Correlations among age, sex, axial length, and subfoveal choroidal thickness in the choriocapillaris structure analyzed using multiple en face image averaging optical coherence tomography angiography
To analyze the structure of the choriocapillaris in healthy eyes by using averaged en face images acquired using swept source optical coherence tomography angiography and to examine the changes in the macular profile in relation to age, sex, axial length, and choroidal thickness. This prospective, c...
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| creator | Ichioka, Ai Ooto, Sotaro Uji, Akihito Manabe, Saki Shiragami, Chieko Tsujikawa, Akitaka |
| description | To analyze the structure of the choriocapillaris in healthy eyes by using averaged en face images acquired using swept source optical coherence tomography angiography and to examine the changes in the macular profile in relation to age, sex, axial length, and choroidal thickness.
This prospective, cross-sectional study included 81 eyes of 81 subjects without ophthalmologic or systemic diseases who underwent a full ophthalmologic examination, including 3 × 3-mm macular optical coherence tomography angiography. Four to nine choriocapillaris en face images were registered and averaged. The averaged images were then binarized and analyzed.
The averaged choriocapillaris images showed a continuous capillary meshwork, whereas the unaveraged images had a granular appearance. The mean total area and size of flow voids were 0.99 ± 0.20 mm2 and 567.8 ± 201.5 μm2, respectively, and these values correlated positively with age (p = 0.002, R = 0.336 and p = 0.026, R = 0.247, respectively). Age-related gains in the mean total area and flow void size were 4.20 × 10-3 mm2 and 3.07 μm2 per year, respectively. However, the mean total area and flow void size had no significant correlation with axial length, subfoveal choroidal thickness, or sex.
Multiple averaged en face swept source optical coherence tomography angiography is more effective than a single optical coherence tomography angiography scan for better visualizing the choriocapillaris. The total area and size of flow voids within a 3 × 3-mm macular area positively correlated with age. This technique can be useful for investigating the changes arising in macular diseases. |
| doi_str_mv | 10.1371/journal.pone.0259880 |
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This prospective, cross-sectional study included 81 eyes of 81 subjects without ophthalmologic or systemic diseases who underwent a full ophthalmologic examination, including 3 × 3-mm macular optical coherence tomography angiography. Four to nine choriocapillaris en face images were registered and averaged. The averaged images were then binarized and analyzed.
The averaged choriocapillaris images showed a continuous capillary meshwork, whereas the unaveraged images had a granular appearance. The mean total area and size of flow voids were 0.99 ± 0.20 mm2 and 567.8 ± 201.5 μm2, respectively, and these values correlated positively with age (p = 0.002, R = 0.336 and p = 0.026, R = 0.247, respectively). Age-related gains in the mean total area and flow void size were 4.20 × 10-3 mm2 and 3.07 μm2 per year, respectively. However, the mean total area and flow void size had no significant correlation with axial length, subfoveal choroidal thickness, or sex.
