
o
r
d
e
p
r
e
s
s
i
o
n
d
e
te
c
t
i
o
n
c
a
r
r
y
ep
i
s
t
e
m
i
c
i
n
ju
s
t
i
c
e
,
w
h
i
c
h
l
e
ad
s
t
h
em
to
m
i
s
i
n
t
e
r
p
r
e
t
th
e
s
e
lf
-
co
g
n
i
t
io
n
o
f
m
a
r
g
i
n
a
l
i
ze
d
g
r
o
u
p
s
;
i
f
a
l
g
o
r
i
th
m
s
in
c
o
r
p
o
r
a
t
e
g
e
o
g
r
ap
h
i
c
l
o
c
a
t
io
n
a
n
d
o
t
h
er
f
ac
t
o
r
s
a
s
p
r
ed
i
c
ti
v
e
v
ar
i
a
b
le
s
,
t
h
ey
w
i
l
l
a
l
s
o
e
m
b
e
d
s
t
r
u
c
tu
r
a
l
d
i
s
a
d
v
an
t
a
g
e
s
in
t
o
c
l
in
i
c
a
l
d
e
c
i
s
i
o
n
-
m
a
k
in
g
,
g
en
e
r
a
t
i
n
g
b
i
a
s
e
d
d
i
ag
n
o
s
e
s
[
3
5
]
.
T
h
is
s
tu
d
y
o
r
g
a
n
izes
an
d
in
te
g
r
ates
ex
is
tin
g
r
esear
ch
f
in
d
in
g
s
in
th
e
f
ield
o
f
d
i
g
ital
m
en
ta
l
h
ea
lth
.
I
t
co
r
r
ec
ts
th
e
e
r
r
o
n
eo
u
s
m
is
co
n
ce
p
tio
n
th
at
in
clu
s
iv
ity
a
n
d
e
q
u
ity
ar
e
m
ar
g
in
al
eth
ical
co
n
s
id
er
atio
n
s
f
o
r
th
is
f
ield
,
an
d
p
r
o
p
o
s
es
th
at
th
e
two
ar
e
th
e
co
r
e
f
o
u
n
d
atio
n
s
th
at
u
n
d
er
p
in
th
e
leg
itima
cy
o
f
th
e
d
ig
ital
m
en
tal
h
ea
lth
s
ec
to
r
.
T
h
e
s
tu
d
y
h
o
ld
s
th
at
all
r
elev
an
t
wo
r
k
m
u
s
t
e
n
g
ag
e
with
d
iv
e
r
s
e
co
m
m
u
n
iti
es,
alig
n
with
lo
ca
l
cu
ltu
r
es,
an
d
r
ejec
t
s
u
p
er
f
icial
ad
ap
tatio
n
o
f
W
ester
n
m
o
d
el
s
.
Failu
r
e
to
m
ee
t
th
ese
r
eq
u
ir
em
en
ts
will
lead
to
s
ev
er
e
co
n
s
eq
u
e
n
ce
s
,
in
clu
d
in
g
f
r
ag
m
en
ted
s
er
v
ices a
n
d
s
y
s
tem
atic
g
ap
s
in
s
er
v
ice
q
u
ality
.
3
.
3
.
T
he
g
lo
ba
l e
t
hica
l div
ide a
nd
im
pli
ca
t
io
ns
f
o
r
po
licy
a
nd
pra
ct
ice
T
h
e
co
r
e
ar
g
u
m
en
t
o
f
th
is
s
tu
d
y
is
th
at
in
th
e
f
ield
o
f
g
lo
b
al
d
ig
ital
m
en
tal
h
ea
l
th
s
er
v
ice
g
o
v
er
n
an
ce
,
lo
n
g
-
s
tan
d
in
g
u
n
r
eso
lv
ed
eth
ical
d
iv
id
es
p
er
s
is
t
b
etwe
en
E
as
ter
n
an
d
W
ester
n
co
u
n
tr
ies,
a
ju
d
g
m
en
t
t
h
at
is
co
r
r
o
b
o
r
at
ed
b
y
p
r
io
r
s
u
p
p
o
r
tin
g
r
esear
ch
[
1
]
.
T
h
is
s
tu
d
y
an
aly
s
es
th
e
g
eo
g
r
a
p
h
ic
d
is
tr
ib
u
tio
n
o
f
2
0
e
x
is
tin
g
s
tu
d
ies
in
th
e
f
ield
an
d
f
in
d
s
th
at
as
m
an
y
as
s
ix
o
f
th
ese
s
tu
d
ies
o
r
ig
in
ate
f
r
o
m
th
e
US.
T
h
is
co
n
f
ir
m
s
th
at
k
n
o
wled
g
e
p
r
o
d
u
ctio
n
i
n
th
is
f
ield
is
h
ig
h
ly
co
n
ce
n
tr
ate
d
in
h
ig
h
-
in
co
m
e
c
o
u
n
tr
ies,
wh
ich
alig
n
s
with
th
e
u
n
iv
er
s
al
ch
ar
ac
ter
is
tic
o
f
th
e
g
lo
b
al
k
n
o
wled
g
e
p
r
o
d
u
ctio
n
s
y
s
tem
th
at
p
r
io
r
itizes
W
ester
n
p
er
s
p
ec
tiv
es a
n
d
r
eg
u
lato
r
y
m
o
d
els.
C
u
r
r
en
tly
,
t
h
e
d
ev
elo
p
m
en
t
o
f
g
lo
b
al
p
r
iv
ac
y
p
r
o
tectio
n
f
r
am
ewo
r
k
s
e
x
h
ib
its
n
o
tab
l
e
r
eg
io
n
al
di
f
f
er
en
ce
s
.
T
h
e
US
an
d
th
e
EU
h
av
e
alr
ea
d
y
estab
lis
h
ed
well
-
d
ev
elo
p
ed
p
r
iv
ac
y
r
e
g
u
latio
n
s
,
in
clu
d
in
g
f
r
am
ewo
r
k
s
s
u
ch
as
HI
PAA
an
d
GDPR
,
wh
er
ea
s
n
o
n
-
W
ester
n
co
u
n
tr
ies
lik
e
Ma
lay
s
ia
an
d
So
u
th
Af
r
ica
ar
e
s
till
wo
r
k
in
g
to
d
ev
elo
p
co
m
p
ar
ab
le
s
y
s
tem
s
.
Pra
ctitio
n
er
s
in
th
ese
r
eg
io
n
s
,
f
ac
i
n
g
a
lack
o
f
clea
r
g
u
id
elin
es,
s
tr
u
g
g
le
to
ad
d
r
es
s
th
e
co
m
p
lex
eth
ical
ch
allen
g
es
em
er
g
in
g
f
r
o
m
th
e
lo
ca
l
im
p
lem
en
tatio
n
o
f
d
ig
ital ser
v
ices.
T
h
is
s
tu
d
y
co
n
tr
ib
u
tes
to
t
h
e
co
r
e
r
esear
ch
p
r
o
p
o
s
itio
n
s
in
th
e
f
ield
b
y
ad
d
in
g
a
tem
p
o
r
al
p
er
s
p
ec
tiv
e.
An
a
n
aly
s
is
o
f
ac
ad
em
ic
p
u
b
lis
h
in
g
tr
en
d
s
r
ev
e
als
a
s
h
ar
p
in
cr
ea
s
e
in
th
e
n
u
m
b
er
o
f
p
u
b
licatio
n
s
in
th
is
ar
ea
s
in
ce
2
0
2
0
.
As
n
o
ted
in
[
3
6
]
,
th
e
C
OVI
D
-
1
9
p
an
d
em
ic
ac
ted
as
a
cr
itical
r
ea
l
-
wo
r
ld
test
f
o
r
s
cien
tific
r
esear
ch
p
r
ac
tices,
b
r
in
g
in
g
eth
ical
is
s
u
es
th
at
wer
e
p
r
ev
io
u
s
ly
th
eo
r
etica
l
in
to
p
r
ac
tical
ap
p
licatio
n
.
T
h
is
s
tu
d
y
s
u
g
g
ests
th
at
s
tr
o
n
g
r
esear
ch
in
ter
est
in
th
e
f
ield
will
p
er
s
is
t
th
r
o
u
g
h
2
0
2
3
an
d
2
0
2
4
,
with
e
th
ical
co
n
s
id
er
atio
n
s
n
o
w
f
ir
m
ly
in
t
eg
r
ated
in
to
its
o
n
g
o
in
g
d
e
v
e
lo
p
m
en
t.
