Overcoming the bottleneck of platelet lysate supply in large-scale clinical expansion of adipose-derived stem cells: A comparison of fresh versus three types of platelet lysates from outdated buffy coat–derived platelet concentrates
Abstract Background Platelet lysates (PL) represent a promising replacement for xenogenic growth supplement for adipose-derived stem cell (ASC) expansions. However, fresh platelets from human blood donors are not clinically feasible for large-scale cell expansion based on their limited supply. There...
Gespeichert in:
Veröffentlicht in: | Cytotherapy (Oxford, England) England), 2017-02, Vol.19 (2), p.222-234 |
---|---|
Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 234 |
---|---|
container_issue | 2 |
container_start_page | 222 |
container_title | Cytotherapy (Oxford, England) |
container_volume | 19 |
creator | Glovinski, Peter V Herly, Mikkel Mathiasen, Anders B Svalgaard, Jesper D Borup, Rehannah Talman, Maj-Lis M Elberg, Jens J Kølle, Stig-Frederik T Drzewiecki, Krzysztof T Fischer-Nielsen, Anne |
description | Abstract Background Platelet lysates (PL) represent a promising replacement for xenogenic growth supplement for adipose-derived stem cell (ASC) expansions. However, fresh platelets from human blood donors are not clinically feasible for large-scale cell expansion based on their limited supply. Therefore, we tested PLs prepared via three methods from outdated buffy coat–derived platelet concentrates (PCs) to establish an efficient and feasible expansion of ASCs for clinical use. Methods PLs were prepared by the freeze-thaw method from freshly drawn platelets or from outdated buffy coat–derived PCs stored in the platelet additive solution, InterSol. Three types of PLs were prepared from outdated PCs with platelets suspended in either (1) InterSol (not manipulated), (2) InterSol + supplemented with plasma or (3) plasma alone (InterSol removed). Using these PLs, we compared ASC population doubling time, cell yield, differentiation potential and cell surface markers. Gene expression profiles were analyzed using microarray assays, and growth factor concentrations in the cell culture medium were measured using enzyme-linked immunosorbent assay (ELISA). Results Of the three PL compositions produced from outdated PCs, removal of Intersol and resuspension in plasma prior to the first freezing process was overall the best. This specific outdated PL induced ASC growth kinetics, surface markers, plastic adherence and differentiation potentials comparable with PL from fresh platelets. ASCs expanded in PL from fresh versus outdated PCs exhibited different expressions of 17 overlapping genes, of which 10 were involved in cellular proliferation, although not significantly reflected by cell growth. Only minor differences in growth factor turnover were observed. Conclusion PLs from outdated platelets may be an efficient and reliable source of human growth supplement allowing for large-scale ASC expansion for clinical use. |
doi_str_mv | 10.1016/j.jcyt.2016.10.014 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1844031563</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1465324916305758</els_id><sourcerecordid>1844031563</sourcerecordid><originalsourceid>FETCH-LOGICAL-c455t-f45311c42c814946ab9dee6027f335e05be7788f2a94d7861746118cabb186c03</originalsourceid><addsrcrecordid>eNp9Ustu1DAUjRCIlsIPsEBesslgJ7bjQQipqnhJlboA1pbj3LSeOnHwdUZkxz_whyz5ChxNpwuEWPn66pz7OOcWxXNGN4wy-Wq32dklbaoc58SGMv6gOGW8acpKSPlwjaUo64pvT4oniDtKK6qUeFycVI1SjZLitPh9tYdow-DGa5JugLQhJQ8j2FsSejJ5k8BDIn7BHBGcp8kvxI3Em3gNJVrjgVjvRpcjAt8nM6IL48o1nZsCQtlBdHvoCCYYiAXv8TU5J7nlZKLDA7aPgDckT4Iz5jEiAEnLBPiPGTCDw0DCnLr860g79_2Sy5n068fPY697jg2jhTHFlfi0eNQbj_Ds7j0rvr5_9-XiY3l59eHTxfllabkQqey5qBmzvLKK8S2Xpt12AJJWTV_XAqhoocny9ZXZ8i6LyBouGVPWtC1T0tL6rHh5qDvF8G0GTHpwuC5uRggzaqY4pzUTss7Q6gC1MSBG6PUU3WDiohnVq8d6p1eP9erxmsseZ9KLu_pzO0B3TzmamgFvDgDIW-4dRI3WQRaicxFs0l1w_6__9i_60eBbWAB3YY5j1k8zjZWm-vN6ZeuRMVlT0QhV_wFhF9Tr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1844031563</pqid></control><display><type>article</type><title>Overcoming the bottleneck of platelet lysate supply in