{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:07:01Z","timestamp":1789510021491,"version":"build-2803163510"},"reference-count":52,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T00:00:00Z","timestamp":1685232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Progress in the field of muscular dystrophy (MD) using a multidisciplinary approach based on international standards of care has led to a significant increase in the life expectancy of patients. The challenge of transitioning from pediatric to adult healthcare has been acknowledged for over a decade, yet it continues to be a last-minute concern. Currently, there is no established consensus on how to evaluate the effectiveness of the transition process. Our study aimed to identify how well patients are prepared for the transition and to determine their needs. We conducted a descriptive, cross-sectional study on 15 patients aged 14 to 21 years. The patients completed a sociodemographic and a Transition Readiness Assessment Questionnaire (TRAQ). We also analyzed the comorbidities of these patients. Our study revealed that only 46.7% of the patients had engaged in a conversation with a medical professional, namely, a child neurologist, about transitioning. A total of 60% of the participants expressed having confidence in their self-care ability. However, the median TRAQ score of 3.6 shows that these patients overestimate themselves. We emphasize the necessity for a slow, personalized transition led by a multidisciplinary team to ensure the continuity of state-of-the-art care from pediatric to adult healthcare services and the achievement of the highest possible quality of life for these patients.<\/jats:p>","DOI":"10.3390\/children10060959","type":"journal-article","created":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T15:30:47Z","timestamp":1685287847000},"page":"959","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Importance of Implementing a Transition Strategy for Patients with Muscular Dystrophy: From Child to Adult\u2014Insights from a Tertiary Centre for Rare Neurological Diseases"],"prefix":"10.3390","volume":"10","author":[{"given":"Maria","family":"Lupu","sequence":"first","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Ioghen","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7014-7065","authenticated-orcid":false,"given":"Radu-\u0218tefan","family":"Perjoc","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andra-Maria","family":"Scarlat","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana Aurelia","family":"Vlad\u00e2cenco","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Paediatric Neurology, Dr Victor Gomoiu Children\u2019s Hospital, 022102 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5061-7821","authenticated-orcid":false,"given":"Eugenia","family":"Roza","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Paediatric Neurology, Dr Victor Gomoiu Children\u2019s Hospital, 022102 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Ana-Maria","family":"Epure","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology, Dr Victor Gomoiu Children\u2019s Hospital, 022102 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca Ioana","family":"Teleanu","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Paediatric Neurology, Dr Victor Gomoiu Children\u2019s Hospital, 022102 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia Maria","family":"Severin","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Department, Peadiatric Neurology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wasilewska, E., Ma\u0142gorzewicz, S., Sobierajska-Rek, A., Jab\u0142o\u0144ska-Brud\u0142o, J., G\u00f3rska, L., \u015aledzi\u0144ska, K., Bautembach-Minkowska, J., and Wierzba, J. (2020). Transition from Childhood to Adulthood in Patients with Duchenne Muscular Dystrophy. Medicina, 56.","DOI":"10.3390\/medicina56090426"},{"key":"ref_2","unstructured":"LaPelusa, A., and Kentris, M. (2023, March 08). Muscular Dystrophy. [Updated 2023 Feb 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2. Available online: https:\/\/www.ncbi.nlm.nih."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s13023-017-0631-3","article-title":"The Burden, Epidemiology, Costs and Treatment for Duchenne Muscular Dystrophy: An Evidence Review","volume":"12","author":"Ryder","year":"2017","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_4","unstructured":"Teleanu, R.I., Epure, D.A.