Quantification of Coupled Stiffness and Fiber Orientation Remodeling in Hypertensive Rat Right-Ventricular Myocardium Using 3D Ultrasound Speckle Tracking with Biaxial Testing
Mechanical and structural changes of right ventricular (RV) in response to pulmonary hypertension (PH) are inadequately understood. While current standard biaxial testing provides information on the mechanical behavior of RV tissues using surface markers, it is unable to fully assess structural and...
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description | Mechanical and structural changes of right ventricular (RV) in response to pulmonary hypertension (PH) are inadequately understood. While current standard biaxial testing provides information on the mechanical behavior of RV tissues using surface markers, it is unable to fully assess structural and mechanical properties across the full tissue thickness. In this study, the mechanical and structural properties of normotensive and pulmonary hypertension right ventricular (PHRV) myocardium through its full thickness were examined using mechanical testing combined with 3D ultrasound speckle tracking (3D-UST). RV pressure overload was induced in Sprague-Dawley rats by pulmonary artery (PA) banding. The second Piola-Kirchhoff stress tensors and Green-Lagrangian strain tensors were computed in the RV myocardium using the biaxial testing combined with 3D-UST. A previously established non-linear curve-fitting algorithm was applied to fit experimental data to a Strain Energy Function (SEF) for computation of myofiber orientation. The fiber orientations obtained by the biaxial testing with 3D-UST compared well with the fiber orientations computed from the histology. In addition, the re-orientation of myofiber in the right ventricular free wall (RVFW) along longitudinal direction (apex-to-outflow-tract direction) was noticeable in response to PH. For normotensive RVFW samples, the average fiber orientation angles obtained by 3D-UST with biaxial test spiraled from 20° at the endo-cardium to -42° at the epi-cardium (Δ = 62°). For PHRV samples, the average fiber orientation angles obtained by 3D-UST with biaxial test had much less spiral across tissue thickness: 3° at endo-cardium to -7° at epi-cardium (Δ = 10°, P |
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While current standard biaxial testing provides information on the mechanical behavior of RV tissues using surface markers, it is unable to fully assess structural and mechanical properties across the full tissue thickness. In this study, the mechanical and structural properties of normotensive and pulmonary hypertension right ventricular (PHRV) myocardium through its full thickness were examined using mechanical testing combined with 3D ultrasound speckle tracking (3D-UST). RV pressure overload was induced in Sprague-Dawley rats by pulmonary artery (PA) banding. The second Piola-Kirchhoff stress tensors and Green-Lagrangian strain tensors were computed in the RV myocardium using the biaxial testing combined with 3D-UST. A previously established non-linear curve-fitting algorithm was applied to fit experimental data to a Strain Energy Function (SEF) for computation of myofiber orientation. The fiber orientations obtained by the biaxial testing with 3D-UST compared well with the fiber orientations computed from the histology. In addition, the re-orientation of myofiber in the right ventricular free wall (RVFW) along longitudinal direction (apex-to-outflow-tract direction) was noticeable in response to PH. For normotensive RVFW samples, the average fiber orientation angles obtained by 3D-UST with biaxial test spiraled from 20° at the endo-cardium to -42° at the epi-cardium (Δ = 62°). For PHRV samples, the average fiber orientation angles obtained by 3D-UST with biaxial test had much less spiral across tissue thickness: 3° at endo-cardium to -7° at epi-cardium (Δ = 10°, P<0.005 compared to normotensive).