Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients
Malnutrition is frequent in patients with idiopathic pulmonary fibrosis (IPF). We examined the relationship between malnutrition at diagnosis and all-cause hospitalization, survival, and acute exacerbation in newly diagnosed IPF patients. In this prospective cohort study, the nutritional status of 1...
Gespeichert in:
| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2022-06, Vol.41 (6), p.1335-1342 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1342 |
|---|---|
| container_issue | 6 |
| container_start_page | 1335 |
| container_title | Clinical nutrition (Edinburgh, Scotland) |
| container_volume | 41 |
| creator | Jouneau, Stéphane Rousseau, Chloé Lederlin, Mathieu Lescoat, Alain Kerjouan, Mallorie Chauvin, Pierre Luque-Paz, David Guillot, Stéphanie Oger, Emmanuel Vernhet, Laurent Thibault, Ronan |
| description | Malnutrition is frequent in patients with idiopathic pulmonary fibrosis (IPF). We examined the relationship between malnutrition at diagnosis and all-cause hospitalization, survival, and acute exacerbation in newly diagnosed IPF patients.
In this prospective cohort study, the nutritional status of 153 consecutive newly-diagnosed IPF outpatients was evaluated by measuring body mass index (BMI), fat-free mass index (FFMI) with bioelectrical impedance analysis, and food intake with the Self Evaluation of Food Intake (SEFI)®. Diagnosis was taken as the baseline date and malnutrition was defined as an FFMI below 17 (men) or 15 kg/m2 (women). To determine the factors associated with all-cause hospitalization and mortality, univariate Cox regression analyses were performed and variables with P |
| doi_str_mv | 10.1016/j.clnu.2022.05.001 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03689797v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0261561422001522</els_id><sourcerecordid>2666549539</sourcerecordid><originalsourceid>FETCH-LOGICAL-c434t-a59635b097f2d5b4751e5806c9a22a428f8faebb332e769714ce584c18293bdb3</originalsourceid><addsrcrecordid>eNp9kc9u1DAQhy0EokvhBTggH-GQ4D-xE0tcqqpQpEVc4GxNbIf1ksTBdorKS_DKOGzZIydbM58_eeaH0EtKakqofHuszTivNSOM1UTUhNBHaEcFZxVVHX-MdoRJWglJmwv0LKUjIUTwtnuKLrgQXbmrHfr9CYojR599mDHMFltnooPkLB5CsNjPGb47DBlbD9_mkHzCEEshpWA85ML99PmADyEtPsPof8FZNYW4VfI9DgP21ocF8sEbvKzjFGaI93jwffyrLB3v5pyeoycDjMm9eDgv0df3N1-ub6v95w8fr6_2lWl4kysQSnLRE9UOzIq-aQV1ZSRpFDAGDeuGbgDX95wz10rV0saUfmNoxxTvbc8v0ZuT9wCjXqKfym90AK9vr_Z6qxEuO9Wq9o4W9vWJXWL4sbqU9eSTceMIswtr0kxKKRpV9llQdkJNGStFN5zdlOgtNH3UW2h6C00ToUto5dGrB__aT86en_xLqQDvToArG7nzLupkyraMsz46k7UN_n_-P9Oaq0U</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2666549539</pqid></control><display><type>article</type><title>Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients</title><source>ScienceDirect Journals (5 years ago - present)</source><creator>Jouneau, Stéphane ; Rousseau, Chloé ; Lederlin, Mathieu ; Lescoat, Alain ; Kerjouan, Mallorie ; Chauvin, Pierre ; Luque-Paz, David ; Guillot, Stéphanie ; Oger, Emmanuel ; Vernhet, Laurent ; Thibault, Ronan</creator><creatorcontrib>Jouneau, Stéphane ; Rousseau, Chloé ; Lederlin, Mathieu ; Lescoat, Alain ; Kerjouan, Mallorie ; Chauvin, Pierre ; Luque-Paz, David ; Guillot, Stéphanie ; Oger, Emmanuel ; Vernhet, Laurent ; Thibault, Ronan</creatorcontrib><description><![CDATA[Malnutrition is frequent in patients with idiopathic pulmonary fibrosis (IPF). We examined the relationship between malnutrition at diagnosis and all-cause hospitalization, survival, and acute exacerbation in newly diagnosed IPF patients.
