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Asmussen J, Davidsen KA, Olsen AL, Skovgaard AM, Bilenberg N. The longitudinal association of combined regulatory problems in infancy and mental health outcome in early childhood: a systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02262-0. [PMID: 37493835 DOI: 10.1007/s00787-023-02262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
Co-occurring regulatory problems in infancy, RPs, including excessive crying, feeding-eating and sleeping, have been found associated with mental health problems in school ages. Still, an overview is needed on trajectories of co-occurring or combined RPs, and mental health problems in early childhood. The aim of this review is to systematically review the literature on longitudinal community-based studies of combined RPs measuring mental health outcomes in early childhood. Following the PRISMA guideline, we systematically reviewed the literature published 2000-2020, in which combined RPs are assessed in infancy, and mental health is examined using standardised measures at ages 1-7 years. The search was performed in four databases MEDLINE, EMBASE, PsycINFO and Scopus. A protocol is published on PROSPERO. Based on 1978 screened articles, 42 papers were screened for eligibility, of which six were included, comprising data on two or more RPs investigated among a total of 20,675 children. Assessment of risk of bias in the studies showed overall good quality in five of the six papers. The literature reviewed suggests that combined RPs in infancy are early markers of mental health problems during early childhood, and highlights that community studies exploring the longitudinal associations of combined RP and mental health problems in preschool and early school age are still scarce. Overall, the review points to the need of research into preventive intervention targeting early manifestations of childhood dysregulation, such as RPs.
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Affiliation(s)
- Jette Asmussen
- Department of Clinical Research, Research Unit of Child and Adolescent Mental Health, University of Southern Denmark, J.B Winsløws Vej 16, 5000, Odense C, Denmark.
| | - Kirstine Agnete Davidsen
- Department of Psychology, University of Southern Denmark, Mental Health Services, Region of Southern Denmark, Research Unit &, Odense, Denmark
| | - Anne Lise Olsen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Psychiatry Odense, Odense, Denmark
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2
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Pant SW, Skovgaard AM, Ammitzbøll J, Holstein BE, Pedersen TP. Motor development problems in infancy predict mental disorders in childhood: a longitudinal cohort study. Eur J Pediatr 2022; 181:2655-2661. [PMID: 35384508 DOI: 10.1007/s00431-022-04462-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/26/2022] [Accepted: 03/31/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED The purpose of this study is to examine whether motor development problems in infancy predicted mental disorders later in childhood, taking a wide array of potential confounding variables into consideration. This longitudinal study included an unselected study population of 33238 newborn children from the Copenhagen area, Denmark. Data on the predictor variable, motor development problems at 8-10 months of age, were obtained from the community health nurses' systematic evaluation of the child's motor development during a home visit and stored in the Child Health Database. Data on outcome, diagnosed mental disorders before the age of 8 years, were obtained from the Danish National Patient Register. Potential confounding variables were obtained from the Child Health Database, the National Birth Register and the Civil Registration System. The prevalence of motor development problems at 8-10 months of age was 19.3%; the incidence of any diagnosed mental disorder from 11 months of age to the 8th birthday was 4.0%. Motor development problems were associated with an increased risk of being diagnosed with a mental disorder before the 8th birthday, adjusted odds ratio (AOR) 1.47 (1.29-1.67). Motor development problems were associated with later neurodevelopmental disorders, AOR 1.77 (1.52-2.06), in particular autism spectrum disorders, AOR 1.63 (1.31-2.03), hyperactivity/attention deficit disorders, AOR 1.29 (1.03-1.61) and disorders of intellectual disability, AOR 3.28 (2.39-4.49). CONCLUSION Motor development problems as early at 8-10 months of age were predictive of neurodevelopmental disorders before the 8th birthday. The findings call for clinical attention and more research on preventive potentials in the community child health care. WHAT IS KNOWN • Children with ASD, ADHD and ID have high prevalence of early motor development problems. WHAT IS NEW • Motor development problems in infancy predicted neurodevelopmental disorders before the 8th birthday. • This observation could improve early identification and prevention of mental health problems in childhood.
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Affiliation(s)
- Sofie Weber Pant
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Janni Ammitzbøll
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Bjørn E Holstein
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark.
| | - Trine Pagh Pedersen
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, DK-1455, Copenhagen, Denmark
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Skovgaard AM, Bakermans-kranenburg M, Pontoppidan M, Tjørnhøj-thomsen T, Madsen KR, Voss I, Wehner SK, Pedersen TP, Finseth L, Taylor RS, Tolstrup JS, Ammitzbøll J. The Infant Health Study - Promoting mental health and healthy weight through sensitive parenting to infants with cognitive, emotional, and regulatory vulnerabilities: protocol for a stepped-wedge cluster-randomized trial and a process evaluation within municipality settings. BMC Public Health 2022; 22. [PMID: 35090411 PMCID: PMC8796192 DOI: 10.1186/s12889-022-12551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. Methods We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. Discussion The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. Trial registration www.ClinicalTrials.gov; IDNCT04601779; Protocol ID 95-110-21307. Registered 25 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12551-z.
