Descripción general
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Las displasias esqueléticas, también conocidas como osteocondrodisplasias, son un grupo clínica y fenotípicamente heterogéneo de más de 450 trastornos hereditarios caracterizados por anomalías principalmente en el crecimiento del cartílago y hueso, aunque también pueden afectar músculos, tendones y ligamentos, lo que resulta en una forma y tamaño anormales del esqueleto. y desproporción de huesos largos, columna y cabeza. Se diferencian en historias naturales, pronósticos, patrones de herencia y mecanismos fisiopatológicos. Varían en severidad desde aquellos que son embrionariamente letales hasta aquellos con mínima morbilidad. Aproximadamente el 5% de los niños con defectos de nacimiento congénitos tienen displasias esqueléticas. Hasta hace poco, el diagnóstico de displasia esquelética se basaba casi exclusivamente en un fenotipado cuidadoso; sin embargo, el advenimiento de las pruebas genómicas tiene el potencial de hacer un diagnóstico más preciso y definitivo basado en el diagnóstico clínico sospechado. Las 4 displasias esqueléticas más frecuentes son la displasia tanatofórica, la acondroplasia, la osteogénesis imperfecta y la acondrogénesis. El patrón de herencia de las displasias esqueléticas es variable e incluye autosómico dominante, recesivo y ligado al cromosoma X.
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El panel de precisión de displasias esqueléticas de Igenomix se puede utilizar para realizar un diagnóstico diferencial directo y preciso de las anomalías esqueléticas que, en última instancia, conducen a un mejor tratamiento y pronóstico de la enfermedad. Proporciona un análisis completo de los genes involucrados en esta enfermedad utilizando secuenciación de próxima generación (NGS) para comprender completamente el espectro de genes relevantes involucrados.
Indicaciones
- El panel de precisión de displasia esquelética de Igenomix está indicado para aquellos pacientes con un diagnóstico clínico sospechado de displasia esquelética que presente las siguientes manifestaciones:
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Antecedentes familiares de displasia esquelética.
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Múltiples abortos espontáneos o mortinatos en una familia
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Hidramnios materno (exceso de líquido amniótico durante el embarazo)
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Hidropesía fetal (edema fetal generalizado)
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Baja estatura desproporcionada
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Discapacidad intelectual
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Baja estatura desproporcionada
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Otras manifestaciones asociadas
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Ocular: cataratas, miopía
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Cavidad bucal: úvula bífida, paladar hendido
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Sistema nervioso central (SNC): procesos patológicos intracraneales, deterioro neurológico
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Piel: pliegues cutáneos redundantes, acantosis nigricans
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Polidactilia
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Uñas: Uñas hipoplásticas
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Articulaciones: múltiples dislocaciones de unión
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Fracturas de huesos largos
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Corazón: comunicación interauricular, conducto arterioso persistente, transposición de grandes vasos
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Utilidad clínica
La utilidad clínica de este panel es:
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La confirmación genética y molecular para un diagnóstico clínico preciso de un paciente sintomático.
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Inicio temprano del tratamiento con un equipo multidisciplinario que incluye tratamiento de apoyo en forma de atención médica, atención quirúrgica temprana, rehabilitación y fisioterapia.
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Detección prenatal de displasias esqueléticas para un tratamiento obstétrico y perinatal dirigido de los lactantes afectados.
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Combinar datos fenotípicos y genotípicos para mejorar la tasa de diagnóstico de estos pacientes en la población objetivo.
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Evaluación de riesgo de familiares asintomáticos según el modo de herencia.
