Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods

Few studies have focused on assessing Salmonella infection in the nursery and its role in further pig production periods. Mesenteric lymph nodes, intestinal content, and meat juice from 389 6-week-old male piglets intended for human consumption from five breeding farms and 191 pooled floor fecal sam...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Pathogens (Basel) 2021-01, Vol.10 (2), p.123, Article 123
Hauptverfasser: Bernad-Roche, Maria, Casanova-Higes, Alejandro, Marin-Alcala, Clara M., Cebollada-Solanas, Alberto, Mainar-Jaime, Raul C.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 2
container_start_page 123
container_title Pathogens (Basel)
container_volume 10
creator Bernad-Roche, Maria
Casanova-Higes, Alejandro
Marin-Alcala, Clara M.
Cebollada-Solanas, Alberto
Mainar-Jaime, Raul C.
description Few studies have focused on assessing Salmonella infection in the nursery and its role in further pig production periods. Mesenteric lymph nodes, intestinal content, and meat juice from 389 6-week-old male piglets intended for human consumption from five breeding farms and 191 pooled floor fecal samples from gilt development units (GDU) from the same farms were analyzed to estimate and characterize (by pulsed-field gel electrophoresis and antimicrobial resistance analyses) Salmonella infection. The prevalence of infection and shedding among piglets was 36.5% and 37.3%, respectively, shedding being significantly associated with infection (Odds Ratio = 12.7; CI 7.3-22.0). Salmonella Rissen; S. 4,[5],12:i:-; and S. Derby were the most common serotypes. A low level of Salmonella-specific maternal antibodies at the beginning of the nursery period suggested it was a period of high risk of infection. Resistance to 3rd- and 4th-generation cephalosporins was detected in piglet isolates although the piglets never received antibiotics, indicating they could be vectors of antimicrobial resistance. The same Salmonella clones were detected in piglet and GDU isolates, suggesting that infected piglets play a significant role in the infection of gilts and consequently of finishing pigs in the case of production farms. The control of Salmonella infection in nursery piglets may decrease the risk of abattoir and carcass contamination.
doi_str_mv 10.3390/pathogens10020123
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2483497805</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_cb63145885364c85aa77a80718adc07e</doaj_id><sourcerecordid>2483497805</sourcerecordid><originalsourceid>FETCH-LOGICAL-c493t-83023d70523896eedef6f661d8a1d24a0fdc3d33f4c6d876d1492dbe4823e4ce3</originalsourceid><addsrcrecordid>eNqNkl1rFDEUhgdRbKn9Ad5IwBtBVvM1SeZGkMXahaKL1euQTc7sZplNtklG6b83061Lqzfm5uTjyUNyeJvmJcHvGOvw-70pm7iGkAnGFBPKnjSnFEsxw4rIpw_mJ815zltch8LT-nlzwliLOe7kaXNzbYZdDDAMBi1CD7b4GJAP6MuYMqRbtPTrAUpGJji0qPVbHGA6LxtA1_sExqHYo6MlZp9RiehiTJVIaJmiGw_SJSQfXX7RPOvNkOH8vp41Py4-fZ9fzq6-fl7MP17NLO9YmSmGKXMSt5SpTgA46EUvBHHKEEe5wb2zzDHWcyucksIR3lG3Aq4oA26BnTWLg9dFs9X75Hcm3epovL7biGmtTSreDqDtSjDCW6VaJrhVrTFSGoUlUcZZLCfXh4NrP6524CyEkszwSPr4JPiNXsefWnaE4Latgjf3ghRvRshF73y2U9cDxDFrWp8tWtlJVtHXf6HbOKZQWzVRjHdS4UlIDpRNMecE_fExBOspH_qffNQ7rx7-4njjTxoq8PYA_IJV7LP1ECwcsRogQakSsp2yRCqt_p-e-2KmFMzjGAr7Dcp72dk</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2483497805</pqid></control><display><type>article</type><title>Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>DOAJ Directory of Open Access Journals</source><source>Web of Science - Science Citation Index Expanded - 2021&lt;img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /&gt;</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Bernad-Roche, Maria ; Casanova-Higes, Alejandro ; Marin-Alcala, Clara M. ; Cebollada-Solanas, Alberto ; Mainar-Jaime, Raul C.</creator><creatorcontrib>Bernad-Roche, Maria ; Casanova-Higes, Alejandro ; Marin-Alcala, Clara M. ; Cebollada-Solanas, Alberto ; Mainar-Jaime, Raul C.