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Hasnain F, Herran RM, Henning SC, Ditmars AM, Pisoni DB, Sehgal ST, Kronenberger WG. Verbal Fluency in Prelingually Deaf, Early Implanted Children and Adolescents With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1394-1409. [PMID: 36857026 PMCID: PMC10457083 DOI: 10.1044/2022_jslhr-22-00383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/21/2022] [Accepted: 12/18/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Verbal fluency tasks assess the ability to quickly and efficiently retrieve words from the mental lexicon by requiring subjects to rapidly generate words within a phonological or semantic category. This study investigated differences between cochlear implant users and normal-hearing peers in the clustering and time course of word retrieval during phonological and semantic verbal fluency tasks. METHOD Twenty-eight children and adolescents (aged 9-17 years) with cochlear implants and 33 normal-hearing peers completed measures of verbal fluency, nonverbal intelligence, speech perception, and verbal short-term/working memory. Phonological and semantic verbal fluency tests were scored for total words generated, words generated in each 10-s interval of the 1-min task, latency to first word generated, number of word clusters, average cluster size, and number of word/cluster switches. RESULTS Children and adolescents with cochlear implants generated fewer words than normal-hearing peers throughout the entire 60-s time interval of the phonological and semantic fluency tasks. Cochlear implant users also had slower start latency times and produced fewer clusters and switches than normal-hearing peers during the phonological fluency task. Speech perception and verbal working memory scores were more strongly associated with verbal fluency scores in children and adolescents with cochlear implants than in normal-hearing peers. CONCLUSIONS Cochlear implant users show poorer phonological and semantic verbal fluency than normal-hearing peers, and their verbal fluency is significantly associated with speech perception and verbal working memory. These findings suggest deficits in fluent retrieval of phonological and semantic information from long-term lexical memory in cochlear implant users.
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Affiliation(s)
- Fahad Hasnain
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - Reid M. Herran
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - Shirley C. Henning
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - Allison M. Ditmars
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - David B. Pisoni
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
- Department of Psychological and Brain Sciences, Indiana University, Bloomington
| | - Susan T. Sehgal
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - William G. Kronenberger
- Department of Otolaryngology – Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
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Arán Filippetti V, Krumm G, López MB. Clustering and Switching During Verbal Fluency in Typical and Atypical Development: A Systematic Review in Children and Adolescents. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03787-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Fernandes AC, Viegas ÂA, Lacerda ACR, Nobre JNP, Morais RLDS, Figueiredo PHS, Costa HS, Camargos ACR, Ferreira FDO, de Freitas PM, Santos T, da Silva Júnior FA, Bernardo-Filho M, Taiar R, Sartorio A, Mendonça VA. Association between executive functions and gross motor skills in overweight/obese and eutrophic preschoolers: cross-sectional study. BMC Pediatr 2022; 22:498. [PMID: 35999515 PMCID: PMC9400322 DOI: 10.1186/s12887-022-03553-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 08/10/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Preschool age (3-5 years old) is a crucial period for children to acquire gross motor skills and develop executive functions (EFs). However, the association between the qualitative gross motor skills and EFs remains unknown in preschoolers, especially among overweight and obese children. METHODS This was a cross-sectional, exploratory, and quantitative study carried out on 49 preschool children, divided into two subgroups according to their body mass index (overweight/obese: 24; eutrophic [normal weight]: 25). The mean age was 4.59 years. More than half of the sample were boys (55%) and most of the mothers had completed high school (67%) and were class C socioeconomic level (63%). Gross motor skills were assessed using the Test of Gross Motor Development-2, while EFs were evaluated using Semantic verbal fluency (SVF), Tower of Hanoi (TH), Day/Night Stroop, and Delayed Gratification tests. Multiple linear regression models adjusted for sex, age, maternal education, socioeconomic status, quality of the home environment, and quality of the school environment using the stepwise method were executed, considering the cognitive tasks as independent variables and gross motor skills as dependent variable. RESULTS The overweight/obese preschoolers showed worse locomotor skills than their eutrophic peers and below average gross motor quotient (GMQ). Overweight/obese girls performed worse in OC skills than boys with excess weight. SVF (number of errors) and TH (rule breaks) explained 57.8% of the variance in object control (OC) skills and 40.5% of the variance in GMQ (p < .05) in the overweight/obese children. Surprisingly, there was no significant association between any of the EF tasks and gross motor skills in the eutrophic children. CONCLUSION A relationship between EF tasks (number of errors in SVF and rule breaks in TH) and gross motor skills (OC and GMQ) was demonstrated in the overweight/obese preschoolers, indicating that worse cognitive flexibility, working memory, planning, and problem solving are associated with worse gross motor skills in this population when compared to eutrophic children.