Multiple averaged en face swept source optical coherence tomography angiography is more effective than a single optical coherence tomography angiography scan for better visualizing the choriocapillaris. The total area and size of flow voids within a 3 × 3-mm macular area positively correlated with age. This technique can be useful for investigating the changes arising in macular diseases.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0259880</identifier><identifier>PMID: 34780537</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age ; Aged ; Angiography ; Biology and Life Sciences ; Choroid ; Choroid - blood supply ; Choroid - diagnostic imaging ; Coherence (Optics) ; Correlation ; Cross-Sectional Studies ; Demographic aspects ; Diabetes ; Diabetic retinopathy ; Evaluation ; Face ; Female ; Flow ; Humans ; Image acquisition ; Macular degeneration ; Male ; Measurement ; Medical imaging ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Ophthalmology ; Optical Coherence Tomography ; People and Places ; Prospective Studies ; Radiographic Image Interpretation, Computer-Assisted - methods ; Research and Analysis Methods ; Sex ; Social Sciences ; Supervision ; Thickness ; Tomography ; Tomography, Optical Coherence ; University faculty ; University graduates ; Visualization</subject><ispartof>PloS one, 2021-11, Vol.16 (11), p.e0259880-e0259880</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Ichioka 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>2021 Ichioka et al 2021 Ichioka et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-64cd1218285d5656dd4213ff7f07b2ecbc61983ded340579572b1937623a10963</citedby><cites>FETCH-LOGICAL-c758t-64cd1218285d5656dd4213ff7f07b2ecbc61983ded340579572b1937623a10963</cites><orcidid>0000-0001-6366-7097 ; 0000-0002-4609-8416</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/PMC8592481/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592481/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34780537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Vavvas, Demetrios G.</contributor><creatorcontrib>Ichioka, Ai</creatorcontrib><creatorcontrib>Ooto, Sotaro</creatorcontrib><creatorcontrib>Uji, Akihito</creatorcontrib><creatorcontrib>Manabe, Saki</creatorcontrib><creatorcontrib>Shiragami, Chieko</creatorcontrib><creatorcontrib>Tsujikawa, Akitaka</creatorcontrib><title>Correlations among age, sex, axial length, and subfoveal choroidal thickness in the choriocapillaris structure analyzed using multiple en face image averaging optical coherence tomography angiography</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To analyze the structure of the choriocapillaris in healthy eyes by using averaged en face images acquired using swept source optical coherence tomography angiography and to examine the changes in the macular profile in relation to age, sex, axial length, and choroidal thickness.
This prospective, cross-sectional study included 81 eyes of 81 subjects without ophthalmologic or systemic diseases who underwent a full ophthalmologic examination, including 3 × 3-mm macular optical coherence tomography angiography. Four to nine choriocapillaris en face images were registered and averaged. The averaged images were then binarized and analyzed.
The averaged choriocapillaris images showed a continuous capillary meshwork, whereas the unaveraged images had a granular appearance. The mean total area and size of flow voids were 0.99 ± 0.20 mm2 and 567.8 ± 201.5 μm2, respectively, and these values correlated positively with age (p = 0.002, R = 0.336 and p = 0.026, R = 0.247, respectively). Age-related gains in the mean total area and flow void size were 4.20 × 10-3 mm2 and 3.07 μm2 per year, respectively. However, the mean total area and flow void size had no significant correlation with axial length, subfoveal choroidal thickness, or sex.
Multiple averaged en face swept source optical coherence tomography angiography is more effective than a single optical coherence tomography angiography scan for better visualizing the choriocapillaris. The total area and size of flow voids within a 3 × 3-mm macular area positively correlated with age. This technique can be useful for investigating the changes arising in macular diseases.