Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive
Anhedonia (loss of pleasure) is characterized by low responsiveness to rewards and, by virtue of being one of the two core symptoms of depression, by altered responses to stress. We investigated the effect of an acute stress experience (i.e., a tandem skydive) that was expected to elicit both intens...
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| description | Anhedonia (loss of pleasure) is characterized by low responsiveness to rewards and, by virtue of being one of the two core symptoms of depression, by altered responses to stress. We investigated the effect of an acute stress experience (i.e., a tandem skydive) that was expected to elicit both intense fear and intense euphoria in a sample of anhedonic young adults.
(1) To examine individual differences in alpha-amylase reactivity to and recovery from a tandem skydive in anhedonic young adults; (2) to investigate whether trait depressive and anxiety problems, trait positive affect (PA), i.e., level of pleasure and reward responsiveness, and state anxiety, PA and self-esteem prior to the skydive were associated with alpha-amylase reactivity and recovery patterns; (3) to investigate whether alpha-amylase reactivity and recovery patterns were associated with pre- to post-jump changes in state anxiety, PA, and self-esteem.
Participants were 61 individuals with persistent anhedonia (Mage = 21.38, 78.7% female), who filled out a baseline questionnaire at the start of the study, and momentary questionnaires (3 times per day) before and after the tandem skydive. Alpha-amylase was measured at four time points by means of salivettes (2 before and 2 after the skydive).
Alpha-amylase reactivity and recovery patterns were highly similar across individuals, although mean levels varied greatly. No associations were found between any of the trait and state measures and reactivity and recovery. Only state self-esteem was affected by the reactivity and recovery patterns, in that individuals who showed high reactivity and low recovery experienced decreases in self-esteem after the skydive.
Alpha-amylase patterns following a tandem skydive in anhedonic individuals are highly similar to patterns previously found in healthy individuals. Although replication is warranted, our findings tentatively suggest that a strong stress response that cannot be downregulated well predicts a decrease in self-esteem. |
| doi_str_mv | 10.1371/journal.pone.0204556 |
| format | Article |
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(1) To examine individual differences in alpha-amylase reactivity to and recovery from a tandem skydive in anhedonic young adults; (2) to investigate whether trait depressive and anxiety problems, trait positive affect (PA), i.e., level of pleasure and reward responsiveness, and state anxiety, PA and self-esteem prior to the skydive were associated with alpha-amylase reactivity and recovery patterns; (3) to investigate whether alpha-amylase reactivity and recovery patterns were associated with pre- to post-jump changes in state anxiety, PA, and self-esteem.
Participants were 61 individuals with persistent anhedonia (Mage = 21.38, 78.7% female), who filled out a baseline questionnaire at the start of the study, and momentary questionnaires (3 times per day) before and after the tandem skydive. Alpha-amylase was measured at four time points by means of salivettes (2 before and 2 after the skydive).
Alpha-amylase reactivity and recovery patterns were highly similar across individuals, although mean levels varied greatly. No associations were found between any of the trait and state measures and reactivity and recovery. Only state self-esteem was affected by the reactivity and recovery patterns, in that individuals who showed high reactivity and low recovery experienced decreases in self-esteem after the skydive.