</creatorcontrib><description>Few studies have focused on assessing Salmonella infection in the nursery and its role in further pig production periods. Mesenteric lymph nodes, intestinal content, and meat juice from 389 6-week-old male piglets intended for human consumption from five breeding farms and 191 pooled floor fecal samples from gilt development units (GDU) from the same farms were analyzed to estimate and characterize (by pulsed-field gel electrophoresis and antimicrobial resistance analyses) Salmonella infection. The prevalence of infection and shedding among piglets was 36.5% and 37.3%, respectively, shedding being significantly associated with infection (Odds Ratio = 12.7; CI 7.3-22.0). Salmonella Rissen; S. 4,[5],12:i:-; and S. Derby were the most common serotypes. A low level of Salmonella-specific maternal antibodies at the beginning of the nursery period suggested it was a period of high risk of infection. Resistance to 3rd- and 4th-generation cephalosporins was detected in piglet isolates although the piglets never received antibiotics, indicating they could be vectors of antimicrobial resistance. The same Salmonella clones were detected in piglet and GDU isolates, suggesting that infected piglets play a significant role in the infection of gilts and consequently of finishing pigs in the case of production farms. The control of Salmonella infection in nursery piglets may decrease the risk of abattoir and carcass contamination.</description><identifier>ISSN: 2076-0817</identifier><identifier>EISSN: 2076-0817</identifier><identifier>DOI: 10.3390/pathogens10020123</identifier><identifier>PMID: 33504097</identifier><language>eng</language><publisher>BASEL: Mdpi</publisher><subject>Abattoirs ; Age ; Antibiotics ; Antibodies ; Antimicrobial agents ; Antimicrobial resistance ; Bacterial infections ; Cephalosporins ; Drug resistance ; Electrophoresis ; Farms ; Feces ; Gel electrophoresis ; Health risks ; Hogs ; Infections ; Intestine ; Life Sciences &amp; Biomedicine ; Low level ; Lymph nodes ; Meat ; Microbiology ; nursery piglets ; Pathogens ; PFGE ; prevalence ; Pulsed-field gel electrophoresis ; Salmonella ; Salmonellosis ; Science &amp; Technology ; Serology ; Serotypes ; Shedding ; swine ; Swine production ; Weaning</subject><ispartof>Pathogens (Basel), 2021-01, Vol.10 (2), p.123, Article 123</ispartof><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>11</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000622867500001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c493t-83023d70523896eedef6f661d8a1d24a0fdc3d33f4c6d876d1492dbe4823e4ce3</citedby><cites>FETCH-LOGICAL-c493t-83023d70523896eedef6f661d8a1d24a0fdc3d33f4c6d876d1492dbe4823e4ce3</cites><orcidid>0000-0002-3017-3012 ; 0000-0002-1974-9025 ; 0000-0001-5442-7702 ; 0000-0002-9340-0665</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/PMC7911055/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911055/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2106,2118,27933,27934,39267,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33504097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bernad-Roche, Maria</creatorcontrib><creatorcontrib>Casanova-Higes, Alejandro</creatorcontrib><creatorcontrib>Marin-Alcala, Clara M.</creatorcontrib><creatorcontrib>Cebollada-Solanas, Alberto</creatorcontrib><creatorcontrib>Mainar-Jaime, Raul C.</creatorcontrib><title>Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods</title><title>Pathogens (Basel)</title><addtitle>PATHOGENS</addtitle><addtitle>Pathogens</addtitle><description>Few studies have focused on assessing Salmonella infection in the nursery and its role in further pig production periods. Mesenteric lymph nodes, intestinal content, and meat juice from 389 6-week-old male piglets intended for human consumption from five breeding farms and 191 pooled floor fecal samples from gilt development units (GDU) from the same farms were analyzed to estimate and characterize (by pulsed-field gel electrophoresis and antimicrobial resistance analyses) Salmonella infection. The prevalence of infection and shedding among piglets was 36.5% and 37.3%, respectively, shedding being significantly associated with infection (Odds Ratio = 12.7; CI 7.3-22.0). Salmonella Rissen; S. 4,[5],12:i:-; and S. Derby were the most common serotypes. A low level of Salmonella-specific maternal antibodies at the beginning of the nursery period suggested it was a period of high risk of infection. Resistance to 3rd- and 4th-generation cephalosporins was detected in piglet isolates although the piglets never received antibiotics, indicating they could be vectors of antimicrobial resistance. The same Salmonella clones were detected in piglet and GDU isolates, suggesting that infected piglets play a significant role in the infection of gilts and consequently of finishing pigs in the case of production farms. The control of Salmonella infection in nursery piglets may decrease the risk of abattoir and carcass contamination.