large-scale clinical expansion of adipose-derived stem cells: A comparison of fresh versus three types of platelet lysates from outdated buffy coat–derived platelet concentrates</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Glovinski, Peter V ; Herly, Mikkel ; Mathiasen, Anders B ; Svalgaard, Jesper D ; Borup, Rehannah ; Talman, Maj-Lis M ; Elberg, Jens J ; Kølle, Stig-Frederik T ; Drzewiecki, Krzysztof T ; Fischer-Nielsen, Anne</creator><creatorcontrib>Glovinski, Peter V ; Herly, Mikkel ; Mathiasen, Anders B ; Svalgaard, Jesper D ; Borup, Rehannah ; Talman, Maj-Lis M ; Elberg, Jens J ; Kølle, Stig-Frederik T ; Drzewiecki, Krzysztof T ; Fischer-Nielsen, Anne</creatorcontrib><description>Abstract Background Platelet lysates (PL) represent a promising replacement for xenogenic growth supplement for adipose-derived stem cell (ASC) expansions. However, fresh platelets from human blood donors are not clinically feasible for large-scale cell expansion based on their limited supply. Therefore, we tested PLs prepared via three methods from outdated buffy coat–derived platelet concentrates (PCs) to establish an efficient and feasible expansion of ASCs for clinical use. Methods PLs were prepared by the freeze-thaw method from freshly drawn platelets or from outdated buffy coat–derived PCs stored in the platelet additive solution, InterSol. Three types of PLs were prepared from outdated PCs with platelets suspended in either (1) InterSol (not manipulated), (2) InterSol + supplemented with plasma or (3) plasma alone (InterSol removed). Using these PLs, we compared ASC population doubling time, cell yield, differentiation potential and cell surface markers. Gene expression profiles were analyzed using microarray assays, and growth factor concentrations in the cell culture medium were measured using enzyme-linked immunosorbent assay (ELISA). Results Of the three PL compositions produced from outdated PCs, removal of Intersol and resuspension in plasma prior to the first freezing process was overall the best. This specific outdated PL induced ASC growth kinetics, surface markers, plastic adherence and differentiation potentials comparable with PL from fresh platelets. ASCs expanded in PL from fresh versus outdated PCs exhibited different expressions of 17 overlapping genes, of which 10 were involved in cellular proliferation, although not significantly reflected by cell growth. Only minor differences in growth factor turnover were observed. Conclusion PLs from outdated platelets may be an efficient and reliable source of human growth supplement allowing for large-scale ASC expansion for clinical use.</description><identifier>ISSN: 1465-3249</identifier><identifier>EISSN: 1477-2566</identifier><identifier>DOI: 10.1016/j.jcyt.2016.10.014</identifier><identifier>PMID: 27887865</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adipose Tissue - cytology ; adipose-derived stem cells ; Adult ; Adult Stem Cells - cytology ; Adult Stem Cells - physiology ; Advanced Basic Science ; Blood Buffy Coat - cytology ; Blood Buffy Coat - transplantation ; Blood Platelets - chemistry ; Blood Platelets - cytology ; Blood Preservation - methods ; Blood Specimen Collection - methods ; Cell Culture Techniques - methods ; Cell Extracts - supply & distribution ; Cell Proliferation ; Cell Separation ; cell therapy ; Culture Media - metabolism ; Female ; Freezing ; gene expression ; growth factors ; Humans ; Other ; Plasma - cytology ; platelet lysate ; Platelet Transfusion - methods ; Platelet-Rich Plasma - cytology ; Refrigeration ; Time Factors</subject><ispartof>Cytotherapy (Oxford, England), 2017-02, Vol.19 (2), p.222-234</ispartof><rights>International Society for Cellular Therapy</rights><rights>2017 International Society for Cellular Therapy</rights><rights>Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-f45311c42c814946ab9dee6027f335e05be7788f2a94d7861746118cabb186c03</citedby><cites>FETCH-LOGICAL-c455t-f45311c42c814946ab9dee6027f335e05be7788f2a94d7861746118cabb186c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27887865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Glovinski, Peter