Laparoscopic Nephrectomy versus Open Nephrectomy for Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis
To compare efficacy and safety of laparoscopicnephrectomy (LN) versus open nephrectomy (ON) in the management of autosomal dominant polycystic kidney disease (ADPKD), we conducted a systematic review and meta-analysis. A systematic search of the electronic databases PubMed, Scopus, and the Cochrane...
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| creator | Guo, Pengyu Xu, Wanhai Li, Huibo Ren, Tong Ni, Shaobin Ren, Minghua |
| description | To compare efficacy and safety of laparoscopicnephrectomy (LN) versus open nephrectomy (ON) in the management of autosomal dominant polycystic kidney disease (ADPKD), we conducted a systematic review and meta-analysis.
A systematic search of the electronic databases PubMed, Scopus, and the Cochrane Library was performed up to October 2014. This systematic review was performed based on observational comparative studies that assessed the two techniques. The weighted mean difference (WMD) and risk ratio (RR), with their corresponding 95% confidence interval (CI), were calculated to compare continuous and dichotomous variables, respectively.
Seven studies were identified, including 195 cases (118 LN/77 ON). Although LN was associated with longer operative time (WMD 30.236, 95%CI 14.541 -45.932, P |
| doi_str_mv | 10.1371/journal.pone.0129317 |
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A systematic search of the electronic databases PubMed, Scopus, and the Cochrane Library was performed up to October 2014. This systematic review was performed based on observational comparative studies that assessed the two techniques. The weighted mean difference (WMD) and risk ratio (RR), with their corresponding 95% confidence interval (CI), were calculated to compare continuous and dichotomous variables, respectively.
Seven studies were identified, including 195 cases (118 LN/77 ON). Although LN was associated with longer operative time (WMD 30.236, 95%CI 14.541 -45.932, P<0.001) and the specimen might not have been resected as heavy as the ON group (WMD -986.516, 95%CI -1883.24--89.795, P = 0.031), patients in this group might benefit from a shorter length of hospital stay (WMD -3.576, 95%CI 4.976--2.176, P <0.001), less estimated blood loss (WMD -180.245, 95%CI -317.939--42.556, P = 0.010), and lower need of transfusion (RR 0.345, 95%CI 0.183-0.650, P = 0.001). The LN group also had less overall complications (RR 0.545, 95%CI 0.329-0.903, P = 0.018). The need of narcotic analgesics between the two groups might have no significant difference (WMD -54.66, 95%CI -129.76-20.44, P = 0.154).
LN for giant symptomatic ADPKD was feasible, safe and efficacious. Morbidity was significantly reduced compared with the open approach. For an experienced laparoscopist, LN might be a better alternative.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0129317</identifier><identifier>PMID: 26053633</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analgesics ; Aneurysms ; Blood Loss, Surgical ; Blood Transfusion ; Blood transfusions ; Care and treatment ; Comparative analysis ; Comparative studies ; Complications ; Confidence intervals ; Continuity (mathematics) ; Cysts ; Disease control ; Hospitals ; Humans ; Kidney diseases ; Kidneys ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Meta-analysis ; Morbidity ; Mortality ; Nephrectomy ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Operative Time ; Pain ; Patients ; Polycystic kidney ; Polycystic kidney disease ; Polycystic Kidney, Autosomal Dominant - complications ; Polycystic Kidney, Autosomal Dominant - surgery ; Postoperative Complications ; Studies ; Surgery ; Systematic review ; Transfusion ; Treatment Outcome ; Weapons of mass destruction</subject><ispartof>PloS one, 2015-06, Vol.10 (6), p.e0129317-e0129317</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Guo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Guo et al 2015 Guo et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-d7ce39f3ea79bf0fc35dee5dbf0f713d538a6457b9d1eeb3107a039e1e98ef313</citedby><cites>FETCH-LOGICAL-c692t-d7ce39f3ea79bf0fc35dee5dbf0f713d538a6457b9d1eeb3107a039e1e98ef313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460089/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460089/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26053633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>James, Leighton R</contributor><creatorcontrib>Guo, Pengyu</creatorcontrib><creatorcontrib>Xu, Wanhai</creatorcontrib><creatorcontrib>Li, Huibo</creatorcontrib><creatorcontrib>Ren, Tong</creatorcontrib><creatorcontrib>Ni, Shaobin</creatorcontrib><creatorcontrib>Ren, Minghua</creatorcontrib><title>Laparoscopic Nephrectomy versus Open Nephrectomy for Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To compare efficacy and safety of laparoscopicnephrectomy (LN) versus open nephrectomy (ON) in the management of autosomal dominant polycystic kidney disease (ADPKD), we conducted a systematic review and meta-analysis.
