Occurrence and seasonality of aflatoxin M1 in milk in two different climate zones

BACKGROUND Aflatoxin M1 (AFM1) is a mycotoxin found in milk as a result of the ingestion of aflatoxin B1 (AFB1) by dairy cattle. Because of its carcinogenic properties, the control of its occurrence in dairy products is of great importance. We evaluated the occurrence and seasonality of AFM1 in milk...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of the science of food and agriculture 2019-04, Vol.99 (6), p.3203-3206
Hauptverfasser: Venâncio, Rafael Luiz, Ludovico, Agostinho, de Santana, Elsa Helena Walter, de Toledo, Eduardo Amaral, de Almeida Rego, Fabiola Cristine, dos Santos, Joice Sifuentes
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 3206
container_issue 6
container_start_page 3203
container_title Journal of the science of food and agriculture
container_volume 99
creator Venâncio, Rafael Luiz
Ludovico, Agostinho
de Santana, Elsa Helena Walter
de Toledo, Eduardo Amaral
de Almeida Rego, Fabiola Cristine
dos Santos, Joice Sifuentes
description BACKGROUND Aflatoxin M1 (AFM1) is a mycotoxin found in milk as a result of the ingestion of aflatoxin B1 (AFB1) by dairy cattle. Because of its carcinogenic properties, the control of its occurrence in dairy products is of great importance. We evaluated the occurrence and seasonality of AFM1 in milk from farms with subtropical and temperate climates, where significant milk production occurs. Forty samples of raw milk were collected from bulk tansk milk during the summer (five samples from a subtropical climate and 14 from a temperate climate) and winter (six samples from a subtropical climate and 15 from a temperate climate) months of 2017 and conducted an analysis using an enzyme‐linked immunosorbent assay (ELISA) (detection limit 5 ng L−1). Data from eight random samples were compared with respect to liquid chromatography with mass spectrometry detection and ELISA. A significant correlation was observed. RESULTS The presence of AFM1 was detected in 87.50% (n = 35) of the samples analyzed (a mean of 16.66 ng L−1 and a median of 12.42 ng L−1 in positive samples); however, its concentration in all samples was below the maximum limit allowed by European (50 ng L−1) and Brazilian (500 ng L−1) legislations. There were no significant differences in the levels of AFM1 between the properties located in the two climate zones, in both summer and winter. The estimated daily intake of AFM1 based on the milk analyzed was 0.0107 ng kg−1 day−1 for adolescents, 0.0072 ng kg−1 day−1 for adults and 0.0098 ng kg−1 day−1 for the elderly. CONCLUSION The present work demonstrated a low exposure to AFM1. © 2018 Society of Chemical Industry
doi_str_mv 10.1002/jsfa.9487
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2191302394</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2191302394</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-5e7f71e6600df8a930ba77c9bbb623e8b992909a0e5175117f51b97d5b9dadef3</originalsourceid><addsrcrecordid>eNp1kD1PwzAQhi0EoqUw8AeQJSaGtOe4juuxqigfKqoQMFt2YkspaVzsRKX8ehxa2FjuHe65V6cHoUsCQwKQjlbBqqEYT_gR6hMQPAEgcIz6cZcmjIzTHjoLYQUAQmTZKepRGFNgIuuj52Wet96bOjdY1QUORgVXq6psdthZrGylGvdZ1viJ4DjXZfXeZbN1uCitNfGywXlVrlVj8JerTThHJ1ZVwVwccoDe5revs_tksbx7mE0XSU4Z5Qkz3HJisgygsBMlKGjFeS601llKzUQLkQoQCgwjnBHCLSNa8IJpUajCWDpA1_vejXcfrQmNXLnWx9eDTIkgFFIqxpG62VO5dyF4Y-XGx2f9ThKQnTzZyZOdvMheHRpbvTbFH_lrKwKjPbAtK7P7v0k-vsynP5XfTl94zg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2191302394</pqid></control><display><type>article</type><title>Occurrence and seasonality of aflatoxin M1 in milk in two different climate zones</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Venâncio, Rafael Luiz ; Ludovico, Agostinho ; de Santana, Elsa Helena Walter ; de Toledo, Eduardo Amaral ; de Almeida Rego, Fabiola Cristine ; dos Santos, Joice Sifuentes</creator><creatorcontrib>Venâncio, Rafael Luiz ; Ludovico, Agostinho ; de Santana, Elsa Helena Walter ; de Toledo, Eduardo Amaral ; de Almeida Rego, Fabiola Cristine ; dos Santos, Joice Sifuentes</creatorcontrib><description>BACKGROUND Aflatoxin M1 (AFM1) is a mycotoxin found in milk as a result of the ingestion of aflatoxin B1 (AFB1) by dairy cattle. Because of its carcinogenic properties, the control of its occurrence in dairy products is of great importance. We evaluated the occurrence and seasonality of AFM1 in milk from farms with subtropical and temperate climates, where significant milk production occurs. Forty samples of raw milk were collected from bulk tansk milk during the summer (five samples from a subtropical climate and 14 from a temperate climate) and winter (six samples from a subtropical climate and 15 from a temperate climate) months of 2017 and conducted an analysis using an enzyme‐linked immunosorbent assay (ELISA) (detection limit 5 ng L−1). Data from eight random samples were compared with respect to liquid chromatography with mass spectrometry detection and ELISA. A significant correlation was observed. RESULTS The presence of AFM1 was detected in 87.50% (n = 35) of the samples analyzed (a mean of 16.66 ng L−1 and a median of 12.42 ng L−1 in positive samples); however, its concentration in all samples was below the maximum limit allowed by European (50 ng L−1) and Brazilian (500 ng L−1) legislations. There were no significant differences in the levels of AFM1 between the properties located in the two climate zones, in both summer and winter. The estimated daily intake of AFM1 based on the milk analyzed was 0.0107 ng kg−1 day−1 for adolescents, 0.0072 ng kg−1 day−1 for adults and 0.0098 ng kg−1 day−1 for the elderly. CONCLUSION The present work demonstrated a low exposure to AFM1. © 2018 Society of Chemical Industry</description><identifier>ISSN: 0022-5142</identifier><identifier>EISSN: 1097-0010</identifier><identifier>DOI: 10.1002/jsfa.9487</identifier><identifier>PMID: 30430596</identifier><language>eng</language><publisher>Chichester, UK: John Wiley &amp; Sons, Ltd</publisher><subject>Adolescents ; Adults ; Aflatoxin B1 ; Aflatoxin M1 ; Aflatoxin M1 - analysis ; Aflatoxin M1 - metabolism ; Animals ; Brazil ; Carcinogens ; Cattle ; Chromatography, Liquid ; Climate ; Consumer Product Safety ; Dairy products ; Enzyme-Linked Immunosorbent Assay ; estimated daily intake ; Farms ; Food Contamination - analysis ; Geriatrics ; Humans ; immunoassay ; Ingestion ; Liquid chromatography ; Mass spectrometry ; Mass spectroscopy ; Milk ; Milk - chemistry ; Milk - metabolism ; Milk production ; Older people ; Organic chemistry ; raw milk ; Seasonal variations ; Seasons ; Summer ; survey ; Winter</subject><ispartof>Journal of the science of food and agriculture, 2019-04, Vol.99 (6), p.3203-3206</ispartof><rights>2018 Society of Chemical Industry</rights><rights>2018 Society of Chemical Industry.</rights><rights>2019 Society of Chemical Industry</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-5e7f71e6600df8a930ba77c9bbb623e8b992909a0e5175117f51b97d5b9dadef3</citedby><cites>FETCH-LOGICAL-c3537-5e7f71e6600df8a930ba77c9bbb623e8b992909a0e5175117f51b97d5b9dadef3</cites><orcidid>0000-0002-1089-0620</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjsfa.9487$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjsfa.9487$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30430596$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Venâncio, Rafael Luiz</creatorcontrib><creatorcontrib>Ludovico, Agostinho</creatorcontrib><creatorcontrib>de Santana, Elsa Helena Walter</creatorcontrib><creatorcontrib>de Toledo, Eduardo Amaral</creatorcontrib><creatorcontrib>de Almeida Rego, Fabiola Cristine</creatorcontrib><creatorcontrib>dos Santos, Joice Sifuentes</creatorcontrib><title>Occurrence and seasonality of aflatoxin M1 in milk in two different climate zones</title><title>Journal of the science of food