T
h
r
o
u
g
h
a
n
in
teg
r
at
iv
e
an
aly
s
is
o
f
th
e
co
r
e
th
em
e
o
f
th
e
p
r
esen
t
s
tu
d
y
,
th
e
au
th
o
r
s
o
f
th
is
p
ap
er
ex
tr
ac
t
th
r
ee
in
ter
co
n
n
ec
te
d
p
r
ac
tical
in
s
ig
h
ts
f
o
r
th
e
o
n
-
th
e
-
g
r
o
u
n
d
im
p
lem
en
ta
tio
n
o
f
d
ig
ital
eth
ics
in
th
e
m
e
n
tal
h
ea
lth
f
ield
.
First
,
th
er
e
is
an
u
r
g
en
t
n
ee
d
f
o
r
in
ter
n
atio
n
al
co
llab
o
r
atio
n
led
b
y
th
e
W
o
r
ld
Hea
lth
Or
g
an
izatio
n
(
W
HO
)
,
Ass
o
ciat
io
n
o
f
So
u
th
ea
s
t
Asi
an
Natio
n
s
(
ASEA
N
)
,
an
d
th
e
Af
r
ican
Un
io
n
to
d
ev
elo
p
u
n
iv
er
s
al
eth
ical
p
r
in
ci
p
les
ad
ap
ted
to
d
if
f
e
r
en
t
r
eg
u
lato
r
y
an
d
cu
ltu
r
al
co
n
te
x
ts
.
Seco
n
d
,
p
r
ac
titi
o
n
er
tr
ai
n
in
g
m
u
s
t
ex
p
a
n
d
b
ey
o
n
d
t
h
e
s
co
p
e
o
f
clin
ical
co
m
p
eten
ce
to
ad
d
n
ew
co
n
t
en
t
co
v
er
i
n
g
d
i
g
ital
eth
ics,
d
ata
s
ec
u
r
ity
,
an
d
cu
ltu
r
al
s
en
s
itiv
ity
f
o
r
o
n
lin
e
s
ce
n
a
r
io
s
.
W
ester
n
co
u
n
tr
ies
h
av
e
alr
ea
d
y
in
teg
r
ated
s
u
ch
d
ig
ital
co
m
p
eten
cies
in
to
m
e
n
tal
h
ea
lth
tr
ain
in
g
,
wh
ile
n
o
n
-
W
ester
n
co
u
n
tr
ies
g
en
er
ally
lag
in
th
is
r
e
g
ar
d
.
T
h
ir
d
,
eth
ics
g
o
v
er
n
an
ce
m
u
s
t
s
h
if
t
f
r
o
m
a
p
ass
iv
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Ad
v
Ap
p
l Sci
I
SS
N:
2252
-
8
8
1
4
E
th
ica
l iss
u
es in
d
ig
ita
l m
en
ta
l h
ea
lth
d
elive
r
y:
a
c
o
mp
r
eh
en
s
ive
…
(
N
u
r
u
l A
in
Mo
h
d
Da
u
d
)
917
r
esp
o
n
s
e
to
p
r
o
ac
tiv
e
r
is
k
p
r
e
d
ictio
n
.
Fo
r
A
I
an
d
d
i
g
ital
p
h
en
o
ty
p
in
g
tech
n
o
l
o
g
ies,
r
is
k
s
m
u
s
t
b
e
an
ticip
ated
b
ef
o
r
e
lar
g
e
-
s
ca
le
d
ep
lo
y
m
en
t
,
r
ath
er
th
a
n
r
em
e
d
iated
af
ter
h
ar
m
s
o
cc
u
r
.
4.
CO
NCLU
SI
O
N
T
h
e
o
v
er
ar
c
h
in
g
th
em
e
o
f
th
is
s
co
p
in
g
r
ev
iew
is
th
e
eth
ical
im
p
licatio
n
s
o
f
d
eliv
er
in
g
m
e
n
tal
h
ea
lth
co
u
n
s
ellin
g
th
r
o
u
g
h
d
ig
ital
m
ea
n
s
.
Fro
m
d
ata
s
ec
u
r
ity
to
th
e
in
teg
r
ity
o
f
p
atien
t
-
clin
ician
r
elatio
n
s
h
ip
s
,
th
is
th
em
e
ad
d
r
ess
es
h
o
w
th
e
s
h
if
t
f
r
o
m
in
-
p
er
s
o
n
to
d
ig
ital
s
ett
in
g
s
in
tr
o
d
u
ce
s
n
ew
eth
ical
d
ilem
m
as.
Alth
o
u
g
h
th
e
ex
is
tin
g
liter
atu
r
e
ex
te
n
s
iv
ely
d
is
c
u
s
s
es
p
r
iv
ac
y
,
d
ata
s
ec
u
r
ity
,
a
n
d
in
f
o
r
m
ed
co
n
s
en
t,
s
ev
er
al
g
a
p
s
r
em
ain
.
T
h
er
e
is
lim
ited
r
esear
ch
o
n
em
p
ir
ical
s
tu
d
ies
co
n
d
u
cted
in
th
is
ar
ea
,
as
m
u
c
h
r
esear
ch
h
as
b
ee
n
b
ased
o
n
co
n
ce
p
tu
al
r
e
v
iews.
T
h
is
lim
itat
io
n
also
r
ev
o
lv
es
ar
o
u
n
d
th
e
lo
ca
lizatio
n
o
f
d
i
g
ital
m
en
tal
h
ea
lth
to
o
ls
to
s
u
it
d
iv
er
s
e
c
u
ltu
r
al
b
ac
k
g
r
o
u
n
d
s
.
M
o
s
t
in
ter
v
en
tio
n
s
an
d
eth
ical
f
r
am
ewo
r
k
s
ar
e
b
ased
o
n
W
ester
n
m
o
d
els,
leav
in
g
n
o
n
-
W
ester
n
cu
ltu
r
al
im
p
licatio
n
s
u
n
d
er
e
x
p
lo
r
ed
.
Alth
o
u
g
h
s
tu
d
ies
h
av
e
ad
d
r
ess
ed
th
e
eth
ical
co
n
ce
r
n
s
o
f
u
s
in
g
AI
ch
atb
o
ts
a
n
d
p
h
e
n
o
ty
p
i
n
g
t
o
o
ls
,
th
er
e
is
litt
le
lo
n
g
-
ter
m
d
ata
o
n
h
o
w
th
ese
tech
n
o
lo
g
ies
af
f
ec
t
m
e
n
tal
h
ea
lth
o
u
tco
m
es
an
d
p
atien
t
au
to
n
o
m
y
o
v
e
r
tim
e.
Alth
o
u
g
h
th
er
e
is
an
ac
k
n
o
wled
g
e
m
en
t
o
f
t
h
e
d
i
g
ital
d
iv
id
e,
f
ew
s
tu
d
ies
h
av
e
p
r
o
p
o
s
ed
ac
ti
o
n
ab
le
s
o
lu
t
io
n
s
to
m
itig
ate
in
e
q
u
ities
in
ac
ce
s
s
to
d
ig
ital
co
u
n
s
ellin
g
,
esp
ec
ially
in
lo
w
-
r
eso
u
r
c
e
s
ettin
g
s
.
Fu
r
th
er
r
esear
ch
is
n
ee
d
ed
o
n
h
o
w
th
e
s
h
if
t
to
d
ig
ital
co
u
n
s
ellin
g
af
f
ec
ts
th
e
tr
ad
itio
n
al
p
atien
t
-
clin
ician
r
elatio
n
s
h
ip
,
esp
e
cially
in
lo
n
g
-
ter
m
th
er
ap
eu
ti
c
s
ettin
g
s
.
B
alan
cin
g
in
n
o
v
atio
n
with
eth
ical
s
ta
n
d
ar
d
s
is
a
co
n
s
is
ten
t
th
em
e,
m
ain
ly
to
en
s
u
r
e
eq
u
itab
le
ac
ce
s
s
an
d
p
r
o
tect
v
u
ln
er
ab
le
p
o
p
u
latio
n
s
.
ACK
NO
WL
E
DG
M
E
N
T
S
T
h
e
au
th
o
r
s
wo
u
ld
lik
e
to
e
x
p
r
ess
s
in
ce
r
e
ap
p
r
ec
iatio
n
t
o
U
n
iv
er
s
iti
Pen
d
id
ik
an
Su
ltan
I
d
r
is
(
UPSI)
,
p
ar
ticu
lar
ly
th
e
Facu
lty
o
f
Hu
m
an
Dev
elo
p
m
e
n
t
an
d
th
e
De
p
ar
tm
en
t
o
f
Gu
i
d
an
ce
an
d
C
o
u
n
s
ellin
g
,
f
o
r
t
h
eir
s
u
p
p
o
r
t in
t
h
e
co
m
p
letio
n
o
f
t
h
is
s
tu
d
y
.
