Spironolactone in Combination with α-glycosyl Isoquercitrin Prevents Steatosis-related Early Hepatocarcinogenesis in Rats through the Observed NADPH Oxidase Modulation

Administration of the diuretic, spironolactone (SR), can inhibit chronic liver diseases. We determined the effects of SR alone or in combination with the antioxidant α-glycosyl isoquercitrin (AGIQ) on hyperlipidemia- and steatosis-related precancerous lesions in high-fat diet (HFD)-fed rats subjecte...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Toxicologic pathology 2018-07, Vol.46 (5), p.530-539
Hauptverfasser: Murayama, Hirotada, Eguchi, Ayumi, Nakamura, Misato, Kawashima, Masahi, Nagahara, Rei, Mizukami, Sayaka, Kimura, Masayuki, Makino, Emi, Takahashi, Naofumi, Ohtsuka, Ryoichi, Koyanagi, Mihoko, Hayashi, Shim-mo, Maronpot, Robert R., Shibutani, Makoto, Yoshida, Toshinori
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 539
container_issue 5
container_start_page 530
container_title Toxicologic pathology
container_volume 46
creator Murayama, Hirotada
Eguchi, Ayumi
Nakamura, Misato
Kawashima, Masahi
Nagahara, Rei
Mizukami, Sayaka
Kimura, Masayuki
Makino, Emi
Takahashi, Naofumi
Ohtsuka, Ryoichi
Koyanagi, Mihoko
Hayashi, Shim-mo
Maronpot, Robert R.
Shibutani, Makoto
Yoshida, Toshinori
description Administration of the diuretic, spironolactone (SR), can inhibit chronic liver diseases. We determined the effects of SR alone or in combination with the antioxidant α-glycosyl isoquercitrin (AGIQ) on hyperlipidemia- and steatosis-related precancerous lesions in high-fat diet (HFD)-fed rats subjected to a two-stage hepatocarcinogenesis model. Rats were fed with control basal diet or HFD, which was administered with SR alone or in combination with an antioxidant AGIQ in drinking water. An HFD increased body weight, intra-abdominal fat (adipose) tissue weight, and plasma lipids, which were reduced by coadministration of SR and AGIQ. SR and AGIQ coadministration also reduced hepatic steatosis and preneoplastic glutathione S-transferase placental form-positive foci, in association with decrease in NADPH oxidase (NOX) subunit p22phox-positive cells and an increase in active-caspase-3-positive cells in the foci. Hepatic gene expression analysis revealed that the coadministration of SR and AGIQ altered mRNA levels of lipogenic enzymes (Scd1 and Fasn), antioxidant-related enzymes (Catalase), NOX component (P67phox), and anti-inflammatory transcriptional factor (Pparg). Our results indicated that SR in combination with AGIQ had the potential of suppressing hyperlipidemia- and steatosis-related early hepatocarcinogenesis through the reduced expression of NOX subunits.
doi_str_mv 10.1177/0192623318778508
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2047249470</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0192623318778508</sage_id><sourcerecordid>2047249470</sourcerecordid><originalsourceid>FETCH-LOGICAL-c379t-ad0178f0f3d51a73117dc2a9f3b41d33e836b035152a25bb1dbdc515cc44e01c3</originalsourceid><addsrcrecordid>eNp1kcFu1DAQhi0Eokvhzgn5yCXgiZN1cqyWwlZquxWFc-TYk11XXnuxncK-EVdepM9Uhy0cKvU0suf7__H4J-QtsA8AQnxk0JbzknNohGhq1jwjM6g5L2DO4DmZTe1i6h-RVzHeMAYNVOwlOSrbpuL1vJ2R39c7E7zzVqrkHVLj6MJve-NkMt7RnyZt6N2fYm33yse9pWfR_xgxKJNCRq8C3qJLkV4nlMlHE4uAVibU9FQGu6dL3OV7JbPA-TU6zMg046vMorQJflxvckW66iOG26y7PPl0taSrX0bLiPTC69H-fcpr8mKQNuKbh3pMvn8-_bZYFuerL2eLk_NCcdGmQmoGohnYwHUNUvD8TVqVsh14X4HmHBs-7xmvoS5lWfc96F6rfFKqqpCB4sfk_cF3F6ZNY-q2Jiq0Vjr0Y-xKVomyaivBMsoOqAo-xoBDtwtmK8O-A9ZN-XSP88mSdw_uY79F_V_wL5AMFAcgyjV2N34MLm_7tOE9K4GciA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2047249470</pqid></control><display><type>article</type><title>Spironolactone in Combination with α-glycosyl Isoquercitrin Prevents Steatosis-related Early Hepatocarcinogenesis in Rats