</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0165320</identifier><identifier>PMID: 27780271</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Algorithms ; Animal tissues ; Animals ; Banding ; Biaxial tests ; Bioengineering ; Biology and Life Sciences ; Biomechanical Phenomena ; Cardiology ; Computation ; Curve fitting ; Engineering schools ; Failure ; Fiber orientation ; Heart ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Histology ; Hypertension ; Hypertension, Pulmonary - pathology ; Hypertension, Pulmonary - veterinary ; Male ; Mathematical analysis ; Mechanical properties ; Mechanical tests ; Medicine ; Medicine and Health Sciences ; Myocardium ; Myocardium - pathology ; Parameter estimation ; Physical Sciences ; Pulmonary arteries ; Pulmonary artery ; Pulmonary Artery - surgery ; Pulmonary hypertension ; Rats ; Rats, Sprague-Dawley ; Research and Analysis Methods ; Stiffness ; Stress tensors ; Stress, Mechanical ; Surface markers ; Tensors ; Tracking ; Ultrasonic imaging ; Ultrasonography ; Ultrasound ; Ventricle ; Ventricular Remodeling</subject><ispartof>PloS one, 2016-10, Vol.11 (10), p.e0165320-e0165320</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Park 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>2016 Park et al 2016 Park et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-c80572a289206fbfa8b2d6523c9a8d4595bad52d598a06334e81c91915949573</citedby><cites>FETCH-LOGICAL-c725t-c80572a289206fbfa8b2d6523c9a8d4595bad52d598a06334e81c91915949573</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/PMC5079565/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079565/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2919,23857,27915,27916,53782,53784,79361,79362</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27780271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Kellermayer, Miklos S.</contributor><creatorcontrib>Park, Dae Woo</creatorcontrib><creatorcontrib>Sebastiani, Andrea</creatorcontrib><creatorcontrib>Yap, Choon Hwai</creatorcontrib><creatorcontrib>Simon, Marc A</creatorcontrib><creatorcontrib>Kim, Kang</creatorcontrib><title>Quantification of Coupled Stiffness and Fiber Orientation Remodeling in Hypertensive Rat Right-Ventricular Myocardium Using 3D Ultrasound Speckle Tracking with Biaxial Testing</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Mechanical and structural changes of right ventricular (RV) in response to pulmonary hypertension (PH) are inadequately understood. While current standard biaxial testing provides information on the mechanical behavior of RV tissues using surface markers, it is unable to fully assess structural and mechanical properties across the full tissue thickness. In this study, the mechanical and structural properties of normotensive and pulmonary hypertension right ventricular (PHRV) myocardium through its full thickness were examined using mechanical testing combined with 3D ultrasound speckle tracking (3D-UST). RV pressure overload was induced in Sprague-Dawley rats by pulmonary artery (PA) banding. The second Piola-Kirchhoff stress tensors and Green-Lagrangian strain tensors were computed in the RV myocardium using the biaxial testing combined with 3D-UST. A previously established non-linear curve-fitting algorithm was applied to fit experimental data to a Strain Energy Function (SEF) for computation of myofiber orientation. The fiber orientations obtained by the biaxial testing with 3D-UST compared well with the fiber orientations computed from the histology. In addition, the re-orientation of myofiber in the right ventricular free wall (RVFW) along longitudinal direction (apex-to-outflow-tract direction) was noticeable in response to PH. For normotensive RVFW samples, the average fiber orientation angles obtained by 3D-UST with biaxial test spiraled from 20° at the endo-cardium to -42° at the epi-cardium (Δ = 62°). For PHRV samples, the average fiber orientation angles obtained by 3D-UST with biaxial test had much less spiral across tissue thickness: 3° at endo-cardium to -7° at epi-cardium (Δ = 10°, P<0.005 compared to normotensive).