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Affiliation(s)
- Amanda Cristina Fernandes
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK - Rodovia MGT - 367 - Km 583, N°. 5000 - Alto da Jacuba / ZIP, Diamantina, Minas Gerais, 39100-000, Brazil
| | - Ângela Alves Viegas
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK - Rodovia MGT - 367 - Km 583, N°. 5000 - Alto da Jacuba / ZIP, Diamantina, Minas Gerais, 39100-000, Brazil
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Juliana Nogueira Pontes Nobre
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Rosane Luzia De Souza Morais
- Programa de Pós-Graduação Saúde, Sociedade e Ambiente (PPGSaSA), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK - Rodovia MGT - 367 - Km 583, N°. 5000 - Alto da Jacuba / ZIP, Diamantina, Minas Gerais, 39100-000, Brazil
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Henrique Silveira Costa
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK - Rodovia MGT - 367 - Km 583, N°. 5000 - Alto da Jacuba / ZIP, Diamantina, Minas Gerais, 39100-000, Brazil
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Resende Camargos
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Patrícia Martins de Freitas
- Programa de Pós-Graduação em Psicologia da Saúde (PPGPSI), Instituto Multidisciplinar em Saúde da Universidade Federal da Bahia (UFBA), Vitória da Conquista, Bahia, Brazil
| | - Thiago Santos
- Departamento de Ciências Biológicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Fidelis Antônio da Silva Júnior
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Mário Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas - LAVIMPI, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes and Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Redha Taiar
- Université de Reims Champagne Ardenne, MATIM, 51100, Reims, France
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Division of Auxology and Metabolic Diseases & Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
| | - Vanessa Amaral Mendonça
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Campus JK - Rodovia MGT - 367 - Km 583, N°. 5000 - Alto da Jacuba / ZIP, Diamantina, Minas Gerais, 39100-000, Brazil.
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas (PPGMCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil.
- Centro Integrado de Pesquisa e Pós-Graduação em Saúde (CIPq saúde), Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil.
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Scala I, Concolino D, Nastasi A, Esposito G, Crisci D, Sestito S, Ferraro S, Albano L, Ruoppolo M, Parenti G, Strisciuglio P. Beneficial Effects of Slow-Release Large Neutral Amino Acids after a Phenylalanine Oral Load in Patients with Phenylketonuria. Nutrients 2021; 13:nu13114012. [PMID: 34836270 PMCID: PMC8618154 DOI: 10.3390/nu13114012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
The mainstay of phenylketonuria treatment is a low protein diet, supplemented with phenylalanine (Phe)-free protein substitutes and micronutrients. Adhering to this diet is challenging, and even patients with good metabolic control who follow the dietary prescriptions in everyday life ignore the recommendations occasionally. The present study explores the ability of slow-release large neutral amino acids (srLNAAs) to prevent Phe increase following a Phe dietary load. Fourteen phenylketonuric patients aged ≥13 years were enrolled in a 6-week protocol. Oral acute Phe loads of 250 and 500 mg were added to the evening meal together with srLNAAs (0.5 gr/kg). Phe and tyrosine were dosed before dinner, 2h-after dinner, and after the overnight fast. After oral Phe loads, mean plasma Phe remained stable and below 600 µmol/L. No Phe peaks were registered. Tyrosine levels significantly increased, and Phe/Tyrosine ratio decreased. No adverse events were registered. In conclusion, a single oral administration of srLNAAs at the dose of 0.5 gr/kg is effective in maintaining stable plasma Phe during acute oral loads with Phe-containing food and may be added to the dietetic scheme in situations in which patients with generally good adherence to diet foresee a higher than prescribed Phe intake due to their commitments.
