Child Development Disorders, Pervasive

儿童发育障碍,Pervasive
  • 文章类型: Systematic Review
    目的:综述脂联素水平与儿童孤独症谱系障碍(ASDs)的关系。
    背景:ASD与普遍的社交互动和沟通异常有关。研究人员已经研究了ASD的各种病理生理机制,以确定早期诊断的预测因子,以优化治疗结果。免疫功能障碍,可能是由抗炎脂肪因子的减少介导的,脂联素,随着其他脂肪因子的变化,可能在增加ASD风险中起核心作用。然而,其他因素,例如母体维生素D水平低,动脉粥样硬化,糖尿病,肥胖,心脏代谢疾病,早产,和催产素基因多态性也可能导致ASD风险增加。
    方法:在数据库上搜索;PubMed,谷歌学者,和Cochrane使用关键词;脂联素,脂肪因子,ASD,自闭症,自闭症,包括直到2022年9月出版的英语语言研究。数据提取了有和没有ASD的儿童脂联素水平之间的平均差异。
    结果:搜索产生了六项研究,提供了年轻ASD患者脂联素水平的数据。从表1可以看出,六项研究中有四项对ASD和脂联素水平之间的负相关呈阳性。此外,4项阳性研究和1项阴性研究中的2项发现低脂联素水平与自闭症症状的严重程度相关。然而,一项综述研究的结果不显著.
    结论:综述的大多数研究发现ASDs患儿的脂联素水平较低,自闭症症状的严重程度也较低。
    OBJECTIVE: To review the relationship between adiponectin levels and autism spectrum disorders (ASDs) in children.
    BACKGROUND: ASDs are associated with pervasive social interaction and communication abnormalities. Researchers have studied various pathophysiological mechanisms underlying ASDs to identify predictors for an early diagnosis to optimize treatment outcomes. Immune dysfunction, perhaps mediated by a decrease in anti-inflammatory adipokine, adiponectin, along with changes in other adipokines, may play a central role in increasing the risk for ASDs. However, other factors, such as low maternal vitamin D levels, atherosclerosis, diabetes, obesity, cardio-metabolic diseases, preterm delivery, and oxytocin gene polymorphism may also contribute to increased risk for ASDs.
    METHODS: Searches on the database; PubMed, Google Scholar, and Cochrane using keywords; adiponectin, adipokines, ASD, autism, autistic disorder, included English-language studies published till September 2022. Data were extracted on mean differences between adiponectin levels in children with and without ASDs.
    RESULTS: The search yielded six studies providing data on adiponectin levels in young patients with ASDs. As can be seen from Table 1, four of the six studies were positive for an inverse correlation between ASD and adiponectin levels. In addition, two of the four positive and one negative studies found low adiponectin levels associated with and the severity of autistic symptoms. However, results from one reviewed study were insignificant.
    CONCLUSIONS: Most studies reviewed yielded lower adiponectin levels in children with ASDs as well as the severity of autistic symptoms.
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  • 文章类型: Journal Article
    本文的总体目标是通过发育神经科学的视角来检查早期干预的功效。我们首先简要总结从受孕到出生后最初几年的神经发育。我们强调经验在产后的作用,与几十年来对关键时期的研究一致,我们认为,经验既可以代表机遇期,也可以代表脆弱期。因为可塑性是早期干预的核心,接下来,我们将注意力转向从两个不同的文献中获得的早期干预的功效:在不利环境中成长的儿童的早期干预服务,和儿童发生神经发育迟缓或疾病的可能性升高。在前者的情况下,我们选择了针对护理的干预措施,在后者的情况下,我们强调最近在自闭症方面的工作。在我们的审查中,一个一致的主题是讨论早期干预如何嵌入发育中的大脑。我们通过讨论我们的评论对政策的影响来结束我们的文章,然后我们为未来的研究提供建议。
    The overarching goal of this paper is to examine the efficacy of early intervention when viewed through the lens of developmental neuroscience. We begin by briefly summarizing neural development from conception through the first few postnatal years. We emphasize the role of experience during the postnatal period, and consistent with decades of research on critical periods, we argue that experience can represent both a period of opportunity and a period of vulnerability. Because plasticity is at the heart of early intervention, we next turn our attention to the efficacy of early intervention drawing from two distinct literatures: early intervention services for children growing up in disadvantaged environments, and children at elevated likelihood of developing a neurodevelopmental delay or disorder. In the case of the former, we single out interventions that target caregiving and in the case of the latter, we highlight recent work on autism. A consistent theme throughout our review is a discussion of how early intervention is embedded in the developing brain. We conclude our article by discussing the implications our review has for policy, and we then offer recommendations for future research.