-M., Vlad\u00e2cenco, O.A., and Lupu, M. (2022). Esen\u021bialul \u00cen Neurologia Pediatric\u0103, Editura Universitar\u0103 \u201cCarol Davila\u201d Bucure\u015fti a Universit\u0103\u0163ii de Medicin\u0103 \u015fi Farmacie \u201cCarol Davila\u201d. [1st ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E2304","DOI":"10.1212\/WNL.0000000000012910","article-title":"Life Expectancy in Duchenne Muscular Dystrophy","volume":"97","author":"Broomfield","year":"2021","journal-title":"Neurology"},{"key":"ref_6","first-page":"1426","article-title":"Characterizing Demographics, Comorbidities, and Costs of Care among Populations with Duchenne Muscular Dystrophy with Medicaid and Commercial Coverage","volume":"27","author":"Klimchak","year":"2021","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.nmd.2016.11.012","article-title":"Study of Duchenne Muscular Dystrophy Long-Term Survivors Aged 40 Years and Older Living in Specialized Institutions in Japan","volume":"27","author":"Saito","year":"2017","journal-title":"Neuromuscul. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.3109\/09638288.2014.956187","article-title":"Transitioning to Adulthood with a Progressive Condition: Best Practice Assumptions and Individual Experiences of Young Men with Duchenne Muscular Dystrophy","volume":"37","author":"Hamdani","year":"2015","journal-title":"Disabil. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S1054-139X(03)00208-8","article-title":"Transition to Adult Health Care for Adolescents and Young Adults with Chronic Conditions: Position Paper of the Society for Adolescent Medicine","volume":"33","author":"Rosen","year":"2003","journal-title":"J. Adolesc. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"A8","DOI":"10.1186\/1750-1172-7-S2-A8","article-title":"Transition from Childhood to Adulthood in Duchenne Muscular Dystrophy (DMD)","volume":"7","author":"Rodger","year":"2012","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_11","unstructured":"White, P., Schmidt, A., Ilango, S., Shorr, J., Beck, D., and McManus, M. (2023, March 09). Six Core Elements of Health Care Transition\u2122 3.0: An Implementation Guide. Washington, DC: Got Transition, The National Alliance to Advance Adolescent Health. Available online: www.IHI.org."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.1099-0860.2012.00437.x","article-title":"Other Voices, Other Rooms: Reflections on Talking to Young Men with Duchenne Muscular Dystrophy and Their Families About Transition to Adulthood","volume":"26","author":"Abbott","year":"2012","journal-title":"Child. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S1474-4422(18)30025-5","article-title":"Diagnosis and Management of Duchenne Muscular Dystrophy, Part 2: Respiratory, Cardiac, Bone Health, and Orthopaedic Management","volume":"17","author":"Birnkrant","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s00415-014-7585-3","article-title":"Adult Care for Duchenne Muscular Dystrophy in the UK","volume":"262","author":"Rodger","year":"2015","journal-title":"J. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.47102\/annals-acadmedsg.2019163","article-title":"Perspectives on Palliative Care Among Duchenne Muscular Dystrophy Patients and Their Families in Singapore","volume":"49","author":"Tapawan","year":"2020","journal-title":"Ann. Acad. Med. Singapore."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.acap.2014.03.008","article-title":"The Transition Readiness Assessment Questionnaire (TRAQ): Its Factor Structure, Reliability, and Validity","volume":"14","author":"Wood","year":"2014","journal-title":"Acad. Pediatr."},{"key":"ref_17","unstructured":"Adam, M.P., Everman, D.B., Mirzaa, G.M., Pagon, R.A., Wallace, S.E., Bean, L.J.H., Gripp, K.W., and Amemiya, A. (2023, March 09). GeneReviews\u00ae [Internet]. Seattle (WA): University of Washington, Seattle; 1993\u20132022. PMID: 20301490. Available online: https:\/\/www.genome.jp\/dbget-bin\/www_bget?refseq:NP_001116538."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e541","DOI":"10.1097\/DBP.0000000000001105","article-title":"The Hidden Disease: Delayed Diagnosis in Duchenne Muscular Dystrophy and Co-Occurring Conditions","volume":"43","author":"Lee","year":"2022","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/mus.27574","article-title":"Age at Diagnosis for Duchenne Muscular Dystrophy: Why We Must Do Better","volume":"66","author":"Quinlivan","year":"2022","journal-title":"Muscle Nerve"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/mus.27532","article-title":"Time to Diagnosis of Duchenne Muscular Dystrophy Remains Unchanged: Findings from the Muscular Dystrophy Surveillance, Tracking, and Research Network, 2000\u20132015","volume":"66","author":"Thomas","year":"2022","journal-title":"Muscle Nerve"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S1474-4422(18)30026-7","article-title":"Diagnosis and Management of Duchenne Muscular Dystrophy, Part 3: Primary Care, Emergency Management, Psychosocial Care, and Transitions of Care across the Lifespan","volume":"17","author":"Birnkrant","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s42466-022-00206-8","article-title":"Essen Transition Model for Neuromuscular Diseases","volume":"4","author":"Fleischer","year":"2022","journal-title":"Neurol. Res. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1161\/CIRCIMAGING.110.960740","article-title":"Cardiac Involvement in Patients with Muscular Dystrophies","volume":"4","author":"Verhaert","year":"2011","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S1474-4422(09)70272-8","article-title":"Diagnosis and Management of Duchenne Muscular Dystrophy, Part 2: Implementation of Multidisciplinary Care","volume":"9","author":"Bushby","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/ppul.23215","article-title":"Cardiac Phenotype Determines Survival in Duchenne Muscular Dystrophy","volume":"51","author":"Birnkrant","year":"2016","journal-title":"Pediatr. Pulmonol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1007\/s00246-020-02309-y","article-title":"Risk Factors for Cardiac and Non-Cardiac Causes of Death in Males with Duchenne Muscular Dystrophy","volume":"41","author":"Knecht","year":"2020","journal-title":"Pediatr. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e006340","DOI":"10.1161\/JAHA.117.006340","article-title":"Predictors of Death in Adults with Duchenne Muscular Dystrophy\u2013Associated Cardiomyopathy","volume":"6","author":"Cheeran","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.2147\/TCRM.S55889","article-title":"Assessment and Management of Respiratory Function in Patients with Duchenne Muscular Dystrophy: Current and Emerging Options","volume":"11","author":"Aliverti","year":"2015","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/ppul.23172","article-title":"Characterization of Pulmonary Function in Duchenne Muscular Dystrophy","volume":"50","author":"Mayer","year":"2015","journal-title":"Pediatr. Pulmonol."},{"key":"ref_30","first-page":"18","article-title":"A Review of Respiratory Management in Children with Duchenne Muscular Dystrophy","volume":"1","author":"Buzoianu","year":"2021","journal-title":"Pediatruro"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1542\/peds.2018-0333D","article-title":"Rehabilitation Management of the Patient with Duchenne Muscular Dystrophy","volume":"142","author":"Case","year":"2018","journal-title":"Pediatrics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S1474-4422(18)30024-3","article-title":"Diagnosis and Management of Duchenne Muscular Dystrophy, Part 1: Diagnosis, and Neuromuscular, Rehabilitation, Endocrine, and Gastrointestinal and Nutritional Management","volume":"17","author":"Birnkrant","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1542\/peds.2018-0333E","article-title":"Bone Health and Osteoporosis Management of the Patient with Duchenne Muscular Dystrophy","volume":"142","author":"Ward","year":"2018","journal-title":"Pediatrics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1002\/mus.24346","article-title":"Outcome Reliability in Non-Ambulatory Boys\/Men with Duchenne Muscular Dystrophy","volume":"51","author":"Connolly","year":"2015","journal-title":"Muscle Nerve"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S0140-6736(17)32405-4","article-title":"How Glucocorticoids Change Life in Duchenne Muscular Dystrophy","volume":"391","author":"Goemans","year":"2018","journal-title":"Lancet"},{"key":"ref_36","first-page":"485376","article-title":"del R.; Ch\u00e1vez Garc\u00eda, A.L.; Rodr\u00edguez-Cruz, M. Muscular Dystrophies at Different Ages: Metabolic and Endocrine Alterations","volume":"2012","year":"2012","journal-title":"Int. J. Endocrinol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.nmd.2011.02.006","article-title":"Endocrine Aspects of Duchenne Muscular Dystrophy","volume":"21","author":"Bianchi","year":"2011","journal-title":"Neuromuscul. Disord."