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Affiliation(s)
- Iris Scala
- Department of Maternal and Child Health, Federico II University Hospital, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-7463348; +39-081-7463769
| | - Daniela Concolino
- Pediatric Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (D.C.); (S.S.); (S.F.)
| | - Anna Nastasi
- Physiology Nutrition Unit, Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy;
| | - Giulia Esposito
- Department of Translational Medical Science, Section of Pediatrics, Federico II University, 80131 Naples, Italy; (G.E.); (G.P.); (P.S.)
| | - Daniela Crisci
- CEINGE Biotecnologie Avanzate Scarl, 80131 Naples, Italy; (D.C.); (L.A.); (M.R.)
| | - Simona Sestito
- Pediatric Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (D.C.); (S.S.); (S.F.)
| | - Stefania Ferraro
- Pediatric Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (D.C.); (S.S.); (S.F.)
| | - Lucia Albano
- CEINGE Biotecnologie Avanzate Scarl, 80131 Naples, Italy; (D.C.); (L.A.); (M.R.)
| | - Margherita Ruoppolo
- CEINGE Biotecnologie Avanzate Scarl, 80131 Naples, Italy; (D.C.); (L.A.); (M.R.)
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University, 80131 Naples, Italy
| | - Giancarlo Parenti
- Department of Translational Medical Science, Section of Pediatrics, Federico II University, 80131 Naples, Italy; (G.E.); (G.P.); (P.S.)
- Telethon Institute of Genetics and Medicine, 80078 Pozzuoli, Italy
| | - Pietro Strisciuglio
- Department of Translational Medical Science, Section of Pediatrics, Federico II University, 80131 Naples, Italy; (G.E.); (G.P.); (P.S.)
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Large Neutral Amino Acids (LNAAs) Supplementation Improves Neuropsychological Performances in Adult Patients with Phenylketonuria. Nutrients 2020; 12:nu12041092. [PMID: 32326614 PMCID: PMC7230959 DOI: 10.3390/nu12041092] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/29/2020] [Accepted: 04/10/2020] [Indexed: 11/17/2022] Open
Abstract
Phenylketonuria is an inborn error of phenylalanine (Phe) metabolism diagnosed by newborn screening and treated early with diet. Although diet prevents intellectual disability, patients often show impairment of executive functions, working memory, sustained attention, and cognitive flexibility. Large neutral amino acids (LNAAs) have been proposed as a dietary supplement for PKU adults. Few studies show that LNAAs may help in improving metabolic control as well as cognitive functions. In this study, 10 adult PKU patients with poor metabolic control were treated for 12 months with LNAAs (MovisCom, 0.8–1 g/kg/day) and underwent Phe and Tyrosine (Tyr) monitoring monthly. Neuropsychological assessment was performed at T0, T+3, and T+12 months by using the American Psychological General Well-Being Index, the Wisconsin Card Sorting Test, the Test of Attentional Performance, and the 9-Hole Peg Test. No change in plasma Phe levels was observed during LNAAs supplementation, while Tyr levels significantly improved during LNAAs supplementation (p = 0.03). Psychometric tests showed an improvement of distress and well-being rates, of executive functions, attention, and vigilance, whereas no difference was noted regarding hand dexterity. This study adds evidence of the advantage of LNAAs supplementation in improving cognitive functions and well-being in patients with PKU with poor metabolic control.