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  • 文章类型: Journal Article
    在自闭症谱系儿童中研究的结果类型包括临床特征,比如社会功能,通信,语言,或自闭症症状。在多个时间点测量这些结果的研究有助于提高我们对儿童发展的期望的理解。在轨迹研究中,研究人员在三个或更多时间点评估结果。这种方法比两个时间点研究具有优势,因为它允许研究人员描述发展速度的变化,比如加速度,高原,或减速。我们确定并审查了103项已发表的自闭症诊断儿童(至18岁)的轨迹研究。重要的是,我们没有包括治疗或其效果的研究,我们也没有总结研究结果。相反,这篇综述总结了现有已发表研究的特点,包括使用的方法,随着时间的推移和年龄的推移,已经研究了许多不同的结果。这个总结可能对自闭症患者和看护人(父母)感兴趣,他们想知道关于自闭症儿童发育过程中期望什么的研究的存在。我们建议未来的轨迹研究努力试图弥补低收入和中等收入国家研究的不足;更多关注以下对护理人员和自闭症患者有意义的结果;并试图填补需要更多结果特定数据的年龄差距。
    UNASSIGNED: The types of outcomes studied in children on the autism spectrum include clinical characteristics, such as social functioning, communication, language, or autism symptoms. Research that measures these outcomes at multiple timepoints is useful to improve our understanding of what to expect as children develop. In trajectory studies, researchers assess outcomes at three or more timepoints. This method has advantages over two-timepoint studies because it allows researchers to describe changes in the speed of development, such as accelerations, plateaus, or slowdowns. We identified and reviewed 103 published trajectory studies in children (to age 18 years) with an autism diagnosis. Importantly, we did not include studies of treatments or their effects, nor did we summarize the results of studies. Instead, this review summarizes the characteristics of the available published research, including the methods used, the many different outcomes that have been studied over time and the ages over which they have been studied. This summary may be of interest to autistic people and caregivers (parents) who want to know about the existence of research that provides answers about what to expect during an autistic child\'s development. We have recommended that future trajectory research efforts try to make up for the lack of studies from low- and middle-income countries; that more attention is given to the following outcomes that are meaningful to caregivers and autistic people; and to try to fill in the age gaps where more outcome-specific data are needed.
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  • 文章类型: Journal Article
    自闭症谱系疾病(自闭症)的诊断提供了关于个体功能水平的有限信息,信息是确定支持和资金需求的关键。使用Arksey和O\'Malley引入的框架,这项范围审查旨在确定适合自闭症谱系学龄儿童的功能措施,并评估其总体效用,包括内容相对于国际功能分类的有效性,残疾与健康(ICF)和自闭症的ICF核心集。使用成果测量评级表(OMRF)确定13种包含的工具的总体效用,自适应行为评估系统(ABAS-3)获得最高的整体效用评级。与ICF和ICF自闭症核心集相关的工具的内容有效性各不相同,几乎没有评估工具,包括与ICF的环境因素相关的任何项目。ABAS-3与自闭症综合ICF核心集链接的代码总数最多,而Vineland适应性行为量表(Vineland-3)与自闭症综合ICF核心集和自闭症简要ICF核心集(6-16年)链接的唯一代码数量最多。测量光谱上学龄儿童的功能可能具有挑战性,然而,重要的是要准确地掌握他们的能力,以确保公平和个性化地获得资金和支持。
    A diagnosis of an autism spectrum condition (autism) provides limited information regarding an individual\'s level of functioning, information key in determining support and funding needs. Using the framework introduced by Arksey and O\'Malley, this scoping review aimed to identify measures of functioning suitable for school-aged children on the autism spectrum and evaluate their overall utility, including content validity against the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets for Autism. The overall utility of the 13 included tools was determined using the Outcome Measures Rating Form (OMRF), with the Adaptive Behavior Assessment System (ABAS-3) receiving the highest overall utility rating. Content validity of the tools in relation to the ICF and ICF Core Sets for Autism varied, with few assessment tools including any items linking to Environmental Factors of the ICF. The ABAS-3 had the greatest total number of codes linking to the Comprehensive ICF Core Set for Autism while the Vineland Adaptive Behavior Scales (Vineland-3) had the greatest number of unique codes linking to both the Comprehensive ICF Core Set for Autism and the Brief ICF Core Set for Autism (6-16 years). Measuring functioning of school-aged children on the spectrum can be challenging, however, it is important to accurately capture their abilities to ensure equitable and individualised access to funding and supports.