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Holstein BE, Pant SW, Ammitzbøll J, Laursen B, Madsen KR, Skovgaard AM, Pedersen TP. Parental education, parent-child relations and diagnosed mental disorders in childhood: prospective child cohort study. Eur J Public Health 2021; 31:514-520. [PMID: 33880520 DOI: 10.1093/eurpub/ckab053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mental disorder in childhood is an important public health issue. We aimed to examine the prospective association between parental education at childbirth and diagnosed mental disorders in young children and explore whether this association was mediated or modified by parent-child relations in infancy. METHODS Prospective cohort study of all newborn was from 2002 to 2010 from 16 municipalities in the capital region of Copenhagen, Denmark, with follow-up until their 8th birthday, N = 40 762. Baseline data included information from national population registers and from health visitors' records at child aged 0 to 10 months. Outcome variable: any mental disorder diagnosed at hospital from age 11 months to 8 years. RESULTS Low parental education was predictive of diagnosed child mental disorder, adjusted odds ratio (AOR) = 1.83 (95% CI 1.49-2.23). Problematic parent-child relation at age 8-10 months was also predictive of mental disorder, AOR = 2.06 (1.57-2.70) but did not mediate the association between parental education and mental disorder. AOR for mental disorders was 3.24 (2.03-5.16 for the combination vocational training and problematic parent-child relation and 2.49 (1.42-4.38) for the combination primary school and problematic parent-child relation. CONCLUSIONS Low parental education and problematic parent-child relation were independent risk factors for diagnosed mental disorders in the age span of 11 months to 8 years.
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Affiliation(s)
- Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sofie W Pant
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janni Ammitzbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Bjarne Laursen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Katrine R Madsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine P Pedersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Brasfield J, Goulding SM, Kancherla V. Duration of breast feeding and attention-deficit/hyperactivity disorder in United States preschool-aged children. Res Dev Disabil 2021; 115:103995. [PMID: 34049210 DOI: 10.1016/j.ridd.2021.103995] [Citation(s) in RCA: 3] [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: 11/23/2020] [Revised: 03/21/2021] [Accepted: 05/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by difficulties sustaining attention and controlling hyperactivity and impulsive behavior. Population-based studies concerning the association between breast-feeding duration and ADHD among preschool-aged children in the United States (U.S.) have been sparse. AIMS To determine whether there is an association between the duration of breast feeding and ADHD in U.S. children aged 2-5 years. METHODS AND PROCEDURES We used nationally representative data from the 2016, 2017, and 2018 National Survey of Children's Health (NSCH) to examine the association between breast-feeding duration and ADHD in U.S. preschool-aged children. Sample characteristics were compared using Rao-Scott chi-square test, and adjusted prevalence odds ratios and 95 % confidence intervals were estimated using unconditional logistic regression. OUTCOMES AND RESULTS Of the 20,453 children eligible for our study, 1.5 % had received a diagnosis of ADHD and 77.5 % were reported to have been fed human milk as infants. Prevalence odds of ADHD were 57 % lower among children fed human milk for 6-12 months compared to children never fed human milk after controlling for potential confounders. Among children with durations of breast feeding lasting less than 6 months or lasting 12 months or longer, prevalence odds of ADHD were not significantly lower than the comparison group, children who were never fed human milk, after controlling for potential confounders. CONCLUSIONS AND IMPLICATIONS We noted an inverse association between breast feeding durations of 6-12 months and parent-reported diagnosis of ADHD in preschool-aged children in the U.S. Future studies should use longitudinal designs to examine ADHD and duration of breast-feeding measures.
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Affiliation(s)
- Joy Brasfield
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Sandra M Goulding
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Vijaya Kancherla
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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Olsen EM, Rask CU, Elberling H, Jeppesen P, Clemmensen L, Munkholm A, Li XQ, Hansen MH, Rimvall MK, Linneberg A, Munch IC, Larsen M, Jørgensen T, Skovgaard AM. Cohort Profile: The Copenhagen Child Cohort Study (CCC2000). Int J Epidemiol 2021; 49:370-371l. [PMID: 31876909 DOI: 10.1093/ije/dyz256] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022] Open
Affiliation(s)
- Else Marie Olsen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Aarhus, Aarhus, Denmark
| | - Hanne Elberling
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Services, Capital Region, Copenhagen, Denmark
| | - Pia Jeppesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Services, Capital Region, Copenhagen, Denmark
| | - Lars Clemmensen
- Child and Adolescent Mental Health Services, Capital Region, Copenhagen, Denmark.,Centre for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Anja Munkholm
- Child and Adolescent Mental Health Services, Capital Region, Copenhagen, Denmark.,Department of Paediatrics and Adolescent Medicine, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Xiao Qiang Li
- Department of Ophthalmology, Rigshospitalet Glostrup, Capital Region, Copenhagen, Denmark
| | | | - Martin K Rimvall
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Services, Capital Region, Copenhagen, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Inger Christine Munch
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Ophthalmology, Zealand University Hospital, Region of Zealand, Roskilde, Denmark
| | - Michael Larsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet Glostrup, Capital Region, Copenhagen, Denmark
| | - Torben Jørgensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark.,Faculty of Medicine, Aalborg University, Aarlborg, Denmark
| | - Anne Mette Skovgaard
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