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Hawks Z, Hood AM, Lerman-Sinkoff DB, Shimony JS, Rutlin J, Lagoni D, Grange DK, White DA. White and gray matter brain development in children and young adults with phenylketonuria. NEUROIMAGE-CLINICAL 2019; 23:101916. [PMID: 31491833 PMCID: PMC6627563 DOI: 10.1016/j.nicl.2019.101916] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/09/2019] [Accepted: 06/29/2019] [Indexed: 12/27/2022]
Abstract
Phenylketonuria (PKU) is a recessive disorder characterized by disruption in the metabolism of the amino acid phenylalanine (Phe). Prior research indicates that individuals with PKU have substantial white matter (WM) compromise. Much less is known about gray matter (GM) in PKU, but a small body of research suggests volumetric differences compared to controls. To date, developmental trajectories of GM structure in individuals with PKU have not been examined, nor have trajectories of WM and GM been examined within a single study. To address this gap in the literature, we compared longitudinal brain development over a three-year period in individuals with PKU (n = 35; 18 male) and typically-developing controls (n = 71; 35 male) aged 7–21 years. Using diffusion tensor imaging (DTI) and structural magnetic resonance imaging (MRI), we observed whole-brain and regional WM differences between individuals with PKU and controls, which were often exacerbated with increasing age. In marked contrast with trajectories of WM development, trajectories of GM development did not differ between individuals with PKU and controls, indicating that neuropathology in PKU is more prominent in WM than GM. Within individuals with PKU, mediation analyses revealed that whole-brain mean diffusivity (MD) and regional MD in the corpus callosum and centrum semiovale mediated the relationship between dietary treatment compliance (i.e., Phe control) and executive abilities, suggesting a plausible neurobiological mechanism by which Phe control may influence cognitive outcomes. Our findings clarify the specificity, timing, and cognitive consequences of whole-brain and regional WM pathology, with implications for treatment and research in PKU. Individuals with PKU exhibited widespread, age-related white matter compromise. Developmental trajectories of gray matter were comparable for PKU and controls. Within PKU, white matter compromise influenced cognitive outcomes.
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Affiliation(s)
- Zoë Hawks
- Department of Psychological & Brain Sciences, Campus Box 1125, Washington University, St. Louis, MO, United States.
| | - Anna M Hood
- Department of Psychological & Brain Sciences, Campus Box 1125, Washington University, St. Louis, MO, United States.
| | - Dov B Lerman-Sinkoff
- Department of Psychological & Brain Sciences, Campus Box 1125, Washington University, St. Louis, MO, United States; Department of Biomedical Engineering, Washington University, St. Louis, MO, United States
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jerrel Rutlin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Daniel Lagoni
- Department of Psychological & Brain Sciences, Campus Box 1125, Washington University, St. Louis, MO, United States
| | - Dorothy K Grange
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Desirée A White
- Department of Psychological & Brain Sciences, Campus Box 1125, Washington University, St. Louis, MO, United States; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
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Neuropsychological Profile of Children with Early and Continuously Treated Phenylketonuria: Systematic Review and Future Approaches. J Int Neuropsychol Soc 2019; 25:624-643. [PMID: 31030702 DOI: 10.1017/s1355617719000146] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To provide a comprehensive systematic review of the literature by examining studies published on all cognitive aspects of children with early and continuously treated phenylketonuria (ECT-PKU) included in the databases Medline, PsycINFO, and PsycARTICLE. METHOD In addition to a classical approach, we summarized methodology and results of each study in order to discuss current theoretical and methodological issues. We also examined recent advances in biochemical markers and treatments of PKU, with implications for future research on metabolic control and its role as a determinant of neuropsychological outcome. RESULTS Consistent with previous reviews, the hypothesis of a specific and central executive impairment in children with ECT-PKU was suggested. However, findings are inconclusive regarding the nature of executive impairments as well as their specificity, impact on everyday life, persistence over time, and etiology. CONCLUSION Given the current state of the science, we suggest future directions for research that utilizes a developmental and integrative approach to examine the effects of recent advances in biochemical markers and treatment of PKU. (JINS, 2019, 25, 624-643).
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Chami S, Munro N, Docking K, McGregor K, Arciuli J, Baker E, Heard R. Changes in semantic fluency across childhood: Normative data from Australian-English speakers. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:262-273. [PMID: 28084112 DOI: 10.1080/17549507.2016.1276214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 12/14/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Verbal fluency tests are often used as part of an assessment battery to investigate children's lexical knowledge as well as executive function skills. To date, however, issues surrounding consistency of measurement cloud comparisons across studies, with the developmental performance of Australian-English speaking children also currently lacking. This study tracked verbal fluency development as measured by two semantic fluency tasks that included coding of fluency, clustering and switching type responses. METHOD Participants included 355 typically developing Australian-English speaking children (4-10 years) and 46 young adults. Total fluency was determined by the number of words produced for each category (Animals or Food), minus repetitions and rule violations. Semantic clusters (words generated within a subcategory) were coded while switches between single words or subcategories were differentiated and coded as either hard or cluster switches. RESULT Fluency showed consistent improvement over age. Cluster Switches and Hard Switches showed some evidence of a plateau in performance relative to fluency, but in opposite direction. Other measures showed no strong trends over age. Results were similar for both semantic categories. CONCLUSION Our results highlight the rich information available within a semantic fluency task and the importance of differentiating hard and cluster switches in paediatric samples.
