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Till B, Arendt F, Rothauer P, Niederkrotenthaler T. The Role of the Narrative in Educative Suicide Awareness Materials: A Randomized Controlled Trial. HEALTH COMMUNICATION 2024; 39:403-416. [PMID: 36659822 DOI: 10.1080/10410236.2023.2167580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
There has been a debate about the suitability of different narratives in educative suicide prevention materials. Whereas some suicide prevention experts recommend raising awareness of suicide by highlighting its prevalence, others argue that this approach may normalize suicide and advocate focusing on help resources instead. Unfortunately, empirical evidence regarding this question is lacking. This randomized controlled trial aimed to test the impact of educative news articles that conveyed different narratives of suicide prevention. One article focused on the prevalence of suicide, one article highlighted professional help resources, and one article emphasized on how everyone can help to prevent suicide. We randomized n = 334 participants to read either one of these three articles or an article unrelated to suicide. Data on suicidal ideation, stigmatizing attitudes toward suicidal individuals, attitudes toward suicide prevention, and help-seeking intentions were collected with questionnaires, and implicit measures were used to assess participants' mental accessibility of concepts related to suicide and suicide prevention. Participants exposed to the article highlighting the high prevalence of suicide tended to show a higher accessibility of potentially detrimental cognitive concepts related to suicide. In contrast, the accessibility of the concept of "helping" and that "suicide is preventable" was higher in participants' memory when exposed to materials focusing on help. It seems that the impact of educative suicide awareness materials on readers' access to suicide- and suicide-prevention-related concepts in memory varied depending on the narrative featured in the article.
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Affiliation(s)
- Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna
- Wiener Werkstaette for Suicide Research
| | - Florian Arendt
- Wiener Werkstaette for Suicide Research
- Department of Communication, University of Vienna
| | - Pascal Rothauer
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna
- Wiener Werkstaette for Suicide Research
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Parrott S, Park H. Suicide in Song: A Thematic Analysis of 674 Songs Referencing Suicide. HEALTH COMMUNICATION 2024:1-9. [PMID: 38450700 DOI: 10.1080/10410236.2024.2326698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Music is a ubiquitous form of entertainment, engaging millions and providing emotional release for both musicians and listeners. Songs referencing suicide - a generally taboo subject - are common in U.S. culture, appearing in every genre of music from country to hip hop, punk rock to blues. Suicide songs prompt concern among the lay public (e.g., lawmakers, parents) and also researchers, whose work has documented statistically significant relationships between musical preference and suicidality. Still, suicide songs could also carry positive effects for listeners through behavioral modeling by illustrating alternatives to suicide. The outcomes are likely dependent, in part, on lyrical content. To understand lyrical content about suicide, the present study used thematic analysis to identify common threads in modern English-language songs referencing suicide. The lyrics of 674 songs were examined. The analysis identified 5 themes in which musicians illustrated: (1) support and empathy for people struggling with suicide, (2) personal experience with suicidal thoughts, (3) endorsement of suicide, (4) suicide as rebellion or revenge, and (5) self-medication. The study provides the foundation for future research on the relationship between song exposure and listener beliefs, attitudes, and behavior related to suicide.