through the Observed NADPH Oxidase Modulation</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><source>Alma/SFX Local Collection</source><creator>Murayama, Hirotada ; Eguchi, Ayumi ; Nakamura, Misato ; Kawashima, Masahi ; Nagahara, Rei ; Mizukami, Sayaka ; Kimura, Masayuki ; Makino, Emi ; Takahashi, Naofumi ; Ohtsuka, Ryoichi ; Koyanagi, Mihoko ; Hayashi, Shim-mo ; Maronpot, Robert R. ; Shibutani, Makoto ; Yoshida, Toshinori</creator><creatorcontrib>Murayama, Hirotada ; Eguchi, Ayumi ; Nakamura, Misato ; Kawashima, Masahi ; Nagahara, Rei ; Mizukami, Sayaka ; Kimura, Masayuki ; Makino, Emi ; Takahashi, Naofumi ; Ohtsuka, Ryoichi ; Koyanagi, Mihoko ; Hayashi, Shim-mo ; Maronpot, Robert R. ; Shibutani, Makoto ; Yoshida, Toshinori</creatorcontrib><description>Administration of the diuretic, spironolactone (SR), can inhibit chronic liver diseases. We determined the effects of SR alone or in combination with the antioxidant α-glycosyl isoquercitrin (AGIQ) on hyperlipidemia- and steatosis-related precancerous lesions in high-fat diet (HFD)-fed rats subjected to a two-stage hepatocarcinogenesis model. Rats were fed with control basal diet or HFD, which was administered with SR alone or in combination with an antioxidant AGIQ in drinking water. An HFD increased body weight, intra-abdominal fat (adipose) tissue weight, and plasma lipids, which were reduced by coadministration of SR and AGIQ. SR and AGIQ coadministration also reduced hepatic steatosis and preneoplastic glutathione S-transferase placental form-positive foci, in association with decrease in NADPH oxidase (NOX) subunit p22phox-positive cells and an increase in active-caspase-3-positive cells in the foci. Hepatic gene expression analysis revealed that the coadministration of SR and AGIQ altered mRNA levels of lipogenic enzymes (Scd1 and Fasn), antioxidant-related enzymes (Catalase), NOX component (P67phox), and anti-inflammatory transcriptional factor (Pparg). Our results indicated that SR in combination with AGIQ had the potential of suppressing hyperlipidemia- and steatosis-related early hepatocarcinogenesis through the reduced expression of NOX subunits.</description><identifier>ISSN: 0192-6233</identifier><identifier>EISSN: 1533-1601</identifier><identifier>DOI: 10.1177/0192623318778508</identifier><identifier>PMID: 29843569</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Animals ; Body Weight - drug effects ; Diet, High-Fat ; Drug Therapy, Combination ; Fatty Liver - complications ; Fatty Liver - drug therapy ; Fatty Liver - pathology ; Liver Neoplasms, Experimental - etiology ; Liver Neoplasms, Experimental - pathology ; Liver Neoplasms, Experimental - prevention &amp; control ; Male ; NADPH Oxidases - metabolism ; Organ Size - drug effects ; Oxidative Stress - drug effects ; Precancerous Conditions - pathology ; Precancerous Conditions - prevention &amp; control ; Quercetin - administration &amp; dosage ; Quercetin - analogs &amp; derivatives ; Quercetin - therapeutic use ; Rats, Inbred F344 ; Spironolactone - administration &amp; dosage ; Spironolactone - therapeutic use</subject><ispartof>Toxicologic pathology, 2018-07, Vol.46 (5), p.530-539</ispartof><rights>The Author(s) 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-ad0178f0f3d51a73117dc2a9f3b41d33e836b035152a25bb1dbdc515cc44e01c3</citedby><cites>FETCH-LOGICAL-c379t-ad0178f0f3d51a73117dc2a9f3b41d33e836b035152a25bb1dbdc515cc44e01c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0192623318778508$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0192623318778508$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,781,785,21824,27929,27930,43626,43627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29843569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murayama, Hirotada