Alpha-amylase patterns following a tandem skydive in anhedonic individuals are highly similar to patterns previously found in healthy individuals. Although replication is warranted, our findings tentatively suggest that a strong stress response that cannot be downregulated well predicts a decrease in self-esteem.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0204556</identifier><identifier>PMID: 30248153</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adults ; alpha-Amylases - metabolism ; Amylases ; Analysis ; Anhedonia ; Anhedonia - physiology ; Anxiety ; Anxiety - enzymology ; Biology and Life Sciences ; Depression (Mood disorder) ; Emotions ; Enzymes ; Female ; Health aspects ; Hedonic response ; Hormones ; Humans ; Interdisciplinary aspects ; Internet ; Male ; Medicine and Health Sciences ; Mental depression ; Parachuting ; People and Places ; Personality - physiology ; Physical Sciences ; Physiology ; Psychological aspects ; Psychopathology ; Reactivity ; Recovery ; Reinforcement ; Research and Analysis Methods ; Risk-Taking ; Saliva - enzymology ; Self Concept ; Self esteem ; Skydiving ; Social Behavior ; Social Sciences ; Sports - physiology ; Stress response ; Stress, Psychological - enzymology ; Stresses ; Studies ; Time Factors ; Young Adult ; Young adults ; α-Amylase</subject><ispartof>PloS one, 2018-09, Vol.13 (9), p.e0204556-e0204556</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Vrijen 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>2018 Vrijen et al 2018 Vrijen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-817927bce170ba4bd051e9f78c9a0b54e692ef4de92b4c4c0a64104513de5eb93</citedby><cites>FETCH-LOGICAL-c692t-817927bce170ba4bd051e9f78c9a0b54e692ef4de92b4c4c0a64104513de5eb93</cites><orcidid>0000-0001-5144-7863</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152985/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152985/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30248153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Puebla, Iratxe</contributor><creatorcontrib>Vrijen, Charlotte</creatorcontrib><creatorcontrib>van Roekel, Eeske</creatorcontrib><creatorcontrib>Oldehinkel, Albertine J</creatorcontrib><title>Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Anhedonia (loss of pleasure) is characterized by low responsiveness to rewards and, by virtue of being one of the two core symptoms of depression, by altered responses to stress. We investigated the effect of an acute stress experience (i.e., a tandem skydive) that was expected to elicit both intense fear and intense euphoria in a sample of anhedonic young adults.
(1) To examine individual differences in alpha-amylase reactivity to and recovery from a tandem skydive in anhedonic young adults; (2) to investigate whether trait depressive and anxiety problems, trait positive affect (PA), i.e., level of pleasure and reward responsiveness, and state anxiety, PA and self-esteem prior to the skydive were associated with alpha-amylase reactivity and recovery patterns; (3) to investigate whether alpha-amylase reactivity and recovery patterns were associated with pre- to post-jump changes in state anxiety, PA, and self-esteem.
Participants were 61 individuals with persistent anhedonia (Mage = 21.38, 78.7% female), who filled out a baseline questionnaire at the start of the study, and momentary questionnaires (3 times per day) before and after the tandem skydive. Alpha-amylase was measured at four time points by means of salivettes (2 before and 2 after the skydive).
Alpha-amylase reactivity and recovery patterns were highly similar across individuals, although mean levels varied greatly. No associations were found between any of the trait and state measures and reactivity and recovery. Only state self-esteem was affected by the reactivity and recovery patterns, in that individuals who showed high reactivity and low recovery experienced decreases in self-esteem after the skydive.
Alpha-amylase patterns following a tandem skydive in anhedonic individuals are highly similar to patterns previously found in healthy individuals. Although replication is warranted, our findings tentatively suggest that a strong stress response that cannot be downregulated well predicts a decrease in self-esteem.