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Puthiyapurayil J, Anupam Kumar TV, Syriac G, R M, Kt R, Najmunnisa. Parental perception of oral health related quality of life and barriers to access dental care among children with intellectual needs in Kottayam, central Kerala-A cross sectional study. SPECIAL CARE IN DENTISTRY 2021; 42:177-186. [PMID: 34614254 DOI: 10.1111/scd.12658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the parental perception of oral health related quality of life and barriers to access dental care among children with intellectual needs. METHOD This cross sectional study was conducted among randomly selected 300 parents of children aged 4-12 years with intellectual needs (mental retardation, cerebral palsy, epilepsy, autism). Data on oral health related quality of life (OHRQoL) were collected with parental-caregivers perceptions questionnaire (P-CPQ). DMFT/dmft index was used to express caries prevalence as per World Health Organisation. Chi-squared test, analysis of variance, t-test and correlation were performed. RESULTS Parents of children who fell in the high severity DMFT category reported higher score in all four domains of OHRQoL when compared to low severity and moderate severity. Parents of children suffering from autism had higher score in all four domain of OHRQoL (p = .000).Majority of the parents rated their children's oral health as either fair (47%) or poor (42%). Predominant barriers for access dental care were financial difficulties (35.3%), lack of knowledge about dental care (24%), transportation difficulties (15%). CONCLUSION The present study revealed that higher caries prevalence has negative impact on OHRQoL of children with intellectual needs and their parents faced certain barriers for accessing dental care.
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Affiliation(s)
- Jeeva Puthiyapurayil
- Department of Pediatric and Preventive Dentistry, Government Dental College, Kottayam, India
| | - T V Anupam Kumar
- Department of Pediatric and Preventive Dentistry, Government Dental College, Kottayam, India
| | - Gibi Syriac
- Department of Pediatric and Preventive Dentistry, Government Dental College, Kottayam, India
| | - Maneesha R
- Department of Pediatric and Preventive Dentistry, Government Dental College, Kottayam, India
| | - Raseena Kt
- Department of Pediatric and Preventive Dentistry, Government Dental College, Kottayam, India
| | - Najmunnisa
- Department of Community Dentistry, Government Dental College, Kottayam, India
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Castelo Branco CMC, Cabral GMP, Castro AMGS, Ferreira ACFM, Bonacina CF, Lussi A, Santos MTBR, Diniz MB. Caries prevalence using ICDAS visual criteria and risk assessment in children and adolescents with cerebral palsy: A comparative study. SPECIAL CARE IN DENTISTRY 2021; 41:688-699. [PMID: 34171134 DOI: 10.1111/scd.12621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS To compare the dental caries prevalence using the International Caries Detection and Assessment System (ICDAS) and the caries risk by Caries Management by Risk Assessment (CAMBRA) in individuals with cerebral palsy (CP) and normoactives (NAs). METHODS AND RESULTS Sixty children and adolescents aged 6-12 years (30 CP/30 NA) were clinically evaluated by one calibrated examiner using two-digit ICDAS criteria and converted into components of dmf/DMF indices: d2mf2/D2MF2 (enamel and dentin lesions) and d3mf3/D3MF3 (dentin lesions). An adapted CAMBRA was used for risk classification. The mean d2mf2s/d2mf2t and D2MF2S/D2MF2T for CP were 17.0 ± 16.8/7.5 ± 4.3 and 10.7 ± 17.6/5.3 ± 5.8, respectively, and for NA were 17.2 ± 16.9 /6.9 ± 4.8 and 11.1 ± 11.7/5.5 ± 4.7, respectively. The mean d3mf3s/d3mf3t and D3MF3S/D3MF3T for CP were 10.1 ± 16.7/3.0 ± 4.1 and 4.9 ± 15.6/0.2 ± 0.4, respectively, while for NA the mean values were 9.8 ± 13.0/3.5 ± 3.8 and 2.1 ± 5.7/0.9 ± 2.0, respectively. There were no statistically differences for caries prevalence and risk in both groups (p > 0.05). CONCLUSIONS Dental caries was highly prevalent in CP and NA children and adolescents. Enamel and dentin lesions and high caries risk were the most common condition.