</description><subject>Algorithms</subject><subject>Animal tissues</subject><subject>Animals</subject><subject>Banding</subject><subject>Biaxial tests</subject><subject>Bioengineering</subject><subject>Biology and Life Sciences</subject><subject>Biomechanical Phenomena</subject><subject>Cardiology</subject><subject>Computation</subject><subject>Curve fitting</subject><subject>Engineering schools</subject><subject>Failure</subject><subject>Fiber orientation</subject><subject>Heart</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Histology</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - pathology</subject><subject>Hypertension, Pulmonary - veterinary</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Mechanical properties</subject><subject>Mechanical tests</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Myocardium</subject><subject>Myocardium - pathology</subject><subject>Parameter estimation</subject><subject>Physical Sciences</subject><subject>Pulmonary arteries</subject><subject>Pulmonary artery</subject><subject>Pulmonary Artery - surgery</subject><subject>Pulmonary hypertension</subject><subject>Rats</subject><subject>Rats, Sprague-Dawley</subject><subject>Research and Analysis Methods</subject><subject>Stiffness</subject><subject>Stress tensors</subject><subject>Stress, Mechanical</subject><subject>Surface markers</subject><subject>Tensors</subject><subject>Tracking</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Ventricle</subject><subject>Ventricular Remodeling</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</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>eNqNk99OFDEUxidGI4i-gdEmJkYvdu2f6XR6Q4IoQoIhLgu3TafT2S1027XtIDyVr2iHXQhruCBzMZPT3_f1zNeeoniL4BgRhr5c-D44acdL7_QYoooSDJ8V24gTPKowJM8ffG8Vr2K8gJCSuqpeFluYsRpihraLv7966ZLpjJLJeAd8B_Z9v7S6Bae53DkdI5CuBQem0QGcBKNdWqETvfCttsbNgHHg8GapQ9IumisNJjKBiZnN0-g848Go3soAft54JUNr-gU4i4OMfANnNgUZfZ93OF1qdWk1mAapLoflPybNwVcjr420YKpjysXXxYtO2qjfrN87xfTg-3T_cHR88uNof-94pBimaaRqSBmWuOYYVl3TybrBbUUxUVzWbUk5bWRLcUt5LWFFSKlrpDjiiPKSU0Z2ivcr26X1UayjjgLVBGPEKaKZOFoRrZcXYhnMQoYb4aURtwUfZkKGZJTVApVK8wq2WHNUIkzrslINaxuF6xrrBmev3fVufbPQrRoyk3bDdHPFmbmY-StBIeO0Gpr5tDYI_nefkxILE5W2Vjrt-9u-GcGZrZ-C0orhkqCMfvgPfTyINTWT-V-N63xuUQ2mYq9kiMOSsSHQ8SNUflq9MCpf4c7k-obg84YgM0lfp5nsYxRHp5Onsyfnm-zHB-xcS5vm0dt-uNJxEyxXoAo-xqC7-_NAUAwTeJeGGCZQrCcwy949PMt70d3IkX-9iCzY</recordid><startdate>20161025</startdate><enddate>20161025</enddate><creator>Park, Dae Woo</creator><creator>Sebastiani, Andrea</creator><creator>Yap, Choon Hwai</creator><creator>Simon, Marc A</creator><creator>Kim, Kang</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>20161025</creationdate><title>Quantification of Coupled Stiffness and Fiber Orientation Remodeling in Hypertensive Rat Right-Ventricular Myocardium Using 3D Ultrasound Speckle Tracking with Biaxial Testing</title><author>Park, Dae Woo ; Sebastiani, Andrea ; Yap, Choon Hwai ; Simon, Marc A ; Kim, Kang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-c80572a289206fbfa8b2d6523c9a8d4595bad52d598a06334e81c91915949573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Algorithms</topic><topic>Animal tissues</topic><topic>Animals</topic><topic>Banding</topic><topic>Biaxial tests</topic><topic>Bioengineering</topic><topic>Biology and Life Sciences</topic><topic>Biomechanical Phenomena</topic><topic>Cardiology</topic><topic>Computation</topic><topic>Curve fitting</topic><topic>Engineering schools</topic><topic>Failure</topic><topic>Fiber orientation</topic><topic>Heart</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Histology</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary - pathology</topic><topic>Hypertension, Pulmonary - veterinary</topic><topic>Male</topic><topic>Mathematical analysis</topic><topic>Mechanical properties</topic><topic>Mechanical tests</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Myocardium</topic><topic>Myocardium - pathology</topic><topic>Parameter estimation</topic><topic>Physical Sciences</topic><topic>Pulmonary arteries</topic><topic>Pulmonary artery</topic><topic>Pulmonary Artery - surgery</topic><topic>Pulmonary hypertension</topic><topic>Rats</topic><topic>Rats, Sprague-Dawley</topic><topic>Research and Analysis Methods</topic><topic>Stiffness</topic><topic>Stress tensors</topic><topic>Stress, Mechanical</topic><topic>Surface markers</topic><topic>Tensors</topic><topic>Tracking</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><topic>Ventricle</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Dae Woo</creatorcontrib><creatorcontrib>Sebastiani, Andrea</creatorcontrib><creatorcontrib>Yap, Choon