</description><subject>Abattoirs</subject><subject>Age</subject><subject>Antibiotics</subject><subject>Antibodies</subject><subject>Antimicrobial agents</subject><subject>Antimicrobial resistance</subject><subject>Bacterial infections</subject><subject>Cephalosporins</subject><subject>Drug resistance</subject><subject>Electrophoresis</subject><subject>Farms</subject><subject>Feces</subject><subject>Gel electrophoresis</subject><subject>Health risks</subject><subject>Hogs</subject><subject>Infections</subject><subject>Intestine</subject><subject>Life Sciences &amp; Biomedicine</subject><subject>Low level</subject><subject>Lymph nodes</subject><subject>Meat</subject><subject>Microbiology</subject><subject>nursery piglets</subject><subject>Pathogens</subject><subject>PFGE</subject><subject>prevalence</subject><subject>Pulsed-field gel electrophoresis</subject><subject>Salmonella</subject><subject>Salmonellosis</subject><subject>Science &amp; Technology</subject><subject>Serology</subject><subject>Serotypes</subject><subject>Shedding</subject><subject>swine</subject><subject>Swine production</subject><subject>Weaning</subject><issn>2076-0817</issn><issn>2076-0817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</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>eNqNkl1rFDEUhgdRbKn9Ad5IwBtBVvM1SeZGkMXahaKL1euQTc7sZplNtklG6b83061Lqzfm5uTjyUNyeJvmJcHvGOvw-70pm7iGkAnGFBPKnjSnFEsxw4rIpw_mJ815zltch8LT-nlzwliLOe7kaXNzbYZdDDAMBi1CD7b4GJAP6MuYMqRbtPTrAUpGJji0qPVbHGA6LxtA1_sExqHYo6MlZp9RiehiTJVIaJmiGw_SJSQfXX7RPOvNkOH8vp41Py4-fZ9fzq6-fl7MP17NLO9YmSmGKXMSt5SpTgA46EUvBHHKEEe5wb2zzDHWcyucksIR3lG3Aq4oA26BnTWLg9dFs9X75Hcm3epovL7biGmtTSreDqDtSjDCW6VaJrhVrTFSGoUlUcZZLCfXh4NrP6524CyEkszwSPr4JPiNXsefWnaE4Latgjf3ghRvRshF73y2U9cDxDFrWp8tWtlJVtHXf6HbOKZQWzVRjHdS4UlIDpRNMecE_fExBOspH_qffNQ7rx7-4njjTxoq8PYA_IJV7LP1ECwcsRogQakSsp2yRCqt_p-e-2KmFMzjGAr7Dcp72dk</recordid><startdate>20210125</startdate><enddate>20210125</enddate><creator>Bernad-Roche, Maria</creator><creator>Casanova-Higes, Alejandro</creator><creator>Marin-Alcala, Clara M.</creator><creator>Cebollada-Solanas, Alberto</creator><creator>Mainar-Jaime, Raul C.</creator><general>Mdpi</general><general>MDPI AG</general><general>MDPI</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T7</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-3017-3012</orcidid><orcidid>https://orcid.org/0000-0002-1974-9025</orcidid><orcidid>https://orcid.org/0000-0001-5442-7702</orcidid><orcidid>https://orcid.org/0000-0002-9340-0665</orcidid></search><sort><creationdate>20210125</creationdate><title>Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods</title><author>Bernad-Roche, Maria ; Casanova-Higes, Alejandro ; Marin-Alcala, Clara M. ; Cebollada-Solanas, Alberto ; Mainar-Jaime, Raul C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c493t-83023d70523896eedef6f661d8a1d24a0fdc3d33f4c6d876d1492dbe4823e4ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abattoirs</topic><topic>Age</topic><topic>Antibiotics</topic><topic>Antibodies</topic><topic>Antimicrobial agents</topic><topic>Antimicrobial resistance</topic><topic>Bacterial infections</topic><topic>Cephalosporins</topic><topic>Drug resistance</topic><topic>Electrophoresis</topic><topic>Farms</topic><topic>Feces</topic><topic>Gel electrophoresis</topic><topic>Health risks</topic><topic>Hogs</topic><topic>Infections</topic><topic>Intestine</topic><topic>Life Sciences &amp; Biomedicine</topic><topic>Low level</topic><topic>Lymph nodes</topic><topic>Meat</topic><topic>Microbiology</topic><topic>nursery piglets</topic><topic>Pathogens</topic><topic>PFGE</topic><topic>prevalence</topic><topic>Pulsed-field gel electrophoresis</topic><topic>Salmonella</topic><topic>Salmonellosis</topic><topic>Science &amp; Technology</topic><topic>Serology</topic><topic>Serotypes</topic><topic>Shedding</topic><topic>swine</topic><topic>Swine production</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bernad-Roche, Maria</creatorcontrib><creatorcontrib>Casanova-Higes, Alejandro</creatorcontrib><creatorcontrib>Marin-Alcala, Clara M.