Genes y enfermedades
GENE |
OMIM DISEASES |
INHERITANCE* |
% GENE COVERAGE (20X) |
HGMD** |
||
ABCC9 |
Acromegaloid Facial |
AD |
100% |
51 of 51 |
||
ACAN |
Osteochondritis Dissecans, |
AD,AR |
86.19% |
63 of 65 |
||
ACP5 |
Combined Immunodeficiency |
AR |
100% |
27 of 28 |
||
ACTB |
Baraitser-Winter Cerebrofrontofacial |
AD |
100% |
40 of 40 |
||
ACTG1 |
Baraitser-Winter Cerebrofrontofacial |
AD |
98.59% |
55 of 55 |
||
AFF4 |
Chops Syndrome, |
AD |
99.42% |
6 of 6 |
||
AIFM1 |
Combined Oxidative |
X,XR,G |
100% |
NA of NA |
||
AKT1 |
Breast Cancer, |
AD |
100% |
6 of 6 |
||
ALDH3A2 |
Sjogren-Larsson |
AR |
96% |
119 of 119 |
||
ALG9 |
ALG9-CDG Congenital |
AR |
99.99% |
6 of 6 |
||
ANAPC1 |
Rothmund-Thomson |
AR |
86.31% |
3 of 4 |
||
ANKH |
Chondrocalcinosis, |
AD |
100% |
19 of 19 |
||
ANOS1 |
Hypogonadotropic |
X,XR,G |
96.86% |
NA of NA |
||
ARSB |
Mucopolysaccharidosis |
AR |
99.83% |
217 of 220 |
||
B3GALT6 |
Ehlers-Danlos Syndrome |
AR |
65.09% |
24 of 39 |
||
B4GALT7 |
B4GALT7-Related |
AR |
99.92% |
11 of 11 |
||
BGN |
Meester-Loeys Syndrome, |
X,XR,G |
99.87% |
NA of NA |
||
BMPR1B |
Acromesomelic Dysplasia |
AD,AR |
100% |
33 of 34 |
||
CANT1 |
Desbuquois Dysplasia, |
AR |
99.98% |
29 of 30 |
||
CCDC141 |
Hypogonadotropic |
AR |
99,70% |
1 of 1 |
||
CDH3 |
Eem Syndrome, |
AR |
95% |
34 of 36 |
||
CDKN1C |
Beckwith-Wiedemann Syndrome, |
AD |
73.58% |
55 of 76 |
||
CEP120 |
Jeune Syndrome, |
AR |
99.80% |
9 of 9 |
||
CFAP410 |
Amyotrophic Lateral |
AR |
na |
na |
||
CHD7 |
CHARGE Syndrome, |
AD |
96.25% |
823 of 896 |
||
CHST3 |
CHST3-Related Skeletal |
AR |
99.97% |
38 of 38 |
||
COL10A1 |
Metaphyseal |
AD |
96.18% |
55 of 55 |
||
COL11A1 |
Autosomal Dominant |
AD,AR |
100% |
104 of 106 |
||
COL11A2 |
Autosomal Dominant |
AD,AR |
99.98% |
58 of 58 |
||
COL1A1 |
Arthrochalasia, |
AD |
99.98% |
1156 of 1159 |
||
COL1A2 |
Arthrochalasia Ehlers-Danlos |
AD,AR |
100% |
576 of 581 |
||
COL2A1 |
Achondrogenesis Type 2, |
AD,MU |
100% |
583 of 583 |
||
COL3A1 |
Acrogeria, Ehlers-Danlos |
AD,AR |
100% |
676 of 676 |
||
COL9A1 |
Autosomal Recessive |
AD,AR |
99.98% |
8 of 8 |
||
COL9A2 |
Autosomal Recessive Stickler |
AD,AR |
100% |
16 of 16 |
||
COL9A3 |
Autosomal Recessive Stickler |
AD |
99.98% |
20 of 20 |
||
COMP |
Multiple Epiphyseal Dysplasia, |
AD |
99.71% |
189 of 189 |
||
CTSA |
Galactosialidosis, |
AR |
100% |