and agriculture</title><addtitle>J Sci Food Agric</addtitle><description>BACKGROUND Aflatoxin M1 (AFM1) is a mycotoxin found in milk as a result of the ingestion of aflatoxin B1 (AFB1) by dairy cattle. Because of its carcinogenic properties, the control of its occurrence in dairy products is of great importance. We evaluated the occurrence and seasonality of AFM1 in milk from farms with subtropical and temperate climates, where significant milk production occurs. Forty samples of raw milk were collected from bulk tansk milk during the summer (five samples from a subtropical climate and 14 from a temperate climate) and winter (six samples from a subtropical climate and 15 from a temperate climate) months of 2017 and conducted an analysis using an enzyme‐linked immunosorbent assay (ELISA) (detection limit 5 ng L−1). Data from eight random samples were compared with respect to liquid chromatography with mass spectrometry detection and ELISA. A significant correlation was observed. RESULTS The presence of AFM1 was detected in 87.50% (n = 35) of the samples analyzed (a mean of 16.66 ng L−1 and a median of 12.42 ng L−1 in positive samples); however, its concentration in all samples was below the maximum limit allowed by European (50 ng L−1) and Brazilian (500 ng L−1) legislations. There were no significant differences in the levels of AFM1 between the properties located in the two climate zones, in both summer and winter. The estimated daily intake of AFM1 based on the milk analyzed was 0.0107 ng kg−1 day−1 for adolescents, 0.0072 ng kg−1 day−1 for adults and 0.0098 ng kg−1 day−1 for the elderly. CONCLUSION The present work demonstrated a low exposure to AFM1. © 2018 Society of Chemical Industry</description><subject>Adolescents</subject><subject>Adults</subject><subject>Aflatoxin B1</subject><subject>Aflatoxin M1</subject><subject>Aflatoxin M1 - analysis</subject><subject>Aflatoxin M1 - metabolism</subject><subject>Animals</subject><subject>Brazil</subject><subject>Carcinogens</subject><subject>Cattle</subject><subject>Chromatography, Liquid</subject><subject>Climate</subject><subject>Consumer Product Safety</subject><subject>Dairy products</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>estimated daily intake</subject><subject>Farms</subject><subject>Food Contamination - analysis</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>immunoassay</subject><subject>Ingestion</subject><subject>Liquid chromatography</subject><subject>Mass spectrometry</subject><subject>Mass spectroscopy</subject><subject>Milk</subject><subject>Milk - chemistry</subject><subject>Milk - metabolism</subject><subject>Milk production</subject><subject>Older people</subject><subject>Organic chemistry</subject><subject>raw milk</subject><subject>Seasonal variations</subject><subject>Seasons</subject><subject>Summer</subject><subject>survey</subject><subject>Winter</subject><issn>0022-5142</issn><issn>1097-0010</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kD1PwzAQhi0EoqUw8AeQJSaGtOe4juuxqigfKqoQMFt2YkspaVzsRKX8ehxa2FjuHe65V6cHoUsCQwKQjlbBqqEYT_gR6hMQPAEgcIz6cZcmjIzTHjoLYQUAQmTZKepRGFNgIuuj52Wet96bOjdY1QUORgVXq6psdthZrGylGvdZ1viJ4DjXZfXeZbN1uCitNfGywXlVrlVj8JerTThHJ1ZVwVwccoDe5revs_tksbx7mE0XSU4Z5Qkz3HJisgygsBMlKGjFeS601llKzUQLkQoQCgwjnBHCLSNa8IJpUajCWDpA1_vejXcfrQmNXLnWx9eDTIkgFFIqxpG62VO5dyF4Y-XGx2f9ThKQnTzZyZOdvMheHRpbvTbFH_lrKwKjPbAtK7P7v0k-vsynP5XfTl94zg</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Venâncio, Rafael Luiz</creator><creator>Ludovico, Agostinho</creator><creator>de Santana, Elsa Helena Walter</creator><creator>de Toledo, Eduardo Amaral</creator><creator>de Almeida Rego, Fabiola Cristine</creator><creator>dos Santos, Joice Sifuentes</creator><general>John Wiley &amp; Sons, Ltd</general><general>John Wiley and