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Holstein BE, Pant SW, Ammitzbøll J, Pedersen TP. Social inequality in parent-infant relations: Epidemiological study of community nurse records. Scand J Public Health 2021; 50:340-346. [PMID: 33461403 DOI: 10.1177/1403494820983137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/16/2022]
Abstract
Background: Some studies suggest that favourable socioeconomic circumstances are associated with better parent-child relations but the documentation of such an association is limited and inconsistent. Few studies focused on infancy, few studies relied on objective measurement of parent-infant relations, and few studies included more than one measurement of parent-infant relations in the first year of life. Aims: To report the prevalence of objectively measured problems in parent-infant relations during the first year of life and to examine the association between socioeconomic circumstances and parent-infant relations in an unselected community sample of infants. Methods: Cross-sectional study of a community sample of children from birth to 10 months in 15 municipalities in Denmark, n = 11,765. The exposure variables were population register data about socioeconomic circumstances: (a) parents' education, (b) family composition, (c) parents' origin, and (d) parents' occupational status. The outcome variable was the health visitor's concerns about the parent-infant relation assessed at four home visits from birth to 10 months after delivery. Results: The proportion of children with concerns about the parent-infant relation was 10.5%, 7.8% at one home visit and 2.8% at two or more home visits. Logistic regression analyses showed that all four indicators of socioeconomic circumstances were associated with concerns about the parent-infant relation in the first year of life. Conclusions: The risk of problematic parent-infant relations were significantly elevated among, children of immigrant parents, and children of parents with shorter education and not in education or work.
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Affiliation(s)
- Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Sofie Weber Pant
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Janni Ammitzbøll
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Denmark
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Abstract
Purpose: During the transition from ingesting milk to ingesting solid food, infants substantiate their eating habits. The present study focuses on this transition. Specifically, it aimed to explore first-time parents’ lived experiences of their infants’ transition from milk to solid foods. Method: The study is based on the descriptive phenomenological approach Reflective Lifeworld Research (RLR). Ten mothers and ten fathers were interviewed twice; when the infants were aged four to five months and again at seven to eight months of age. Data were analysed according to RLR principles. Results: The findings show that the transition from milk to solid food is a demanding in-between phase. The physically intimate feeding situation is replaced by unfamiliar situations in which parents and infant are physically separated and new types of food are introduced. The process of feeding requires parents’ full attention and sensitivity towards the infant’s reactions. Conclusion: The study highlights how shared parental experiences were reflected in frames for how a meal should normally proceed, including parents’ desire to create healthy eating habits and uphold harmony duringfamily meals We suggest for health professionals to present parents with a wider frame of normality, especially as concerns the concept of what constitutes “normal” eating patterns.
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Affiliation(s)
- Annelise Norlyk
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | | | - Hanne Kronborg
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
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Olsen AL, Ammitzbøll J, Olsen EM, Skovgaard AM. Problems of feeding, sleeping and excessive crying in infancy: a general population study. Arch Dis Child 2019; 104:1034-1041. [PMID: 31270094 DOI: 10.1136/archdischild-2019-316851] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/26/2019] [Accepted: 05/20/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To study regulatory problems (RPs) of feeding, sleeping and excessive crying in infancy, and explore the influence of maternal mental health problems and parent-child relationship problems. DESIGN AND SETTING Data were collected in the general child health surveillance delivered to infant families by community health nurses (CHNs). Information on CHNs' assessments and conclusions were obtained on 2598 infants and merged with data from national registers. Descriptive statistics and logistic regression models were used to study RPs in early and late infancy, and the influences due to child, family and parent-child relationship problems. RESULTS Combined RPs (C-RPs), defined as two or more simultaneous problems of feeding, sleeping or excessive crying, was identified in 2.9% and 8.6% of the population between age 2-6 and 8-11 months, respectively. Low maternal schooling and immigrant parents were associated with an increased risk of late C-RPs, but RPs in early infancy stand out as the main predictor of late C-RPs OR 3.4 (95% CI 1.8 to 6.6), and the effect of early maternal mental health problems and parent-child relationship problems seem to be mediated by early C-RPs. CONCLUSIONS Combined problems of feeding, sleeping or excessive crying may exist throughout infancy independently of exposures to maternal mental health problems and parent-child relationship problems. The results indicate that infants with RPs exceeding age 2 months need special attention, in clinical as well as community settings. Suggested intervention includes specific guidance to the parents to help them understand and regulate their infant's sensitivity and reactions.
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Affiliation(s)
- Anne Lise Olsen
- Infant and Toddler Psychiatric Department, Child and Adolescent Centre, University Hospital of Copenhagen, Glostrup, Denmark
| | - Janni Ammitzbøll
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Else Marie Olsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Research Centre for Prevention and Health, Healthcare Services, Capital Region, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Ivanov MV, Simashkova NV, Kozlovskaya GV, Makushkin EV. The epidemiologic study of the risk of autism spectrum disorders in children of 16-24 months in Russia, 2015-2016. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:12-19. [DOI: 10.17116/jnevro20181185212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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