F
UNDING
I
NF
O
R
M
A
T
I
O
N
T
h
is
r
esear
ch
was
f
u
n
d
ed
b
y
th
e
Fu
n
d
am
en
tal
R
esear
ch
Gr
an
t
Sch
em
e
(
FR
GS)
u
n
d
er
th
e
Min
is
tr
y
o
f
Hig
h
er
E
d
u
ca
tio
n
,
Ma
lay
s
ia
(
FR
GS/1
/2
0
2
3
/SS
0
9
/UPS
I
/0
2
/2
)
.
AUTHO
R
CO
NT
RI
B
UT
I
O
NS ST
A
T
E
M
E
N
T
T
h
is
jo
u
r
n
al
u
s
es
th
e
C
o
n
t
r
ib
u
to
r
R
o
les
T
a
x
o
n
o
m
y
(
C
R
ed
iT)
to
r
ec
o
g
n
ize
in
d
iv
i
d
u
al
au
th
o
r
co
n
tr
ib
u
tio
n
s
,
r
ed
u
ce
au
th
o
r
s
h
ip
d
is
p
u
tes,
an
d
f
ac
ilit
ate
co
llab
o
r
atio
n
.
Na
m
e
o
f
Aut
ho
r
C
M
So
Va
Fo
I
R
D
O
E
Vi
Su
P
Fu
Nu
r
u
l A
in
Mo
h
d
Dau
d
✓
✓
✓
✓
✓
✓
✓
✓
Hap
s
ah
Md
Yu
s
o
f
✓
✓
✓
✓
✓
No
r
az
an
i A
h
m
ad
✓
✓
✓
✓
✓
Fau
ziah
Mo
h
d
Sa’
a
d
✓
✓
✓
✓
✓
Nu
r
u
l H
asy
im
ah
Ma
t
R
an
i
✓
✓
✓
✓
✓
✓
Pau
Kee
✓
✓
✓
✓
Nu
r
Sh
u
h
a
n
a
Mo
h
d
San
s
u
d
d
in
✓
✓
✓
C
:
C
o
n
c
e
p
t
u
a
l
i
z
a
t
i
o
n
M
:
M
e
t
h
o
d
o
l
o
g
y
So
:
So
f
t
w
a
r
e
Va
:
Va
l
i
d
a
t
i
o
n
Fo
:
Fo
r
mal
a
n
a
l
y
s
i
s
I
:
I
n
v
e
s
t
i
g
a
t
i
o
n
R
:
R
e
so
u
r
c
e
s
D
:
D
a
t
a
C
u
r
a
t
i
o
n
O
:
W
r
i
t
i
n
g
-
O
r
i
g
i
n
a
l
D
r
a
f
t
E
:
W
r
i
t
i
n
g
-
R
e
v
i
e
w
&
E
d
i
t
i
n
g
Vi
:
Vi
su
a
l
i
z
a
t
i
o
n
Su
:
Su
p
e
r
v
i
s
i
o
n
P
:
P
r
o
j
e
c
t
a
d
mi
n
i
st
r
a
t
i
o
n
Fu
:
Fu
n
d
i
n
g
a
c
q
u
i
si
t
i
o
n
CO
NF
L
I
C
T
O
F
I
N
T
E
R
E
S
T
ST
A
T
E
M
E
NT
T
h
e
au
th
o
r
s
d
ec
lar
e
th
at
th
ey
h
av
e
n
o
k
n
o
w
n
co
m
p
etin
g
f
in
an
cial
in
ter
ests
o
r
p
er
s
o
n
al
r
el
atio
n
s
h
ip
s
th
at
co
u
ld
h
av
e
ap
p
ea
r
ed
t
o
in
f
lu
en
ce
th
e
wo
r
k
r
e
p
o
r
te
d
in
t
h
is
p
ap
er
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
1
4
I
n
t J Ad
v
Ap
p
l Sci
,
Vo
l.
1
5
,
No
.
3
,
Sep
tem
b
er
2
0
2
6
:
911
-
9
2
0
918
I
NF
O
RM
E
D
CO
NS
E
N
T
No
t
ap
p
licab
le.
T
h
is
s
tu
d
y
d
id
n
o
t
i
n
v
o
lv
e
h
u
m
an
p
ar
ticip
an
ts
,
h
u
m
an
d
ata,
o
r
an
y
p
er
s
o
n
ally
id
en
tifia
b
le
in
f
o
r
m
atio
n
at
an
y
s
tag
e
o
f
th
e
r
esear
ch
.
All
d
ata
an
aly
ze
d
wer
e
eith
er
p
u
b
l
icly
av
ailab
le,
f
u
lly
an
o
n
y
m
ized
,
o
r
d
er
i
v
ed
f
r
o
m
n
o
n
‑
h
u
m
a
n
s
o
u
r
ce
s
,
a
n
d
n
o
d
ir
ec
t
i
n
ter
ac
tio
n
with
in
d
iv
id
u
al
s
,
s
u
r
v
e
y
s
,
in
ter
v
iews,
o
r
clin
ical
r
ec
o
r
d
s
was
ca
r
r
ied
o
u
t.
Fo
r
th
ese
r
e
aso
n
s
,
in
f
o
r
m
ed
c
o
n
s
en
t
f
r
o
m
h
u
m
an
p
a
r
ticip
an
ts
was n
o
t r
eq
u
ir
e
d
f
o
r
th
is
s
tu
d
y
.
E
T
H
I
CAL AP
P
RO
V
AL
No
t
ap
p
licab
le.
T
h
is
r
esear
ch
d
id
n
o
t
in
v
o
lv
e
h
u
m
a
n
s
u
b
jects,
h
u
m
an
b
io
lo
g
ical
m
a
te
r
ials
,
o
r
ex
p
er
im
en
tal
p
r
o
ce
d
u
r
es
o
n
an
im
als,
n
o
r
d
id
it
in
clu
d
e
an
y
in
ter
v
en
tio
n
af
f
ec
tin
g
liv
in
g
o
r
g
an
is
m
s
.
T
h
e
wo
r
k
r
elied
s
o
lely
o
n
co
m
p
u
tatio
n
al
m
o
d
els
an
d
p
u
b
licly
av
ail
ab
le
o
r
n
o
n
‑
s
en
s
itiv
e
d
atasets
th
at
d
o
n
o
t
r
aise
p
r
iv
ac
y
o
r
s
af
ety
co
n
ce
r
n
s
.
Acc
o
r
d
in
g
l
y
,
eth
ical
ap
p
r
o
v
al
f
r
o
m
an
in
s
titu
tio
n
al
r
e
v
iew
b
o
ar
d
o
r
an
im
al
eth
ics
co
m
m
ittee
was n
o
t n
ec
ess
ar
y
f
o
r
th
is
s
tu
d
y
.
DATA AV
AI
L
AB
I
L
I
T
Y
T
h
e
au
th
o
r
s
c
o
n
f
i
r
m
t
h
at
th
e
d
ata
s
u
p
p
o
r
ti
n
g
t
h
e
f
i
n
d
in
g
s
o
f
t
h
is
s
t
u
d
y
a
r
e
a
v
a
ila
b
l
e
wit
h
i
n
t
h
e
a
r
ti
cle
.
RE
F
E
R
E
NC
E
S
[
1
]
R
.
B
a
d
r
f
a
m
a
n
d
A
.
Z
a
n
d
i
f
a
r
,
“
C
O
V
I
D
-
1
9
a
n
d
me
n
t
a
l
h
e
a
l
t
h
:
a
n
I
r
a
n
i
a
n
p
e
r
sp
e
c
t
i
v
e
,
”
Asi
a
n
J
o
u
r
n
a
l
o
f
Psy
c
h
i
a
t
ry
,
v
o
l
.
5
4
,
2
0
2
0
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
a
j
p
.
2
0
2
0
.
1
0
2
2
6
6
.
[
2
]
E.
A
b
o
u
j
a
o
u
d
e
,
“
P
r
o
t
e
c
t
i
n
g
p
r
i
v
a
c
y
t
o
p
r
o
t
e
c
t
m
e
n
t
a
l
h
e
a
l
t
h
:
t
h
e
n
e
w
e
t
h
i
c
a
l
i
mp
e
r
a
t
i
v
e
,
”
J
o
u
r
n
a
l
o
f
M
e
d
i
c
a
l
E
t
h
i
c
s
,
v
o
l
.
4
5
,
n
o
.
9
,
p
p
.
6
0
4
–
6
0
7
,
2
0
1
9
,
d
o
i
:
1
0
.