Sons, Limited</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>7QF</scope><scope>7QL</scope><scope>7QQ</scope><scope>7QR</scope><scope>7SC</scope><scope>7SE</scope><scope>7SN</scope><scope>7SP</scope><scope>7SR</scope><scope>7ST</scope><scope>7T5</scope><scope>7T7</scope><scope>7TA</scope><scope>7TB</scope><scope>7TM</scope><scope>7U5</scope><scope>7U9</scope><scope>8BQ</scope><scope>8FD</scope><scope>C1K</scope><scope>F28</scope><scope>FR3</scope><scope>H8D</scope><scope>H8G</scope><scope>H94</scope><scope>JG9</scope><scope>JQ2</scope><scope>KR7</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>M7N</scope><scope>P64</scope><scope>SOI</scope><orcidid>https://orcid.org/0000-0002-1089-0620</orcidid></search><sort><creationdate>201904</creationdate><title>Occurrence and seasonality of aflatoxin M1 in milk in two different climate zones</title><author>Venâncio, Rafael Luiz ; Ludovico, Agostinho ; de Santana, Elsa Helena Walter ; de Toledo, Eduardo Amaral ; de Almeida Rego, Fabiola Cristine ; dos Santos, Joice Sifuentes</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-5e7f71e6600df8a930ba77c9bbb623e8b992909a0e5175117f51b97d5b9dadef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescents</topic><topic>Adults</topic><topic>Aflatoxin B1</topic><topic>Aflatoxin M1</topic><topic>Aflatoxin M1 - analysis</topic><topic>Aflatoxin M1 - metabolism</topic><topic>Animals</topic><topic>Brazil</topic><topic>Carcinogens</topic><topic>Cattle</topic><topic>Chromatography, Liquid</topic><topic>Climate</topic><topic>Consumer Product Safety</topic><topic>Dairy products</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>estimated daily intake</topic><topic>Farms</topic><topic>Food Contamination - analysis</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>immunoassay</topic><topic>Ingestion</topic><topic>Liquid chromatography</topic><topic>Mass spectrometry</topic><topic>Mass spectroscopy</topic><topic>Milk</topic><topic>Milk - chemistry</topic><topic>Milk - metabolism</topic><topic>Milk production</topic><topic>Older people</topic><topic>Organic chemistry</topic><topic>raw milk</topic><topic>Seasonal variations</topic><topic>Seasons</topic><topic>Summer</topic><topic>survey</topic><topic>Winter</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Venâncio, Rafael Luiz</creatorcontrib><creatorcontrib>Ludovico, Agostinho</creatorcontrib><creatorcontrib>de Santana, Elsa Helena Walter</creatorcontrib><creatorcontrib>de Toledo, Eduardo Amaral</creatorcontrib><creatorcontrib>de Almeida Rego, Fabiola Cristine</creatorcontrib><creatorcontrib>dos Santos, Joice Sifuentes</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Aluminium Industry Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Ceramic Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Computer and Information Systems Abstracts</collection><collection>Corrosion Abstracts</collection><collection>Ecology Abstracts</collection><collection>Electronics &amp; Communications Abstracts</collection><collection>Engineered Materials Abstracts</collection><collection>Environment Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Materials Business File</collection><collection>Mechanical &amp; Transportation Engineering Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>METADEX</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ANTE: Abstracts in New Technology &amp; Engineering</collection><collection>Engineering Research Database</collection><collection>Aerospace Database</collection><collection>Copper Technical Reference Library</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Materials Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>Civil Engineering Abstracts</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts – Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environment Abstracts</collection><jtitle>Journal of the science of food and agriculture</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Venâncio, Rafael Luiz</au><au>Ludovico, Agostinho</au><au>de Santana, Elsa Helena Walter</au><au>de