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Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M. Comparison of adults who stutter with and without social anxiety disorder. J Fluency Disord 2018; 56:55-68. [PMID: 29602052 DOI: 10.1016/j.jfludis.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 05/14/2023]
Abstract
PURPOSE Social anxiety disorder is a debilitating anxiety disorder associated with significant life impairment. The purpose of the present study is to evaluate overall functioning for adults who stutter with and without a diagnosis of social anxiety disorder. METHOD Participants were 275 adults who stuttered (18-80 years), including 219 males (79.6%) and 56 females (20.4%), who were enrolled to commence speech treatment for stuttering. Comparisons were made between participants diagnosed with social anxiety disorder (n = 82, 29.8%) and those without that diagnosis (n = 193, 70.2%). RESULTS Although the socially anxious group was significantly younger than the non-socially anxious group, no other demographic differences were found. When compared to the non-socially anxious group, the socially anxious group did not demonstrate significantly higher self-reported stuttering severity or percentage of syllables stuttered. Yet the socially anxious group reported more speech dissatisfaction and avoidance of speaking situations, significantly more psychological problems, and a greater negative impact of stuttering. CONCLUSION Significant differences in speech and psychological variables between groups suggest that, despite not demonstrating more severe stuttering, socially anxious adults who stutter demonstrate more psychological difficulties and have a more negative view of their speech. The present findings suggest that the demographic status of adults who stutter is not worse for those with social anxiety disorder. These findings pertain to a clinical sample, and cannot be generalized to the wider population of adults who stutter from the general community. Further research is needed to understand the longer-term impact of social anxiety disorder for those who stutter.
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Affiliation(s)
- Lisa Iverach
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Mark Jones
- School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
| | - Robyn Lowe
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Susan O'Brian
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Ross G Menzies
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Ann Packman
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Mark Onslow
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
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Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M. Characteristics of adults who stutter by treatments sought. LOGOP PHONIATR VOCO 2018; 44:134-142. [PMID: 29569967 DOI: 10.1080/14015439.2018.1452976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Several treatment approaches are available for adults who stutter, including speech treatment, cognitive behaviour therapy (CBT) treatment for anxiety, and a combination of both. It is useful to determine whether any differences exist between adults who stutter enrolled in different types of treatment. Therefore, the purpose of this study was to compare demographic, speech, and psychological characteristics of adults who stutter enrolled in speech, psychological, and combined treatment programs. Participants were 288 adults who stuttered (18-80 years) enrolled in one of three different treatment programs: Speech Treatment for stuttering (n = 134), Anxiety Treatment for anxiety about stuttering (n = 70), or Speech Treatment for Stuttering With or Without Anxiety Treatment (n = 84). Participants completed a range of demographic, speech, and psychological measures prior to the start of treatment. A significantly higher proportion of participants in the Anxiety Treatment group were in a personal relationship than the other treatment groups. The Anxiety Treatment group had higher average age than the other treatment groups. The Speech Treatment group also demonstrated significantly higher self-rated stuttering severity than the Anxiety Treatment group, even though there were no significant difference between groups for clinician-rated percentage of syllables stuttered. Although most characteristics of adults who stuttered did not vary by treatment type, the present findings suggest that adults who stutter enrolled in speech treatment perceived their stuttering as more severe, which may have prompted treatment seeking. Further research is needed regarding the supportive influence of personal relationship for those with the disorder.
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Affiliation(s)
- Lisa Iverach
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Mark Jones
- b School of Public Health , University of Queensland , Herston , Australia
| | - Robyn Lowe
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Susan O'Brian
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Ross G Menzies
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Ann Packman
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Mark Onslow
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
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Smith KA, Iverach L, O'Brian S, Mensah F, Kefalianos E, Hearne A, Reilly S. Anxiety in 11-Year-Old Children Who Stutter: Findings From a Prospective Longitudinal Community Sample. J Speech Lang Hear Res 2017; 60:1211-1222. [PMID: 28418529 DOI: 10.1044/2016_jslhr-s-16-0035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 10/27/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE To examine if a community sample of 11-year-old children with persistent stuttering have higher anxiety than children who have recovered from stuttering and nonstuttering controls. METHOD Participants in a community cohort study were categorized into 3 groups: (a) those with persistent stuttering, (b) those with recovered stuttering, and (c) nonstuttering controls. Linear regression modeling compared outcomes on measures of child anxiety and emotional and behavioral functioning for the 3 groups. RESULTS Without adjustment for covariates (unadjusted analyses), the group with persistent stuttering showed significantly increased anxiety compared with the recovered stuttering group and nonstuttering controls. The group with persistent stuttering had a higher number of children with autism spectrum disorder and/or learning difficulties. Once these variables were included as covariates in subsequent analysis, there was no difference in anxiety, emotional and behavioral functioning, or temperament among groups. CONCLUSION Although recognized to be associated with stuttering in clinical samples, anxiety was not higher in school-age children who stutter in a community cohort. It may be that anxiety develops later or is less marked in community cohorts compared with clinical samples. We did, however, observe higher anxiety scores in those children who stuttered and had autism spectrum disorder or learning difficulties. Implications and recommendations for research are discussed.