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Affiliation(s)
| | | | | | | | | | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany.,School of Dental Medicine, University of Bern, Switzerland
| | | | - Michele Baffi Diniz
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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Malta CP, Barcelos RCS, Rosa HZ, Bürger ME, Bento LW. Effect of cerebral palsy and dental caries on dental plaque index, salivary parameters and oxidative stress in children and adolescents. Eur Arch Paediatr Dent 2021; 22:21-28. [PMID: 32008171 DOI: 10.1007/s40368-020-00509-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/14/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE The aim of the present study was to investigate the effect of cerebral palsy and dental caries on dental plaque index, salivary parameters and oxidative stress in children and adolescents. METHODS Seventy children and adolescents aged 2-20 years were divided into four groups: neurotypical controls-inactive caries (NCIC; n = 19); neurotypical controls-active caries (NCAC; n = 16); cerebral palsy-inactive caries (CPIC; n = 19); and cerebral palsy-active caries (CPAC; n = 16). The visible dental plaque index was determined after drying the tooth surfaces and without any mechanical or chemical disclosing methods. Salivary pH and buffer capacity were measured 1 hour after collection using a digital pH meter. Saliva was used to evaluate oxidative status based on the levels of reactive species, lipid peroxidation and non-enzymatic antioxidants (reduced glutathione and vitamin C). RESULTS The CPIC and CPAC groups had lower salivary pH and a higher visible dental plaque index. CP was also associated with an increase in salivary levels of markers of oxidative stress and the modulation of salivary levels of non-enzymatic antioxidants. CONCLUSION Cerebral palsy exerts an influence on the salivary profile, oral health and oxidative stress. The individuals with CP had more acidic saliva and a higher dental plaque index, which were positively correlated with caries activity. CP was associated with high salivary levels of reactive species and lipid peroxidation, demonstrating an imbalance in salivary redox that was particularly associated with caries activity. These factors facilitate the development of oral diseases in individuals with cerebral palsy.
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Affiliation(s)
- C P Malta
- Graduate Program in Health and Life Sciences, Universidade Franciscana (UFN), 1175 Silva Jardim St, Santa Maria, RS, 97010-491, Brazil
| | - R C S Barcelos
- Graduate Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
| | - H Z Rosa
- Graduate Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
| | - M E Bürger
- Graduate Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
- Graduate Program in Toxicological Biochemistry, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
| | - L W Bento
- Graduate Program in Health and Life Sciences, Universidade Franciscana (UFN), 1175 Silva Jardim St, Santa Maria, RS, 97010-491, Brazil.
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Magata N, Tanoue N, Ayuse T, Ayuse T. A prospective clinical evaluation of fixed dental prostheses made of metal alloys in patients with cerebral palsy. Clin Exp Dent Res 2020; 7:561-567. [PMID: 33314696 PMCID: PMC8404493 DOI: 10.1002/cre2.378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background In general, the prevalence of caries and other oral and dental issues is increased in patients with disabilities, such as those with cerebral palsy. Providing appropriate dental treatment at a primary dental clinic for patients with cerebral palsy and intellectual disability, among other conditions, is challenging. Objective The objective of this study was to evaluate the longevity and investigate the related prognostic factors of fixed prostheses in patients with cerebral palsy. Methods The records of 36 cerebral palsy patients were used for collecting and analyzing data. A total of 155 prostheses made from metal alloys were finally included in this study. Annual failure rates were calculated; patient‐ and tooth‐related variables associated with prosthesis failure were assessed by a multivariate Cox‐regression analysis and frailty models to introduce random effects. Results The 10‐year prosthesis survival rate was 62% and the 20‐year survival rate was 36%. In terms of prosthesis‐related variables, the type of prosthesis had a significant effect, and the hazard ratio of fixed partial dentures was 2.32 times that of single‐unit crowns. In terms of patient‐related variables, the presence of epilepsy had a significant effect on survival, and the hazard ratio for comorbid epilepsy was 3.76 times that for those without comorbid epilepsy. Conclusions Our findings suggested that fixed prostheses placed in patients with cerebral palsy might have a particularly low survival rate in cases with comorbid epilepsy. It might also be important to consider the type and/or design of the prosthesis carefully to ensure a better prognosis.
