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Martinez-Calderon J, Villar-Alises O, García-Muñoz C, Pineda-Escobar S, Matias-Soto J. Multimodal exercise programs may improve posttraumatic stress disorders symptoms and quality of life in adults with PTSD: An overview of systematic reviews with meta-analysis. Clin Rehabil 2024; 38:573-588. [PMID: 38258461 DOI: 10.1177/02692155231225466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE This overview of reviews aimed to summarize the effectiveness of exercise, regular physical activity or mind-body exercises on posttraumatic stress disorder (PTSD) symptoms and comorbidities associated with PTSD (e.g. depression symptoms) among individuals without age, gender, race, ethnicity or setting restrictions. DATA SOURCES The CINAHL, Embase, PubMed and SPORTDiscus databases were searched from inception to November 16, 2023. REVIEW METHODS Systematic reviews with meta-analysis of randomized clinical trials evaluating exercise, regular physical activity or mind-body exercises were considered. Control groups and outcome measures were not restricted. AMSTAR 2 assessed the methodological quality of reviews. The overlap between reviews was calculated. RESULTS A total of 14 systematic reviews were included meta-analyzing 23 distinct randomized clinical trials. There was a very high overlap between reviews (corrected covered area = 16%). PTSD symptoms, depression symptoms, anxiety symptoms, sleep quality, substance abuse and quality of life were meta-analyzed. No reviews meta-analyzed the effects of regular physical activity. Overall, the meta-analyses found multicomponent exercise programs may have positive results in reducing PTSD symptoms and improving quality of life. In addition, the results of yoga were inconsistent across the meta-analyses for PTSD symptoms, and no differences between groups were found in favor of yoga for depression symptoms. Finally, no specific conclusions could be made about anxiety symptoms, sleep quality and substance abuse. CONCLUSION A multicomponent exercise program may be effective in improving PTSD symptoms and quality of life, whereas yoga may be ineffective for depression symptoms in adults with PTSD.
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla, IBiS, Universidad de Sevilla, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Olga Villar-Alises
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla, IBiS, Universidad de Sevilla, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Saul Pineda-Escobar
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Departamento de Ciencias de la Salud y Biomédicas, Universidad Loyola Andalucía, Sevilla, Spain
| | - Javier Matias-Soto
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Department of Physical Therapy, Faculty of Health Sciences, Universidad de Malaga, Malaga, Spain
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Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
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Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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English A, McKibben E, Sivaramakrishnan D, Hart N, Richards J, Kelly P. A Rapid Review Exploring the Role of Yoga in Healing Psychological Trauma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16180. [PMID: 36498254 PMCID: PMC9741324 DOI: 10.3390/ijerph192316180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
The evidence regarding the benefits of yoga for treating psychological trauma is well-established; however, there is a paucity of qualitative reviews exploring this topic. The purpose of this rapid review is to gain a deeper understanding of the impact that yoga can have on people with a history of psychological trauma and to reveal barriers and facilitators to the uptake of yoga in this cohort, from a qualitative perspective. The Ovid(EMBASE), Ovid(MEDLINE), PsycINFO, PubMed, and SPORTDiscus databases were searched using key terms. The systematic search generated 148 records, and 11 peer-reviewed articles met the inclusion criteria. The following main impacts of yoga on participants were identified: feeling an increased sense of self-compassion; feeling more centred; developing their coping skills; having a better mind-body relationship; and improving their relationships with others. The main barriers were also identified: concerns initiating yoga; time and motivational issues; and the costs and location of classes. The main facilitator was the feeling of safety generated in the trauma-informed yoga classes. This review suggests that yoga offers great potential in the field of trauma recovery. Despite this, more high-quality research with rigorous methodologies is called for to allow this field to advance.