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Affiliation(s)
- Sara Chami
- a Discipline of Speech Pathology , The University of Sydney , Lidcombe , Australia
| | - Natalie Munro
- a Discipline of Speech Pathology , The University of Sydney , Lidcombe , Australia
| | - Kimberley Docking
- a Discipline of Speech Pathology , The University of Sydney , Lidcombe , Australia
| | - Karla McGregor
- a Discipline of Speech Pathology , The University of Sydney , Lidcombe , Australia
- b Department of Communication Sciences and Disorders and the DeLTA Center , University of Iowa , Iowa City , IA , USA , and
| | - Joanne Arciuli
- a Discipline of Speech Pathology , The University of Sydney , Lidcombe , Australia
| | - Elise Baker
- a Discipline of Speech Pathology , The University of Sydney , Lidcombe , Australia
| | - Rob Heard
- c Discipline of Behavioural and Social Sciences in Health , The University of Sydney , Sydney , Australia
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Hawks ZW, Strube MJ, Johnson NX, Grange DK, White DA. Developmental Trajectories of Executive and Verbal Processes in Children with Phenylketonuria. Dev Neuropsychol 2018; 43:207-218. [PMID: 29432026 DOI: 10.1080/87565641.2018.1438439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Phenylketonuria (PKU) is a hereditary disorder characterized by disrupted phenylalanine metabolism and cognitive impairment. However, the precise nature and developmental trajectory of this cognitive impairment remains unclear. The present study used a verbal fluency task to dissociate executive and verbal processes in children with PKU (n = 23; 7-18 years) and controls (n = 44; 7-19 years). Data were collected at three longitudinal timepoints over a three-year period, and the contributions of age, group, and their interaction to fluency performance were evaluated. Results indicated impairments in executive processes in children with PKU, which were exacerbated by declining metabolic control.
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Affiliation(s)
- Zoë W Hawks
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America
| | - Michael J Strube
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America
| | - Neco X Johnson
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America
| | - Dorothy K Grange
- b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , United States of America
| | - Desirée A White
- a Department of Psychological & Brain Sciences , Washington University , St. Louis , Missouri , United States of America.,b Department of Pediatrics , Washington University School of Medicine , St. Louis , Missouri , United States of America
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Bisiacchi P, Mento G, Tarantino V, Burlina A. Subclinical executive function impairment in children with asymptomatic, treated phenylketonuria: A comparison with children with immunodeficiency virus. Cogn Neuropsychol 2017; 35:200-208. [PMID: 29117799 DOI: 10.1080/02643294.2017.1396207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study we compared the neuropsychological profile of phenylketonuria (PKU) and human immunodeficiency virus (HIV) to examine the specificity of the executive function (EF) impairment reported in these two patologies. A total of 55 age-matched children and adolescents were assessed, including 11 patients with PKU, 16 patients with HIV and 28 healthy controls, underwent a neuropsychological assessment. Although neither the PKU nor the HIV group scored below the normative ranges, both groups showed lower scores in neuropsychological tests engaging EFs than controls. In addition, compared to patients with PKU the HIV group performed significantly worse in the Trail-Making Test A, Corsi Span and Verbal Fluency. These findings suggest that EF impairments in PKU (a) are limited to EFs (i.e., working memory and attentional shifting), (b) are not simply due to generalized processing speed deficits and
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Affiliation(s)
- Patrizia Bisiacchi
- a Department of General Psychology , University of Padua , Padua , Italy
| | - Giovanni Mento
- a Department of General Psychology , University of Padua , Padua , Italy
| | | | - Alberto Burlina
- c Division of Inherited Metabolic Diseases , University Hospital Padua
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Romani C, MacDonald A, De Felice S, Palermo L. Speed of processing and executive functions in adults with phenylketonuria: Quick in finding the word, but not the ladybird. Cogn Neuropsychol 2017. [PMID: 28632427 DOI: 10.1080/02643294.2017.1320278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A reduction in processing speed is widely reported in phenylketonuria (PKU), possibly due to white matter pathology. We investigated possible deficits and their relationships with executive functions in a sample of 37 early-treated adults with PKU (AwPKUs). AwPKUs were not characterized by a generalized speed deficit, but instead their performance could be explained by two more specific impairments: (a) a deficit in the allocation of visuo-spatial attention that reduced speed in visual search tasks, in some reading conditions and visuo-motor coordination tasks; and (b) a more conservative decision mechanism that slowed down returning an answer across domains. These results suggest that the impairments in executive functions seen in AwPKUs are not the consequence of a generalized speed deficit. They also suggest that processing speed is linked to the efficiency of a particular cognitive component and cannot be considered a general function spanning domains. Similarities with patterns in ageing are discussed.