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Angiography</subject><subject>Biology and Life Sciences</subject><subject>Choroid</subject><subject>Choroid - blood supply</subject><subject>Choroid - diagnostic imaging</subject><subject>Coherence (Optics)</subject><subject>Correlation</subject><subject>Cross-Sectional Studies</subject><subject>Demographic aspects</subject><subject>Diabetes</subject><subject>Diabetic retinopathy</subject><subject>Evaluation</subject><subject>Face</subject><subject>Female</subject><subject>Flow</subject><subject>Humans</subject><subject>Image acquisition</subject><subject>Macular degeneration</subject><subject>Male</subject><subject>Measurement</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Optical Coherence Tomography</subject><subject>People and Places</subject><subject>Prospective Studies</subject><subject>Radiographic Image Interpretation, Computer-Assisted - methods</subject><subject>Research and Analysis Methods</subject><subject>Sex</subject><subject>Social Sciences</subject><subject>Supervision</subject><subject>Thickness</subject><subject>Tomography</subject><subject>Tomography, Optical Coherence</subject><subject>University faculty</subject><subject>University graduates</subject><subject>Visualization</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</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>eNqNk9tq3DAQhk1padK0b1BaQ6G0kN1KsmV5bwoh9BAIBHq6FbI8tpXKlivJIekL9rU6zjohW3JRfGGN9M0_mhlNkjynZE0zQd-du8kPyq5HN8CaML4pS_Ig2aebjK0KRrKHd9Z7yZMQzgnhWVkUj5O9LBclGmI_-XPsvAeronFDSFXvhjZVLRymAS4PU3VplE0tDG3s0BrqNExV4y4Ad3XnvDM1rmJn9M8BQkjNgAZcHxmn1WisVd6ENEQ_6Th5QA1lr35DnU7BYKh-stGMFlIY0kZpSE2P0VN1AV61M-DGaPQczXXgYUAiut61Xo3dFYq1Zlk_TR41ygZ4tvwPku8fP3w7_rw6Pft0cnx0utKCl3FV5LqmjJas5DUveFHXOaNZ04iGiIqBrnRBN2VWQ53lhIsNF6zCKoqCZYqSTZEdJC-3uqN1QS49CHIuP8lyxJA42RK1U-dy9JiRv5JOGXm94XwrlcekLMiqyLAnvKgaUud5w0rRUMEUiBJonjOOWu-XaFPVQ61hiF7ZHdHdk8F0snUXsuQblpcUBd4sAt79miBE2ZugAdsygJuWe4uCU4Loq3_Q-7NbqFZhAmZoHMbVs6g8KkrGBSV81lrfQ-FXQ280PtjG4P6Ow9sdB2QiXMZWTSHIk69f_p89-7HLvr7DdvhuYxecna6f-y6Yb0HtXQgemtsiUyLnebuphpznTS7zhm4v7jbo1ulmwLK_DNUpFQ</recordid><startdate>20211115</startdate><enddate>20211115</enddate><creator>Ichioka, Ai</creator><creator>Ooto, Sotaro</creator><creator>Uji, Akihito</creator><creator>Manabe, Saki</creator><creator>Shiragami, Chieko</creator><creator>Tsujikawa, Akitaka</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>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>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6366-7097</orcidid><orcidid>https://orcid.org/0000-0002-4609-8416</orcidid></search><sort><creationdate>20211115</creationdate><title>Correlations among age, sex, axial length, and subfoveal choroidal thickness in the choriocapillaris structure analyzed using multiple en face image averaging optical coherence tomography angiography</title><author>Ichioka, Ai ; Ooto, Sotaro ; Uji, Akihito ; Manabe, Saki ; Shiragami, Chieko ; Tsujikawa, Akitaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-64cd1218285d5656dd4213ff7f07b2ecbc61983ded340579572b1937623a10963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Angiography</topic><topic>Biology and Life Sciences</topic><topic>Choroid</topic><topic>Choroid - blood supply</topic><topic>Choroid - diagnostic imaging</topic><topic>Coherence (Optics)</topic><topic>Correlation</topic><topic>Cross-Sectional Studies</topic><topic>Demographic aspects</topic><topic>Diabetes</topic><topic>Diabetic retinopathy</topic><topic>Evaluation</topic><topic>Face</topic><topic>Female</topic><topic>Flow</topic><topic>Humans</topic><topic>Image acquisition</topic><topic>Macular degeneration</topic><topic>Male</topic><topic>Measurement</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Optical Coherence Tomography</topic><topic>People and Places</topic><topic>Prospective Studies</topic><topic>Radiographic Image Interpretation, Computer-Assisted - methods</topic><topic>Research and Analysis Methods</topic><topic>Sex</topic><topic>Social Sciences</topic><topic>Supervision</topic><topic>Thickness</topic><topic>Tomography</topic><topic>Tomography, Optical Coherence</topic><topic>University faculty</topic><topic>University graduates</topic><topic>Visualization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ichioka, Ai</creatorcontrib><creatorcontrib>Ooto, Sotaro</creatorcontrib><creatorcontrib>Uji, Akihito</creatorcontrib><creatorcontrib>Manabe, Saki</creatorcontrib><creatorcontrib>Shiragami, Chieko</creatorcontrib><creatorcontrib>Tsujikawa, Akitaka</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 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>Ichioka, Ai</au><au>Ooto, Sotaro</au><au>Uji, Akihito</au><au>Manabe, Saki</au><au>Shiragami, Chieko</au><au>Tsujikawa, Akitaka</au><au>Vavvas, Demetrios G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlations among age, sex, axial length, and subfoveal choroidal thickness in the choriocapillaris structure analyzed using multiple en face image averaging optical coherence tomography angiography</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-11-15</date><risdate>2021</risdate><volume>16</volume><issue>11</issue><spage>e0259880</spage><epage>e0259880</epage><pages>e0259880-e0259880</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To analyze the structure of the choriocapillaris in healthy eyes by using averaged en face images acquired using swept source optical coherence tomography angiography and to examine the changes in the macular profile in relation to age, sex, axial length, and choroidal thickness.