40 of 40 |
||
CTSK |
Pycnodysostosis |
AR |
99.97% |
59 of 59 |
||
CWC27 |
Retinitis Pigmentosa |
AR |
99.77% |
8 of 8 |
||
DCC |
Colorectal Cancer, |
AD,AR |
94% |
39 of 39 |
||
DCHS1 |
Cerebrofacioarticular Syndrome, |
AD,AR |
99.69% |
30 of 30 |
||
DDR2 |
Spondylometaepiphyseal |
AD,AR |
100% |
13 of 13 |
||
DDRGK1 |
Spondyloepimetaphyseal |
AR |
99.94% |
1 of 1 |
||
DMP1 |
Autosomal Recessive |
AR |
99.89% |
11 of 11 |
||
DNAJC21 |
Bone Marrow |
AR |
99.83% |
12 of 12 |
||
DUSP6 |
Hypogonadotropic Hypogonadism |
AD,AR |
99.36% |
4 of 4 |
||
DYM |
Dyggve-Melchior-Clausen |
AR |
90% |
37 of 37 |
||
DYNC2H1 |
Jeune Syndrome, |
AR,MU,D |
99.78% |
214 of 221 |
||
DYNC2I1 |
Jeune Syndrome, |
AR |
97.76% |
14 of 14 |
||
DYNC2I2 |
Jeune Syndrome, |
AR |
99.54% |
23 of 23 |
||
DYNC2LI1 |
Ellis Van Creveld Syndrome, |
AR |
91.58% |
16 of 16 |
||
EIF2AK3 |
Multiple Epiphyseal |
AR |
99.30% |
89 of 89 |
||
ENPP1 |
Generalized Arterial |
AD,AR,MU,P |
96.59% |
73 of 75 |
||
ERF |
Chitayat Syndrome, |
AD |
99.73% |
31 of 31 |
||
EXOC6B |
Spondyloepimetaphyseal |
AR |
99.99% |
2 of 3 |
||
EXTL3 |
Immunoskeletal Dysplasia |
AR |
99.99% |
10 of 10 |
||
FAM111A |
Autosomal Dominant |
AD |
99.47% |
9 of 10 |
||
FAT4 |
Cerebrofacioarticular |
AR |
99.80% |
41 of 41 |
||
FEZF1 |
Hypogonadotropic |
AR |
99.95% |
3 of 3 |
||
FGF17 |
Hypogonadotropic |
AD,AR |
99.98% |
8 of 8 |
||
FGF8 |
Alobar Holoprosencephaly, |
AD |
98.36% |
38 of 38 |
||
FGFR1 |
Encephalocraniocutaneous |
AD |
100% |
279 of 280 |
||
FGFR3 |
Severe Achondroplasia With |
AD,AR |
99.89% |
77 of 78 |
||
FLNA |
X-linked Cardiac Valvular |
X,XR,XD,G |
100% |
NA of NA |
||
FLNB |
Atelosteogenesis |
AD,AR |
100% |
124 of 124 |
||
FLRT3 |
Hypogonadotropic |
AD |
99.98% |
7 of 7 |
||
FN1 |
Fibronectin Glomerulopathy, |
AD |
100% |
34 of 34 |
||
GDF5 |
Acromesomelic Dysplasia |
AD,AR |
99.48% |
48 of 51 |
||
GJA1 |
Alopecia Congenita With |
AD,AR,MU,O |
100% |
119 of 119 |
||
GLI3 |
Acrocallosal Syndrome, |
AD,AR |
100% |
231 of 231 |
||
GNAS |
ACTH-Independent |
AD |
99.95% |
263 of 273 |
||
GPX4 |
Spondylometaphyseal |
AR |
79.72% |
3 of 3 |
||
HBB |
Alpha-Thalassemia, |
AD,AR |
100% |
753 of 789 |
||
HDAC6 |
Chondrodysplasia With |
X,XD,G |
100% |
NA of NA |
||
HESX1 |
Combined Pituitary |
AD,AR |
100% |
26 of 26 |
||
HS6ST1 |
Hypogonadotropic |
AD |
99.97% |
8 of 8 |
||
HSPA9 |