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  • 文章类型: Journal Article
    尽管有大量的研究和临床证据表明音乐干预对自闭症患者的有效性,在这个社区对音乐处理的理解是有限的。我们探讨了自闭症社区内音乐处理差异的研究证据是否可用。我们进行了范围审查,以搜索带有“音乐”一词的文献,“处理,\"和\"自闭症\"(和变体)。我们搜索了PubMed,CINAHL,Scopus,WebofScience,PsycInfo,学术搜索完成,ERIC,和音乐索引数据库共10,857篇文章,有5,236个重复。其余5,621个标题和摘要由四名本科生和研究生以及PI组成的团队进行了资格筛选。纳入75项研究进行数据提取。对数据进行了描述性统计分析,study,刺激,和参与者信息,以及对结果和发现的主题分析。鉴于文献的新兴性质,我们的发现是初步的,主要使用非音乐听觉刺激,被动聆听体验,和低估的人口统计。然而,文献显示了自闭症患者在音乐处理方面存在差异的一些证据,包括减少对非音乐和音乐刺激的习惯;截断,延迟,或不同的发育轨迹;以及可能的补偿性高阶机制,即使在存在不同的神经相关因素的情况下也能产生相似的行为反应。鼓励音乐治疗师采取发展的观点,不仅是一般技能,但特别是这个社区的音乐技能发展,为了谨慎地推断这些发现,鉴于目前证据的局限性。
    Despite abundant research and clinical evidence of the effectiveness of music interventions for people in the autism spectrum, understanding of music processing in this community is limited. We explored whether research evidence of differences in music processing within the autistic community is available. We developed a scoping review to search for literature with the terms \"music\", \"processing,\" and \"autism\" (and variants). We searched PubMed, CINAHL, Scopus, Web of Science, PsycInfo, Academic Search Complete, ERIC, and Music Index databases for a total of 10,857 articles, with 5,236 duplicates. The remaining 5,621 titles and abstracts were screened for eligibility by a team of four undergraduate and graduate students and the PI. Seventy-five studies were included for data extraction. Data were analyzed with descriptive statistics regarding author, study, stimulus, and participant information, and a thematic analysis of outcome and findings. Our findings are preliminary given the emerging nature of the literature, the use of mostly non-musical auditory stimuli, passive listening experiences, and underreported demographics. However, the literature shows some evidence of differences in music processing for autistic individuals, including reduced habituation to non-musical and musical stimuli; truncated, delayed, or divergent developmental trajectories; and possible compensatory higher-order mechanisms that yield similar behavioral responses even in the presence of divergent neural correlates. Music therapists are encouraged to adopt a developmental perspective, not only of general skills, but specifically of music skill development in this community, and to extrapolate these findings with caution, given the current limitations in the evidence.