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Affiliation(s)
- Scott Parrott
- Department of Journalism & Creative Media, The University of Alabama
| | - Haseon Park
- Hubbard School of Journalism & Mass Communication, The University of Minnesota
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Till B, Arendt F, Kirchner S, Naderer B, Niederkrotenthaler T. The role of monocausal versus multicausal explanations of suicide in suicide reporting: A randomized controlled trial. Suicide Life Threat Behav 2023; 53:1063-1075. [PMID: 37823595 DOI: 10.1111/sltb.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Media guidelines for reporting on suicide recommend that journalists should avoid monocausal explanations of suicide, but it is unclear if media items with monocausal explanations elicit different effects as compared to multicausal portrayals. METHOD Using a web-based randomized controlled trial (n = 969), we tested five versions of a news article about the suicide of a teenage girl with varying portrayals of reasons for the suicide: (1) bullying as the sole (external) factor (i.e., monocausal), (2) several external social factors, (3) a combination of internal and external factors, (4) a combination of internal and external factors along with a focus on suicide prevention, or (5) no reason for the suicide (control group). We measured perceptions about the cause of suicide, attitudes toward suicide and suicide prevention, and identification with the suicidal protagonist with questionnaires. RESULTS Readers of articles that portrayed suicide as being caused by one specific reason or exclusively social factors tended to adopt these misconceptions. Identification with the suicidal protagonist did not vary between interventions groups, but was lower in the control group. CONCLUSION Highlighting the multifactorial etiology of suicide in news articles may help to avoid the misconception that suicide is a monocausal issue.
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Affiliation(s)
- Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Florian Arendt
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Communication, University of Vienna, Vienna, Austria
| | - Stefanie Kirchner
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Brigitte Naderer
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
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Levi-Belz Y, Starostintzki Malonek R, Hamdan S. Trends in Newspaper Coverage of Suicide in Israel: An 8-Year Longitudinal Study. Arch Suicide Res 2023; 27:1191-1206. [PMID: 36036903 DOI: 10.1080/13811118.2022.2111534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND The nature of newspaper coverage of suicide events can impact suicide risk. Thus, the World Health Organization published recommendations for reporting suicide in the media. To date, Israel has no data regarding adherence to these media guidelines and no indication of the influence of the Israeli National Suicide Prevention Program (NSPP) on adherence. Aiming to fill these gaps, the current study examined (1) Israeli newspapers' adherence to the guidelines for suicide coverage and (2) the impact of the NSPP on the adherence level of media reporting. METHOD Adherence to newspapers coverage guidelines was examined in two leading Israeli newspapers at three time points: T1 (2012, two years before the NSPP's establishment), T2 (2016-2017, 2-3 years after its establishment), and T3 (2018-2019, 4-5 years after NSPP's establishment). All articles reporting on suicide or suicidal behavior were analyzed at each time point regarding their adherence to the media guidelines. RESULTS Two hundred articles were assessed and analyzed. The adherence level was 49.35% across all time points. We found improved adherence at T2 (after the initiation of the NSPP) in most of the guidelines but a slight decline at T3. Adherence to guidelines regarding prevention (Do guidelines) showed no significant improvement over time. CONCLUSIONS General adherence to guidelines was relatively low. However, steps can be taken to improve media coverage of suicide stories. The NSPP should make greater efforts to promote changes in media coverage of suicide events in Israel, such as providing information about risk factors, prevention, and intervention. HIGHLIGHTSA longitudinal study examined Israeli newspapers over three time points in the last decade.General adherence level to the suicide coverage guidelines was 49.35% across all time points.The National Suicide Prevention Program was linked to improvement in adherence to most guidelines.
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Lindsay BL, Szeto ACH. The Influence of Media on the Stigma of Suicide when a Postsecondary Student Dies by Suicide. Arch Suicide Res 2023; 27:1278-1295. [PMID: 36106828 DOI: 10.1080/13811118.2022.2121672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This study investigated whether media articles from a postsecondary institution could influence students' stigma toward suicide after a student dies by suicide. Undergraduate participants (N = 425) read a fictitious scenario about a student suicide and were randomly assigned to a control article (no mention of the suicide) or one of three intervention articles that acknowledged the suicide and included a discussion with a psychologist, a friend of the decedent, or a suicide survivor. The stigma toward suicide survivors, particularly stereotypes, was significantly less after the three intervention articles compared to the control. No differences were found between the intervention articles or regarding the stigma toward suicide decedents. Reduced stigma toward survivors indicates that acknowledging a suicide, when possible, should be considered.