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Affiliation(s)
- Nobuaki Magata
- Division of Clinical Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naomi Tanoue
- Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan
| | - Terumi Ayuse
- Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan
| | - Takao Ayuse
- Division of Clinical Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Ruiz LA, Diniz MB, Loyola-Rodriguez JP, Habibe CH, Garrubbo CC, Santos MTBR. A controlled study comparing salivary osmolality, caries experience and caries risk in patients with cerebral palsy. Med Oral Patol Oral Cir Bucal 2018; 23:e211-e215. [PMID: 29476677 PMCID: PMC5911353 DOI: 10.4317/medoral.22135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/12/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is a permanent neurological disorder accompanied by secondary musculoskeletal masticatory disorder, with repercussion on chewing and deglutition functions. In these conditions, the liquids ingestion is compromised resulting in salivary osmolality alteration. The objective of this study was to compare salivary osmolality, caries experience and caries risk between normoreactive individuals and patients with CP. MATERIAL AND METHODS The participants were 4-20 years old: 52 patients with CP treated at a reference rehabilitation centre (study group, SG), and 52 normoreactive individuals (control group, CG). Saliva was collected for five minutes using cotton rolls. Following centrifugation, salivary osmolality was determined by freezing point depression osmometry. Evaluations included caries experience (DMFT index), and caries risk based on a caries-risk assessment tool (CAT). Descriptive and inferential statistics (Chi square and Student t tests) were used to compare the groups. Receiver operating characteristic (ROC) analyses were performed and the area under the ROC curve (Az) was calculated. The level of significance was set at 5%. RESULTS The groups were homogeneous for sex (p=0.843) and age (p=0.128). In the SG, spastic type CP was the most prevalent (80.8%), and patients showed significantly higher salivary osmolality values compared with the CG (p<0.001). No significant differences in caries experience (p=0.159) or caries risk (p=0.297) were observed. ROC curve analysis determined a salivary osmolality cutoff point of >74 for the SG and >54 for the CG in the presence of dental caries. A significant correlation was verified between salivary osmolality and the DMFT index for the SG (p≤0.05). CONCLUSIONS Although patients with CP showed higher salivary osmolality values, higher caries experience and caries risk were not observed compared with normoreactive individuals.
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Affiliation(s)
- L-A Ruiz
- Universidade Cruzeiro do Sul, School of Dentistry, Department of Patients with Special Needs, Rua Constantino de Sousa, 454, apto 141, ZIPCODE: 04605-001 São Paulo, SP, Brazil,
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DOMINGUES NB, AYRES KCM, MARIUSSO MR, ZUANON ÂCC, GIRO EMA. Caracterização dos pacientes e procedimentos executados no serviço de atendimento a pacientes com necessidades especiais da Faculdade de Odontologia de Araraquara – UNESP. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ResumoObjetivoCaracterizar os pacientes atendidos e os procedimentos realizados no Serviço de Atendimento a Pacientes com Necessidades Especiais da Faculdade de Odontologia de Araraquara (FOAr) – UNESP.MetodologiaA partir dos prontuários odontológicos dos pacientes atendidos em nível ambulatorial entre 2007 e 2013, foram obtidas informações em relação a idade no início do tratamento, tipo de deficiência, medicamentos usados, número de sessões de atendimento e número e tipo de procedimentos odontológicos realizados.ResultadoDos 232 prontuários analisados, observou-se que mais da metade dos pacientes (56,0%) apresentava deficiência mental, paralisia cerebral ou anomalias congênitas determinadas por agentes infecciosos, com deficiência mental associada. Entre as anomalias congênitas, a mais prevalente foi a Síndrome de Down (9,9%). Apenas 20% dos pacientes iniciaram o tratamento antes dos dez anos de idade e 62,0% faziam uso de anticonvulsivantes, antipsicóticos, ansiolíticos, antiepilépticos e antidepressivos. Foram realizados 4.506 procedimentos odontológicos, sendo 37,6% preventivos e 62,4% curativos (Restauradores, 28,0%; Periodontais, 13,9%; Endodônticos, 9,7%; Cirúrgicos, 9,1%; Protéticos, 1,7%). Observou-se também que, para a maior parte dos pacientes (63%), foram necessárias até dez sessões para a realização do tratamento.ConclusãoOs pacientes que procuraram tratamento odontológico no Serviço de Atendimento a Pacientes com Necessidades Especiais da FOAr apresentavam, na sua maioria, deficiências com envolvimento neurológico. Apesar de esse serviço priorizar os procedimentos preventivos, a maior parte dos procedimentos executados foi curativa, o que está diretamente relacionado com a procura tardia pelo tratamento odontológico.
