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Chovan S, Fiľakovská Bobáková D, Madarasová Gecková A, Hubková B, Štrkolcová G, Reijneveld SA, de Kroon MLA. Biological and contextual determinants of early development in marginalized Roma communities: A research protocol of the RomaREACH study. Int J Equity Health 2024; 23:200. [PMID: 39369256 PMCID: PMC11453050 DOI: 10.1186/s12939-024-02287-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/23/2024] [Indexed: 10/07/2024] Open
Abstract
BACKGROUND The period of early childhood bears significant importance from the lifespan perspective. Children from marginalized Roma communities face several risk factors that endanger their early development. Based on the gaps in available evidence, the aim of the RomaREACH research project (Research on Early Childhood in marginalized Roma communities) is, therefore, to explore the complex mechanisms influencing psychomotor development in the first 3 years of a child's life in marginalized Roma communities, and to translate and adapt instruments for measuring development and parenting in marginalized Roma communities and assess their psychometric qualities and suitability METHODS: The project comprises two parts. The first part is a validation study of the translated Caregiver-Reported Early Development Instrument (CREDI) and the Comprehensive Early Childhood Parenting Questionnaire (CECPAQ), tools for the assessment of early development and of parenting strategies and practices. The second part is a longitudinal cohort study, in which the relationships of risk and protective factors with development are explored. DISCUSSION The RomaREACH project is a multicomponent study of social determinants of health and development in early childhood that can provide new evidence on the relationship of risk and protective factors with early development. Such young children from difficult-to-reach marginalized Roma communities are rarely included in research, and information about the scope and the extent of inequities in health and development in the period of early childhood is scarce. The expected results of the RomaREACH project have the potential to influence policy and practice by providing validated tools and evidence-based insights that can help mitigate the developmental risks faced by children in marginalized Roma communities and contribute to improving developmental outcomes and equity.
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Affiliation(s)
- Shoshana Chovan
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Trieda SNP 1, Kosice, 040 11, Slovak Republic.
- Department of Health Psychology and Research Methodology, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice, 040 01, Slovak Republic.
| | - Daniela Fiľakovská Bobáková
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Trieda SNP 1, Kosice, 040 11, Slovak Republic
- Department of Health Psychology and Research Methodology, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice, 040 01, Slovak Republic
- Olomouc University Social Health Institute, Palacky University in Olomouc, Univerzitni 22, Olomouc, 771 11, Czech Republic
| | - Andrea Madarasová Gecková
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Trieda SNP 1, Kosice, 040 11, Slovak Republic
- Department of Health Psychology and Research Methodology, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice, 040 01, Slovak Republic
- Faculty of Social and Economic Sciences, Institute of Applied Psychology, Comenius Universityin Bratislava, Mlynske Luhy 4, Bratislava, 821 05, Slovakia
| | - Beáta Hubková
- Department of Medical and Clinical Biochemistry, PJ Safarik University, Trieda SNP 1, Kosice, 040 11, Slovak Republic
| | - Gabriela Štrkolcová
- Department of Epizootiology, Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, Kosice, 040 01, Slovak Republic
| | - Sijmen A Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, the Netherlands
| | - Marlou L A de Kroon
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, the Netherlands
- Department of Environment and Health, Youth Health Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, Louven, 3000, Belgium
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Imtiaz A, Ul Haq Z, Doi SAR, Fazid S, Khan MN. Effectiveness of lipid-based nutrient supplementation during the first 1000 days of life for early childhood development: A community-based trial from Pakistan. MATERNAL & CHILD NUTRITION 2024:e13727. [PMID: 39318197 DOI: 10.1111/mcn.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/29/2024] [Accepted: 08/20/2024] [Indexed: 09/26/2024]
Abstract
A community-based, cluster non-randomized controlled trial was conducted in Kurram district, Pakistan between January 2018 to December 2020. Age-appropriate lipid-based nutrient supplements and health education (sessions conducted in the households) were given to pregnant women and their born children (6-23 months) in the intervention arm (n = 40 clusters) versus health education only in the control arm (n = 40 clusters) to evaluate its effect on child development. The first and second developmental assessments were completed at ~24 months (n = 689) and ~32 months (n = 608), respectively, using the Caregiver-Reported Early Development Instrument Long form. The overall and domain-specific (motor, language, cognitive and socio-emotional) scores were computed with higher scores indicating better child development. Higher development scores, including overall (β = 0.40, 95% confidence interval [CI]: 0.14, 0.65; p = 0.002), cognitive (β = 0.27, 95% CI: 0.10, 0.45; p = 0.002), motor (β = 0.39, 95% CI: 0.22, 0.56; p < 0.001) and language (β = 0.33, 95% CI: 0.14, 0.51; p = 0.001) were reported for children who received the intervention compared to the control arm at first developmental assessment. However, the effect was not sustained after the discontinuation of the intervention. The LNS received by the mothers (during pregnancy and first 6 months after delivery) and by children during 6-23 months of age was beneficial for the children. The trial is registered in the International Standard Randomised Controlled Trial Number Registry (ID: ISRCTN94319790) on December 11, 2017.