V</creatorcontrib><creatorcontrib>Herly, Mikkel</creatorcontrib><creatorcontrib>Mathiasen, Anders B</creatorcontrib><creatorcontrib>Svalgaard, Jesper D</creatorcontrib><creatorcontrib>Borup, Rehannah</creatorcontrib><creatorcontrib>Talman, Maj-Lis M</creatorcontrib><creatorcontrib>Elberg, Jens J</creatorcontrib><creatorcontrib>Kølle, Stig-Frederik T</creatorcontrib><creatorcontrib>Drzewiecki, Krzysztof T</creatorcontrib><creatorcontrib>Fischer-Nielsen, Anne</creatorcontrib><title>Overcoming the bottleneck of platelet lysate supply in large-scale clinical expansion of adipose-derived stem cells: A comparison of fresh versus three types of platelet lysates from outdated buffy coat–derived platelet concentrates</title><title>Cytotherapy (Oxford, England)</title><addtitle>Cytotherapy</addtitle><description>Abstract Background Platelet lysates (PL) represent a promising replacement for xenogenic growth supplement for adipose-derived stem cell (ASC) expansions. However, fresh platelets from human blood donors are not clinically feasible for large-scale cell expansion based on their limited supply. Therefore, we tested PLs prepared via three methods from outdated buffy coat–derived platelet concentrates (PCs) to establish an efficient and feasible expansion of ASCs for clinical use. Methods PLs were prepared by the freeze-thaw method from freshly drawn platelets or from outdated buffy coat–derived PCs stored in the platelet additive solution, InterSol. Three types of PLs were prepared from outdated PCs with platelets suspended in either (1) InterSol (not manipulated), (2) InterSol + supplemented with plasma or (3) plasma alone (InterSol removed). Using these PLs, we compared ASC population doubling time, cell yield, differentiation potential and cell surface markers. Gene expression profiles were analyzed using microarray assays, and growth factor concentrations in the cell culture medium were measured using enzyme-linked immunosorbent assay (ELISA). Results Of the three PL compositions produced from outdated PCs, removal of Intersol and resuspension in plasma prior to the first freezing process was overall the best. This specific outdated PL induced ASC growth kinetics, surface markers, plastic adherence and differentiation potentials comparable with PL from fresh platelets. ASCs expanded in PL from fresh versus outdated PCs exhibited different expressions of 17 overlapping genes, of which 10 were involved in cellular proliferation, although not significantly reflected by cell growth. Only minor differences in growth factor turnover were observed. Conclusion PLs from outdated platelets may be an efficient and reliable source of human growth supplement allowing for large-scale ASC expansion for clinical use.</description><subject>Adipose Tissue - cytology</subject><subject>adipose-derived stem cells</subject><subject>Adult</subject><subject>Adult Stem Cells - cytology</subject><subject>Adult Stem Cells - physiology</subject><subject>Advanced Basic Science</subject><subject>Blood Buffy Coat - cytology</subject><subject>Blood Buffy Coat - transplantation</subject><subject>Blood Platelets - chemistry</subject><subject>Blood Platelets - cytology</subject><subject>Blood Preservation - methods</subject><subject>Blood Specimen Collection - methods</subject><subject>Cell Culture Techniques - methods</subject><subject>Cell Extracts - supply & distribution</subject><subject>Cell Proliferation</subject><subject>Cell Separation</subject><subject>cell therapy</subject><subject>Culture Media - metabolism</subject><subject>Female</subject><subject>Freezing</subject><subject>gene expression</subject><subject>growth factors</subject><subject>Humans</subject><subject>Other</subject><subject>Plasma - cytology</subject><subject>platelet lysate</subject><subject>Platelet Transfusion - methods</subject><subject>Platelet-Rich Plasma - cytology</subject><subject>Refrigeration</subject><subject>Time