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Niederkrotenthaler T, Tran US, Baginski H, Sinyor M, Strauss MJ, Sumner SA, Voracek M, Till B, Murphy S, Gonzalez F, Gould M, Garcia D, Draper J, Metzler H. Association of 7 million+ tweets featuring suicide-related content with daily calls to the Suicide Prevention Lifeline and with suicides, United States, 2016-2018. Aust N Z J Psychiatry 2023; 57:994-1003. [PMID: 36239594 PMCID: PMC10947496 DOI: 10.1177/00048674221126649] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = -0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = -0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10-5, standard error = 2.6 × 10-5, p = 0.015). CONCLUSION This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION As Predicted, #66922, 26 May 2021.
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Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Ulrich S Tran
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna, Vienna, Austria
| | - Hubert Baginski
- Complexity Science Hub Vienna, Vienna, Austria
- Institute of Information Systems Engineering, Vienna University of Technology, Vienna, Austria
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Markus J Strauss
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Steven A Sumner
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control, Atlanta, GA, USA
| | - Martin Voracek
- Wiener Werkstaette for Suicide Research, Vienna, Austria
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna, Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Sean Murphy
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Frances Gonzalez
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Madelyn Gould
- Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | - David Garcia
- Complexity Science Hub Vienna, Vienna, Austria
- Institute of Interactive Systems and Data Science, Faculty of Computer Science and Biomedical Engineering, Graz University of Technology, Graz, Austria
| | - John Draper
- Vibrant Emotional Health, National Suicide Prevention Lifeline, New York, NY, USA
| | - Hannah Metzler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
- Institute of Interactive Systems and Data Science, Faculty of Computer Science and Biomedical Engineering, Graz University of Technology, Graz, Austria
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Metzler H, Baginski H, Niederkrotenthaler T, Garcia D. Detecting Potentially Harmful and Protective Suicide-Related Content on Twitter: Machine Learning Approach. J Med Internet Res 2022; 24:e34705. [PMID: 35976193 PMCID: PMC9434391 DOI: 10.2196/34705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 06/02/2022] [Accepted: 06/08/2022] [Indexed: 01/11/2023] Open
Abstract
Background Research has repeatedly shown that exposure to suicide-related news media content is associated with suicide rates, with some content characteristics likely having harmful and others potentially protective effects. Although good evidence exists for a few selected characteristics, systematic and large-scale investigations are lacking. Moreover, the growing importance of social media, particularly among young adults, calls for studies on the effects of the content posted on these platforms. Objective This study applies natural language processing and machine learning methods to classify large quantities of social media data according to characteristics identified as potentially harmful or beneficial in media effects research on suicide and prevention. Methods We manually labeled 3202 English tweets using a novel annotation scheme that classifies suicide-related tweets into 12 categories. Based on these categories, we trained a benchmark of machine learning models for a multiclass and a binary classification task. As models, we included a majority classifier, an approach based on word frequency (term frequency-inverse document frequency with a linear support vector machine) and 2 state-of-the-art deep learning models (Bidirectional Encoder Representations from Transformers [BERT] and XLNet). The first task classified posts into 6 main content categories, which are particularly relevant for suicide prevention based on previous evidence. These included personal stories of either suicidal ideation and attempts or coping and recovery, calls for action intending to spread either problem awareness or prevention-related information, reporting of suicide cases, and other tweets irrelevant to these 5 categories. The second classification task was binary and separated posts in the 11 categories referring to actual suicide from posts in the off-topic category, which use suicide-related terms in another meaning or context. Results In both tasks, the performance of the 2 deep learning models was very similar and better than that of the majority or the word frequency classifier. BERT and XLNet reached accuracy scores above 73% on average across the 6 main categories in the test set and F1-scores between 0.69 and 0.85 for all but the suicidal ideation and attempts category (F1=0.55). In the binary classification task, they correctly labeled around 88% of the tweets as about suicide versus off-topic, with BERT achieving F1-scores of 0.93 and 0.74, respectively. These classification performances were similar to human performance in most cases and were comparable with state-of-the-art models on similar tasks. Conclusions The achieved performance scores highlight machine learning as a useful tool for media effects research on suicide. The clear advantage of BERT and XLNet suggests that there is crucial information about meaning in the context of words beyond mere word frequencies in tweets about suicide. By making data labeling more efficient, this work has enabled large-scale investigations on harmful and protective associations of social media content with suicide rates and help-seeking behavior.