</description><subject>Adults</subject><subject>alpha-Amylases - metabolism</subject><subject>Amylases</subject><subject>Analysis</subject><subject>Anhedonia</subject><subject>Anhedonia - physiology</subject><subject>Anxiety</subject><subject>Anxiety - enzymology</subject><subject>Biology and Life Sciences</subject><subject>Depression (Mood disorder)</subject><subject>Emotions</subject><subject>Enzymes</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hedonic response</subject><subject>Hormones</subject><subject>Humans</subject><subject>Interdisciplinary aspects</subject><subject>Internet</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Parachuting</subject><subject>People and Places</subject><subject>Personality - physiology</subject><subject>Physical Sciences</subject><subject>Physiology</subject><subject>Psychological aspects</subject><subject>Psychopathology</subject><subject>Reactivity</subject><subject>Recovery</subject><subject>Reinforcement</subject><subject>Research and Analysis Methods</subject><subject>Risk-Taking</subject><subject>Saliva - enzymology</subject><subject>Self Concept</subject><subject>Self esteem</subject><subject>Skydiving</subject><subject>Social Behavior</subject><subject>Social Sciences</subject><subject>Sports - physiology</subject><subject>Stress response</subject><subject>Stress, Psychological - enzymology</subject><subject>Stresses</subject><subject>Studies</subject><subject>Time Factors</subject><subject>Young Adult</subject><subject>Young adults</subject><subject>α-Amylase</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1uL1DAUx4so7rr6DUQLgujDjLk0vbwIw-JlYGHB22tIk9OZjJmmm6SD_famO91lKvsgfWhz8vv_T89JTpK8xGiJaYE_7GzvWmGWnW1hiQjKGMsfJee4omSRE0Qfn3yfJc-83yHEaJnnT5MzikhWYkbPE7Uy3VYsxH4wwkPqQMigDzoMqWhVXEp7ADeknQgBXOtT3caNLSjbapkOtm83qVC9CT7twDXW7fUYSUNUwz71vwelD_A8edII4-HF9L5Ifn7-9OPy6-Lq-sv6cnW1kHlFwqLERUWKWgIuUC2yWiGGoWqKUlYC1SyDSEGTKahInclMIpFnONaNqQIGdUUvktdH385Yz6cGeU4wxgXJaUEjsT4Syood75zeCzdwKzS_DVi34cIFLQ1wSoSksqgYpThTCtVFo5Csy6wUiIIYvT5O2fp6D0pCG5wwM9P5Tqu3fGMPPMeMVCWLBu8mA2dvevCB77WXYIxowfa3_01wWZJqzPXmH_Th6iZqI2IBum1szCtHU75irCgYoQRHavkAFZ94YlrG29ToGJ8J3s8EkQnwJ2xE7z1ff__2_-z1rzn79oTdgjBh663pg7atn4PZEZTOeu-guW8yRnwchrtu8HEY-DQMUfbq9IDuRXe3n_4FM9UFVA</recordid><startdate>20180924</startdate><enddate>20180924</enddate><creator>Vrijen, Charlotte</creator><creator>van Roekel, Eeske</creator><creator>Oldehinkel, Albertine J</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><orcidid>https://orcid.org/0000-0001-5144-7863</orcidid></search><sort><creationdate>20180924</creationdate><title>Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive</title><author>Vrijen, Charlotte ; van Roekel, Eeske ; Oldehinkel, Albertine J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-817927bce170ba4bd051e9f78c9a0b54e692ef4de92b4c4c0a64104513de5eb93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adults</topic><topic>alpha-Amylases - metabolism</topic><topic>Amylases</topic><topic>Analysis</topic><topic>Anhedonia</topic><topic>Anhedonia - physiology</topic><topic>Anxiety</topic><topic>Anxiety - enzymology</topic><topic>Biology and Life Sciences</topic><topic>Depression (Mood disorder)</topic><topic>Emotions</topic><topic>Enzymes</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hedonic response</topic><topic>Hormones</topic><topic>Humans</topic><topic>Interdisciplinary aspects</topic><topic>Internet</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Mental depression</topic><topic>Parachuting</topic><topic>People and Places</topic><topic>Personality - physiology</topic><topic>Physical Sciences</topic><topic>Physiology</topic><topic>Psychological aspects</topic><topic>Psychopathology</topic><topic>Reactivity</topic><topic>Recovery</topic><topic>Reinforcement</topic><topic>Research and Analysis Methods</topic><topic>Risk-Taking</topic><topic>Saliva - enzymology</topic><topic>Self Concept</topic><topic>Self esteem</topic><topic>Skydiving</topic><topic>Social Behavior</topic><topic>Social Sciences</topic><topic>Sports - physiology</topic><topic>Stress response</topic><topic>Stress, Psychological - enzymology</topic><topic>Stresses</topic><topic>Studies</topic><topic>Time Factors</topic><topic>Young Adult</topic><topic>Young adults</topic><topic>α-Amylase</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vrijen, Charlotte</creatorcontrib><creatorcontrib>van Roekel, Eeske</creatorcontrib><creatorcontrib>Oldehinkel, Albertine J</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>Vrijen, Charlotte</au><au>van Roekel, Eeske</au><au>Oldehinkel, Albertine J</au><au>Puebla, Iratxe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-09-24</date><risdate>2018</risdate><volume>13</volume><issue>9</issue><spage>e0204556</spage><epage>e0204556</epage><pages>e0204556-e0204556</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Anhedonia (loss of pleasure) is characterized by low responsiveness to rewards and, by virtue of being one of the two core symptoms of depression, by altered responses to stress. We investigated the effect of an acute stress experience (i.e., a tandem skydive) that was expected to elicit both intense fear and intense euphoria in a sample of anhedonic young adults.