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Sinha N, Singh B, Chhabra KG, Patil S. Comparison of oral health status between children with cerebral palsy and normal children in India: A case-control study. J Indian Soc Periodontol 2015; 19:78-82. [PMID: 25810598 PMCID: PMC4365163 DOI: 10.4103/0972-124x.145800] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 06/30/2014] [Indexed: 11/19/2022] Open
Abstract
Background: The aim of the present research was to describe and compare the oral health of children with cerebral palsy (CP) with the normal children in India. Materials and Methods: Fifty children with CP of the age range 7-17 years and fifty normal children were selected for the study. An oral examination was carried out and decayed, missing, and filled teeth (dmft/DMFT) index, oral hygiene index-simplified (OHI-S) index, Angles malocclusion were charted along with other significant dental findings. Data were analyzed using Student's t-test and Kruskal–Wallis one-way ANOVA test. Results: The mean dmft/DMFT of the CP group was 4.11 ± 2.62, while that of controls was 2.95 ± 2.75, which showed higher caries prevalence in the CP group. There was a significant association between the dmft/DMFT (P = 0.03), OHI-S (P = 0.001), and Angles Class 2 malocclusion and CP. Conclusions: Cerebral palsy group had higher caries, poor oral hygiene and Class 2 malocclusion when compared to controls primarily because of their compromised general health condition and also less dental awareness. Effort should be made for better organization of preventive dental care and promoting dental health of this challenged population.
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Affiliation(s)
- Nidhi Sinha
- Department of Conservative Dentistry and Endodontics, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India
| | - Bijay Singh
- Department of Prosthdontics, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India
| | - Kumar Gaurav Chhabra
- Department of Public Health Dentistry, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India
| | - Santosh Patil
- Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital, Jodhpur, Rajasthan, India
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Campos PHD, Andrade RSL, Rojas PL, Ferreira MCD, Santos MTBR, Guaré RDO, Diniz MB. Avaliação da microdureza do esmalte de dentes decíduos de crianças com paralisia cerebral. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: Em indivíduos com paralisia cerebral, ocorre redução do fluxo salivar, o que pode predispor à hipomineralização do esmalte e à cárie dentária. OBJETIVO: Comparar a microdureza do esmalte de dentes decíduos anteriores e posteriores de crianças com paralisia cerebral (PC) e crianças normorreativas (NR). MATERIAL E MÉTODO: Foram utilizados 58 dentes decíduos esfoliados/extraídos, que foram distribuídos em quatro grupos: (A) anteriores de PC (n=14); (B) anteriores de NR (n=16); (C) posteriores de PC (n=14), e (D) posteriores de NR (n=14). Os dentes foram seccionados, incluídos em resina acrílica, lixados e polidos. A análise da microdureza longitudinal foi realizada em microdurômetro com endentador do tipo Knoop, com carga estática de 25 g/f e tempo de 5 segundos. Foram realizadas três fileiras de 12 endentações, distanciadas entre si em 100 mm, com profundidade entre 10 e 180 mm. Foram obtidas as médias de cada profundidade para cada dente e, posteriormente, as médias de cada profundidade para cada grupo avaliado. O teste estatístico empregado foi o de Mann-Whitney (α=5%). RESULTADO: As médias de microdureza foram 253,5 ± 55,3 (A), 247,6 ± 45,7 (B), 284,4 ± 68,7 (C) e 252,2 ± 53,8 (D). Não houve diferença estatisticamente significante entre os grupos A e B e os grupos C e D, para cada profundidade e para a média global (p>0,05). CONCLUSÃO: Pôde-se concluir que a microdureza de esmalte de dentes decíduos anteriores e posteriores de crianças com PC foi semelhante à microdureza de esmalte de dentes decíduos de crianças normorreativas.