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Affiliation(s)
- Hannah Metzler
- Section for the Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Unit Suicide Research and Mental Health Promotion, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Complexity Science Hub Vienna, Vienna, Austria.,Computational Social Science Lab, Institute of Interactive Systems and Data Science, Graz University of Technology, Graz, Austria.,Institute for Globally Distributed Open Research and Education, Vienna, Austria
| | - Hubert Baginski
- Complexity Science Hub Vienna, Vienna, Austria.,Institute of Information Systems Engineering, Vienna University of Technology, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - David Garcia
- Section for the Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Complexity Science Hub Vienna, Vienna, Austria.,Computational Social Science Lab, Institute of Interactive Systems and Data Science, Graz University of Technology, Graz, Austria
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Kirchner S, Till B, Plöderl M, Niederkrotenthaler T. Effects of "It Gets Better" Suicide Prevention Videos on Youth Identifying as Lesbian, Gay, Bisexual, Transgender, Queer, or Other Sexual or Gender Minorities: A Randomized Controlled Trial. LGBT Health 2022; 9:436-446. [PMID: 35575732 PMCID: PMC9499448 DOI: 10.1089/lgbt.2021.0383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: The “It Gets Better” project (IGBP) features video narratives of lesbian, gay, bisexual, transgender, queer persons or persons with other sexual or gender minority identities (LGBTQ+) of overcoming coming-out-related difficulties. This is the first experimental study investigating effects of these videos. Methods: We conducted a double-blind randomized controlled trial on-site in Austria and online in German-language settings from January to November 2020 with LGBTQ+ youth (14–22 years; n = 483), randomized to an IGBP (n = 242) or control video (n = 241). Suicidal ideation (primary outcome), help-seeking intentions, hopelessness, mood, and sexual identity were assessed at baseline (T1), postexposure (T2), and 4-week follow-up (T3). We assessed differences among gender identities, sexual orientations, with regard to depressive symptoms, and the role of identification. Data were analyzed with linear mixed models and mediation analysis. Results: There was no overall effect on suicidal ideation, but nonbinary/transgender individuals experienced a small-sized improvement (T2: mean change [MC] from baseline MC = −0.06 [95% confidence interval {CI} −0.16 to 0.05], p = 0.60; mean difference [MD] to controls MD = −0.42 [95% CI −0.79 to −0.06], p = 0.02, d = −0.10). An indirect preventive effect on suicidal ideation at T2 through the degree of identification with the protagonist in the video was observed. There was improvement in help-seeking intentions in the intervention group (T2: MC = 0.25 [95% CI 0.15 to 0.35], p < 0.001; MD = 0.28 [95% CI 0.01 to 0.54], p < 0.05, d = 0.09). Conclusion: Video narratives featuring coping might have some potential to decrease suicidal ideation and encourage help-seeking among vulnerable youth identifying with videos, but effects are small and short-lived. Study Registration: German Clinical Trial Registry (DRKS00019913).
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Affiliation(s)
- Stefanie Kirchner
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Martin Plöderl
- Department for Crisis Intervention and Suicide Prevention, University Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department for Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Niederkrotenthaler T, Till B, Kirchner S, Sinyor M, Braun M, Pirkis J, Tran US, Voracek M, Arendt F, Ftanou M, Kovacs R, King K, Schlichthorst M, Stack S, Spittal MJ. Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis. THE LANCET PUBLIC HEALTH 2022; 7:e156-e168. [DOI: 10.1016/s2468-2667(21)00274-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022] Open
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