A systematic search of the electronic databases PubMed, Scopus, and the Cochrane Library was performed up to October 2014. This systematic review was performed based on observational comparative studies that assessed the two techniques. The weighted mean difference (WMD) and risk ratio (RR), with their corresponding 95% confidence interval (CI), were calculated to compare continuous and dichotomous variables, respectively.
Seven studies were identified, including 195 cases (118 LN/77 ON). Although LN was associated with longer operative time (WMD 30.236, 95%CI 14.541 -45.932, P<0.001) and the specimen might not have been resected as heavy as the ON group (WMD -986.516, 95%CI -1883.24--89.795, P = 0.031), patients in this group might benefit from a shorter length of hospital stay (WMD -3.576, 95%CI 4.976--2.176, P <0.001), less estimated blood loss (WMD -180.245, 95%CI -317.939--42.556, P = 0.010), and lower need of transfusion (RR 0.345, 95%CI 0.183-0.650, P = 0.001). The LN group also had less overall complications (RR 0.545, 95%CI 0.329-0.903, P = 0.018). The need of narcotic analgesics between the two groups might have no significant difference (WMD -54.66, 95%CI -129.76-20.44, P = 0.154).
LN for giant symptomatic ADPKD was feasible, safe and efficacious. Morbidity was significantly reduced compared with the open approach. For an experienced laparoscopist, LN might be a better alternative.</description><subject>Analgesics</subject><subject>Aneurysms</subject><subject>Blood Loss, Surgical</subject><subject>Blood Transfusion</subject><subject>Blood transfusions</subject><subject>Care and treatment</subject><subject>Comparative analysis</subject><subject>Comparative studies</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Continuity (mathematics)</subject><subject>Cysts</subject><subject>Disease control</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Meta-analysis</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Nephrectomy</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Operative Time</subject><subject>Pain</subject><subject>Patients</subject><subject>Polycystic kidney</subject><subject>Polycystic kidney disease</subject><subject>Polycystic Kidney, Autosomal Dominant - complications</subject><subject>Polycystic Kidney, Autosomal Dominant - surgery</subject><subject>Postoperative Complications</subject><subject>Studies</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Transfusion</subject><subject>Treatment Outcome</subject><subject>Weapons of mass destruction</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99v0zAQxyMEYmPwHyCwhITgocWOUzvZA1K18aOisGkDXi3HubSukjjETkf-Ef5enDabGrQH5Aef7j73te_sC4LnBE8J5eTdxrRNJYtpbSqYYhImlPAHwTFJaDhhIaYPD-yj4Im1G4xnNGbscXAUMm8ySo-DP0tZy8ZYZWqt0Deo1w0oZ8oObaGxrUUXNVQjf24adCmdhspZdKPdGs1bZ6wpZYHOTakrWTl0aYpOddZ5zS86q6BD59qCtHCK5ujaB6CUffAKthpukKwy9BWcnMx9RZ3V9mnwKJeFhWfDfhL8-Pjh-9nnyfLi0-JsvpwoloRuknEFNMkpSJ6kOc4VnWUAs6y3OaGZr1eyaMbTJCMAKSWYS0wTIJDEkFNCT4KXe926MFYMLbWCsJjxmEQ7YrEnMiM3om50KZtOGKnFzmGalZCNL6UAwfMwnqXAYg4sUgTSNE6yKJWQJzEOeei13g-ntWkJmfItbGQxEh1HKr0WK7MVUcQwjhMv8GYQaMyvFqwTpbYKikJWYNrdvTll_t6RR1_9g95f3UCtpC9AV7nx56peVMwjwknEZ6zXmt5D-ZVBqZX_f7n2_lHC21GCZxz8divZWisW11f_z178HLOvD9g1yMKtrSlap01lx2C0B5X_27aB_K7JBIt-fG67IfrxEcP4-LQXhw90l3Q7L_QverYYoQ</recordid><startdate>20150608</startdate><enddate>20150608</enddate><creator>Guo, Pengyu</creator><creator>Xu, Wanhai</creator><creator>Li, Huibo</creator><creator>Ren, Tong</creator><creator>Ni, Shaobin</creator><creator>Ren, Minghua</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150608</creationdate><title>Laparoscopic Nephrectomy versus Open Nephrectomy for Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis</title><author>Guo, Pengyu ; Xu, Wanhai ; Li, Huibo ; Ren, Tong ; Ni, Shaobin ; Ren, Minghua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-d7ce39f3ea79bf0fc35dee5dbf0f713d538a6457b9d1eeb3107a039e1e98ef313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Analgesics</topic><topic>Aneurysms</topic><topic>Blood Loss, Surgical</topic><topic>Blood Transfusion</topic><topic>Blood transfusions</topic><topic>Care and treatment</topic><topic>Comparative analysis</topic><topic>Comparative studies</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Continuity (mathematics)</topic><topic>Cysts</topic><topic>Disease control</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Meta-analysis</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Nephrectomy</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrectomy - methods</topic><topic>Operative Time</topic><topic>Pain</topic><topic>Patients</topic><topic>Polycystic