1
1
3
6
/
m
e
d
e
t
h
i
c
s
-
2
0
1
8
-
1
0
5
3
1
3
.
[
3
]
T.
H
a
ss
e
m
a
n
d
S
.
L
a
h
e
r
,
“
E
v
a
l
u
a
t
i
n
g
t
h
e
e
f
f
i
c
a
c
y
o
f
e
t
h
i
c
a
l
g
u
i
d
e
l
i
n
e
s
f
o
r
o
n
l
i
n
e
scre
e
n
i
n
g
o
f
m
e
n
t
a
l
h
e
a
l
t
h
i
n
S
o
u
t
h
A
f
r
i
c
a
,
”
Fro
n
t
i
e
rs
i
n
Ps
y
c
h
o
l
o
g
y
,
v
o
l
.
1
3
,
2
0
2
2
,
d
o
i
:
1
0
.
3
3
8
9
/
f
p
s
y
g
.
2
0
2
2
.
8
7
5
9
1
1
.
[
4
]
P
.
S
h
a
r
ma,
R
.
W
a
g
a
n
i
,
a
n
d
M
.
A
.
V
a
r
g
h
e
se
,
“
B
i
b
l
i
o
me
t
r
i
c
a
n
a
l
y
si
s
o
f
r
e
se
a
r
c
h
i
n
e
t
h
i
c
a
l
c
o
n
c
e
r
n
s
a
n
d
d
i
l
e
mm
a
s o
f
d
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
c
a
r
e
i
n
t
h
e
l
a
s
t
t
w
o
d
e
c
a
d
e
s
,
”
F
ro
n
t
i
e
rs
i
n
H
u
m
a
n
D
y
n
a
m
i
c
s
,
v
o
l
.
6
,
J
a
n
.
2
0
2
5
,
d
o
i
:
1
0
.
3
3
8
9
/
f
h
u
md
.
2
0
2
4
.
1
5
0
2
4
3
2
.
[
5
]
T.
W
y
k
e
s,
J
.
L
i
p
sh
i
t
z
,
a
n
d
S
.
M
.
S
c
h
u
e
l
l
e
r
,
“
To
w
a
r
d
s
t
h
e
d
e
s
i
g
n
o
f
e
t
h
i
c
a
l
st
a
n
d
a
r
d
s
r
e
l
a
t
e
d
t
o
d
i
g
i
t
a
l
me
n
t
a
l
h
e
a
l
t
h
a
n
d
a
l
l
i
t
s
a
p
p
l
i
c
a
t
i
o
n
s,
”
C
u
rr
e
n
t
T
re
a
t
m
e
n
t
O
p
t
i
o
n
s
i
n
P
syc
h
i
a
t
ry
,
v
o
l
.
6
,
n
o
.
3
,
p
p
.
2
3
2
–
2
4
2
,
S
e
p
.
2
0
1
9
,
d
o
i
:
1
0
.
1
0
0
7
/
s
4
0
5
0
1
-
0
1
9
-
0
0
1
8
0
-
0.
[
6
]
C
.
B
.
F
i
s
h
e
r
a
n
d
A
.
L
.
F
r
i
e
d
,
“
I
n
t
e
r
n
e
t
-
med
i
a
t
e
d
p
s
y
c
h
o
l
o
g
i
c
a
l
ser
v
i
c
e
s a
n
d
t
h
e
A
meric
a
n
P
sy
c
h
o
l
o
g
i
c
a
l
A
ss
o
c
i
a
t
i
o
n
e
t
h
i
c
s c
o
d
e
,
”
Psy
c
h
o
t
h
e
r
a
p
y
,
v
o
l
.
4
0
,
n
o
.
1
–
2
,
p
p
.
1
0
3
–
1
1
1
,
2
0
0
3
,
d
o
i
:
1
0
.
1
0
3
7
/
0
0
3
3
-
3
2
0
4
.
4
0
.
1
-
2
.
1
0
3
.
[
7
]
X
.
Zh
o
u
e
t
a
l
.
,
“
T
h
e
r
o
l
e
o
f
t
e
l
e
h
e
a
l
t
h
i
n
r
e
d
u
c
i
n
g
t
h
e
m
e
n
t
a
l
h
e
a
l
t
h
b
u
r
d
e
n
f
r
o
m
C
O
V
I
D
-
1
9
,
”
T
e
l
e
m
e
d
i
c
i
n
e
a
n
d
e
-
H
e
a
l
t
h
,
v
o
l
.
2
6
,
n
o
.
4
,
p
p
.
3
7
7
–
3
7
9
,
2
0
2
0
,
d
o
i
:
1
0
.
1
0
8
9
/
t
mj
.
2
0
2
0
.
0
0
6
8
.
[
8
]
H
.
A
r
k
se
y
a
n
d
L
.
O
’
M
a
l
l
e
y
,
“
S
c
o
p
i
n
g
st
u
d
i
e
s:
t
o
w
a
r
d
s
a
m
e
t
h
o
d
o
l
o
g
i
c
a
l
f
r
a
mew
o
r
k
,
”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
r
n
a
l
o
f
S
o
c
i
a
l
Re
s
e
a
r
c
h
Me
t
h
o
d
o
l
o
g
y
:
T
h
e
o
ry
a
n
d
Pr
a
c
t
i
c
e
,
v
o
l
.
8
,
n
o
.
1
,
p
p
.
1
9
–
3
2
,
2
0
0
5
,
d
o
i
:
1
0
.
1
0
8
0
/
1
3
6
4
5
5
7
0
3
2
0
0
0
1
1
9
6
1
6
.
[
9
]
C
.
M
o
r
e
n
o
e
t
a
l
.
,
“
H
o
w
m
e
n
t
a
l
h
e
a
l
t
h
c
a
r
e
sh
o
u
l
d
c
h
a
n
g
e
a
s
a
c
o
n
se
q
u
e
n
c
e
o
f
t
h
e
C
O
V
I
D
-
1
9
p
a
n
d
e
mi
c
,
”
T
h
e
L
a
n
c
e
t
Psy
c
h
i
a
t
r
y
,
v
o
l
.
7
,
n
o
.
9
,
p
p
.
8
1
3
–
8
2
4
,
2
0
2
0
,
d
o
i
:
1
0
.
1
0
1
6
/
S
2
2
1
5
-
0
3
6
6
(
2
0
)
3
0
3
0
7
-
2.
[
1
0
]
J.
S
t
o
l
l
,
J
.
A
.
M
ü
l
l
e
r
,
a
n
d
M
.
Tr
a
c
h
sel
,
“
Et
h
i
c
a
l
i
ss
u
e
s
i
n
o
n
l
i
n
e
p
sy
c
h
o
t
h
e
r
a
p
y
:
a
n
a
r
r
a
t
i
v
e
r
e
v
i
e
w
,
”
Fro
n
t
i
e
rs
i
n
Psy
c
h
i
a
t
r
y
,
v
o
l
.
1
0
,
2
0
2
0
,
d
o
i
:
1
0
.
3
3
8
9
/
f
p
sy
t
.
2
0
1
9
.
0
0
9
9
3
.
[
1
1
]
E.
C
h
i
a
u
z
z
i
,
A
.
C
l
a
y
t
o
n
,
a
n
d
J
.
H
u
h
-
Y
o
o
,
“
V
i
d
e
o
c
o
n
f
e
r
e
n
c
i
n
g
-
b
a
s
e
d
t
e
l
e
men
t
a
l
h
e
a
l
t
h
:
i
mp
o
r
t
a
n
t
q
u
e
st
i
o
n
s
f
o
r
t
h
e
C
O
V
I
D
-
19
e
r
a
f
r
o
m
c
l
i
n
i
c
a
l
a
n
d
p
a
t
i
e
n
t
-
c
e
n
t
e
r
e
d
p
e
r
s
p
e
c
t
i
v
e
s
,
”
J
MIR
M
e
n
t
a
l
H
e
a
l
t
h
,
v
o
l
.
7
,
n
o
.
1
2
,
2
0
2
0
,
d
o
i
:
1
0
.
2
1
9
6
/
2
4
0
2
1
.
[
1
2
]
A
.
O
’
Le
a
r
y
e
t
a
l
.
,
“
U
s
i
n
g
w
e
a
r
a
b
l
e
d
i
g
i
t
a
l
d
e
v
i
c
e
s
t
o
scr
e
e
n
c
h
i
l
d
r
e
n
f
o
r
m
e
n
t
a
l
h
e
a
l
t
h
c
o
n
d
i
t
i
o
n
s:
e
t
h
i
c
a
l
p
r
o
mi
s
e
s
a
n
d
c
h
a
l
l
e
n
g
e
s,”
S
e
n
s
o
rs
,
v
o
l
.