</creatorcontrib><creatorcontrib>Eguchi, Ayumi</creatorcontrib><creatorcontrib>Nakamura, Misato</creatorcontrib><creatorcontrib>Kawashima, Masahi</creatorcontrib><creatorcontrib>Nagahara, Rei</creatorcontrib><creatorcontrib>Mizukami, Sayaka</creatorcontrib><creatorcontrib>Kimura, Masayuki</creatorcontrib><creatorcontrib>Makino, Emi</creatorcontrib><creatorcontrib>Takahashi, Naofumi</creatorcontrib><creatorcontrib>Ohtsuka, Ryoichi</creatorcontrib><creatorcontrib>Koyanagi, Mihoko</creatorcontrib><creatorcontrib>Hayashi, Shim-mo</creatorcontrib><creatorcontrib>Maronpot, Robert R.</creatorcontrib><creatorcontrib>Shibutani, Makoto</creatorcontrib><creatorcontrib>Yoshida, Toshinori</creatorcontrib><title>Spironolactone in Combination with α-glycosyl Isoquercitrin Prevents Steatosis-related Early Hepatocarcinogenesis in Rats through the Observed NADPH Oxidase Modulation</title><title>Toxicologic pathology</title><addtitle>Toxicol Pathol</addtitle><description>Administration of the diuretic, spironolactone (SR), can inhibit chronic liver diseases. We determined the effects of SR alone or in combination with the antioxidant α-glycosyl isoquercitrin (AGIQ) on hyperlipidemia- and steatosis-related precancerous lesions in high-fat diet (HFD)-fed rats subjected to a two-stage hepatocarcinogenesis model. Rats were fed with control basal diet or HFD, which was administered with SR alone or in combination with an antioxidant AGIQ in drinking water. An HFD increased body weight, intra-abdominal fat (adipose) tissue weight, and plasma lipids, which were reduced by coadministration of SR and AGIQ. SR and AGIQ coadministration also reduced hepatic steatosis and preneoplastic glutathione S-transferase placental form-positive foci, in association with decrease in NADPH oxidase (NOX) subunit p22phox-positive cells and an increase in active-caspase-3-positive cells in the foci. Hepatic gene expression analysis revealed that the coadministration of SR and AGIQ altered mRNA levels of lipogenic enzymes (Scd1 and Fasn), antioxidant-related enzymes (Catalase), NOX component (P67phox), and anti-inflammatory transcriptional factor (Pparg). Our results indicated that SR in combination with AGIQ had the potential of suppressing hyperlipidemia- and steatosis-related early hepatocarcinogenesis through the reduced expression of NOX subunits.</description><subject>Animals</subject><subject>Body Weight - drug effects</subject><subject>Diet, High-Fat</subject><subject>Drug Therapy, Combination</subject><subject>Fatty Liver - complications</subject><subject>Fatty Liver - drug therapy</subject><subject>Fatty Liver - pathology</subject><subject>Liver Neoplasms, Experimental - etiology</subject><subject>Liver Neoplasms, Experimental - pathology</subject><subject>Liver Neoplasms, Experimental - prevention &amp; control</subject><subject>Male</subject><subject>NADPH Oxidases - metabolism</subject><subject>Organ Size - drug effects</subject><subject>Oxidative Stress - drug effects</subject><subject>Precancerous Conditions - pathology</subject><subject>Precancerous Conditions - prevention &amp; control</subject><subject>Quercetin - administration &amp; dosage</subject><subject>Quercetin - analogs &amp; derivatives</subject><subject>Quercetin - therapeutic use</subject><subject>Rats, Inbred F344</subject><subject>Spironolactone - administration &amp; dosage</subject><subject>Spironolactone - therapeutic