</creatorcontrib><creatorcontrib>Cebollada-Solanas, Alberto</creatorcontrib><creatorcontrib>Mainar-Jaime, Raul C.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Pathogens (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernad-Roche, Maria</au><au>Casanova-Higes, Alejandro</au><au>Marin-Alcala, Clara M.</au><au>Cebollada-Solanas, Alberto</au><au>Mainar-Jaime, Raul C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods</atitle><jtitle>Pathogens (Basel)</jtitle><stitle>PATHOGENS</stitle><addtitle>Pathogens</addtitle><date>2021-01-25</date><risdate>2021</risdate><volume>10</volume><issue>2</issue><spage>123</spage><pages>123-</pages><artnum>123</artnum><issn>2076-0817</issn><eissn>2076-0817</eissn><abstract>Few studies have focused on assessing Salmonella infection in the nursery and its role in further pig production periods. Mesenteric lymph nodes, intestinal content, and meat juice from 389 6-week-old male piglets intended for human consumption from five breeding farms and 191 pooled floor fecal samples from gilt development units (GDU) from the same farms were analyzed to estimate and characterize (by pulsed-field gel electrophoresis and antimicrobial resistance analyses) Salmonella infection. The prevalence of infection and shedding among piglets was 36.5% and 37.3%, respectively, shedding being significantly associated with infection (Odds Ratio = 12.7; CI 7.3-22.0). Salmonella Rissen; S. 4,[5],12:i:-; and S. Derby were the most common serotypes. A low level of Salmonella-specific maternal antibodies at the beginning of the nursery period suggested it was a period of high risk of infection. Resistance to 3rd- and 4th-generation cephalosporins was detected in piglet isolates although the piglets never received antibiotics, indicating they could be vectors of antimicrobial resistance. The same Salmonella clones were detected in piglet and GDU isolates, suggesting that infected piglets play a significant role in the infection of gilts and consequently of finishing pigs in the case of production farms. The control of Salmonella infection in nursery piglets may decrease the risk of abattoir and carcass contamination.</abstract><cop>BASEL</cop><pub>Mdpi</pub><pmid>33504097</pmid><doi>10.3390/pathogens10020123</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-3017-3012</orcidid><orcidid>https://orcid.org/0000-0002-1974-9025</orcidid><orcidid>https://orcid.org/0000-0001-5442-7702</orcidid><orcidid>https://orcid.org/0000-0002-9340-0665</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2076-0817
ispartof Pathogens (Basel), 2021-01, Vol.10 (2), p.123, Article 123
issn 2076-0817
2076-0817
language eng
recordid cdi_proquest_journals_2483497805
source MDPI - Multidisciplinary Digital Publishing Institute; DOAJ Directory of Open Access Journals; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access
subjects Abattoirs
Age
Antibiotics
Antibodies
Antimicrobial agents
Antimicrobial resistance
Bacterial infections
Cephalosporins
Drug resistance
Electrophoresis
Farms
Feces
Gel electrophoresis
Health risks
Hogs
Infections
Intestine
Life Sciences & Biomedicine
Low level
Lymph nodes
Meat
Microbiology
nursery piglets
Pathogens
PFGE
prevalence
Pulsed-field gel electrophoresis
Salmonella
Salmonellosis
Science & Technology
Serology
Serotypes
Shedding
swine
Swine production
Weaning
title Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-11-30T13%3A37%3A22IST&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=Salmonella%20Infection%20in%20Nursery%20Piglets%20and%20Its%20Role%20in%20the%20Spread%20of%20Salmonellosis%20to%20Further%20Production%20Periods&rft.jtitle=Pathogens%20(Basel)&rft.au=Bernad-Roche,%20Maria&rft.date=2021-01-25&rft.volume=10&rft.issue=2&rft.spage=123&rft.pages=123-&rft.artnum=123&rft.issn=2076-0817&rft.eissn=2076-0817&rft_id=info:doi/10.3390/pathogens10020123&rft_dat=%3Cproquest_cross%3E2483497805%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=2483497805&rft_id=info:pmid/33504097&rft_doaj_id=oai_doaj_org_article_cb63145885364c85aa77a80718adc07e&rfr_iscdi=true