2
4
,
n
o
.
1
0
,
2
0
2
4
,
d
o
i
:
1
0
.
3
3
9
0
/
s2
4
1
0
3
2
1
4
.
[
1
3
]
J.
A
.
S
k
o
r
b
u
r
g
a
n
d
P
.
F
r
i
e
se
n
,
“
M
i
n
d
t
h
e
g
a
p
s
:
e
t
h
i
c
a
l
a
n
d
e
p
i
st
e
mi
c
i
ss
u
e
s
i
n
t
h
e
d
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
r
e
sp
o
n
s
e
t
o
C
O
V
I
D
-
1
9
,
”
H
a
st
i
n
g
s
C
e
n
t
e
r R
e
p
o
r
t
,
v
o
l
.
5
1
,
n
o
.
6
,
p
p
.
2
3
–
2
6
,
2
0
2
1
,
d
o
i
:
1
0
.
1
0
0
2
/
h
a
s
t
.
1
2
9
2
.
[
1
4
]
D
.
D
.
Lu
x
t
o
n
,
E.
-
L
.
N
e
l
s
o
n
,
a
n
d
M
.
M
.
M
a
h
e
u
,
A
p
r
a
c
t
i
t
i
o
n
e
r’
s
g
u
i
d
e
t
o
t
e
l
e
m
e
n
t
a
l
h
e
a
l
t
h
:
H
o
w
t
o
c
o
n
d
u
c
t
l
e
g
a
l
,
e
t
h
i
c
a
l
,
and
e
v
i
d
e
n
c
e
-
b
a
se
d
t
e
l
e
p
r
a
c
t
i
c
e
.
W
a
s
h
i
n
g
t
o
n
,
D
C
,
U
S
A
:
A
mer
i
c
a
n
P
s
y
c
h
o
l
o
g
i
c
a
l
A
ss
o
c
i
a
t
i
o
n
,
2
0
1
6
,
d
o
i
:
1
0
.
1
0
3
7
/
1
4
9
3
8
-
0
0
0
.
[
1
5
]
J.
A
.
S
k
o
r
b
u
r
g
,
K
.
O
’
D
o
h
e
r
t
y
,
a
n
d
P
.
F
r
i
e
se
n
,
“
P
e
r
so
n
s
o
r
d
a
t
a
p
o
i
n
t
s
?
e
t
h
i
c
s,
a
r
t
i
f
i
c
i
a
l
i
n
t
e
l
l
i
g
e
n
c
e
,
a
n
d
t
h
e
p
a
r
t
i
c
i
p
a
t
o
r
y
t
u
r
n
i
n
men
t
a
l
h
e
a
l
t
h
r
e
sea
r
c
h
,
”
Am
e
ri
c
a
n
Ps
y
c
h
o
l
o
g
i
s
t
,
v
o
l
.
7
9
,
n
o
.
1
,
p
p
.
1
3
7
–
1
4
9
,
2
0
2
4
,
d
o
i
:
1
0
.
1
0
3
7
/
a
mp
0
0
0
1
1
6
8
.
[
1
6
]
K
.
K
r
e
t
z
sc
h
mar
,
H
.
T
y
r
o
l
l
,
G
.
P
a
v
a
r
i
n
i
,
A
.
M
a
n
z
i
n
i
,
a
n
d
I
.
S
i
n
g
h
,
“
C
a
n
y
o
u
r
p
h
o
n
e
b
e
y
o
u
r
t
h
e
r
a
p
i
s
t
?
y
o
u
n
g
p
e
o
p
l
e
’
s
e
t
h
i
c
a
l
p
e
r
s
p
e
c
t
i
v
e
s
o
n
t
h
e
u
se
o
f
f
u
l
l
y
a
u
t
o
mat
e
d
c
o
n
v
e
r
sat
i
o
n
a
l
a
g
e
n
t
s
(
c
h
a
t
b
o
t
s)
i
n
m
e
n
t
a
l
h
e
a
l
t
h
s
u
p
p
o
r
t
,
”
Bi
o
m
e
d
i
c
a
l
I
n
f
o
rm
a
t
i
c
s
I
n
si
g
h
t
s
,
v
o
l
.
1
1
,
n
o
.
1
1
,
2
0
1
9
,
d
o
i
:
1
0
.
1
1
7
7
/
1
1
7
8
2
2
2
6
1
9
8
2
9
0
8
3
.
[
1
7
]
C
.
N
e
b
e
k
e
r
,
J.
T
o
r
o
u
s
,
a
n
d
R
.
J
.
B
.
E
l
l
i
s
,
“
B
u
i
l
d
i
n
g
t
h
e
c
a
se
f
o
r
a
c
t
i
o
n
a
b
l
e
e
t
h
i
c
s
i
n
d
i
g
i
t
a
l
h
e
a
l
t
h
r
e
s
e
a
r
c
h
s
u
p
p
o
r
t
e
d
b
y
a
r
t
i
f
i
c
i
a
l
i
n
t
e
l
l
i
g
e
n
c
e
,
”
B
MC
M
e
d
i
c
i
n
e
,
v
o
l
.
1
7
,
n
o
.
1
,
2
0
1
9
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
2
9
1
6
-
019
-
1
3
7
7
-
7.
[
1
8
]
R
.
B
i
r
k
,
A
.
La
v
i
s
,
F
.
L
u
c
i
v
e
r
o
,
a
n
d
G
.
S
a
mu
e
l
,
“
F
o
r
w
h
a
t
i
t
’
s
w
o
r
t
h
.
U
n
e
a
r
t
h
i
n
g
t
h
e
v
a
l
u
e
s
e
m
b
e
d
d
e
d
i
n
d
i
g
i
t
a
l
p
h
e
n
o
t
y
p
i
n
g
f
o
r
men
t
a
l
h
e
a
l
t
h
,
”
B
i
g
D
a
t
a
a
n
d
S
o
c
i
e
t
y
,
v
o
l
.
8
,
n
o
.
2
,
p
p
.
1
–
5
,
2
0
2
1
,
d
o
i
:
1
0
.
1
1
7
7
/
2
0
5
3
9
5
1
7
2
1
1
0
4
7
3
1
9
.
[
1
9
]
S
.
C
o
g
h
l
a
n
,
K
.
Le
i
n
s,
S
.
S
h
e
l
d
r
i
c
k
,
M
.
C
h
e
o
n
g
,
P
.
G
o
o
d
i
n
g
,
a
n
d
S
.
D
’
A
l
f
o
n
s
o
,
“
T
o
c
h
a
t
o
r
b
o
t
t
o
c
h
a
t
:
e
t
h
i
c
a
l
i
ssu
e
s
w
i
t
h
u
si
ng
c
h
a
t
b
o
t
s
i
n
me
n
t
a
l
h
e
a
l
t
h
,
”
D
i
g
i
t
a
l
H
e
a
l
t
h
,
v
o
l
.
9
,
p
p
.
1
–
1
1
,
2
0
2
3
,
d
o
i
:
1
0
.
1
1
7
7
/
2
0
5
5
2
0
7
6
2
3
1
1
8
3
5
4
2
.
[
2
0
]
M
.
M
c
C
r
a
d
d
e
n
,
K
.
H
u
i
,
a
n
d
D
.
Z
.
B
u
c
h
m
a
n
,
“
Ev
i
d
e
n
c
e
,
e
t
h
i
c
s
a
n
d
t
h
e
p
r
o
mi
se
o
f
a
r
t
i
f
i
c
i
a
l
i
n
t
e
l
l
i
g
e
n
c
e
i
n
p
s
y
c
h
i
a
t
r
y
,
”
J
o
u
rn
a
l
o
f
Me
d
i
c
a
l
E
t
h
i
c
s
,
v
o
l
.
4
9
,
n
o
.
8
,
p
p
.
5
7
3
–
5
7
9
,
2
0
2
3
,
d
o
i
:
1
0
.
1
1
3
6
/
j
me
-
2
0
2
2
-
1
0
8
4
4
7
.
[
2
1
]
G
.
A
r
b
a
n
a
s,
“
C
h
a
t
G
P
T
a
n
d
o
t
h
e
r
c
h
a
t
b
o
t
s
i
n
p
s
y
c
h
i
a
t
r
y
,
”
Arc
h
i
v
e
s
o
f
p
s
y
c
h
i
a
t
r
y
r
e
se
a
rc
h
,
v
o
l
.
6
0
,
n
o
.
2
,
p
p
.
1
3
7
–
1
4
2
,
2
0
2
4
,
d
o
i
:
1
0
.