use</subject><issn>0192-6233</issn><issn>1533-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhi0Eokvhzgn5yCXgiZN1cqyWwlZquxWFc-TYk11XXnuxncK-EVdepM9Uhy0cKvU0suf7__H4J-QtsA8AQnxk0JbzknNohGhq1jwjM6g5L2DO4DmZTe1i6h-RVzHeMAYNVOwlOSrbpuL1vJ2R39c7E7zzVqrkHVLj6MJve-NkMt7RnyZt6N2fYm33yse9pWfR_xgxKJNCRq8C3qJLkV4nlMlHE4uAVibU9FQGu6dL3OV7JbPA-TU6zMg046vMorQJflxvckW66iOG26y7PPl0taSrX0bLiPTC69H-fcpr8mKQNuKbh3pMvn8-_bZYFuerL2eLk_NCcdGmQmoGohnYwHUNUvD8TVqVsh14X4HmHBs-7xmvoS5lWfc96F6rfFKqqpCB4sfk_cF3F6ZNY-q2Jiq0Vjr0Y-xKVomyaivBMsoOqAo-xoBDtwtmK8O-A9ZN-XSP88mSdw_uY79F_V_wL5AMFAcgyjV2N34MLm_7tOE9K4GciA</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Murayama, Hirotada</creator><creator>Eguchi, Ayumi</creator><creator>Nakamura, Misato</creator><creator>Kawashima, Masahi</creator><creator>Nagahara, Rei</creator><creator>Mizukami, Sayaka</creator><creator>Kimura, Masayuki</creator><creator>Makino, Emi</creator><creator>Takahashi, Naofumi</creator><creator>Ohtsuka, Ryoichi</creator><creator>Koyanagi, Mihoko</creator><creator>Hayashi, Shim-mo</creator><creator>Maronpot, Robert R.</creator><creator>Shibutani, Makoto</creator><creator>Yoshida, Toshinori</creator><general>SAGE Publications</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>201807</creationdate><title>Spironolactone in Combination with α-glycosyl Isoquercitrin Prevents Steatosis-related Early Hepatocarcinogenesis in Rats through the Observed NADPH Oxidase Modulation</title><author>Murayama, Hirotada ; Eguchi, Ayumi ; Nakamura, Misato ; Kawashima, Masahi ; Nagahara, Rei ; Mizukami, Sayaka ; Kimura, Masayuki ; Makino, Emi ; Takahashi, Naofumi ; Ohtsuka, Ryoichi ; Koyanagi, Mihoko ; Hayashi, Shim-mo ; Maronpot, Robert R. ; Shibutani, Makoto ; Yoshida, Toshinori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-ad0178f0f3d51a73117dc2a9f3b41d33e836b035152a25bb1dbdc515cc44e01c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Animals</topic><topic>Body Weight - drug effects</topic><topic>Diet, High-Fat</topic><topic>Drug Therapy, Combination</topic><topic>Fatty Liver - complications</topic><topic>Fatty Liver - drug therapy</topic><topic>Fatty Liver - pathology</topic><topic>Liver Neoplasms, Experimental - etiology</topic><topic>Liver Neoplasms, Experimental - pathology</topic><topic>Liver Neoplasms, Experimental - prevention &amp; control</topic><topic>Male</topic><topic>NADPH Oxidases - metabolism</topic><topic>Organ Size - drug effects</topic><topic>Oxidative Stress - drug effects</topic><topic>Precancerous Conditions - pathology</topic><topic>Precancerous Conditions - prevention &amp; control</topic><topic>Quercetin - administration &amp; dosage</topic><topic>Quercetin - analogs &amp; derivatives</topic><topic>Quercetin - therapeutic use</topic><topic>Rats, Inbred F344</topic><topic>Spironolactone - administration &amp; dosage</topic><topic>Spironolactone - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Murayama, Hirotada</creatorcontrib><creatorcontrib>Eguchi, Ayumi</creatorcontrib><creatorcontrib>Nakamura, Misato</creatorcontrib><creatorcontrib>Kawashima, Masahi</creatorcontrib><creatorcontrib>Nagahara, Rei</creatorcontrib><creatorcontrib>Mizukami, Sayaka</creatorcontrib><creatorcontrib>Kimura, Masayuki</creatorcontrib><creatorcontrib>Makino, Emi</creatorcontrib><creatorcontrib>Takahashi, Naofumi</creatorcontrib><creatorcontrib>Ohtsuka, Ryoichi</creatorcontrib><creatorcontrib>Koyanagi, Mihoko</creatorcontrib><creatorcontrib>Hayashi, Shim-mo</creatorcontrib><creatorcontrib>Maronpot, Robert R.</creatorcontrib><creatorcontrib>Shibutani, Makoto</creatorcontrib><creatorcontrib>Yoshida, Toshinori</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>Toxicologic pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Murayama, Hirotada</au><au>Eguchi, Ayumi</au><au>Nakamura, Misato</au><au>Kawashima, Masahi</au><au>Nagahara, Rei</au><au>Mizukami, Sayaka</au><au>Kimura, Masayuki</au><au>Makino, Emi</au><au>Takahashi, Naofumi</au><au>Ohtsuka, Ryoichi</au><au>Koyanagi, Mihoko</au><au>Hayashi, Shim-mo</au><au>Maronpot, Robert R.