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Affiliation(s)
- Arabella English
- Edinburgh Medical School, The University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Elizabeth McKibben
- Faculty of Health, Victoria University of Wellington, Wellington 6140, New Zealand
| | - Divya Sivaramakrishnan
- Physical Activity for Health Research Centre (PAHRC), The University of Edinburgh, Edinburgh EH8 8AQ, UK
| | - Niamh Hart
- Physical Activity for Health Research Centre (PAHRC), The University of Edinburgh, Edinburgh EH8 8AQ, UK
| | - Justin Richards
- Faculty of Health, Victoria University of Wellington, Wellington 6140, New Zealand
| | - Paul Kelly
- Physical Activity for Health Research Centre (PAHRC), The University of Edinburgh, Edinburgh EH8 8AQ, UK
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The effects of a 12-week yoga intervention on body awareness in people with multiple sclerosis: A non-controlled pilot study. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gettings RD, Kirtley J, Wilson-Menzfeld G, Oxburgh GE, Farrell D, Kiernan MD. Exploring the Role of Social Connection in Interventions With Military Veterans Diagnosed With Post-traumatic Stress Disorder: Systematic Narrative Review. Front Psychol 2022; 13:873885. [PMID: 35874405 PMCID: PMC9305387 DOI: 10.3389/fpsyg.2022.873885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background It has been identified that military veterans have distinct experiences of loneliness and social isolation and, when comparing this community to other client groups with a PTSD diagnosis, veterans respond less favorably to treatment. However, the link between PTSD and loneliness for veterans remains insufficiently researched and it is unclear if there are effective interventions tackling this distinct experience of loneliness. Aims This systematic narrative review aimed to synthesize existing evidence incorporating elements of social connection, social isolation, and loneliness within interventions for military veterans with a diagnosis of PTSD, consequently aiming to examine the impact of such interventions upon this community. Methods Six databases were searched, utilizing relevant search criteria, with no date restrictions. Articles were included if they involved intervention or treatment for military veterans with PTSD and considered elements of social connection, social isolation, and/or loneliness. The initial search returned 202 papers. After exclusions, removal of duplications, and a reference/citation search, 28 papers remained and were included in this review. Results From the 28 studies, 11 directly addressed social isolation and two studies directly addressed loneliness. Six themes were generated: (i) rethinking the diagnosis of PTSD, (ii) holistic interventions, (iii) peer support, (iv) social reintegration, (v) empowerment through purpose and community, and (vi) building trust. Conclusions A direct focus upon social reintegration and engagement, psychosocial functioning, building trust, peer support, group cohesiveness and empowerment through a sense of purpose and learning new skills may mitigate experiential loneliness and social isolation for veterans with PTSD. Future research and practice should further explore the needs of the PTSD-diagnosed veteran community, seek to explore and identify potential common routes toward the development of PTSD within this community and consider bespoke interventions for tackling loneliness.
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Affiliation(s)
- Richard D. Gettings
- Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jenna Kirtley
- Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Gemma Wilson-Menzfeld
- Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Gavin E. Oxburgh
- Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Derek Farrell
- Department of Violence, Trauma and Criminology, Worcester University, Worcester, United Kingdom
| | - Matthew D. Kiernan
- Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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McIver S, O’Shea M, Nixon B, Seidler Z, Evans S. “The only man on the mat”: yoga as a therapeutic pathway for men’s mental health. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2093624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Shane McIver
- Faculty of Health, Deakin University, Burwood, Australia
| | - Melissa O’Shea
- Faculty of Health, Deakin University, Burwood, Australia
| | - Bo Nixon
- Faculty of Health, Deakin University, Burwood, Australia
| | - Zac Seidler
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Subhadra Evans
- Faculty of Health, Deakin University, Burwood, Australia
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Yamuna U, Majumdar V, Saoji AA. Effect of Yoga on homocysteine level, symptomatology and quality of life in industrial workers with Chronic Venous Insufficiency: Study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Rosen M, Nguyen BA, Khetarpal S, Sgro G. What Do You Want Us to Know?: Learning From Life Stories to Improve Veterans' Healthcare Experiences. J Patient Exp 2022; 9:23743735211069833. [PMID: 35005224 PMCID: PMC8733362 DOI: 10.1177/23743735211069833] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
My Life My Story (MLMS) is a national Veterans Health Administration (VA) life story interview program that aims to provide more humanistic care for veterans by focusing on the patient as a person. Our project took place at the Pittsburgh VA Healthcare System and had 3 main goals: (1) describe themes that emerge in MLMS interviews from the prompting question, what do you want your healthcare provider to know about you?; (2) identify topics of importance to veterans and suggest ways for healthcare providers to explore them; and (3) foster a culture at the Pittsburgh VA that places not only the health but also the personal triumphs, hardships, and aspirations of veterans at the center. Veterans provided verbal consent to have their previously recorded stories used in this study. Stories were coded and then analyzed for patterns and themes. A total of 17 veterans participated in our study. Themes that emerged from the stories include (1) Early Hardships; (2) Economic Disadvantage; (3) Polaroid Snapshots; (4) Around the World; (5) Haunted by Combat; (6) Life-altering Moments; (7) Homecoming; (8) Romantic Beginnings & Obstacles; (9) Inequity across Gender & Race; and (10) Facing Mortality. This study's findings underscore the need to address the traumas associated with military service, as well as the challenges faced with re-integration into civilian life, when working with veterans. The MLMS interviews explored in this study can help clinicians identify topics of importance to veterans, strengthen their relationships with their patients, and improve the care that veterans receive.