2
0
4
7
1
/
j
u
n
e
.
2
0
2
4
.
6
0
.
0
2
.
0
7
.
[
2
2
]
C
.
M
.
M
ö
r
c
h
,
A
.
G
u
p
t
a
,
a
n
d
B
.
L.
M
i
sh
a
r
a
,
“
C
a
n
a
d
a
p
r
o
t
o
c
o
l
:
a
n
e
t
h
i
c
a
l
c
h
e
c
k
l
i
s
t
f
o
r
t
h
e
u
s
e
o
f
a
r
t
i
f
i
c
i
a
l
I
n
t
e
l
l
i
g
e
n
c
e
i
n
s
u
i
c
i
d
e
p
r
e
v
e
n
t
i
o
n
a
n
d
m
e
n
t
a
l
h
e
a
l
t
h
,
”
Art
i
f
i
c
i
a
l
I
n
t
e
l
l
i
g
e
n
c
e
i
n
Me
d
i
c
i
n
e
,
v
o
l
.
1
0
8
,
2
0
2
0
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
a
r
t
m
e
d
.
2
0
2
0
.
1
0
1
9
3
4
.
[
2
3
]
G
.
N
.
V
i
l
a
z
a
a
n
d
D
.
M
c
C
a
sh
i
n
,
“
I
s
t
h
e
a
u
t
o
ma
t
i
o
n
o
f
d
i
g
i
t
a
l
me
n
t
a
l
h
e
a
l
t
h
e
t
h
i
c
a
l
?
a
p
p
l
y
i
n
g
a
n
e
t
h
i
c
a
l
f
r
a
mew
o
r
k
t
o
c
h
a
t
b
o
t
s
f
o
r
c
o
g
n
i
t
i
v
e
b
e
h
a
v
i
o
u
r
t
h
e
r
a
p
y
,
”
Fr
o
n
t
i
e
rs i
n
D
i
g
i
t
a
l
H
e
a
l
t
h
,
v
o
l
.
3
,
n
o
.
2
,
p
p
.
1
4
5
–
1
5
8
,
2
0
2
1
,
d
o
i
:
1
0
.
3
3
8
9
/
f
d
g
t
h
.
2
0
2
1
.
6
8
9
7
3
6
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Ad
v
Ap
p
l Sci
I
SS
N:
2252
-
8
8
1
4
E
th
ica
l iss
u
es in
d
ig
ita
l m
en
ta
l h
ea
lth
d
elive
r
y:
a
c
o
mp
r
eh
en
s
ive
…
(
N
u
r
u
l A
in
Mo
h
d
Da
u
d
)
919
[
2
4
]
N
.
M
.
-
M
a
r
t
i
n
,
H
.
T.
G
r
e
e
l
y
,
a
n
d
M
.
K
.
C
h
o
,
“
Et
h
i
c
a
l
d
e
v
e
l
o
p
m
e
n
t
o
f
d
i
g
i
t
a
l
p
h
e
n
o
t
y
p
i
n
g
t
o
o
l
s
f
o
r
me
n
t
a
l
h
e
a
l
t
h
a
p
p
l
i
c
a
t
i
o
n
s:
D
e
l
p
h
i
st
u
d
y
,
”
J
MIR
m
H
e
a
l
t
h
a
n
d
u
H
e
a
l
t
h
,
v
o
l
.
9
,
n
o
.
7
,
2
0
2
1
,
d
o
i
:
1
0
.
2
1
9
6
/
2
7
3
4
3
.
[
2
5
]
L.
V
a
l
e
n
t
i
n
e
,
S
.
D
’
A
l
f
o
n
s
o
,
a
n
d
R
.
Le
d
e
r
m
a
n
,
“
R
e
c
o
mm
e
n
d
e
r
sy
st
e
ms
f
o
r
me
n
t
a
l
h
e
a
l
t
h
a
p
p
s:
a
d
v
a
n
t
a
g
e
s
a
n
d
e
t
h
i
c
a
l
c
h
a
l
l
e
n
g
e
s,”
AI
a
n
d
S
o
c
i
e
t
y
,
v
o
l
.
3
8
,
n
o
.
4
,
p
p
.
1
6
2
7
–
1
6
3
8
,
2
0
2
3
,
d
o
i
:
1
0
.
1
0
0
7
/
s
0
0
1
4
6
-
0
2
1
-
0
1
3
2
2
-
w.
[
2
6
]
I
.
P
a
v
e
z
,
T.
C
o
r
r
e
a
,
a
n
d
C
.
F
a
r
í
a
s
,
“
Th
e
p
o
w
e
r
o
f
e
mo
t
i
o
n
s:
t
h
e
e
t
h
i
c
s
o
f
c
a
r
e
i
n
t
h
e
d
i
g
i
t
a
l
i
n
c
l
u
s
i
o
n
p
r
o
c
e
sse
s
o
f
mar
g
i
n
a
l
i
z
e
d
c
o
mm
u
n
i
t
i
e
s,”
S
o
c
i
a
l
I
n
c
l
u
s
i
o
n
,
v
o
l
.
1
1
,
n
o
.
3
,
p
p
.
2
7
5
–
2
8
5
,
2
0
2
3
,
d
o
i
:
1
0
.
1
7
6
4
5
/
si
.
v
1
1
i
3
.
6
6
2
3
.
[
2
7
]
M
.
F
a
i
ss
n
e
r
,
E.
K
u
h
n
,
R
.
M
ü
l
l
e
r
,
a
n
d
S
.
L
a
a
c
k
e
,
“
D
e
t
e
c
t
i
n
g
y
o
u
r
d
e
p
r
e
ss
i
o
n
w
i
t
h
y
o
u
r
sm
a
r
t
p
h
o
n
e
?
–
a
n
e
t
h
i
c
a
l
a
n
a
l
y
si
s
o
f
e
p
i
s
t
e
mi
c
i
n
j
u
s
t
i
c
e
i
n
p
a
ss
i
v
e
s
e
l
f
-
t
r
a
c
k
i
n
g
a
p
p
s,
”
E
t
h
i
c
s
a
n
d
I
n
f
o
rm
a
t
i
o
n
T
e
c
h
n
o
l
o
g
y
,
v
o
l
.
2
6
,
n
o
.
2
,
2
0
2
4
,
d
o
i
:
1
0
.
1
0
0
7
/
s
1
0
6
7
6
-
024
-
0
9
7
6
5
-
7.
[
2
8
]
M
.
A
.
A
l
k
u
r
e
i
s
h
i
e
t
a
l
.
,
“
D
i
g
i
t
a
l
l
y
d
i
s
c
o
n
n
e
c
t
e
d
:
q
u
a
l
i
t
a
t
i
v
e
st
u
d
y
o
f
p
a
t
i
e
n
t
p
e
r
s
p
e
c
t
i
v
e
s
o
n
t
h
e
d
i
g
i
t
a
l
d
i
v
i
d
e
a
n
d
p
o
t
e
n
t
i
a
l
so
l
u
t
i
o
n
s
,
”
J
MIR
H
u
m
a
n
F
a
c
t
o
rs
,
v
o
l
.
8
,
n
o
.
4
,
D
e
c
.
2
0
2
1
,
d
o
i
:
1
0
.
2
1
9
6
/
3
3
3
6
4
.
[
2
9
]
F
.
C
a
l
l
a
r
d
,
D
.
K
o
t
o
u
z
a
,
P
.
G
a
r
n
e
t
t
,
a
n
d
L
.
R
o
c
h
a
,
“
M
e
n
t
a
l
h
e
a
l
t
h
i
n
u
n
i
v
e
r
si
t
i
e
s
i
n
a
n
a
g
e
o
f
d
i
g
i
t
a
l
c
a
p
i
t
a
l
i
sm:
t
h
e
U
n
i
t
e
d
K
i
n
g
d
o
m
a
s
e
x
e
m
p
l
a
r
y
c
a
se
,
”
S
S
M
-
Me
n
t
a
l
H
e
a
l
t
h
,
v
o
l
.
2
,
2
0
2
2
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
ss
mm
h
.
2
0
2
2
.
1
0
0
0
9
4
.
[
3
0
]
G
.
C
.
S
.
K
e
o
n
g
,
“
‘
C
l
i
c
k
i
n
g
w
i
t
h
o
u
t
u
n
d
e
r
s
t
a
n
d
i
n
g
’
:
a
m
i
x
e
d
-
m
e
t
h
o
d
s
a
n
a
l
y
s
i
s
o
f
u
ser
a
g
r
e
e
m
e
n
t
s
i
n
d
i
g
i
t
a
l
me
n
t
a
l
h
e
a
l
t
h
serv
i
c
e
s
,
”
I
n
t
e
rn
a
t
i
o
n
a
l
J
o
u
rn
a
l
o
f
M
e
d
i
c
a
l
I
n
f
o
rm
a
t
i
c
s
,
v
o
l
.