In this prospective cohort study, the nutritional status of 153 consecutive newly-diagnosed IPF outpatients was evaluated by measuring body mass index (BMI), fat-free mass index (FFMI) with bioelectrical impedance analysis, and food intake with the Self Evaluation of Food Intake (SEFI)®. Diagnosis was taken as the baseline date and malnutrition was defined as an FFMI below 17 (men) or 15 kg/m2 (women). To determine the factors associated with all-cause hospitalization and mortality, univariate Cox regression analyses were performed and variables with P < 0.2 were included in a stepwise multivariable analysis.
A quarter (26%; 40/153) of the patients were suffering from malnutrition at baseline, which was more frequent (62%) in patients whose BMI was <25 kg/m2. Patients whose baseline FFMI was low were more likely to be hospitalized (Hazard Ratio (HR) = 1.98 [95% confidence interval, 1.15; 3.41], P = 0.0139) and/or die (HR = 1.79 [1.11; 2.89], P = 0.0165), but their acute exacerbation rate was similar to that of patients with normal FFMIs. Decreased food intake (SEFI®<7) at baseline was associated with all-cause hospitalization (P = 0.003) and mortality (P < 0.0001) during follow-up. Baseline higher gender-age-physiology (GAP) scores (HR = 1.24 [1.01; 1.52], P = 0.0434; HR = 1.71 [1.37; 2.14], P < 0.0001, respectively), lower BMI (HR = 0.89 [0.83; 0.96], P = 0.003; HR = 0.89 [0.82; 0.96], P = 0.003), and decreased food intake (SEFI® score) (HR = 0.81 [0.71; 0.93], P = 0.003; HR = 0.72 [0.64; 0.81], P < 0.0001), but not FFMI, were independently associated with all-cause hospitalization and mortality rates during follow-up.
Malnutrition and decreased food intake at IPF diagnosis are associated with all-cause hospitalization and mortality. Future studies will determine whether dedicated interventions to improve food intake and nutritional status could improve outcomes for IPF patients.
•The prevalence of malnutrition at idiopathic pulmonary fibrosis (IPF) is frequent (26%).•Malnutrition and decreased food intake at IPF diagnosis are associated with increased hospitalization and mortality.•GAP score, BMI and food intake (SEFI®) are independently associated with all-cause hospitalization and mortality.]]></description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2022.05.001</identifier><identifier>PMID: 35580539</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Appetite ; Bioengineering ; Body composition ; Food and Nutrition ; Human health and pathology ; Interstitial lung disease ; Life Sciences ; Nintedanib ; Pirfenidone ; Pulmonology and respiratory tract ; Weight</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2022-06, Vol.41 (6), p.1335-1342</ispartof><rights>2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-a59635b097f2d5b4751e5806c9a22a428f8faebb332e769714ce584c18293bdb3</citedby><cites>FETCH-LOGICAL-c434t-a59635b097f2d5b4751e5806c9a22a428f8faebb332e769714ce584c18293bdb3</cites><orcidid>0000-0003-2466-4445 ; 0000-0001-9837-2977 ; 0000-0002-6038-5649 ; 0000-0002-1949-3461 ; 0000-0001-5845-6447 ; 0000-0002-4523-675X ; 0000-0003-1388-5277</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2022.05.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35580539$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03689797$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Jouneau, Stéphane</creatorcontrib><creatorcontrib>Rousseau, Chloé</creatorcontrib><creatorcontrib>Lederlin, Mathieu</creatorcontrib><creatorcontrib>Lescoat, Alain</creatorcontrib><creatorcontrib>Kerjouan, Mallorie</creatorcontrib><creatorcontrib>Chauvin, Pierre</creatorcontrib><creatorcontrib>Luque-Paz, David</creatorcontrib><creatorcontrib>Guillot, Stéphanie</creatorcontrib><creatorcontrib>Oger, Emmanuel</creatorcontrib><creatorcontrib>Vernhet, Laurent</creatorcontrib><creatorcontrib>Thibault, Ronan</creatorcontrib><title>Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description><![CDATA[Malnutrition is frequent in patients with idiopathic pulmonary fibrosis (IPF). We examined the relationship between malnutrition at diagnosis and all-cause hospitalization, survival, and acute exacerbation in newly diagnosed IPF patients.