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  • 文章类型: Journal Article
    培训初级保健提供者为自闭症谱系障碍(ASD)提供诊断评估,减少等待时间并改善诊断访问。尚未系统地审查与这些评估的质量以及对系统能力的影响有关的结果。本系统综述确定并总结了已发表的研究,其中包括针对初级保健提供者(PCP)的ASD诊断培训,旨在指导未来的培训和评估方法。
    电子数据库的系统搜索,引用列表,期刊确定了6项符合3项纳入标准的研究:PCP培训,社区设置,并报告培训结果。对这些研究进行了严格的审查,以描述(1)研究设计,(2)培训模式,(3)结果。
    所有研究要么是前期设计,要么是非随机试验,参与者数量相对较少。关于提供的培训和计划评估过程的研究之间存在相当大的异质性。评估最多的结果是获得自闭症诊断和诊断准确性。
    对PCP进行ASD诊断的培训可以与专业团队评估达成较高的诊断协议,并减少诊断等待时间。当前数据受到样本量小的限制,低质量到公平质量的研究方法,以及异质研究设计和结果评估。证据不足以得出关于训练PCP进行ASD诊断评估的总体效果的结论。由于还需要进一步的研究,本综述强调了在评估ASD评估的质量时需要考虑哪些结果。
    Training primary care providers to provide diagnostic assessments for autism spectrum disorder (ASD) decreases wait times and improves diagnostic access. Outcomes related to the quality of these assessments and the impacts on system capacity have not been systematically examined. This systematic review identifies and summarizes published studies that included ASD diagnostic training for primary care providers (PCPs) and aims to guide future training and evaluation methods.
    Systematic searches of electronic databases, reference lists, and journals identified 6 studies that met 3 inclusion criteria: training for PCPs, community setting, and training outcome(s) reported. These studies were critically reviewed to characterize (1) study design, (2) training model, and (3) outcomes.
    All studies were either pre-post design or nonrandomized trials with a relatively small number of participants. There was considerable heterogeneity among studies regarding the training provided and the program evaluation process. The most evaluated outcomes were access to autism diagnosis and accuracy of diagnosis.
    Training PCPs to make ASD diagnoses can yield high diagnostic agreement with specialty teams\' assessments and reduce diagnostic wait times. Current data are limited by small sample size, poor to fair quality study methodology, and heterogenous study designs and outcome evaluations. Evidence is insufficient to draw conclusions about the overall effects of training PCPs for ASD diagnostic assessments. Since further research is still needed, this review highlights which outcomes are relevant to consider when evaluating the quality of ASD assessments across the continuum of approaches.
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  • 文章类型: Journal Article
    近年来,对避免病理性需求的诊断要求有所增加,但是避免病态需求仍然是一个有争议的问题。病理性需求回避的概念因破坏自闭症患者的自我倡导而受到批评,并忽略了焦虑作为潜在或促成原因的潜在作用。本研究旨在总结和回顾当前研究对儿童和青少年病理需求回避的方法学质量和发现。进一步的目的是描述如何确定避免病理性需求,并探索与自闭症和其他发育和精神疾病的关系。经过全面搜索,确定了13项使用广泛方法的相关研究,并进行了系统的质量评估。所有研究都基于病理需求回避的识别,直接或间接,纽森及其同事的原始研究描述。然而,用于制定这些标准的方法没有明确描述.大多数研究完全依赖父母报告的数据,并且普遍未能考虑所研究行为的替代解释。没有研究探索具有病理需求回避的个体的观点。目前,所审查研究中有关定义和测量的问题限制了有关所描述行为的均匀性或稳定性的任何结论,或者展示它们的个人特征。病理性需求回避与其他情绪和行为困难之间的关系应在未来的研究中探索,病态个体的观点也需要自己回避。
    Requests for diagnoses of pathological demand avoidance have increased over recent years, but pathological demand avoidance remains a controversial issue. The concept of pathological demand avoidance has been criticised for undermining the self-advocacy of autistic people and neglecting the potential role of anxiety as a possible underlying or contributing cause. The current study was undertaken to summarise and review the methodological quality and findings from current research into pathological demand avoidance in children and adolescents. Further aims were to describe how pathological demand avoidance has been identified and to explore the relationships with autism and other developmental and psychiatric disorders. After a comprehensive search, 13 relevant studies using a wide range of methods were identified and systematic quality assessments were undertaken. All the studies had based the identification of pathological demand avoidance, directly or indirectly, on descriptions from the original study by Newson and colleagues. However, the methods used to develop these criteria were not clearly described. Most studies relied exclusively on parental report for data, and there was a general failure to take account of alternative explanations for the behaviours under study. No studies explored the views of individuals with pathological demand avoidance themselves. Problems concerning definition and measurement in the reviewed studies currently limit any conclusions regarding the uniformity or stability of the behaviours described, or the characteristics of individuals displaying them. Relationships between pathological demand avoidance and other emotional and behavioural difficulties should be explored in future research, as should the perspectives of individuals with pathological demand avoidance themselves.