2
1
3
,
J
u
n
.
2
0
2
6
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
i
j
me
d
i
n
f
.
2
0
2
6
.
1
0
6
3
8
4
.
[
3
1
]
D
.
C
.
M
o
h
r
,
M
.
Z
h
a
n
g
,
a
n
d
S
.
M
.
S
c
h
u
e
l
l
e
r
,
“
P
e
r
so
n
a
l
sen
s
i
n
g
:
u
n
d
e
r
st
a
n
d
i
n
g
men
t
a
l
h
e
a
l
t
h
u
si
n
g
u
b
i
q
u
i
t
o
u
s
s
e
n
so
r
s
a
n
d
m
a
c
h
i
n
e
l
e
a
r
n
i
n
g
,
”
An
n
u
a
l
Re
v
i
e
w
o
f
C
l
i
n
i
c
a
l
Ps
y
c
h
o
l
o
g
y
,
v
o
l
.
1
3
,
n
o
.
1
,
p
p
.
2
3
–
4
7
,
2
0
1
7
,
d
o
i
:
1
0
.
1
1
4
6
/
a
n
n
u
r
e
v
-
c
l
i
n
p
sy
-
032816
-
0
4
4
9
4
9
.
[
3
2
]
J.
E.
S
a
b
i
n
a
n
d
J
.
C
.
H
a
r
l
a
n
d
,
“
P
r
o
f
e
ssi
o
n
a
l
e
t
h
i
c
s
f
o
r
d
i
g
i
t
a
l
a
g
e
p
sy
c
h
i
a
t
r
y
:
b
o
u
n
d
a
r
i
e
s
,
p
r
i
v
a
c
y
,
a
n
d
c
o
m
mu
n
i
c
a
t
i
o
n
,
”
C
u
rre
n
t
Psy
c
h
i
a
t
r
y
R
e
p
o
r
t
s
,
v
o
l
.
1
9
,
n
o
.
9
,
S
e
p
.
2
0
1
7
,
d
o
i
:
1
0
.
1
0
0
7
/
s
1
1
9
2
0
-
0
1
7
-
0
8
1
5
-
5.
[
3
3
]
L.
R
o
b
i
n
s
o
n
e
t
a
l
.
,
“
D
i
g
i
t
a
l
i
n
e
q
u
a
l
i
t
i
e
s
a
n
d
w
h
y
t
h
e
y
ma
t
t
e
r
,
”
I
n
f
o
r
m
a
t
i
o
n
,
C
o
m
m
u
n
i
c
a
t
i
o
n
a
n
d
S
o
c
i
e
t
y
,
v
o
l
.
2
4
,
n
o
.
3
,
p
p
.
3
9
6
–
4
1
0
,
2
0
2
1
,
d
o
i
:
1
0
.
1
0
8
0
/
1
3
6
9
1
1
8
X
.
2
0
2
0
.
1
7
7
6
3
7
3
.
[
3
4
]
J.
T
o
r
o
u
s
e
t
a
l
.
,
“
T
h
e
g
r
o
w
i
n
g
f
i
e
l
d
o
f
d
i
g
i
t
a
l
p
sy
c
h
i
a
t
r
y
:
c
u
r
r
e
n
t
e
v
i
d
e
n
c
e
a
n
d
t
h
e
f
u
t
u
r
e
o
f
a
p
p
s
,
s
o
c
i
a
l
m
e
d
i
a
,
c
h
a
t
b
o
t
s,
a
n
d
v
i
r
t
u
a
l
r
e
a
l
i
t
y
,
”
Wo
r
l
d
Psy
c
h
i
a
t
r
y
,
v
o
l
.
2
0
,
n
o
.
3
,
p
p
.
3
1
8
–
3
3
5
,
2
0
2
1
,
d
o
i
:
1
0
.
1
0
0
2
/
w
p
s.
2
0
8
8
3
.
[
3
5
]
J.
H
.
B
e
n
t
l
e
y
,
N
.
T
i
n
,
a
n
d
N
.
P
a
sc
h
a
l
,
“
M
e
n
t
a
l
h
e
a
l
t
h
a
p
p
s
a
n
d
t
h
e
c
u
l
t
u
r
a
l
d
i
sp
a
r
i
t
i
e
s
i
n
a
l
g
o
r
i
t
h
mi
c
d
e
si
g
n
:
a
sco
p
i
n
g
r
e
v
i
e
w
,
”
J
o
u
rn
a
l
o
f
Me
d
i
c
a
l
I
n
t
e
rn
e
t
Re
s
e
a
r
c
h
,
v
o
l
.
2
3
,
n
o
.
7
,
2
0
2
1
,
d
o
i
:
1
0
.
2
1
9
6
/
2
0
0
9
8
.
[
3
6
]
J.
C
h
u
a
n
d
A
.
L
e
i
n
o
,
“
C
u
l
t
u
r
a
l
a
d
a
p
t
a
t
i
o
n
a
n
d
i
t
s
i
m
p
o
r
t
a
n
c
e
f
o
r
d
i
g
i
t
a
l
m
e
n
t
a
l
h
e
a
l
t
h
serv
i
c
e
s,”
D
i
g
i
t
a
l
H
e
a
l
t
h
,
v
o
l
.
5
,
p
p
.
1
–
6
,
2
0
1
9
,
d
o
i
:
1
0
.
1
1
7
7
/
2
0
5
5
2
0
7
6
1
9
8
5
6
1
6
9
.
B
I
O
G
RAP
H
I
E
S O
F
AUTH
O
RS
Nurul
Ain
M
o
h
d
Da
u
d
is
a
n
a
ss
o
c
iate
p
ro
fe
ss
o
r
in
th
e
De
p
a
rt
m
e
n
t
o
f
G
u
id
a
n
c
e
a
n
d
C
o
u
n
se
ll
in
g
,
F
a
c
u
lt
y
o
f
Hu
m
a
n
De
v
e
lo
p
m
e
n
t,
Un
i
v
e
rsiti
P
e
n
d
i
d
ik
a
n
S
u
lt
a
n
I
d
ris
,
M
a
lay
sia
.
S
h
e
e
a
rn
e
d
h
e
r
P
h
.
D
.
i
n
M
u
lt
icu
lt
u
ra
l
Co
u
n
se
ll
in
g
in
Ed
u
c
a
ti
o
n
fr
o
m
th
e
Un
iv
e
rsit
y
o
f
Brist
o
l.
S
h
e
sp
e
c
ialize
d
i
n
q
u
a
li
tativ
e
m
e
th
o
d
o
l
o
g
y
a
n
d
m
u
l
ti
c
u
lt
u
ra
l
c
o
u
n
se
ll
in
g
.
He
r
re
se
a
rc
h
fo
c
u
se
s
o
n
a
d
ig
it
a
li
z
a
ti
o
n
fra
m
e
wo
rk
fo
r
m
e
n
tal
h
e
a
l
th
t
o
imp
r
o
v
e
t
h
e
e
th
ica
l
e
ffe
c
ti
v
e
n
e
ss
o
f
m
e
n
tal
h
e
a
lt
h
p
ra
c
ti
ti
o
n
e
rs'
d
e
li
v
e
ry
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
at
e
m
a
il
:
n
u
r
u
l.
a
in
@f
p
m
.
u
p
si.ed
u
.
m
y
.
H
a
p
sa
h
Md
Yus
o
f
is
a
se
n
io
r
lec
tu
re
r
i
n
t
h
e
De
p
a
rtme
n
t
o
f
G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
i
n
g
,
F
a
c
u
lt
y
o
f
Hu
m
a
n
De
v
e
lo
p
m
e
n
t,
U
n
iv
e
rsiti
P
e
n
d
id
i
k
a
n
S
u
lt
a
n
Id
ris,
M
a
lay
sia
.
S
h
e
e
a
rn
e
d
h
e
r
P
h
.
D
.
in
Co
u
n
se
ll
o
r
E
d
u
c
a
ti
o
n
a
n
d
S
u
p
e
r
v
is
io
n
fr
o
m
S
o
u
t
h
e
rn
Ill
in
o
is
Un
iv
e
rsity
Ca
rb
o
n
d
a
le,
U
n
it
e
d
S
t
a
tes
.
He
r
re
se
a
r
c
h
fo
c
u
se
s
o
n
su
p
e
rv
isio
n
a
n
d
g
e
ro
n
to
lo
g
y
in
c
o
u
n
se
ll
i
n
g
.