(1) To examine individual differences in alpha-amylase reactivity to and recovery from a tandem skydive in anhedonic young adults; (2) to investigate whether trait depressive and anxiety problems, trait positive affect (PA), i.e., level of pleasure and reward responsiveness, and state anxiety, PA and self-esteem prior to the skydive were associated with alpha-amylase reactivity and recovery patterns; (3) to investigate whether alpha-amylase reactivity and recovery patterns were associated with pre- to post-jump changes in state anxiety, PA, and self-esteem.
Participants were 61 individuals with persistent anhedonia (Mage = 21.38, 78.7% female), who filled out a baseline questionnaire at the start of the study, and momentary questionnaires (3 times per day) before and after the tandem skydive. Alpha-amylase was measured at four time points by means of salivettes (2 before and 2 after the skydive).
Alpha-amylase reactivity and recovery patterns were highly similar across individuals, although mean levels varied greatly. No associations were found between any of the trait and state measures and reactivity and recovery. Only state self-esteem was affected by the reactivity and recovery patterns, in that individuals who showed high reactivity and low recovery experienced decreases in self-esteem after the skydive.
Alpha-amylase patterns following a tandem skydive in anhedonic individuals are highly similar to patterns previously found in healthy individuals. Although replication is warranted, our findings tentatively suggest that a strong stress response that cannot be downregulated well predicts a decrease in self-esteem.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30248153</pmid><doi>10.1371/journal.pone.0204556</doi><tpages>e0204556</tpages><orcidid>https://orcid.org/0000-0001-5144-7863</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adults alpha-Amylases - metabolism Amylases Analysis Anhedonia Anhedonia - physiology Anxiety Anxiety - enzymology Biology and Life Sciences Depression (Mood disorder) Emotions Enzymes Female Health aspects Hedonic response Hormones Humans Interdisciplinary aspects Internet Male Medicine and Health Sciences Mental depression Parachuting People and Places Personality - physiology Physical Sciences Physiology Psychological aspects Psychopathology Reactivity Recovery Reinforcement Research and Analysis Methods Risk-Taking Saliva - enzymology Self Concept Self esteem Skydiving Social Behavior Social Sciences Sports - physiology Stress response Stress, Psychological - enzymology Stresses Studies Time Factors Young Adult Young adults α-Amylase |
| title | Alpha-amylase reactivity and recovery patterns in anhedonic young adults performing a tandem skydive |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T02%3A39%3A22IST&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=Alpha-amylase%20reactivity%20and%20recovery%20patterns%20in%20anhedonic%20young%20adults%20performing%20a%20tandem%20skydive&rft.jtitle=PloS%20one&rft.au=Vrijen,%20Charlotte&rft.date=2018-09-24&rft.volume=13&rft.issue=9&rft.spage=e0204556&rft.epage=e0204556&rft.pages=e0204556-e0204556&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0204556&rft_dat=%3Cgale_plos_%3EA557752321%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=2111726373&rft_id=info:pmid/30248153&rft_galeid=A557752321&rft_doaj_id=oai_doaj_org_article_32ac3c7953314dd0b7fd0cb848a03ea3&rfr_iscdi=true |