Autosomal Dominant |
AD,AR |
99.72% |
14 of 14 |
||
HSPG2 |
Dyssegmental Dysplasia |
AR |
99.41% |
68 of 69 |
||
IARS2 |
Cataract-Growth Hormone |
AR |
99.95% |
11 of 11 |
||
IDUA |
Hurler Syndrome, |
AR |
99.73% |
287 of 292 |
||
IFT140 |
Jeune Syndrome, |
AR |
99.97% |
81 of 81 |
||
IFT172 |
Bardet-Biedl Syndrome, |
AR |
100% |
37 of 37 |
||
IFT80 |
Asphyxiating Thoracic |
AR |
99.96% |
16 of 16 |
||
IHH |
Acrocapitofemoral |
AD,AR |
99.39% |
28 of 29 |
||
IL17RD |
Hypogonadotropic |
AD,AR |
99.95% |
17 of 17 |
||
KCNJ8 |
Brugada Syndrome, |
|
100% |
8 of 8 |
||
KIF22 |
Spondyloepimetaphyseal |
AD |
100% |
4 of 4 |
||
KIF7 |
Acrocallosal Syndrome, |
AR |
94.91% |
47 of 50 |
||
KISS1R |
Hypogonadotropic |
AD,AR |
99.41% |
42 of 43 |
||
KRAS |
Aplasia Cutis Congenita |
AD |
100% |
38 of 38 |
||
LBR |
Greenberg Dysplasia, |
AD,AR |
99.98% |
34 of 34 |
||
LEMD3 |
12q14 Microdeletion Syndrome, |
AD |
99.06% |
30 of 33 |
||
LIFR |
Stuve-Wiedemann |
AR |
99.81% |
33 of 33 |
||
LMX1B |
9q33.3q34.11 Microdeletion |
AD |
100% |
191 of 191 |
||
LONP1 |
Codas Syndrome |
AR |
99.84% |
21 of 21 |
||
LOXL3 |
Autosomal Recessive |
|
99.97% |
7 of 7 |
||
LTBP3 |
Acromicric Dysplasia, |
AD,AR |
97.67% |
22 of 23 |
||
MAB21L2 |
Syndromic Microphthalmia |
AD,AR |
99.97% |
8 of 8 |
||
MATN3 |
Multiple Epiphyseal Dysplasia, |
AD,AR |
86.16% |
24 of 25 |
||
MBTPS1 |
Spondyloepiphyseal |
AR |
99.99% |
5 of 5 |
||
MMP13 |
Metaphyseal Anadysplasia, |
AD,AR |
100% |
10 of 10 |
||
MYSM1 |
Bone Marrow Failure Syndrome, |
AR |
98.50% |
4 of 4 |
||
NANS |
Spondyloepimetaphyseal Dysplasia, |
AR |
99.97% |
12 of 12 |
||
NEU1 |
Congenital Sialidosis Type 2, |
AR |
100% |
68 of 68 |
||
NKX3-2 |
Spondylo-Megaepiphyseal- |
AR |
99.02% |
5 of 5 |
||
NLRC4 |
Autoinflammation With Infantile |
AD |
99.54% |
15 of 15 |
||
NLRP3 |
Cinca Syndrome, |
AD |
100% |
152 of 152 |
||
NOTCH2 |
Acroosteolysis Dominant Type, |
AD |
99.88% |
91 of 91 |
||
NPR2 |
Acromesomelic Dysplasia, |
AD,AR |
100% |
81 of 81 |
||
NSMF |
Hypogonadotropic |
AD |
99.69% |
11 of 11 |
||
P4HB |
Cole-Carpenter Syndrome |
AD |
94.97% |
13 of 13 |
||
PAM16 |
Chondrodysplasia, |
AR |
41% |
2 of 2 |
||
PAPSS2 |
Spondyloepimetaphyseal |
AR |
99.97% |
27 of 27 |
||
PCYT1A |
Leber Congenital Amaurosis, |
AR |
99.98% |
22 of 22 |
||
PEX1 |
Deafness-Enamel |
AR |
97.02% |
126 of 134 |
||
PEX10 |