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1542\/peds.2018-0333F","article-title":"Obesity and Endocrine Management of the Patient with Duchenne Muscular Dystrophy","volume":"142","author":"Weber","year":"2018","journal-title":"Pediatrics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1542\/peds.2018-0333G","article-title":"Nutritional and Gastrointestinal Management of the Patient with Duchenne Muscular Dystrophy","volume":"142","author":"Brumbaugh","year":"2018","journal-title":"Pediatrics"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Lo Cascio, C.M., Goetze, O., Latshang, T.D., Bluemel, S., Frauenfelder, T., and Bloch, K.E. (2016). Gastrointestinal Dysfunction in Patients with Duchenne Muscular Dystrophy. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0163779"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1007\/s00467-020-04587-3","article-title":"Kidney Involvement and Associated Risk Factors in Children with Duchenne Muscular Dystrophy","volume":"35","author":"Kutluk","year":"2020","journal-title":"Pediatr. Nephrol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.nmd.2020.05.001","article-title":"Combining Genetics, Neuropsychology and Neuroimaging to Improve Understanding of Brain Involvement in Duchenne Muscular Dystrophy\u2014A Narrative Review","volume":"30","author":"Doorenweerd","year":"2020","journal-title":"Neuromuscul. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1002\/ana.24222","article-title":"Reduced Cerebral Gray Matter and Altered White Matter in Boys with Duchenne Muscular Dystrophy","volume":"76","author":"Doorenweerd","year":"2014","journal-title":"Ann. Neurol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4081\/mi.2012.e5","article-title":"Psychological Aspects in Children Affected by Duchenne de Boulogne Muscular Dystrophy","volume":"4","author":"Parisi","year":"2012","journal-title":"Ment. Illn."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S99","DOI":"10.1542\/peds.2018-0333L","article-title":"Psychosocial Management of the Patient with Duchenne Muscular Dystrophy","volume":"142","author":"Colvin","year":"2018","journal-title":"Pediatrics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"32045","DOI":"10.3402\/qhw.v11.32045","article-title":"The Experiences of Patients with Duchenne Muscular Dystrophy in Facing and Learning about Their Clinical Conditions","volume":"11","author":"Fujino","year":"2016","journal-title":"Int. J. Qual. Stud. Health Well-Being"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1212\/CPJ.0000000000000970","article-title":"Achieving Life Milestones in Duchenne\/Becker Muscular Dystrophy","volume":"11","author":"Donaldson","year":"2021","journal-title":"Neurol. Clin. Pract."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"S110","DOI":"10.1542\/peds.2018-0333M","article-title":"A Transition Toolkit for Duchenne Muscular Dystrophy","volume":"142","author":"Trout","year":"2018","journal-title":"Pediatrics"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"20914","DOI":"10.3402\/qhw.v8i0.20914","article-title":"Independent Living with Duchenne Muscular Dystrophy and Home Mechanical Ventilation in Areas of Japan with Insufficient National Welfare Services","volume":"8","author":"Yamaguchi","year":"2013","journal-title":"Int. J. Qual. Stud. Health Well-Being"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.nmd.2012.02.004","article-title":"Transition to Adulthood for Young Men with Duchenne Muscular Dystrophy: Research from the UK","volume":"22","author":"Abbott","year":"2012","journal-title":"Neuromuscul. Disord."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.nmd.2012.08.009","article-title":"Transition in Duchenne Muscular Dystrophy: An Expert Meeting Report and Description of Transition Needs in an Emergent Patient Population: (Parent Project Muscular Dystrophy Transition Expert Meeting 17\u201318 June 2011, Amsterdam, The Netherlands)","volume":"23","author":"Schrans","year":"2013","journal-title":"Neuromuscul. Disord."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, American Academy of Family Physicians, and American College of Physicians-American Society of Internal Medicine (2002). A Consensus Statement on Health Care Transitions for Young Adults with Special Health Care Needs. Pediatrics, 110, 1304\u20131306.","DOI":"10.1542\/peds.110.S3.1304"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/6\/959\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:43:46Z","timestamp":1760125426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/6\/959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,28]]},"references-count":52,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["children10060959"],"URL":"https:\/\/doi.org\/10.3390\/children10060959","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,28]]}}}