kidney</topic><topic>Polycystic kidney disease</topic><topic>Polycystic Kidney, Autosomal Dominant - complications</topic><topic>Polycystic Kidney, Autosomal Dominant - surgery</topic><topic>Postoperative Complications</topic><topic>Studies</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Transfusion</topic><topic>Treatment Outcome</topic><topic>Weapons of mass destruction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guo, Pengyu</creatorcontrib><creatorcontrib>Xu, Wanhai</creatorcontrib><creatorcontrib>Li, Huibo</creatorcontrib><creatorcontrib>Ren, Tong</creatorcontrib><creatorcontrib>Ni, Shaobin</creatorcontrib><creatorcontrib>Ren, Minghua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guo, Pengyu</au><au>Xu, Wanhai</au><au>Li, Huibo</au><au>Ren, Tong</au><au>Ni, Shaobin</au><au>Ren, Minghua</au><au>James, Leighton R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Nephrectomy versus Open Nephrectomy for Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-06-08</date><risdate>2015</risdate><volume>10</volume><issue>6</issue><spage>e0129317</spage><epage>e0129317</epage><pages>e0129317-e0129317</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare efficacy and safety of laparoscopicnephrectomy (LN) versus open nephrectomy (ON) in the management of autosomal dominant polycystic kidney disease (ADPKD), we conducted a systematic review and meta-analysis.
A systematic search of the electronic databases PubMed, Scopus, and the Cochrane Library was performed up to October 2014. This systematic review was performed based on observational comparative studies that assessed the two techniques. The weighted mean difference (WMD) and risk ratio (RR), with their corresponding 95% confidence interval (CI), were calculated to compare continuous and dichotomous variables, respectively.
Seven studies were identified, including 195 cases (118 LN/77 ON). Although LN was associated with longer operative time (WMD 30.236, 95%CI 14.541 -45.932, P<0.001) and the specimen might not have been resected as heavy as the ON group (WMD -986.516, 95%CI -1883.24--89.795, P = 0.031), patients in this group might benefit from a shorter length of hospital stay (WMD -3.576, 95%CI 4.976--2.176, P <0.001), less estimated blood loss (WMD -180.245, 95%CI -317.939--42.556, P = 0.010), and lower need of transfusion (RR 0.345, 95%CI 0.183-0.650, P = 0.001). The LN group also had less overall complications (RR 0.545, 95%CI 0.329-0.903, P = 0.018). The need of narcotic analgesics between the two groups might have no significant difference (WMD -54.66, 95%CI -129.76-20.44, P = 0.154).
LN for giant symptomatic ADPKD was feasible, safe and efficacious. Morbidity was significantly reduced compared with the open approach. For an experienced laparoscopist, LN might be a better alternative.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26053633</pmid><doi>10.1371/journal.pone.0129317</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-06, Vol.10 (6), p.e0129317-e0129317 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1686781431 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analgesics Aneurysms Blood Loss, Surgical Blood Transfusion Blood transfusions Care and treatment Comparative analysis Comparative studies Complications Confidence intervals Continuity (mathematics) Cysts Disease control Hospitals Humans Kidney diseases Kidneys Laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Meta-analysis Morbidity Mortality Nephrectomy Nephrectomy - adverse effects Nephrectomy - methods Operative Time Pain Patients Polycystic kidney Polycystic kidney disease Polycystic Kidney, Autosomal Dominant - complications Polycystic Kidney, Autosomal Dominant - surgery Postoperative Complications Studies Surgery Systematic review Transfusion Treatment Outcome Weapons of mass destruction |
| title | Laparoscopic Nephrectomy versus Open Nephrectomy for Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T07%3A57%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Laparoscopic%20Nephrectomy%20versus%20Open%20Nephrectomy%20for%20Patients%20with%20Autosomal%20Dominant%20Polycystic%20Kidney%20Disease:%20A%20Systematic%20Review%20and%20Meta-Analysis&rft.jtitle=PloS%20one&rft.au=Guo,%20Pengyu&rft.date=2015-06-08&rft.volume=10&rft.issue=6&rft.spage=e0129317&rft.epage=e0129317&rft.pages=e0129317-e0129317&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0129317&rft_dat=%3Cgale_plos_%3EA417147564%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1686781431&rft_id=info:pmid/26053633&rft_galeid=A417147564&rft_doaj_id=oai_doaj_org_article_7f285be687e64c1ebb89d4baef980272&rfr_iscdi=true |