Autosomal Recessive |
AR |
99.76% |
29 of 32 |
||
PEX11B |
Infantile Refsum Disease, |
AR |
90.29% |
7 of 7 |
||
PEX12 |
Infantile Refsum Disease, |
AR |
100% |
38 of 38 |
||
PEX13 |
Infantile Refsum Disease, |
AR |
99.98% |
11 of 12 |
||
PEX14 |
Infantile Refsum Disease, |
AR |
100% |
4 of 4 |
||
PEX16 |
Infantile Refsum Disease, |
AR |
100% |
17 of 17 |
||
PEX19 |
Infantile Refsum Disease, |
AR |
100% |
5 of 5 |
||
PEX2 |
Infantile Refsum Disease, |
AR |
99.89% |
17 of 17 |
||
PEX26 |
Infantile Refsum Disease, |
AR |
100% |
29 of 29 |
||
PEX3 |
Infantile Refsum Disease, |
AR |
100% |
9 of 9 |
||
PEX5 |
Adrenoleukodystrophy, |
AR |
100% |
12 of 12 |
||
PEX6 |
Autosomal Recessive Spinocerebellar |
AD,AR |
99.94% |
105 of 108 |
||
PEX7 |
Peroxisome Biogenesis Disorder 9B, |
AR |
99.21% |
47 of 53 |
||
PHYH |
Refsum Disease |
AR |
100% |
34 of 34 |
||
POLE |
Colorectal Cancer, |
AD,AR |
100% |
100 of 100 |
||
POLR1C |
Hypomyelination-Hypogonadotropic |
AR |
99.99% |
35 of 35 |
||
POLR1D |
Treacher Collins Syndrome |
AD,AR |
100% |
23 of 23 |
||
POP1 |
Anauxetic Dysplasia |
AR |
99.88% |
6 of 6 |
||
PROK2 |
Hypogonadotropic |
AD |
100% |
20 of 20 |
||
PROKR2 |
Hypogonadotropic Hypogonadism |
AD |
100% |
64 of 64 |
||
PTEN |
Bannayan-Riley-Ruvalcaba |
AD |
99.97% |
609 of 629 |
||
PTH1R |
Blomstrand Lethal |
AD,AR |
100% |
48 of 48 |
||
RECQL4 |
Baller-Gerold Syndrome, |
AR |
96.72% |
134 of 135 |
||
RMRP |
Anauxetic Dysplasia, |
AR |
na |
na |
||
RNU4ATAC |
Lowry-Wood Syndrome, |
AR |
na |
na |
||
RPL10 |
X-linked Mental Retardation, |
X,XR,G |
100% |
NA of NA |
||
RSPRY1 |
Progressive |
AR |
99.98% |
4 of 4 |
||
RUNX2 |
Cleidocranial Dysplasia, |
AD |
73.67% |
189 of 190 |
||
SBDS |
Aplastic Anemia, |
AR |
100% |
77 of 79 |
||
SEC23A |
Craniolenticulosutural Dysplasia |
AR |
100% |
4 of 4 |
||
SEC24D |
Cole-Carpenter Syndrome |
AR |
99.97% |
14 of 14 |
||
SEMA3A |
Brugada Syndrome, |
AD |
100% |
29 of 29 |
||
SF3B4 |
Acrofacial Dysostosis, |
AD |
94.86% |
33 of 40 |
||
SFRP4 |
Pyle Disease |
AR |
99.95% |
5 of 5 |
||
SLC10A7 |
Short Stature, |
AR |
99.99% |
8 of 8 |
||
SLC26A2 |
Achondrogenesis Type 1B, |
AR |
99.59% |
51 of 56 |
||
SLC39A13 |
Ehlers-Danlos |
AR |
100% |
9 of 9 |
||
SMARCAL1 |
Immunoosseous Dysplasia, |
AR |
99.94% |
93 of 93 |
||
SOX10 |
Kallmann Syndrome, |
AD |
99.74% |
139 of 147 |
||
SPRY4 |
Hypogonadotropic |