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  • 文章类型: Journal Article
    背景:尽管进入劳动力市场有困难,自闭症谱系的人通常是成功的。此外,他们被建议带来独特的能力(例如,注重细节,对重复性任务的容忍度)与重复性和限制性行为和兴趣(RRBI)诊断领域相关,这可能对就业有利。
    目的:这项关键和系统的综述检查了支持自闭症谱系员工卓越工作场所表现的证据,特别是关于RRBI域。
    方法:一项系统评价(PRISMA指南)评估了经验性同行评审研究,该研究评估了自闭症谱系员工在工作场所或特定工作任务中的表现。搜索了9个数据库,从参考清单和咨询中确定了其他论文。
    结果:两篇定量论文和四篇定性论文符合标准。结果反映主题;注重细节,对重复性任务的容忍度,特殊/限制利益,其他与RBI相关的优势/关注点。
    结论:由于已确定研究的性质和质量,目前没有强有力的证据支持或否定工作场所自闭症的优势。这篇评论强调了更多研究的必要性,并敦促限制使用可能不适用于自闭症谱系的所有人的刻板印象,争论个体差异的方法来支持自闭症在工作中的优势。
    BACKGROUND: Despite difficulties entering the workforce, people on the autism spectrum are often successful. Furthermore, they are suggested to bring unique abilities (e.g., attention to detail, tolerance for repetitive tasks) related to the repetitive and restrictive behaviours and interests (RRBI) diagnostic domain, that may be advantageous in employment.
    OBJECTIVE: This critical and systematic review examined evidence supporting the superior workplace performance of employees on the autism spectrum, particularly regarding the RRBI domain.
    METHODS: A systematic review (PRISMA guidelines) evaluated empirical peer-reviewed studies that assess employees on the autism spectrum\'s performance in the workplace or on work-specific tasks. Nine databases were searched, with additional papers identified from reference lists and consultation.
    RESULTS: Two quantitative and four qualitative papers met criteria. Results reflect themes; attention to detail, tolerance of repetitive tasks, special/circumscribed interests, other RRBI related advantages/concerns.
    CONCLUSIONS: Due to the nature and quality of the identified studies there is currently no strong evidence supporting or negating a workplace autism advantage. This review highlights the need for more research and urges constraint in utilising stereotypes that may not apply to all on the autism spectrum, arguing an individual differences approach to supporting autism strengths at work.
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  • 文章类型: Journal Article
    普遍拒绝综合征(PRS)是一种复杂的疾病,会影响年轻人导致社交退缩,不能或拒绝进食,喝,动员或说话。受影响的个体退步,无法自理,相当典型地将抵制康复,因赞美而恶化或完全被动。本系统综述旨在描述PRS的临床特征,目前的干预措施,并总结了这种情况的一些疾病方面。没有语言限制,在Embase进行了电子搜索,PsychInfo,Medline,科克伦图书馆,和PubMed数据库产生29篇文章,共79例。我们使用经过调整的纽卡斯尔-渥太华量表进行了评估偏倚风险,并遵守了系统评估和荟萃分析(PRISMA)指南的首选报告项目。确定了124篇文章,其中29例包括在内,共79例。76%的研究具有较低的评估偏倚风险(质量好)。我们的结果表明,PRS与几个条件重叠,主要影响7-15岁的年轻女性,如果早期诊断和治疗,治愈率为78%,但住院治疗的持续时间可能长达9.44个月(8.82SD)。患者有多种相互依赖的风险。主要的诱发因素包括脆弱的病前人格和预先存在的精神障碍。诱发因素是压力源,例如感染和创伤经历。嵌入的父子关系是一个维持因素。治疗方法的主题基本上是康复:(1)与患者和家人合作,(2)接触多学科团队,(3)同行/团体监督。这项研究系统地评估了大量PRS患者的样本,以确定其临床特征和治疗的核心要素。它的主要治疗方法是一种富有同情心的多模式康复策略,透明和包容。
    Pervasive refusal syndrome (PRS) is a complex condition that affects young people leading to social withdrawal, inability or refusal to eat, drink, mobilise or speak. The affected individual regresses and is unable to self-care and quite characteristically will resist rehabilitation, worsen with praise or remain entirely passive. This systematic review was aimed at describing clinical features of PRS, current interventions and to summarise some of the nosological aspects of the condition. Without language restriction, an electronic search was conducted in Embase, PsychInfo, Medline, Cochrane library, and PubMed databases yielding 29 articles with a total of 79 cases. We performed a risk of