In this prospective cohort study, the nutritional status of 153 consecutive newly-diagnosed IPF outpatients was evaluated by measuring body mass index (BMI), fat-free mass index (FFMI) with bioelectrical impedance analysis, and food intake with the Self Evaluation of Food Intake (SEFI)®. Diagnosis was taken as the baseline date and malnutrition was defined as an FFMI below 17 (men) or 15 kg/m2 (women). To determine the factors associated with all-cause hospitalization and mortality, univariate Cox regression analyses were performed and variables with P < 0.2 were included in a stepwise multivariable analysis.
A quarter (26%; 40/153) of the patients were suffering from malnutrition at baseline, which was more frequent (62%) in patients whose BMI was <25 kg/m2. Patients whose baseline FFMI was low were more likely to be hospitalized (Hazard Ratio (HR) = 1.98 [95% confidence interval, 1.15; 3.41], P = 0.0139) and/or die (HR = 1.79 [1.11; 2.89], P = 0.0165), but their acute exacerbation rate was similar to that of patients with normal FFMIs. Decreased food intake (SEFI®<7) at baseline was associated with all-cause hospitalization (P = 0.003) and mortality (P < 0.0001) during follow-up. Baseline higher gender-age-physiology (GAP) scores (HR = 1.24 [1.01; 1.52], P = 0.0434; HR = 1.71 [1.37; 2.14], P < 0.0001, respectively), lower BMI (HR = 0.89 [0.83; 0.96], P = 0.003; HR = 0.89 [0.82; 0.96], P = 0.003), and decreased food intake (SEFI® score) (HR = 0.81 [0.71; 0.93], P = 0.003; HR = 0.72 [0.64; 0.81], P < 0.0001), but not FFMI, were independently associated with all-cause hospitalization and mortality rates during follow-up.
Malnutrition and decreased food intake at IPF diagnosis are associated with all-cause hospitalization and mortality. Future studies will determine whether dedicated interventions to improve food intake and nutritional status could improve outcomes for IPF patients.
•The prevalence of malnutrition at idiopathic pulmonary fibrosis (IPF) is frequent (26%).•Malnutrition and decreased food intake at IPF diagnosis are associated with increased hospitalization and mortality.•GAP score, BMI and food intake (SEFI®) are independently associated with all-cause hospitalization and mortality.]]></description><subject>Appetite</subject><subject>Bioengineering</subject><subject>Body composition</subject><subject>Food and Nutrition</subject><subject>Human health and pathology</subject><subject>Interstitial lung disease</subject><subject>Life Sciences</subject><subject>Nintedanib</subject><subject>Pirfenidone</subject><subject>Pulmonology and respiratory tract</subject><subject>Weight</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhy0EokvhBTggH-GQ4D-xE0tcqqpQpEVc4GxNbIf1ksTBdorKS_DKOGzZIydbM58_eeaH0EtKakqofHuszTivNSOM1UTUhNBHaEcFZxVVHX-MdoRJWglJmwv0LKUjIUTwtnuKLrgQXbmrHfr9CYojR599mDHMFltnooPkLB5CsNjPGb47DBlbD9_mkHzCEEshpWA85ML99PmADyEtPsPof8FZNYW4VfI9DgP21ocF8sEbvKzjFGaI93jwffyrLB3v5pyeoycDjMm9eDgv0df3N1-ub6v95w8fr6_2lWl4kysQSnLRE9UOzIq-aQV1ZSRpFDAGDeuGbgDX95wz10rV0saUfmNoxxTvbc8v0ZuT9wCjXqKfym90AK9vr_Z6qxEuO9Wq9o4W9vWJXWL4sbqU9eSTceMIswtr0kxKKRpV9llQdkJNGStFN5zdlOgtNH3UW2h6C00ToUto5dGrB__aT86en_xLqQDvToArG7nzLupkyraMsz46k7UN_n_-P9Oaq0U</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Jouneau, Stéphane</creator><creator>Rousseau, Chloé</creator><creator>Lederlin, Mathieu</creator><creator>Lescoat, Alain</creator><creator>Kerjouan, Mallorie</creator><creator>Chauvin, Pierre</creator><creator>Luque-Paz, David</creator><creator>Guillot, Stéphanie</creator><creator>Oger, Emmanuel</creator><creator>Vernhet, Laurent</creator><creator>Thibault, Ronan</creator><general>Elsevier Ltd</general><general>Elsevier / European Society for Clinical Nutrition and Metabolism</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0003-2466-4445</orcidid><orcidid>https://orcid.org/0000-0001-9837-2977</orcidid><orcidid>https://orcid.org/0000-0002-6038-5649</orcidid><orcidid>https://orcid.org/0000-0002-1949-3461</orcidid><orcidid>https://orcid.org/0000-0001-5845-6447</orcidid><orcidid>https://orcid.org/0000-0002-4523-675X</orcidid><orcidid>https://orcid.org/0000-0003-1388-5277</orcidid></search><sort><creationdate>20220601</creationdate><title>Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients</title><author>Jouneau, Stéphane ; Rousseau, Chloé ; Lederlin, Mathieu ; Lescoat, Alain ; Kerjouan, Mallorie ; Chauvin, Pierre ; Luque-Paz, David ; Guillot, Stéphanie ; Oger, Emmanuel ; Vernhet, Laurent ; Thibault, Ronan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-a59635b097f2d5b4751e5806c9a22a428f8faebb332e769714ce584c18293bdb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Appetite</topic><topic>Bioengineering</topic><topic>Body composition</topic><topic>Food and Nutrition</topic><topic>Human health and pathology</topic><topic>Interstitial lung disease</topic><topic>Life Sciences</topic><topic>Nintedanib</topic><topic>Pirfenidone</topic><topic>Pulmonology and respiratory tract</topic><topic>Weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jouneau, Stéphane</creatorcontrib><creatorcontrib>Rousseau, Chloé</creatorcontrib><creatorcontrib>Lederlin, Mathieu</creatorcontrib><creatorcontrib>Lescoat, Alain</creatorcontrib><creatorcontrib>Kerjouan, Mallorie</creatorcontrib><creatorcontrib>Chauvin, Pierre</creatorcontrib><creatorcontrib>Luque-Paz, David</creatorcontrib><creatorcontrib>Guillot, Stéphanie</creatorcontrib><creatorcontrib>Oger, Emmanuel</creatorcontrib><creatorcontrib>Vernhet, Laurent</creatorcontrib><creatorcontrib>Thibault, Ronan</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jouneau, Stéphane</au><au>Rousseau, Chloé</au><au>Lederlin, Mathieu</au><au>Lescoat, Alain</au><au>Kerjouan, Mallorie</au><au>Chauvin, Pierre</au><au>Luque-Paz, David</au><au>Guillot, Stéphanie</au><au>Oger, Emmanuel</au><au>Vernhet, Laurent</au><au>Thibault, Ronan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>41</volume><issue>6</issue><spage>1335</spage><epage>1342</epage><pages>1335-1342</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract><![CDATA[Malnutrition is frequent in patients with idiopathic pulmonary fibrosis (IPF). We examined the relationship between malnutrition at diagnosis and all-cause hospitalization, survival, and acute exacerbation in newly diagnosed IPF patients.