This prospective, cross-sectional study included 81 eyes of 81 subjects without ophthalmologic or systemic diseases who underwent a full ophthalmologic examination, including 3 × 3-mm macular optical coherence tomography angiography. Four to nine choriocapillaris en face images were registered and averaged. The averaged images were then binarized and analyzed.
The averaged choriocapillaris images showed a continuous capillary meshwork, whereas the unaveraged images had a granular appearance. The mean total area and size of flow voids were 0.99 ± 0.20 mm2 and 567.8 ± 201.5 μm2, respectively, and these values correlated positively with age (p = 0.002, R = 0.336 and p = 0.026, R = 0.247, respectively). Age-related gains in the mean total area and flow void size were 4.20 × 10-3 mm2 and 3.07 μm2 per year, respectively. However, the mean total area and flow void size had no significant correlation with axial length, subfoveal choroidal thickness, or sex.
Multiple averaged en face swept source optical coherence tomography angiography is more effective than a single optical coherence tomography angiography scan for better visualizing the choriocapillaris. The total area and size of flow voids within a 3 × 3-mm macular area positively correlated with age. This technique can be useful for investigating the changes arising in macular diseases.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34780537</pmid><doi>10.1371/journal.pone.0259880</doi><tpages>e0259880</tpages><orcidid>https://orcid.org/0000-0001-6366-7097</orcidid><orcidid>https://orcid.org/0000-0002-4609-8416</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Age Aged Angiography Biology and Life Sciences Choroid Choroid - blood supply Choroid - diagnostic imaging Coherence (Optics) Correlation Cross-Sectional Studies Demographic aspects Diabetes Diabetic retinopathy Evaluation Face Female Flow Humans Image acquisition Macular degeneration Male Measurement Medical imaging Medicine Medicine and Health Sciences Middle Aged Ophthalmology Optical Coherence Tomography People and Places Prospective Studies Radiographic Image Interpretation, Computer-Assisted - methods Research and Analysis Methods Sex Social Sciences Supervision Thickness Tomography Tomography, Optical Coherence University faculty University graduates Visualization |
| title | Correlations among age, sex, axial length, and subfoveal choroidal thickness in the choriocapillaris structure analyzed using multiple en face image averaging optical coherence tomography angiography |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T19%3A25%3A41IST&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=Correlations%20among%20age,%20sex,%20axial%20length,%20and%20subfoveal%20choroidal%20thickness%20in%20the%20choriocapillaris%20structure%20analyzed%20using%20multiple%20en%20face%20image%20averaging%20optical%20coherence%20tomography%20angiography&rft.jtitle=PloS%20one&rft.au=Ichioka,%20Ai&rft.date=2021-11-15&rft.volume=16&rft.issue=11&rft.spage=e0259880&rft.epage=e0259880&rft.pages=e0259880-e0259880&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0259880&rft_dat=%3Cgale_plos_%3EA682571050%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=2598034623&rft_id=info:pmid/34780537&rft_galeid=A682571050&rft_doaj_id=oai_doaj_org_article_b6300556bf0d44f287f172ae78e14425&rfr_iscdi=true |