assessment bias using an adapted Newcastle-Ottawa Scale and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 124 articles were identified, of which 29 were included and these yielded 79 cases. Seventy-six percent of the studies had a low rate of risk of assessment bias (good quality). Our results show that PRS overlaps with several conditions, mainly affects young females aged 7-15 years and has a recovery rate of 78% if diagnosed and treated early but the duration of inpatient treatment may last up to 9.44 months (8.82 SD). The patients had multiple inter-dependent risks. The major predisposing factors included vulnerable premorbid personality and pre-existing mental disorder. Precipitating factors were stressors such as infection and traumatic experiences. Enmeshed parent-child relationship served as a maintaining factor. The themes of treatment approach are essentially rehabilitative: (1) working collaboratively with patient and family, (2) having access to multidisciplinary team, and (3) peer/group supervision. This study has systematically evaluated a large sample of patients with PRS to ascertain its clinical features and the core elements of its treatment. Its key treatment approach is a multi-modal rehabilitative strategy that is compassionate, transparent and inclusive.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)是指与言语和非言语交流相关的神经发育状况,社交互动,和行为并发症在全球许多地方变得越来越普遍。在过去的几十年中,识别频谱上的个体仍然是一个漫长的过程,因为一些被诊断患有ASD的个体在数学等领域表现出非凡的技能。arts,和其他音乐。为了提高自闭症诊断的准确性和可靠性,许多学者开发了诊断前筛查方法,以帮助早期识别自闭症行为,加快临床诊断转诊流程,并提高所涉及的不同利益相关者对ASD的理解,比如父母,看护者,教师,和家庭成员。然而,这些筛查工具的功能和可靠性因不同的研究而不同,有些仍然值得怀疑。本研究评估并批判性地分析了37种不同的ASD筛查工具,以确定需要通过进一步开发和创新来解决的可能领域。更重要的是,与现有筛选工具相关的不同标准,例如可访问性,精神疾病诊断和统计手册(DSM-5)规范的实现,目标受众之间的可理解性,性能(特别是灵敏度,特异性,和准确性),Web和移动可用性,和受欢迎程度已经被调查。
    Autistic spectrum disorder (ASD) refers to a neurodevelopmental condition associated with verbal and nonverbal communication, social interactions, and behavioural complications that is becoming increasingly common in many parts of the globe. Identifying individuals on the spectrum has remained a lengthy process for the past few decades due to the fact that some individuals diagnosed with ASD exhibit exceptional skills in areas such as mathematics, arts, and music among others. To improve the accuracy and reliability of autism diagnoses, many scholars have developed pre-diagnosis screening methods to help identify autistic behaviours at an early stage, speed up the clinical diagnosis referral process, and improve the understanding of ASD for the different stakeholders involved, such as parents, caregivers, teachers, and family members. However, the functionality and reliability of those screening tools vary according to different research studies and some have remained questionable. This study evaluates and critically analyses 37 different ASD screening tools in order to identify possible areas that need to be addressed through further development and innovation. More importantly, different criteria associated with existing screening tools, such as accessibility, the fulfilment of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifications, comprehensibility among the target audience, performance (specifically sensitivity, specificity, and accuracy), web and mobile availability, and popularity have been investigated.
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