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Affiliation(s)
- Ayesha Imtiaz
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Zia Ul Haq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sheraz Fazid
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Muhammad Naseem Khan
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Deckers SRJM, van Onna M, Gros E, van Balkom H. Developing a screening instrument for underlying core domains of communicative competence in children with communication support needs. Augment Altern Commun 2024:1-14. [PMID: 38967645 DOI: 10.1080/07434618.2024.2367991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 06/08/2024] [Indexed: 07/06/2024] Open
Abstract
A socio-neurocognitive approach to augmentative and alternative communication (AAC) shows several underlying domains of communicative competence: Attention, perception, cognition, memory, orientation, socio-emotional development, motor skills, and language. To determine developmental markers of these underlying core domains of communicative competence in children with communication support needs, we developed a new screening instrument. The present article consists of three consecutive studies. In study 1, we constructed the first version of the screening instrument based on a sample of both children without disabilities and children with Down syndrome. In study 2, we confirmed the reliability (i.e., internal consistency) of the screening instrument in a new group of young children with typical development and established concurrent validity with the Early Language Scale. In study 3, we established concurrent validity with the Communication Matrix in a clinical sample of children with communication support needs. The screening instrument can be used in clinical practice as part of AAC assessment to provide comprehensive insights into strengths and weaknesses in the underlying core domains of communicative competence of children with communication support needs.
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Affiliation(s)
- Stijn R J M Deckers
- Stichting Milo, Intervention Center for Augmentative and Alternative Communicatio, Schijndel, The Netherlands
- Department of Pedagogical Sciences, Radboud University, Nijmegen, The Netherlands
| | | | - Elske Gros
- Department of Pedagogical Sciences, Radboud University, Nijmegen, The Netherlands
| | - Hans van Balkom
- Stichting Milo, Intervention Center for Augmentative and Alternative Communicatio, Schijndel, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Williams EH, Thompson NM, McCray G, Crespo-Llado MM, Bhavnani S, Gajria D, Mukherjee D, Del Bianco T, Lockwood-Estrin G, Mason L, Ngoma V, Namathanga C, Nkhata R, Bennie A, Ranjan A, Kawelama U, Midha N, Singh A, Mpakiza I, Gautam A, Gulati S, Johnson MH, Lancaster G, Belmonte MK, Jones E, Patel V, Chandran S, Mbale E, Divan G, Gladstone M, Chakrabarti B. Scalable Transdiagnostic Early Assessment of Mental Health (STREAM): a study protocol. BMJ Open 2024; 14:e088263. [PMID: 38871663 DOI: 10.1136/bmjopen-2024-088263] [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] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Early childhood development forms the foundations for functioning later in life. Thus, accurate monitoring of developmental trajectories is critical. However, such monitoring often relies on time-intensive assessments which necessitate administration by skilled professionals. This difficulty is exacerbated in low-resource settings where such professionals are predominantly concentrated in urban and often private clinics, making them inaccessible to many. This geographic and economic inaccessibility contributes to a significant 'detection gap' where many children who might benefit from support remain undetected. The Scalable Transdiagnostic Early Assessment of Mental Health (STREAM) project aims to bridge this gap by developing an open-source, scalable, tablet-based platform administered by non-specialist workers to assess motor, social and cognitive developmental status. The goal is to deploy STREAM through public health initiatives, maximising opportunities for effective early interventions. METHODS AND ANALYSIS The STREAM project will enrol and assess 4000 children aged 0-6 years from Malawi (n=2000) and India (n=2000). It integrates three established developmental assessment tools measuring motor, social and cognitive functioning using gamified tasks, observation checklists, parent-report and audio-video recordings. Domain scores for motor, social and cognitive functioning will be developed and assessed for their validity and reliability. These domain scores will then be used to construct age-adjusted developmental reference curves. ETHICS AND DISSEMINATION Ethical approval has been obtained from local review boards at each site (India: Sangath Institutional Review Board; All India Institute of Medical Science (AIIMS) Ethics Committee; Indian Council of Medical Research-Health Ministry Screening Committee; Malawi: College of Medicine Research and Ethics Committee; Malawi Ministry of Health-Blantyre District Health Office). The study adheres to Good Clinical Practice standards and the ethical guidelines of the 6th (2008) Declaration of Helsinki. Findings from STREAM will be disseminated to participating families, healthcare professionals, policymakers, educators and researchers, at local, national and international levels through meetings, academic journals and conferences.