Factors</subject><issn>1465-3249</issn><issn>1477-2566</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Ustu1DAUjRCIlsIPsEBesslgJ7bjQQipqnhJlboA1pbj3LSeOnHwdUZkxz_whyz5ChxNpwuEWPn66pz7OOcWxXNGN4wy-Wq32dklbaoc58SGMv6gOGW8acpKSPlwjaUo64pvT4oniDtKK6qUeFycVI1SjZLitPh9tYdow-DGa5JugLQhJQ8j2FsSejJ5k8BDIn7BHBGcp8kvxI3Em3gNJVrjgVjvRpcjAt8nM6IL48o1nZsCQtlBdHvoCCYYiAXv8TU5J7nlZKLDA7aPgDckT4Iz5jEiAEnLBPiPGTCDw0DCnLr860g79_2Sy5n068fPY697jg2jhTHFlfi0eNQbj_Ds7j0rvr5_9-XiY3l59eHTxfllabkQqey5qBmzvLKK8S2Xpt12AJJWTV_XAqhoocny9ZXZ8i6LyBouGVPWtC1T0tL6rHh5qDvF8G0GTHpwuC5uRggzaqY4pzUTss7Q6gC1MSBG6PUU3WDiohnVq8d6p1eP9erxmsseZ9KLu_pzO0B3TzmamgFvDgDIW-4dRI3WQRaicxFs0l1w_6__9i_60eBbWAB3YY5j1k8zjZWm-vN6ZeuRMVlT0QhV_wFhF9Tr</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Glovinski, Peter V</creator><creator>Herly, Mikkel</creator><creator>Mathiasen, Anders B</creator><creator>Svalgaard, Jesper D</creator><creator>Borup, Rehannah</creator><creator>Talman, Maj-Lis M</creator><creator>Elberg, Jens J</creator><creator>Kølle, Stig-Frederik T</creator><creator>Drzewiecki, Krzysztof T</creator><creator>Fischer-Nielsen, Anne</creator><general>Elsevier Inc</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>7X8</scope></search><sort><creationdate>20170201</creationdate><title>Overcoming the bottleneck of platelet lysate supply in large-scale clinical expansion of adipose-derived stem cells: A comparison of fresh versus three types of platelet lysates from outdated buffy coat–derived platelet concentrates</title><author>Glovinski, Peter V ; Herly, Mikkel ; Mathiasen, Anders B ; Svalgaard, Jesper D ; Borup, Rehannah ; Talman, Maj-Lis M ; Elberg, Jens J ; Kølle, Stig-Frederik T ; Drzewiecki, Krzysztof T ; Fischer-Nielsen, Anne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-f45311c42c814946ab9dee6027f335e05be7788f2a94d7861746118cabb186c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adipose Tissue - cytology</topic><topic>adipose-derived stem cells</topic><topic>Adult</topic><topic>Adult Stem Cells - cytology</topic><topic>Adult Stem Cells - physiology</topic><topic>Advanced Basic Science</topic><topic>Blood Buffy Coat - cytology</topic><topic>Blood Buffy Coat - transplantation</topic><topic>Blood Platelets - chemistry</topic><topic>Blood Platelets - cytology</topic><topic>Blood Preservation - methods</topic><topic>Blood Specimen Collection - methods</topic><topic>Cell Culture Techniques - methods</topic><topic>Cell Extracts - supply & distribution</topic><topic>Cell Proliferation</topic><topic>Cell Separation</topic><topic>cell therapy</topic><topic>Culture Media - metabolism</topic><topic>Female</topic><topic>Freezing</topic><topic>gene expression</topic><topic>growth factors</topic><topic>Humans</topic><topic>Other</topic><topic>Plasma - cytology</topic><topic>platelet lysate</topic><topic>Platelet Transfusion - methods</topic><topic>Platelet-Rich Plasma - cytology</topic><topic>Refrigeration</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glovinski, Peter V</creatorcontrib><creatorcontrib>Herly, Mikkel</creatorcontrib><creatorcontrib>Mathiasen, Anders B</creatorcontrib><creatorcontrib>Svalgaard, Jesper D</creatorcontrib><creatorcontrib>Borup, Rehannah</creatorcontrib><creatorcontrib>Talman, Maj-Lis M</creatorcontrib><creatorcontrib>Elberg, Jens J</creatorcontrib><creatorcontrib>Kølle, Stig-Frederik T</creatorcontrib><creatorcontrib>Drzewiecki, Krzysztof T</creatorcontrib><creatorcontrib>Fischer-Nielsen, Anne</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cytotherapy (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Glovinski, Peter V</au><au>Herly, Mikkel</au><au>Mathiasen, Anders B</au><au>Svalgaard, Jesper D</au><au>Borup, Rehannah</au><au>Talman, Maj-Lis M</au><au>Elberg, Jens J</au><au>Kølle, Stig-Frederik T</au><au>Drzewiecki, Krzysztof T</au><au>Fischer-Nielsen, Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overcoming the bottleneck of platelet lysate supply in large-scale clinical expansion of adipose-derived stem cells: A comparison of fresh versus three types of platelet lysates from outdated buffy coat–derived platelet concentrates</atitle><jtitle>Cytotherapy (Oxford, England)</jtitle><addtitle>Cytotherapy</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>19</volume><issue>2</issue><spage>222</spage><epage>234</epage><pages>222-234</pages><issn>1465-3249</issn><eissn>1477-2566</eissn><abstract>Abstract