Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis
Background Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this d...
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| Veröffentlicht in: | Neurological sciences 2019-02, Vol.40 (2), p.235-241 |
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| creator | Luo, Linting Song, Zhibin Li, Xiaoqiang Huiwang Zeng, Yaqing Qinwang Meiqi He, Jianli |
| description | Background
Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this disease.
Methods
We searched PubMed, the Cochrane Library, and Embase from the inception of electronic data to April 2018. We included randomized, double-blind, placebo-controlled trials reporting amyotrophic lateral sclerosis patients receiving 60-mg intravenous edaravone or intravenous saline placebo for 24 weeks. The primary efficacy evaluation was changed in Amyotrophic Lateral Sclerosis Functional Rating Scale score from baseline to after the trial. Measure of safety was the frequency of investigated adverse events and serious adverse events. Data synthesis and analysis and evaluation of risk of bias were performed using RevMan 5.3 software. Heterogeneity among studies was evaluated with the
I
2
statistic.
Results
A total of 367 patients were analyzed across three randomized controlled trials (183 patients receiving intravenous edaravone; 184 receiving placebo). A difference in ALSFRS-R score between groups at 24 weeks was found (mean difference [MD] = 1.63, 95% confidence interval [CI] 0.26–3.00,
P
= .02). No differences in the frequency of adverse events (odds ratio [OR] = 1.22, 95% CI 0.68–2.19,
P
= .50) or serious adverse events (OR = 0.71, 95% CI 0.43–1.19,
P
= .20) were found.
Conclusion
Intravenous edaravone is efficacious in amyotrophic lateral sclerosis patients, with no severe adverse effects. Additional reliable randomized controlled trials with larger sample sizes will further assess the efficacy and safety of edaravone in amyotrophic lateral sclerosis.
Clinical trial registration
The systematic review and meta-analysis was registered in the international prospective register of systematic reviews. (PROSPERO registration number: CRD42018096191;
http://www.crd.york.ac.uk/PROSPERO
.) |
| doi_str_mv | 10.1007/s10072-018-3653-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2138634758</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2138378055</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3532-bdb172864231f04f56e2ea3638db41a0a058e2511ebb4fcbb2d26eedee8094473</originalsourceid><addsrcrecordid>eNp1kctqGzEUhkVoiZ3LA2QTBN1kM62uM_IyGKcpGLpp1-LMzFEyZi6OJLvMLg_RJ-yTRO44DRSykQTnO_-R9BFyxdlnzljxJRxWkTFuMplrmYkTMud6wTKpCvPheOamUDNyFsKGMcYVl6dkJpkycrEQc7JfOddUUI0U-poGcBhHOjiKNXjYDz3SpqfRI8QO-3ioQDcO0Q_bx6aiLUT00NJQteiH0IQ_z7-BhjFE7CAmwOO-wV9_szuMkEEP7Zi4C_LRQRvw8rifk593qx_L-2z9_eu35e06q6SWIivrkhfC5EpI7phyOkeBIHNp6lJxYMC0QaE5x7JUripLUYscsUY0bKFUIc_JzZS79cPTDkO0XRMqbFvocdgFK7g0efotbRL66T90M-x8uu9EycIwrRPFJ6pK7w0end36pgM_Ws7sQYedpNgkxR6kWJF6ro_Ju7LD-l_Hq4UEiAkIqdQ_oH8b_X7qC0dEmWc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2138378055</pqid></control><display><type>article</type><title>Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Luo, Linting ; Song, Zhibin ; Li, Xiaoqiang ; Huiwang ; Zeng, Yaqing ; Qinwang ; Meiqi ; He, Jianli</creator><creatorcontrib>Luo, Linting ; Song, Zhibin ; Li, Xiaoqiang ; Huiwang ; Zeng, Yaqing ; Qinwang ; Meiqi ; He, Jianli</creatorcontrib><description>Background
Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this disease.