Toledo, Eduardo Amaral</au><au>de Almeida Rego, Fabiola Cristine</au><au>dos Santos, Joice Sifuentes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Occurrence and seasonality of aflatoxin M1 in milk in two different climate zones</atitle><jtitle>Journal of the science of food and agriculture</jtitle><addtitle>J Sci Food Agric</addtitle><date>2019-04</date><risdate>2019</risdate><volume>99</volume><issue>6</issue><spage>3203</spage><epage>3206</epage><pages>3203-3206</pages><issn>0022-5142</issn><eissn>1097-0010</eissn><abstract>BACKGROUND Aflatoxin M1 (AFM1) is a mycotoxin found in milk as a result of the ingestion of aflatoxin B1 (AFB1) by dairy cattle. Because of its carcinogenic properties, the control of its occurrence in dairy products is of great importance. We evaluated the occurrence and seasonality of AFM1 in milk from farms with subtropical and temperate climates, where significant milk production occurs. Forty samples of raw milk were collected from bulk tansk milk during the summer (five samples from a subtropical climate and 14 from a temperate climate) and winter (six samples from a subtropical climate and 15 from a temperate climate) months of 2017 and conducted an analysis using an enzyme‐linked immunosorbent assay (ELISA) (detection limit 5 ng L−1). Data from eight random samples were compared with respect to liquid chromatography with mass spectrometry detection and ELISA. A significant correlation was observed. RESULTS The presence of AFM1 was detected in 87.50% (n = 35) of the samples analyzed (a mean of 16.66 ng L−1 and a median of 12.42 ng L−1 in positive samples); however, its concentration in all samples was below the maximum limit allowed by European (50 ng L−1) and Brazilian (500 ng L−1) legislations. There were no significant differences in the levels of AFM1 between the properties located in the two climate zones, in both summer and winter. The estimated daily intake of AFM1 based on the milk analyzed was 0.0107 ng kg−1 day−1 for adolescents, 0.0072 ng kg−1 day−1 for adults and 0.0098 ng kg−1 day−1 for the elderly. CONCLUSION The present work demonstrated a low exposure to AFM1. © 2018 Society of Chemical Industry</abstract><cop>Chichester, UK</cop><pub>John Wiley &amp; Sons, Ltd</pub><pmid>30430596</pmid><doi>10.1002/jsfa.9487</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-1089-0620</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0022-5142
ispartof Journal of the science of food and agriculture, 2019-04, Vol.99 (6), p.3203-3206
issn 0022-5142
1097-0010
language eng
recordid cdi_proquest_journals_2191302394
source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Adolescents
Adults
Aflatoxin B1
Aflatoxin M1
Aflatoxin M1 - analysis
Aflatoxin M1 - metabolism
Animals
Brazil
Carcinogens
Cattle
Chromatography, Liquid
Climate
Consumer Product Safety
Dairy products
Enzyme-Linked Immunosorbent Assay
estimated daily intake
Farms
Food Contamination - analysis
Geriatrics
Humans
immunoassay
Ingestion
Liquid chromatography
Mass spectrometry
Mass spectroscopy
Milk
Milk - chemistry
Milk - metabolism
Milk production
Older people
Organic chemistry
raw milk
Seasonal variations
Seasons
Summer
survey
Winter
title Occurrence and seasonality of aflatoxin M1 in milk in two different climate zones
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T20%3A06%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Occurrence%20and%20seasonality%20of%20aflatoxin%20M1%20in%20milk%20in%20two%20different%20climate%20zones&rft.jtitle=Journal%20of%20the%20science%20of%20food%20and%20agriculture&rft.au=Ven%C3%A2ncio,%20Rafael%20Luiz&rft.date=2019-04&rft.volume=99&rft.issue=6&rft.spage=3203&rft.epage=3206&rft.pages=3203-3206&rft.issn=0022-5142&rft.eissn=1097-0010&rft_id=info:doi/10.1002/jsfa.9487&rft_dat=%3Cproquest_cross%3E2191302394%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2191302394&rft_id=info:pmid/30430596&rfr_iscdi=true