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Affiliation(s)
- Miriam Rosen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Breanna A Nguyen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Gaetan Sgro
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,VA Pittsburgh Health Care System, Pittsburgh, PA, USA
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Vancampfort D, Sánchez CPR, Hallgren M, Schuch F, Firth J, Rosenbaum S, Van Damme T, Stubbs B. Dropout from exercise randomized controlled trials among people with anxiety and stress-related disorders: A meta-analysis and meta-regression. J Affect Disord 2021; 282:996-1004. [PMID: 33601745 DOI: 10.1016/j.jad.2021.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE . Exercise has established efficacy in people with anxiety and stress-related disorders. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of the evidence, with dropout rates varying across studies. We conducted a meta-analysis to investigate the prevalence and predictors of dropout rates among adults with anxiety and stress-related disorders participating in exercise RCT's. METHODS . Two authors searched major electronic databases up to 07/2020. We included RCT's of exercise interventions in people with anxiety and stress-related disorders that reported dropout rates. A random effects meta-analysis and meta-regression were conducted. RESULTS . Fourteen RCT's involving 16 exercise interventions (n=369, mean age 20.7 to 67.7years; 38.4% male) were included. The trim-and-fill-adjusted prevalence of dropout across all studies was 22.4% (95%CI = 15.0% to 32.0%). Applying controlled motivation strategies (P<0.001) predicted higher dropout. Supervision during all sessions and by an expert in exercise prescription and applying autonomous motivation strategies predicted lower dropout (all P<0.001). Dropout was similar in exercise versus control conditions (OR = 0.84, 95%CI = 0.54 to 1.29, p = 0.42, I2 = 0%; N=16). LIMITATIONS . Potentially important moderators of dropout, such as the severity of mental health symptoms and illness duration were insufficiently available. CONCLUSIONS . Exercise is well tolerated by people with anxiety and stress-related disorders and drop out in RCT's is comparable to control conditions. Thus, exercise is a feasible treatment, in particular when autonomous motivation strategies are included and when the intervention is delivered by healthcare professionals with expertise in exercise prescription.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium.
| | | | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK; NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
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Darroch FE, Roett C, Varcoe C, Oliffe JL, Gonzalez Montaner G. Trauma-informed approaches to physical activity: A scoping study. Complement Ther Clin Pract 2020; 41:101224. [PMID: 32819867 DOI: 10.1016/j.ctcp.2020.101224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- F E Darroch
- Carleton University, Department of Health Sciences, 1125 Colonel By Drive, Ottawa, ON, K1S5B6, Canada.
| | - C Roett
- UBC School of Nursing, Vancouver, BC, V6T 2B5, Canada.
| | - C Varcoe
- UBC School of Nursing, Vancouver, BC, V6T 2B5, Canada.
| | - J L Oliffe
- UBC School of Nursing, Vancouver, BC, V6T 2B5, Canada.
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Capon H, O'Shea M, McIver S. Yoga and mental health: A synthesis of qualitative findings. Complement Ther Clin Pract 2019; 37:122-132. [DOI: 10.1016/j.ctcp.2019.101063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 12/14/2022]
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