He
r
c
u
rre
n
t
re
se
a
rc
h
fo
c
u
se
s
o
n
b
u
il
d
in
g
a
p
sy
c
h
o
so
c
ial
we
ll
-
b
e
i
n
g
m
o
d
e
l
fra
m
e
wo
rk
fo
r
fa
m
il
y
c
a
re
g
iv
e
rs
o
f
th
e
e
ld
e
rly
i
n
M
a
lay
sia
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
h
a
p
sa
h
@fp
m
.
u
p
si.ed
u
.
m
y
.
Dr
.
No
r
a
z
a
n
i
A
h
m
a
d
is
a
se
n
io
r
lec
tu
re
r
in
t
h
e
De
p
a
rtme
n
t
o
f
G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
i
n
g
,
F
a
c
u
lt
y
o
f
Hu
m
a
n
De
v
e
lo
p
m
e
n
t,
U
n
iv
e
rsiti
P
e
n
d
id
i
k
a
n
S
u
lt
a
n
Id
ris,
M
a
lay
sia
.
S
h
e
c
o
m
p
lete
d
h
e
r
P
h
.
D
.
i
n
G
u
id
a
n
c
e
a
n
d
C
o
u
n
se
ll
in
g
fro
m
th
e
U
n
iv
e
rsit
y
o
f
M
a
lay
a
a
n
d
a
n
M
Ed
i
n
Co
u
n
se
ll
in
g
fro
m
Un
iv
e
rsiti
Ke
b
a
n
g
sa
a
n
M
a
lay
sia
.
He
r
a
re
a
o
f
e
x
p
e
rti
se
is
c
o
u
n
se
ll
i
n
g
s
u
p
e
rv
isio
n
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
n
o
ra
z
a
n
i@
fp
m
.
u
p
si
.
e
d
u
.
m
y
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
1
4
I
n
t J Ad
v
Ap
p
l Sci
,
Vo
l.
1
5
,
No
.
3
,
Sep
tem
b
er
2
0
2
6
:
911
-
9
2
0
920
Fa
u
z
ia
h
Mo
h
d
S
a
'a
d
is
a
n
a
ss
o
c
iate
p
ro
fe
ss
o
r
in
t
h
e
De
p
a
rtme
n
t
o
f
G
u
id
a
n
c
e
a
n
d
C
o
u
n
se
ll
in
g
,
F
a
c
u
lt
y
o
f
Hu
m
a
n
De
v
e
lo
p
m
e
n
t,
Un
i
v
e
rsiti
P
e
n
d
i
d
ik
a
n
S
u
lt
a
n
I
d
ris
,
M
a
lay
sia
.
S
h
e
e
a
rn
e
d
h
e
r
P
h
.
D
.
in
P
sy
c
h
o
lo
g
y
i
n
G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
i
n
g
fr
o
m
Un
i
v
e
rsiti
Ke
b
a
n
g
sa
a
n
M
a
lay
sia
a
n
d
M
.
Ed
.
in
G
u
id
a
n
c
e
a
n
d
C
o
u
n
se
ll
in
g
fro
m
Un
iv
e
rsiti
P
u
tra M
a
lay
sia
.
S
h
e
s
p
e
c
ialize
d
in
m
e
n
t
a
l
h
e
a
lt
h
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
fa
u
z
iah
_
m
sa
a
d
@fp
m
.
u
p
si.ed
u
.
m
y
.
Nurul
H
a
sy
im
a
h
Ma
t
Ra
n
i
is
a
lec
tu
re
r
in
th
e
De
p
a
rtme
n
t
o
f
G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
i
n
g
,
F
a
c
u
lt
y
o
f
Hu
m
a
n
De
v
e
lo
p
m
e
n
t,
U
n
iv
e
rsiti
P
e
n
d
id
i
k
a
n
S
u
lt
a
n
Id
ris
,
M
a
lay
sia
.
S
h
e
e
a
rn
e
d
h
e
r
P
h
.
D
.
i
n
G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
in
g
(Et
h
ics
a
n
d
Leg
islatio
n
in
C
o
u
n
se
ll
in
g
)
fro
m
Un
iv
e
rsiti
P
u
tra
M
a
lay
sia
.
S
h
e
ju
st
fi
n
ish
e
d
h
e
r
p
o
st
d
o
c
t
o
r
a
l
stu
d
ies
a
t
th
e
Ch
il
d
li
g
h
t
-
G
lo
b
a
l
Ch
il
d
S
a
fe
ty
In
sti
tu
te
a
t
t
h
e
Un
iv
e
rsity
o
f
Ed
i
n
b
u
rg
h
,
S
c
o
t
lan
d
,
Un
i
ted
Kin
g
d
o
m
.
He
r
re
se
a
rc
h
fo
c
u
se
s o
n
th
e
e
th
ics
a
n
d
leg
islatio
n
in
c
o
u
n
se
ll
i
n
g
,
fa
m
il
y
su
p
p
o
rt
i
n
c
o
u
n
se
ll
in
g
,
a
n
d
c
o
u
n
se
ll
i
n
g
i
n
terv
e
n
t
io
n
fo
r
c
h
il
d
se
x
u
a
l
e
x
p
l
o
it
a
ti
o
n
a
n
d
a
b
u
se
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
h
a
sy
ima
h
@fp
m
.
u
p
si.ed
u
.
m
y
.
Dr
.
Pa
u
Kee
is
a
se
n
io
r
lec
tu
r
e
r
in
th
e
De
p
a
rtme
n
t
o
f
G
u
id
a
n
c
e
a
n
d
C
o
u
n
se
ll
in
g
,
F
a
c
u
lt
y
o
f
Hu
m
a
n
De
v
e
lo
p
m
e
n
t,
Un
iv
e
rsiti
P
e
n
d
i
d
ik
a
n
S
u
lt
a
n
I
d
ri
s
,
M
a
lay
sia
.
S
h
e
e
a
rn
e
d
h
e
r
Ph
.
D
.
in
Cli
n
ica
l
M
e
n
tal
He
a
lt
h
Co
u
n
se
ll
i
n
g
fro
m
Old
D
o
m
in
io
n
Un
i
v
e
rsity
in
No
rfo
lk
,
Virg
in
ia,
U
n
it
e
d
S
tate
s.
He
r
a
c
a
d
e
m
ic
a
n
d
p
ro
fe
ss
io
n
a
l
fo
c
u
s
is
o
n
c
li
n
ica
l
m
e
n
tal
h
e
a
lt
h
c
o
u
n
se
ll
i
n
g
,
w
h
e
re
sh
e
c
o
n
tri
b
u
t
e
s
to
th
e
d
e
v
e
lo
p
m
e
n
t
o
f
f
u
t
u
re
c
o
u
n
se
ll
o
rs
a
n
d
a
d
v
a
n
c
e
s
m
e
n
tal
h
e
a
lt
h
p
ra
c
ti
c
e
s.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
p
a
u
_
k
e
e
@fp
m
.
u
p
si.ed
u
.
m
y
.
Nur
S
h
u
h
a
n
a
M
o
h
d
S
a
n
sud
d
in
is
e
m
p
lo
y
e
d
a
s
a
g
ra
d
u
a
te
re
se
a
rc
h
a
ss
istan
t
in
th
e
De
p
a
rtme
n
t
o
f
G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
i
n
g
,
F
a
c
u
lt
y
o
f
H
u
m
a
n
De
v
e
lo
p
m
e
n
t
a
t
Un
i
v
e
rsiti
P
e
n
d
i
d
ik
a
n
S
u
lt
a
n
Id
ris
,
M
a
lay
sia
.
S
h
e
h
a
s
o
b
tai
n
e
d
h
e
r
b
a
c
h
e
lo
r'
s
d
e
g
re
e
in
Co
u
n
se
ll
i
n
g
fro
m
th
e
Un
i
v
e
rsity
o
f
M
a
lay
a
,
K
u
a
la
Lu
m
p
u
r
.
S
h
e
is
c
u
rre
n
tl
y
p
u
rsu
in
g
h
e
r
P
h
.
D
.
(G
u
id
a
n
c
e
a
n
d
Co
u
n
se
ll
i
n
g
)
a
t
S
u
lt
a
n
I
d
ris
E
d
u
c
a
ti
o
n
Un
i
v
e
rsity
,
Tan
j
u
n
g
M
a
li
m
,
P
e
ra
k
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
n
u
rsh
u
h
a
n
a
8
2
@g
m
a
il
.
c
o
m
.
Evaluation Warning : The document was created with Spire.PDF for Python.