Background Platelet lysates (PL) represent a promising replacement for xenogenic growth supplement for adipose-derived stem cell (ASC) expansions. However, fresh platelets from human blood donors are not clinically feasible for large-scale cell expansion based on their limited supply. Therefore, we tested PLs prepared via three methods from outdated buffy coat–derived platelet concentrates (PCs) to establish an efficient and feasible expansion of ASCs for clinical use. Methods PLs were prepared by the freeze-thaw method from freshly drawn platelets or from outdated buffy coat–derived PCs stored in the platelet additive solution, InterSol. Three types of PLs were prepared from outdated PCs with platelets suspended in either (1) InterSol (not manipulated), (2) InterSol + supplemented with plasma or (3) plasma alone (InterSol removed). Using these PLs, we compared ASC population doubling time, cell yield, differentiation potential and cell surface markers. Gene expression profiles were analyzed using microarray assays, and growth factor concentrations in the cell culture medium were measured using enzyme-linked immunosorbent assay (ELISA). Results Of the three PL compositions produced from outdated PCs, removal of Intersol and resuspension in plasma prior to the first freezing process was overall the best. This specific outdated PL induced ASC growth kinetics, surface markers, plastic adherence and differentiation potentials comparable with PL from fresh platelets. ASCs expanded in PL from fresh versus outdated PCs exhibited different expressions of 17 overlapping genes, of which 10 were involved in cellular proliferation, although not significantly reflected by cell growth. Only minor differences in growth factor turnover were observed. Conclusion PLs from outdated platelets may be an efficient and reliable source of human growth supplement allowing for large-scale ASC expansion for clinical use.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>27887865</pmid><doi>10.1016/j.jcyt.2016.10.014</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1465-3249 |
ispartof | Cytotherapy (Oxford, England), 2017-02, Vol.19 (2), p.222-234 |
issn | 1465-3249 1477-2566 |
language | eng |
recordid | cdi_proquest_miscellaneous_1844031563 |
source | MEDLINE; Alma/SFX Local Collection |
subjects | Adipose Tissue - cytology adipose-derived stem cells Adult Adult Stem Cells - cytology Adult Stem Cells - physiology Advanced Basic Science Blood Buffy Coat - cytology Blood Buffy Coat - transplantation Blood Platelets - chemistry Blood Platelets - cytology Blood Preservation - methods Blood Specimen Collection - methods Cell Culture Techniques - methods Cell Extracts - supply & distribution Cell Proliferation Cell Separation cell therapy Culture Media - metabolism Female Freezing gene expression growth factors Humans Other Plasma - cytology platelet lysate Platelet Transfusion - methods Platelet-Rich Plasma - cytology Refrigeration Time Factors |
title | Overcoming the bottleneck of platelet lysate supply in large-scale clinical expansion of adipose-derived stem cells: A comparison of fresh versus three types of platelet lysates from outdated buffy coat–derived platelet concentrates |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T10%3A07%3A13IST&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=Overcoming%20the%20bottleneck%20of%20platelet%20lysate%20supply%20in%20large-scale%20clinical%20expansion%20of%20adipose-derived%20stem%20cells:%20A%20comparison%20of%20fresh%20versus%20three%20types%20of%20platelet%20lysates%20from%20outdated%20buffy%20coat%E2%80%93derived%20platelet%20concentrates&rft.jtitle=Cytotherapy%20(Oxford,%20England)&rft.au=Glovinski,%20Peter%20V&rft.date=2017-02-01&rft.volume=19&rft.issue=2&rft.spage=222&rft.epage=234&rft.pages=222-234&rft.issn=1465-3249&rft.eissn=1477-2566&rft_id=info:doi/10.1016/j.jcyt.2016.10.014&rft_dat=%3Cproquest_cross%3E1844031563%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=1844031563&rft_id=info:pmid/27887865&rft_els_id=S1465324916305758&rfr_iscdi=true |