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Affiliation(s)
- Cristina Romani
- a School of Life and Health Sciences , Aston University , Birmingham , UK
| | | | - Sara De Felice
- a School of Life and Health Sciences , Aston University , Birmingham , UK
| | - Liana Palermo
- a School of Life and Health Sciences , Aston University , Birmingham , UK.,c Queen Elizabeth Hospital , Birmingham , UK.,d Department of Medical and Surgical Sciences , Magna Graecia University of Catanzaro , Catanzaro , Italy
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12
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Gonçalves HA, Cargnin C, Jacobsen GM, Kochhann R, Joanette Y, Fonseca RP. Clustering and switching in unconstrained, phonemic and semantic verbal fluency: the role of age and school type. JOURNAL OF COGNITIVE PSYCHOLOGY 2017. [DOI: 10.1080/20445911.2017.1313259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hosana Alves Gonçalves
- Clinical and Experimental Neuropsychology Research Group (GNCE), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Caroline Cargnin
- Clinical and Experimental Neuropsychology Research Group (GNCE), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Geise Machado Jacobsen
- Clinical and Experimental Neuropsychology Research Group (GNCE), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata Kochhann
- Clinical and Experimental Neuropsychology Research Group (GNCE), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Yves Joanette
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Rochele Paz Fonseca
- Clinical and Experimental Neuropsychology Research Group (GNCE), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Hazin I, Leite G, Oliveira RM, Alencar JC, Fichman HC, Marques PDN, de Mello CB. Brazilian Normative Data on Letter and Category Fluency Tasks: Effects of Gender, Age, and Geopolitical Region. Front Psychol 2016; 7:684. [PMID: 27242598 PMCID: PMC4861882 DOI: 10.3389/fpsyg.2016.00684] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 04/23/2016] [Indexed: 11/25/2022] Open
Abstract
Verbal fluency is a basic function of language that refers to the ability to produce fluent speech. Despite being an essentially linguistic function, its measurements are also used to evaluate executive aspects of verbal behavior. Performance in verbal fluency (VF) tasks varies according to age, education, and cognitive development. Neurodevelopmental disorders that affect the functioning of frontal areas tend to cause lower performance in VF tasks. Despite the relative consensus that has been reached in terms of the use of VF tasks for the diagnosis of dyslexia and attention-deficit/hyperactivity disorder, few studies have considered regional variations in Brazil. The present study sought to provide normative data on VF tasks in children by considering gender, age, education, and geopolitical region of origin with auxiliary purposes in neuropsychological diagnosis of disorders that occur with executive changes The study included 298 participants, 7–10 years of age of both genders, who performed three letter fluency tasks and three category fluency tasks. The data were subjected to correlational and variance analyses, with age and gender as factors. No effect of gender on the children's performance was found. However, significant differences between age groups were observed, with better performance in letter tasks in older children and better performance in letter tasks compared with category tasks. Significant regional differences in performance on the letter VF task were observed. These results reinforce the importance of regional normative data in countries with high regional cultural variations, such as Brazil.