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Affiliation(s)
- Kylie A Smith
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, AustraliaDepartment of Paediatrics, University of Melbourne, Victoria, Australia
| | - Lisa Iverach
- Australian Stuttering Research Centre, The University of Sydney, Lidcombe NSW, AustraliaDepartment of Psychology, Macquarie University, North Ryde NSW, Australia
| | - Susan O'Brian
- Australian Stuttering Research Centre, The University of Sydney, Lidcombe NSW, Australia
| | - Fiona Mensah
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, AustraliaDepartment of Paediatrics, University of Melbourne, Victoria, Australia
| | - Elaina Kefalianos
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, AustraliaDepartment of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
| | - Anna Hearne
- Speech Language Therapy, Institute of Education, Massey University, Albany, New Zealand
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, AustraliaDepartment of Paediatrics, University of Melbourne, Victoria, AustraliaMenzies Health Institute Queensland, Griffith University, Southport, Australia
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Iverach L, Lowe R, Jones M, O'Brian S, Menzies RG, Packman A, Onslow M. A speech and psychological profile of treatment-seeking adolescents who stutter. J Fluency Disord 2017; 51:24-38. [PMID: 28212718 DOI: 10.1016/j.jfludis.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/30/2016] [Accepted: 11/06/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter. METHOD Participants were 102 adolescents (11-17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11-14 years, n=57) and older (15-17 years, n=45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering. RESULTS The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems-aggression, rule-breaking-in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering. CONCLUSION To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter.
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Affiliation(s)
- Lisa Iverach
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Robyn Lowe
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Mark Jones
- School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD 4006, Australia.
| | - Susan O'Brian
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Ross G Menzies
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Ann Packman
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
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Bridgman K, Onslow M, O'Brian S, Jones M, Block S. Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial. J Speech Lang Hear Res 2016; 59:932-939. [PMID: 27617680 DOI: 10.1044/2016_jslhr-s-15-0011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 01/27/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early stuttering. METHOD The design was a parallel, open plan, noninferiority randomized controlled trial of the standard Lidcombe Program treatment and the experimental webcam Lidcombe Program treatment. Participants were 49 children aged 3 years 0 months to 5 years 11 months at the start of treatment. Primary outcomes were the percentage of syllables stuttered at 9 months postrandomization and the number of consultations to complete Stage 1 of the Lidcombe Program. RESULTS There was insufficient evidence of a posttreatment difference of the percentage of syllables stuttered between the standard and webcam Lidcombe Program treatments. There was insufficient evidence of a difference between the groups for typical stuttering severity measured by parents or the reported clinical relationship with the treating speech-language pathologist. CONCLUSIONS This trial confirmed the viability of the webcam Lidcombe Program intervention. It appears to be as efficacious and economically viable as the standard, clinic Lidcombe Program treatment.
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Affiliation(s)
- Kate Bridgman
- Australian Stuttering Research Centre, The University of Sydney, New South WalesSchool of Allied Health, La Trobe University, Victoria, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, New South Wales
| | - Susan O'Brian
- Australian Stuttering Research Centre, The University of Sydney, New South Wales
| | - Mark Jones
- School of Population Health, The University of Queensland, Australia
| | - Susan Block
- School of Allied Health, La Trobe University, Victoria, Australia
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Smith KA, Iverach L, O'Brian S, Kefalianos E, Reilly S. Anxiety of children and adolescents who stutter: a review. J Fluency Disord 2014; 40:22-34. [PMID: 24929464 DOI: 10.1016/j.jfludis.2014.01.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/22/2014] [Accepted: 01/30/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE Adults who stutter have heightened rates of anxiety disorders, particularly social anxiety disorder, compared with non-stuttering controls. However, the timing of anxiety onset and its development in relation to stuttering is poorly understood. Identifying the typical age of anxiety onset in stuttering has significant clinical implications and is crucial for the management of both disorders across the lifespan. The present review aims to determine the scope of the research pertaining to this topic, identify trends in findings, and delineate timing of anxiety onset in stuttering. METHODS We examine putative risk factors of anxiety present for children and adolescents who stutter, and provide a review of the research evidence relating to anxiety for this population. RESULTS Young people who stutter can experience negative social consequences and negative attitudes towards communication, which is hypothesised to place them at increased risk of developing anxiety. The prevalence of anxiety of young people who stutter, and the timing of anxiety onset in stuttering could not be determined. This was due to methodological limitations in the reviewed research such as small participant numbers, and the use of measures that lack sensitivity to identify anxiety in the targeted population. CONCLUSIONS In sum, the evidence suggests that anxiety in stuttering might increase over time until it exceeds normal limits in adolescence and adulthood. The clinical implications of these findings, and recommendations for future research, are discussed. EDUCATIONAL OBJECTIVES The reader will be able to: (a) discuss contemporary thinking on the role of anxiety in stuttering and reasons for this view; (b) describe risk factors for the development of anxiety in stuttering, experienced by children and adolescents who stutter (c) outline trends in current research on anxiety and children and adolescents with stuttering; and (d) summarise rationales behind recommendations for future research in this area.