Methods
We searched PubMed, the Cochrane Library, and Embase from the inception of electronic data to April 2018. We included randomized, double-blind, placebo-controlled trials reporting amyotrophic lateral sclerosis patients receiving 60-mg intravenous edaravone or intravenous saline placebo for 24 weeks. The primary efficacy evaluation was changed in Amyotrophic Lateral Sclerosis Functional Rating Scale score from baseline to after the trial. Measure of safety was the frequency of investigated adverse events and serious adverse events. Data synthesis and analysis and evaluation of risk of bias were performed using RevMan 5.3 software. Heterogeneity among studies was evaluated with the
I
2
statistic.
Results
A total of 367 patients were analyzed across three randomized controlled trials (183 patients receiving intravenous edaravone; 184 receiving placebo). A difference in ALSFRS-R score between groups at 24 weeks was found (mean difference [MD] = 1.63, 95% confidence interval [CI] 0.26–3.00,
P
= .02). No differences in the frequency of adverse events (odds ratio [OR] = 1.22, 95% CI 0.68–2.19,
P
= .50) or serious adverse events (OR = 0.71, 95% CI 0.43–1.19,
P
= .20) were found.
Conclusion
Intravenous edaravone is efficacious in amyotrophic lateral sclerosis patients, with no severe adverse effects. Additional reliable randomized controlled trials with larger sample sizes will further assess the efficacy and safety of edaravone in amyotrophic lateral sclerosis.
Clinical trial registration
The systematic review and meta-analysis was registered in the international prospective register of systematic reviews. (PROSPERO registration number: CRD42018096191;
http://www.crd.york.ac.uk/PROSPERO
.)</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-018-3653-2</identifier><identifier>PMID: 30483992</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Amyotrophic lateral sclerosis ; Amyotrophic Lateral Sclerosis - drug therapy ; Clinical trials ; Data processing ; Double-blind studies ; Edaravone - adverse effects ; Edaravone - therapeutic use ; Humans ; Intravenous administration ; Medicine ; Medicine & Public Health ; Meta-analysis ; Neurology ; Neuroprotective Agents - adverse effects ; Neuroprotective Agents - therapeutic use ; Neuroradiology ; Neurosciences ; Neurosurgery ; Patients ; Psychiatry ; Randomized Controlled Trials as Topic ; Review Article ; Safety ; Systematic review</subject><ispartof>Neurological sciences, 2019-02, Vol.40 (2), p.235-241</ispartof><rights>Springer-Verlag Italia S.r.l., part of Springer Nature 2018</rights><rights>Neurological Sciences is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3532-bdb172864231f04f56e2ea3638db41a0a058e2511ebb4fcbb2d26eedee8094473</citedby><cites>FETCH-LOGICAL-c3532-bdb172864231f04f56e2ea3638db41a0a058e2511ebb4fcbb2d26eedee8094473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10072-018-3653-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10072-018-3653-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30483992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luo, Linting</creatorcontrib><creatorcontrib>Song, Zhibin</creatorcontrib><creatorcontrib>Li, Xiaoqiang</creatorcontrib><creatorcontrib>Huiwang</creatorcontrib><creatorcontrib>Zeng, Yaqing</creatorcontrib><creatorcontrib>Qinwang</creatorcontrib><creatorcontrib>Meiqi</creatorcontrib><creatorcontrib>He, Jianli</creatorcontrib><title>Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>Background
Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this disease.
Methods
We searched PubMed, the Cochrane Library, and Embase from the inception of electronic data to April 2018. We included randomized, double-blind, placebo-controlled trials reporting amyotrophic lateral sclerosis patients receiving 60-mg intravenous edaravone or intravenous saline placebo for 24 weeks. The primary efficacy evaluation was changed in Amyotrophic Lateral Sclerosis Functional Rating Scale score from baseline to after the trial. Measure of safety was the frequency of investigated adverse events and serious adverse events. Data synthesis and analysis and evaluation of risk of bias were performed using RevMan 5.3 software. Heterogeneity among studies was evaluated with the
I
2
statistic.