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Santos MTBR, Ferreira MCD, Leite MF, Guaré RO. Salivary parameters in Brazilian individuals with cerebral palsy who drool. Child Care Health Dev 2011; 37:404-9. [PMID: 21083696 DOI: 10.1111/j.1365-2214.2010.01176.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although drooling of saliva is considered abnormal in a child over 4 years of age, it has been estimated to occur in approximately in 10-37% of children with cerebral palsy. AIM The aim of this study was to evaluate the flow rate, pH and buffering capacity in saliva of Brazilian individuals with cerebral palsy who drool. METHODS Cross-sectional assessment of saliva from 139 individuals with cerebral palsy (3-16 years old) enrolled in a specialized rehabilitation centre in Sao Paulo, Brazil, divided into two groups, according to the presence (G1) or absence (G2) of drooling and controls (G3): G1 consisted of 63 individuals who drool; G2 consisted of 76 who do not drool; and G3 consisted of 47 individuals with no neurological damage of similar age and sex. Unstimulated whole saliva was collected and salivary flow rate (mL/min), initial pH and buffering capacity, by titration of saliva with a constant amount of 0.01 N HCl, were evaluated. The results from G1, G2 and G3 were compared by one-way anova and the χ(2) -test. RESULTS A higher percentage of severe drooling (60.3%) was observed compared with moderate (27.0%) and mild (12.7%) in the cerebral palsy individuals who drool and the prevalence of drooling was highest among children and adolescents with spastic quadriplegia. Significant reductions in salivary flow rate, initial pH, buffering capacity of whole saliva in pH range 6.0-6.9 and total buffering capacity occurred in G1 and G2 compared with G3. CONCLUSION All individuals with cerebral palsy present lower flow rate, pH and buffering capacity of saliva, which increases the risk of oral diseases.
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Affiliation(s)
- M T B R Santos
- Discipline of Dentistry, Persons with Disabilities Division, Universidade Cruzeiro do Sul, São Paulo, Brazil.
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Santos MTB, Batista R, Guaré RO, Leite MF, Ferreira MCD, Durão MS, Nascimento OA, Jardim JR. Salivary osmolality and hydration status in children with cerebral palsy. J Oral Pathol Med 2011; 40:582-6. [DOI: 10.1111/j.1600-0714.2011.01027.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ferreira MC, Pastore C, Imada R, Guaré R, Leite M, Poyares D, Santos MT. Autonomic nervous system in individuals with cerebral palsy: a controlled study. J Oral Pathol Med 2011; 40:576-81. [DOI: 10.1111/j.1600-0714.2011.01008.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Santos MTB, Guaré RO, Leite MF, Ferreira MCD, Durão MS, Jardim JR. Salivary osmolality in individuals with cerebral palsy. Arch Oral Biol 2010; 55:855-60. [DOI: 10.1016/j.archoralbio.2010.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 06/15/2010] [Accepted: 07/28/2010] [Indexed: 10/19/2022]
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Santos MT, Guaré R, Leite M, Ferreira MC, Nicolau J. Does the neuromotor abnormality type affect the salivary parameters in individuals with cerebral palsy? J Oral Pathol Med 2010; 39:770-4. [DOI: 10.1111/j.1600-0714.2010.00919.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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