</au><au>Shibutani, Makoto</au><au>Yoshida, Toshinori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spironolactone in Combination with α-glycosyl Isoquercitrin Prevents Steatosis-related Early Hepatocarcinogenesis in Rats through the Observed NADPH Oxidase Modulation</atitle><jtitle>Toxicologic pathology</jtitle><addtitle>Toxicol Pathol</addtitle><date>2018-07</date><risdate>2018</risdate><volume>46</volume><issue>5</issue><spage>530</spage><epage>539</epage><pages>530-539</pages><issn>0192-6233</issn><eissn>1533-1601</eissn><abstract>Administration of the diuretic, spironolactone (SR), can inhibit chronic liver diseases. We determined the effects of SR alone or in combination with the antioxidant α-glycosyl isoquercitrin (AGIQ) on hyperlipidemia- and steatosis-related precancerous lesions in high-fat diet (HFD)-fed rats subjected to a two-stage hepatocarcinogenesis model. Rats were fed with control basal diet or HFD, which was administered with SR alone or in combination with an antioxidant AGIQ in drinking water. An HFD increased body weight, intra-abdominal fat (adipose) tissue weight, and plasma lipids, which were reduced by coadministration of SR and AGIQ. SR and AGIQ coadministration also reduced hepatic steatosis and preneoplastic glutathione S-transferase placental form-positive foci, in association with decrease in NADPH oxidase (NOX) subunit p22phox-positive cells and an increase in active-caspase-3-positive cells in the foci. Hepatic gene expression analysis revealed that the coadministration of SR and AGIQ altered mRNA levels of lipogenic enzymes (Scd1 and Fasn), antioxidant-related enzymes (Catalase), NOX component (P67phox), and anti-inflammatory transcriptional factor (Pparg). Our results indicated that SR in combination with AGIQ had the potential of suppressing hyperlipidemia- and steatosis-related early hepatocarcinogenesis through the reduced expression of NOX subunits.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>29843569</pmid><doi>10.1177/0192623318778508</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0192-6233
ispartof Toxicologic pathology, 2018-07, Vol.46 (5), p.530-539
issn 0192-6233
1533-1601
language eng
recordid cdi_proquest_miscellaneous_2047249470
source MEDLINE; SAGE Complete A-Z List; Alma/SFX Local Collection
subjects Animals
Body Weight - drug effects
Diet, High-Fat
Drug Therapy, Combination
Fatty Liver - complications
Fatty Liver - drug therapy
Fatty Liver - pathology
Liver Neoplasms, Experimental - etiology
Liver Neoplasms, Experimental - pathology
Liver Neoplasms, Experimental - prevention & control
Male
NADPH Oxidases - metabolism
Organ Size - drug effects
Oxidative Stress - drug effects
Precancerous Conditions - pathology
Precancerous Conditions - prevention & control
Quercetin - administration & dosage
Quercetin - analogs & derivatives
Quercetin - therapeutic use
Rats, Inbred F344
Spironolactone - administration & dosage
Spironolactone - therapeutic use
title Spironolactone in Combination with α-glycosyl Isoquercitrin Prevents Steatosis-related Early Hepatocarcinogenesis in Rats through the Observed NADPH Oxidase Modulation
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T18%3A22%3A45IST&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=Spironolactone%20in%20Combination%20with%20%CE%B1-glycosyl%20Isoquercitrin%20Prevents%20Steatosis-related%20Early%20Hepatocarcinogenesis%20in%20Rats%20through%20the%20Observed%20NADPH%20Oxidase%20Modulation&rft.jtitle=Toxicologic%20pathology&rft.au=Murayama,%20Hirotada&rft.date=2018-07&rft.volume=46&rft.issue=5&rft.spage=530&rft.epage=539&rft.pages=530-539&rft.issn=0192-6233&rft.eissn=1533-1601&rft_id=info:doi/10.1177/0192623318778508&rft_dat=%3Cproquest_cross%3E2047249470%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=2047249470&rft_id=info:pmid/29843569&rft_sage_id=10.1177_0192623318778508&rfr_iscdi=true