Hwai</creatorcontrib><creatorcontrib>Simon, Marc A</creatorcontrib><creatorcontrib>Kim, Kang</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>ProQuest Nursing and Allied Health Journals</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>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest 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)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</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>ProQuest 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</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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While current standard biaxial testing provides information on the mechanical behavior of RV tissues using surface markers, it is unable to fully assess structural and mechanical properties across the full tissue thickness. In this study, the mechanical and structural properties of normotensive and pulmonary hypertension right ventricular (PHRV) myocardium through its full thickness were examined using mechanical testing combined with 3D ultrasound speckle tracking (3D-UST). RV pressure overload was induced in Sprague-Dawley rats by pulmonary artery (PA) banding. The second Piola-Kirchhoff stress tensors and Green-Lagrangian strain tensors were computed in the RV myocardium using the biaxial testing combined with 3D-UST. A previously established non-linear curve-fitting algorithm was applied to fit experimental data to a Strain Energy Function (SEF) for computation of myofiber orientation. The fiber orientations obtained by the biaxial testing with 3D-UST compared well with the fiber orientations computed from the histology. In addition, the re-orientation of myofiber in the right ventricular free wall (RVFW) along longitudinal direction (apex-to-outflow-tract direction) was noticeable in response to PH. For normotensive RVFW samples, the average fiber orientation angles obtained by 3D-UST with biaxial test spiraled from 20° at the endo-cardium to -42° at the epi-cardium (Δ = 62°). For PHRV samples, the average fiber orientation angles obtained by 3D-UST with biaxial test had much less spiral across tissue thickness: 3° at endo-cardium to -7° at epi-cardium (Δ = 10°, P<0.005 compared to normotensive).</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27780271</pmid><doi>10.1371/journal.pone.0165320</doi><tpages>e0165320</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Algorithms Animal tissues Animals Banding Biaxial tests Bioengineering Biology and Life Sciences Biomechanical Phenomena Cardiology Computation Curve fitting Engineering schools Failure Fiber orientation Heart Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Histology Hypertension Hypertension, Pulmonary - pathology Hypertension, Pulmonary - veterinary Male Mathematical analysis Mechanical properties Mechanical tests Medicine Medicine and Health Sciences Myocardium Myocardium - pathology Parameter estimation Physical Sciences Pulmonary arteries Pulmonary artery Pulmonary Artery - surgery Pulmonary hypertension Rats Rats, Sprague-Dawley Research and Analysis Methods Stiffness Stress tensors Stress, Mechanical Surface markers Tensors Tracking Ultrasonic imaging Ultrasonography Ultrasound Ventricle Ventricular Remodeling |
title | Quantification of Coupled Stiffness and Fiber Orientation Remodeling in Hypertensive Rat Right-Ventricular Myocardium Using 3D Ultrasound Speckle Tracking with Biaxial Testing |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T18%3A02%3A11IST&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=Quantification%20of%20Coupled%20Stiffness%20and%20Fiber%20Orientation%20Remodeling%20in%20Hypertensive%20Rat%20Right-Ventricular%20Myocardium%20Using%203D%20Ultrasound%20Speckle%20Tracking%20with%20Biaxial%20Testing&rft.jtitle=PloS%20one&rft.au=Park,%20Dae%20Woo&rft.date=2016-10-25&rft.volume=11&rft.issue=10&rft.spage=e0165320&rft.epage=e0165320&rft.pages=e0165320-e0165320&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0165320&rft_dat=%3Cgale_plos_%3EA471904777%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=1832219515&rft_id=info:pmid/27780271&rft_galeid=A471904777&rft_doaj_id=oai_doaj_org_article_14ce960d2e914125846cb7dbc2882eb2&rfr_iscdi=true |