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Affiliation(s)
- Elin H Williams
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Nicholas M Thompson
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Faculty of Health, Education and Society, University of Northampton, Northampton, UK
| | | | - Maria M Crespo-Llado
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | | | | | - Debarati Mukherjee
- Indian Institute of Public Health, Bengaluru, Public Health Foundation of India, Kamataka, India
| | - Teresa Del Bianco
- Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
- School of Social Sciences and Professions, London Metropolitan University, London, UK
| | | | - Luke Mason
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vukiwe Ngoma
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | - Allan Bennie
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | | | | | | | | | - Akshat Gautam
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Sheffali Gulati
- Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Matthew K Belmonte
- The Com DEALL Trust, Bengaluru, Karnataka, India
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Emily Jones
- Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Sharat Chandran
- Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
| | - Emmie Mbale
- Department of Paediatrics, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Bhismadev Chakrabarti
- Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Psychology, Ashoka University, Sonipat, India
- India Autism Center, Kolkata, India
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Lauer JM, Kirby MA, Muhihi A, Ulenga N, Aboud S, Liu E, Choy RKM, Arndt MB, Kou J, Fawzi W, Gewirtz A, Sudfeld CR, Manji KP, Duggan CP. Assessing environmental enteric dysfunction via multiplex assay and its relation to growth and development among HIV-exposed uninfected Tanzanian infants. PLoS Negl Trop Dis 2023; 17:e0011181. [PMID: 36943785 PMCID: PMC10030025 DOI: 10.1371/journal.pntd.0011181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/21/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Environmental enteric dysfunction (EED) may contribute to poor growth and development in young children. While validated EED biomarkers are currently lacking, multiplex assays are able to capture multiple domains of the condition. The purpose of this exploratory study was to examine the relationship between biomarkers of EED and subsequent growth and development among Tanzanian HIV-exposed uninfected (HEU) infants. METHODOLOGY We enrolled 467 infants of mothers living with HIV who had participated in a trial of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks (n = 365) and 6 months (n = 266) were analyzed for anti-flagellin and anti-lipopolysaccharide (LPS) IgA and IgG via ELISA as well as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), which incorporates two biomarkers of EED [intestinal fatty acid-binding protein (I-FABP) and soluble CD14 (sCD14)]. Outcomes were 12-month growth [length-for-age z-score (LAZ), weight-for-length z-score (WLZ), and weight-for-age z-score (WAZ)] and development [Caregiver Reported Early Development Instruments (CREDI) z-scores] and were assessed using linear regression. FINDINGS In primary analyses, higher quartiles of 6-month anti-LPS IgG concentrations were significantly associated with lower LAZ at 12 months (ptrend = 0.040). In secondary analyses, higher log2-transformed 6-week anti-flagellin IgA and 6-month anti-LPS IgA concentrations were significantly associated with lower LAZ at 12 months. No associations were observed between I-FABP or sCD14 and infant growth. However, higher log2-transformed 6-week sCD14 concentrations were significantly associated with lower overall CREDI z-scores, while higher log2-transformed 6-month I-FABP concentrations were significantly associated with higher overall CREDI z-scores. CONCLUSIONS Unlike anti-flagellin and anti-LPS Igs, MEEDAT's biomarkers of EED (I-FABP and sCD14) were not associated with subsequent linear growth among HEU infants in Tanzania. The relationship between EED and infant development warrants further study.
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Affiliation(s)
- Jacqueline M. Lauer
- Department of Health Sciences, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, United States of America
| | - Miles A. Kirby
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Alfa Muhihi
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Nzovu Ulenga
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Enju Liu
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Robert K. M. Choy
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States of America
| | - Michael B. Arndt
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Jianqun Kou
- Institute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, United States of America
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Andrew Gewirtz
- Institute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, United States of America
| | - Christopher R. Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Karim P. Manji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Christopher P. Duggan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Ramos de Oliveira CV, Sudfeld CR, Muhihi A, McCoy DC, Fawzi WW, Masanja H, Yousafzai AK. Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural Tanzania. JAMA Netw Open 2022; 5:e2248836. [PMID: 36580331 PMCID: PMC9857043 DOI: 10.1001/jamanetworkopen.2022.48836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Approximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children's socioemotional development; however, there is limited evidence on these outcomes. OBJECTIVE To examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development. DESIGN, SETTING, AND PARTICIPANTS This study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020. EXPOSURES Lifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey. MAIN OUTCOMES AND MEASURES Child socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments. RESULTS A total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, -0.022; 95% CI, -0.045 to -0.006) and physical and sexual IPV (mean difference, -0.045; 95% CI, -0.077 to -0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, -0.073; 95% CI, -0.103 to -0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors. CONCLUSIONS AND RELEVANCE The findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.
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Affiliation(s)
- Clariana Vitória Ramos de Oliveira
- School of Nursing, University of Nevada, Las Vegas
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Christopher Robert Sudfeld
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Alfa Muhihi
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Aisha K. Yousafzai
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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McCoy DC. Building a model of cultural universality with specificity for global early childhood development. CHILD DEVELOPMENT PERSPECTIVES 2021. [DOI: 10.1111/cdep.12438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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