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Affiliation(s)
- Izabel Hazin
- Departmento de Psicologia, Universidade Federal do Rio Grande do Norte Natal, Brazil
| | - Gilmara Leite
- Departamento de Psicologia, Universidade Federal de São Paulo São Paulo, Brazil
| | - Rosinda M Oliveira
- Instituto de Psicologia, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - João C Alencar
- Departamento de Biociências da Universidade Federal do Rio Grande do Norte Natal, Brazil
| | - Helenice C Fichman
- Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro Rio de Janeiro, Brazil
| | - Priscila D N Marques
- Instituto de Psicologia, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
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John S, Rajashekhar B, Guddattu V. Word Retrieval Ability on Phonemic Fluency in Typically Developing Children. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 5:252-63. [PMID: 26980155 DOI: 10.1080/21622965.2015.1050099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Verbal fluency tasks are simple behavioral measures useful in assessing word retrieval abilities. Among the verbal fluency tasks, the utility of the Phonemic Fluency Task in children has received less attention. As the task is dependent on phonemic characteristics of each language, there is a great need for understanding its developmental trend. The present study, therefore, aims to delineate the performance on phonemic fluency in typically developing Malayalam-speaking children. Verbal fluency performance on 2 tasks of phonemic fluency was tested using a cross-sectional study design among 1,015 school-going Malayalam-speaking typically developing children aged 5 to 15 years old. Performance with respect to word productivity and clustering-switching measures was analyzed. The effect of age, gender, and tasks on the outcome measures were investigated in the present study. Study findings revealed a positive influence of age with no statistically significant gender effects. Children employed both task-discrepant and task-consistent organizational strategies during tasks of phonemic fluency, dependent purely on the Malayalam language. Future research focusing on developmental trends across different languages is vital for enhancing the task's clinical sensitivity and specificity among childhood disorders.
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Affiliation(s)
- Sunila John
- a Department of Speech & Hearing, School of Allied Health Sciences , Manipal University , Manipal , Karnataka , India
| | - Bellur Rajashekhar
- a Department of Speech & Hearing, School of Allied Health Sciences , Manipal University , Manipal , Karnataka , India
| | - Vasudeva Guddattu
- b Department of Statistics , Manipal University , Manipal , Karnataka , India
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15
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Christ SE, Moffitt AJ, Peck D, White DA. The effects of tetrahydrobiopterin (BH4) treatment on brain function in individuals with phenylketonuria. NEUROIMAGE-CLINICAL 2013; 3:539-47. [PMID: 24371792 PMCID: PMC3871382 DOI: 10.1016/j.nicl.2013.08.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/15/2013] [Accepted: 08/23/2013] [Indexed: 11/11/2022]
Abstract
Phenylketonuria (PKU) is a rare genetic condition characterized by an absence or mutation of the PAH enzyme, which is necessary for the metabolism of the amino acid phenylalanine into tyrosine. Recently, sapropterin dihydrochloride, a synthetic form of tetrahydrobiopterin (BH4), has been introduced as a supplemental treatment to dietary phe control for PKU. Very little is known regarding BH4 treatment and its effect on brain and cognition. The present study represents the first examination of potential changes in neural activation in patients with PKU during BH4 treatment. To this end, we utilized an n-back working memory task in conjunction with functional magnetic resonance imaging (fMRI) to evaluate functional brain integrity in a sample of individuals with PKU at three timepoints: Just prior to BH4 treatment, after 4 weeks of treatment, and after 6 months of treatment. Neural activation patterns observed for the PKU treatment group were compared with those of a demographically-matched sample of healthy non-PKU individuals who were assessed at identical time intervals. Consistent with past research, baseline evaluation revealed impaired working memory and atypical brain activation in the PKU group as compared to the non-PKU group. Most importantly, BH4 treatment was associated with improvements in both working memory and brain activation, with neural changes evident earlier (4-week timepoint) than changes in working memory performance (6-month timepoint). We examine working memory and neural activation in patients with PKU at baseline. We track behavioral and neural changes related to BH4 treatment in the patients. BH4 treatment associated with improvement in neural activity at 4-week timepoint. BH4 treatment associated with improvement in working memory at 6-month timepoint.