In this prospective cohort study, the nutritional status of 153 consecutive newly-diagnosed IPF outpatients was evaluated by measuring body mass index (BMI), fat-free mass index (FFMI) with bioelectrical impedance analysis, and food intake with the Self Evaluation of Food Intake (SEFI)®. Diagnosis was taken as the baseline date and malnutrition was defined as an FFMI below 17 (men) or 15 kg/m2 (women). To determine the factors associated with all-cause hospitalization and mortality, univariate Cox regression analyses were performed and variables with P < 0.2 were included in a stepwise multivariable analysis.
A quarter (26%; 40/153) of the patients were suffering from malnutrition at baseline, which was more frequent (62%) in patients whose BMI was <25 kg/m2. Patients whose baseline FFMI was low were more likely to be hospitalized (Hazard Ratio (HR) = 1.98 [95% confidence interval, 1.15; 3.41], P = 0.0139) and/or die (HR = 1.79 [1.11; 2.89], P = 0.0165), but their acute exacerbation rate was similar to that of patients with normal FFMIs. Decreased food intake (SEFI®<7) at baseline was associated with all-cause hospitalization (P = 0.003) and mortality (P < 0.0001) during follow-up. Baseline higher gender-age-physiology (GAP) scores (HR = 1.24 [1.01; 1.52], P = 0.0434; HR = 1.71 [1.37; 2.14], P < 0.0001, respectively), lower BMI (HR = 0.89 [0.83; 0.96], P = 0.003; HR = 0.89 [0.82; 0.96], P = 0.003), and decreased food intake (SEFI® score) (HR = 0.81 [0.71; 0.93], P = 0.003; HR = 0.72 [0.64; 0.81], P < 0.0001), but not FFMI, were independently associated with all-cause hospitalization and mortality rates during follow-up.
Malnutrition and decreased food intake at IPF diagnosis are associated with all-cause hospitalization and mortality. Future studies will determine whether dedicated interventions to improve food intake and nutritional status could improve outcomes for IPF patients.
•The prevalence of malnutrition at idiopathic pulmonary fibrosis (IPF) is frequent (26%).•Malnutrition and decreased food intake at IPF diagnosis are associated with increased hospitalization and mortality.•GAP score, BMI and food intake (SEFI®) are independently associated with all-cause hospitalization and mortality.]]></abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>35580539</pmid><doi>10.1016/j.clnu.2022.05.001</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2466-4445</orcidid><orcidid>https://orcid.org/0000-0001-9837-2977</orcidid><orcidid>https://orcid.org/0000-0002-6038-5649</orcidid><orcidid>https://orcid.org/0000-0002-1949-3461</orcidid><orcidid>https://orcid.org/0000-0001-5845-6447</orcidid><orcidid>https://orcid.org/0000-0002-4523-675X</orcidid><orcidid>https://orcid.org/0000-0003-1388-5277</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0261-5614 |
| ispartof | Clinical nutrition (Edinburgh, Scotland), 2022-06, Vol.41 (6), p.1335-1342 |
| issn | 0261-5614 1532-1983 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03689797v1 |
| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Appetite Bioengineering Body composition Food and Nutrition Human health and pathology Interstitial lung disease Life Sciences Nintedanib Pirfenidone Pulmonology and respiratory tract Weight |
| title | Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T23%3A35%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Malnutrition%20and%20decreased%20food%20intake%20at%20diagnosis%20are%20associated%20with%20hospitalization%20and%20mortality%20of%20idiopathic%20pulmonary%20fibrosis%20patients&rft.jtitle=Clinical%20nutrition%20(Edinburgh,%20Scotland)&rft.au=Jouneau,%20St%C3%A9phane&rft.date=2022-06-01&rft.volume=41&rft.issue=6&rft.spage=1335&rft.epage=1342&rft.pages=1335-1342&rft.issn=0261-5614&rft.eissn=1532-1983&rft_id=info:doi/10.1016/j.clnu.2022.05.001&rft_dat=%3Cproquest_hal_p%3E2666549539%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2666549539&rft_id=info:pmid/35580539&rft_els_id=S0261561422001522&rfr_iscdi=true |