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Affiliation(s)
- Kylie A Smith
- Murdoch Childrens Research Institute, Royal Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, Victoria 3010, Australia.
| | - Lisa Iverach
- Centre for Emotional Health, Department of Psychology, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia
| | - Susan O'Brian
- Australian Stuttering Research Centre, University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
| | - Elaina Kefalianos
- Murdoch Childrens Research Institute, Royal Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Audiology and Speech Pathology, University of Melbourne, Victoria 3010, Australia
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Royal Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, Victoria 3010, Australia
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Affiliation(s)
- Susan O'Brian
- Australian Stuttering Research Centre, University of Sydney, Lidcombe, NSW 2060, Australia
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Iverach L, O'Brian S, Jones M, Block S, Lincoln M, Harrison E, Hewat S, Menzies RG, Packman A, Onslow M. The five factor model of personality applied to adults who stutter. J Commun Disord 2010; 43:120-132. [PMID: 20070974 DOI: 10.1016/j.jcomdis.2009.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 11/09/2009] [Accepted: 12/10/2009] [Indexed: 05/28/2023]
Abstract
UNLABELLED Previous research has not explored the Five Factor Model of personality among adults who stutter. Therefore, the present study investigated the five personality domains of Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness, as measured by the NEO Five Factor Inventory (NEO-FFI), in a sample of 93 adults seeking speech treatment for stuttering, and compared these scores with normative data from an Australian and a United States sample. Results revealed that NEO-FFI scores for the stuttering group were within the 'average' range for all five personality domains. However, adults who stutter were characterized by significantly higher Neuroticism, and significantly lower Agreeableness and Conscientiousness, than normative samples. No significant differences were found between groups on the dimensions of Extraversion and Openness. These results are discussed with reference to the relationship between personality factors among adults who stutter, their directionality, and implications for predicting treatment outcome. LEARNING OUTCOMES The reader will be able to: (1) describe the Five Factor Model of personality, including the NEO-FFI personality domains of Extraversion, Neuroticism, Openness, Agreeableness, and Conscientiousness, and (2) discuss differences in NEO-FFI domain scores between adults who stutter and normative samples, and (3) understand the clinical implications of personality profiles in terms of treatment process and outcome for adults who stutter.
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Affiliation(s)
- Lisa Iverach
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
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Morgan O, Verlander NQ, Kennedy F, Moore M, Birch S, Kearney J, Lewthwaite P, Lewis R, O'Brian S, Osman J, Reacher M. Exposures and reported symptoms associated with occupational deployment to the Buncefield fuel depot fire, England 2005. Occup Environ Med 2008; 65:404-11. [DOI: 10.1136/oem.2007.035303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Treatments for stuttering based on variants of Goldiamond's prolonged-speech procedure involve teaching clients to speak with novel speech patterns. Those speech patterns consist of specific skills, described with such terms as soft contacts, gentle onsets, and continuous vocalization. It might be expected that effective client learning of such speech skills would be dependent on clinicians' ability to reliably identify any departures from the correct production of such speech targets. The present study investigated clinicians' reliability in detecting such errors during a prolonged-speech treatment program. Results showed questionable intraclinician agreement and poor interclinician agreement. Nonetheless, the prolonged-speech program in question is known to be effective in controlling stuttered speech. The clinical and theoretical implications of these findings are discussed.
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Affiliation(s)
- M Onslow
- Australian Stuttering Research Centre, The University of Sydney, NSW.
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Abstract
The Lidcombe Programme is an operant intervention for early stuttering that parents administer to children in their everyday speaking environments. The treatment was developed at the Suttering Unit, Bankstown Health Service, Sydney, and The University of Sydney. Recently, staff from the Australian Stuttering Research Centre. The University of Sydney, toured universities and clinics in the UK to present lectures about this treatment. We were encouraged to write this paper because an independent survey showed that most speech and language therapists who attended the presentations were open to this treatment. Prior to and following that lecture tour, publications in the press and professional journals in the UK alluded to many positive features of the Lidcombe Programme, but also raised several issues about it. The purpose of this paper is to summarise the Lidcombe Programme and address the following criticisms of the treatment that were raised in the UK: (1) Stuttering is complex but the Lidcombe Programme is simple; (2) the Lidcombe Programme is not an operant treatment, but invokes positive changes in children's environments; (3) the Lidcombe Programme is harmful to children; and (4) the scientific evidence in support of the Lidcombe Programme is flawed. Each of these issues is addressed from logical, theoretical and empirical viewpoints.
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Affiliation(s)
- M Onslow
- Australian Stuttering Research Centre, University of Sydney, Lidcombe NSW, Australia.
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Andreeff M, Drach J, Koller C, O'Brian S, Kantarjian H, Robertson L, Kornblau S, Escudier S, Zhao S, Estey E, Deisseroth A. Cytokine/ chemotherapy interactions in myeloid leukemia: Clinical results and laboratory correlates. Pathophysiology 1994. [DOI: 10.1016/0928-4680(94)90117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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