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Affiliation(s)
- Shawn E Christ
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Amanda J Moffitt
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Dawn Peck
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, United States
| | - Desirée A White
- Department of Psychology, Washington University, St. Louis, MO, United States
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Antenor-Dorsey JAV, Hershey T, Rutlin J, Shimony JS, McKinstry RC, Grange DK, Christ SE, White DA. White matter integrity and executive abilities in individuals with phenylketonuria. Mol Genet Metab 2013; 109:125-31. [PMID: 23608077 PMCID: PMC3678378 DOI: 10.1016/j.ymgme.2013.03.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 03/31/2013] [Accepted: 03/31/2013] [Indexed: 01/16/2023]
Abstract
Previous studies have revealed white matter abnormalities in the brains of individuals with phenylketonuria (PKU), but the microstructural nature of these abnormalities and their relationship to phenylalanine (Phe) levels and cognitive outcomes are poorly understood. In the current study, the microstructural integrity of white matter in 29 individuals with early-treated PKU and 12 healthy controls was examined using two complementary diffusion tensor imaging (DTI) approaches: region-of-interest (ROI) based analysis and voxel-wise tract based spatial statistics (TBSS) analysis. Relationships among DTI, executive abilities, and Phe level findings were explored. DTI revealed widespread lowering of mean diffusivity (MD) in the white matter of the PKU group in comparison with the control group. Executive abilities were also poorer for individuals with PKU than controls. Within the PKU group, lower MD was associated with higher Phe level and poorer executive abilities. These findings are the first to demonstrate the interplay among microstructural white matter integrity, executive abilities, and Phe control in individuals with PKU.
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Affiliation(s)
- Jo Ann V. Antenor-Dorsey
- Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Tamara Hershey
- Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, St. Louis, MO, USA, 63110
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University School of Medicine, St. Louis, MO, USA, 63110
- Department of Neurology, Campus Box 8111, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Jerrel Rutlin
- Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University School of Medicine, St. Louis, MO, USA, 63110
- Department of Pediatrics, Campus Box 8116, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Dorothy K. Grange
- Department of Pediatrics, Campus Box 8116, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Shawn E. Christ
- Department of Psychological Sciences, 210 McAlester Hall, University of Missouri, Columbia, MO, USA, 65211
| | - Desirée A. White
- Department of Psychology, Campus Box 1125, Washington University, St. Louis, MO, USA, 63130
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Araujo GC, Christ SE, Grange DK, Steiner RD, Coleman C, Timmerman E, White DA. Executive Response Monitoring and Inhibitory Control in Children With Phenylketonuria: Effects of Expectancy. Dev Neuropsychol 2013; 38:139-52. [DOI: 10.1080/87565641.2012.718816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Janos AL, Grange DK, Steiner RD, White DA. Processing speed and executive abilities in children with phenylketonuria. Neuropsychology 2012; 26:735-43. [PMID: 22866986 PMCID: PMC3526340 DOI: 10.1037/a0029419] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Phenylketonuria (PKU) is a hereditary metabolic disorder that often results in neuropsychological impairment, even in individuals treated early and continuously. This study was conducted to examine processing speed, variability in processing speed, and the relationship between processing speed variables and executive abilities in children with early and continuously treated PKU. METHOD Participants were 42 children with PKU and 81 typically developing children from 7 to 18 years of age. Children completed 3 computerized reaction time (RT) tasks (simple RT, go/no-go, stimulus-response compatibility) and 7 tasks assessing executive abilities (working memory, inhibitory control, strategic processing). RESULTS Performance of children with PKU was significantly slower and more variable than that of controls across the 3 tasks administered. When age was considered, it was shown that processing speed improved with age to a comparable degree for both groups. Variability in processing speed, however, decreased more with age for the PKU than control group, reflecting the fact that variability in younger, but not older, children with PKU was greater than that of controls. With regard to executive abilities, processing speed and variability contributed to performance on most, but not all, executive tasks; and after controlling for processing speed and variability, executive impairments were still identified in working memory and inhibitory control (not strategic processing). CONCLUSIONS These findings indicate that information processing is slower and less efficient in children with PKU. In addition, processing speed and variability contribute to some, but not all, of the impairments in executive abilities observed in children with PKU.
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Affiliation(s)
- Alicia L. Janos
- Department of Psychology, Washington University in St. Louis
| | - Dorothy K. Grange
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis Children’s Hospital
| | - Robert D. Steiner
- Departments of Pediatrics and Molecular & Medical Genetics, Child Development and Rehabilitation Center/Doernbecher Children’s Hospital, Oregon Health & Science University
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Hurks PPM. Does Instruction in Semantic Clustering and Switching Enhance Verbal Fluency in Children? Clin Neuropsychol 2012; 26:1019-37. [DOI: 10.1080/13854046.2012.708361] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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