AD,AR |
99.72% |
13 of 13 |
||
SRP54 |
Autosomal Dominant |
AD,AR |
99.95% |
8 of 8 |
||
STAC3 |
Native American Myopathy |
AR |
99.98% |
5 of 5 |
||
TACR3 |
Hypogonadotropic |
AR |
99.97% |
40 of 40 |
||
TBXAS1 |
Ghosal Hematodiaphyseal |
AR |
100% |
6 of 6 |
||
TCOF1 |
Treacher Collins-Franceschetti |
AD |
100% |
326 of 327 |
||
TGFB1 |
Camurati-Engelmann Disease, Cystic |
AD,AR |
99.75% |
24 of 24 |
||
TMEM165 |
Congenital Disorder Of |
AR |
93.69% |
4 of 5 |
||
TMEM67 |
Bardet-Biedl Syndrome, |
AR |
96.93% |
177 of 179 |
||
TONSL |
Sponastrime Dysplasia, |
AR |
98.76% |
36 of 40 |
||
TRAPPC2 |
X-linked Spondyloepiphyseal |
X,XR,G |
99.58% |
NA of NA |
||
TREM2 |
Amyotrophic Lateral Sclerosis, |
AD |
100% |
55 of 55 |
||
TRIP11 |
Achondrogenesis Type 1A, |
AR |
98.94% |
20 of 21 |
||
TRPV4 |
Autosomal Dominant |
AD |
100% |
88 of 88 |
||
TTC21B |
Asphyxiating Thoracic Dystrophy, |
AD,AR |
100% |
67 of 67 |
||
TYROBP |
Nasu-Hakola Disease, |
AR |
100% |
12 of 13 |
||
UFSP2 |
Hip Dysplasia, |
AD |
99.83% |
3 of 3 |
||
VPS33A |
Mucopolysaccharidosis-Like |
AR |
97.86% |
1 of 1 |
||
WDR11 |
Hypogonadotropic |
AD,AR |
100% |
19 of 19 |
||
WDR19 |
Asphyxiating Thoracic Dystrophy, |
AR |
99.96% |
47 of 49 |
||
WDR35 |
Cranioectodermal Dysplasia, |
AR |
100% |
31 of 33 |
||
XYLT1 |
Desbuquois Dysplasia, |
AR |
92.61% |
19 of 23 |
* Herencia: AD: Autosómico Dominante; AR: autosómico recesivo; X: ligado a X; XLR: recesivo vinculado a X; Mi: mitocondrial; Mu: multifactorial; G: herencia gonosomal; D: herencia digénica
** HGMD: número de mutaciones clínicamente relevantes según HGMD
Referencias
Nikkel, S. (2017). Skeletal Dysplasias: What Every Bone Health Clinician Needs to Know. Current Osteoporosis Reports, 15(5), 419-424. doi: 10.1007/s11914-017-0392-x
Calder, A. (2020). The changing world of skeletal dysplasia. The Lancet Child & Adolescent Health, 4(4), 253-254. doi: 10.1016/s2352-4642(20)30056-0
Mortier, G., Cohn, D., Cormier‐Daire, V., Hall, C., Krakow, D., & Mundlos, S. et al. (2019). Nosology and classification of genetic skeletal disorders: 2019 revision. American Journal Of Medical Genetics Part A, 179(12), 2393-2419. doi: 10.1002/ajmg.a.61366
Krakow D. (2015). Skeletal dysplasias. Clinics in perinatology, 42(2), 301–viii. https://doi.org/10.1016/j.clp.2015.03.003
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