Results
A total of 367 patients were analyzed across three randomized controlled trials (183 patients receiving intravenous edaravone; 184 receiving placebo). A difference in ALSFRS-R score between groups at 24 weeks was found (mean difference [MD] = 1.63, 95% confidence interval [CI] 0.26–3.00,
P
= .02). No differences in the frequency of adverse events (odds ratio [OR] = 1.22, 95% CI 0.68–2.19,
P
= .50) or serious adverse events (OR = 0.71, 95% CI 0.43–1.19,
P
= .20) were found.
Conclusion
Intravenous edaravone is efficacious in amyotrophic lateral sclerosis patients, with no severe adverse effects. Additional reliable randomized controlled trials with larger sample sizes will further assess the efficacy and safety of edaravone in amyotrophic lateral sclerosis.
Clinical trial registration
The systematic review and meta-analysis was registered in the international prospective register of systematic reviews. (PROSPERO registration number: CRD42018096191;
http://www.crd.york.ac.uk/PROSPERO
.)</description><subject>Amyotrophic lateral sclerosis</subject><subject>Amyotrophic Lateral Sclerosis - drug therapy</subject><subject>Clinical trials</subject><subject>Data processing</subject><subject>Double-blind studies</subject><subject>Edaravone - adverse effects</subject><subject>Edaravone - therapeutic use</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Neurology</subject><subject>Neuroprotective Agents - adverse effects</subject><subject>Neuroprotective Agents - therapeutic use</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Patients</subject><subject>Psychiatry</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Review Article</subject><subject>Safety</subject><subject>Systematic review</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kctqGzEUhkVoiZ3LA2QTBN1kM62uM_IyGKcpGLpp1-LMzFEyZi6OJLvMLg_RJ-yTRO44DRSykQTnO_-R9BFyxdlnzljxJRxWkTFuMplrmYkTMud6wTKpCvPheOamUDNyFsKGMcYVl6dkJpkycrEQc7JfOddUUI0U-poGcBhHOjiKNXjYDz3SpqfRI8QO-3ioQDcO0Q_bx6aiLUT00NJQteiH0IQ_z7-BhjFE7CAmwOO-wV9_szuMkEEP7Zi4C_LRQRvw8rifk593qx_L-2z9_eu35e06q6SWIivrkhfC5EpI7phyOkeBIHNp6lJxYMC0QaE5x7JUripLUYscsUY0bKFUIc_JzZS79cPTDkO0XRMqbFvocdgFK7g0efotbRL66T90M-x8uu9EycIwrRPFJ6pK7w0end36pgM_Ws7sQYedpNgkxR6kWJF6ro_Ju7LD-l_Hq4UEiAkIqdQ_oH8b_X7qC0dEmWc</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Luo, Linting</creator><creator>Song, Zhibin</creator><creator>Li, Xiaoqiang</creator><creator>Huiwang</creator><creator>Zeng, Yaqing</creator><creator>Qinwang</creator><creator>Meiqi</creator><creator>He, Jianli</creator><general>Springer International Publishing</general><general>Springer Nature B.V</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>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20190201</creationdate><title>Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis</title><author>Luo, Linting ; Song, Zhibin ; Li, Xiaoqiang ; Huiwang ; Zeng, Yaqing ; Qinwang ; Meiqi ; He, Jianli</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3532-bdb172864231f04f56e2ea3638db41a0a058e2511ebb4fcbb2d26eedee8094473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Amyotrophic lateral sclerosis</topic><topic>Amyotrophic Lateral Sclerosis - drug therapy</topic><topic>Clinical trials</topic><topic>Data processing</topic><topic>Double-blind studies</topic><topic>Edaravone - adverse effects</topic><topic>Edaravone - therapeutic use</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Neurology</topic><topic>Neuroprotective Agents - adverse effects</topic><topic>Neuroprotective Agents - therapeutic use</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Patients</topic><topic>Psychiatry</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Review Article</topic><topic>Safety</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luo, Linting</creatorcontrib><creatorcontrib>Song, Zhibin</creatorcontrib><creatorcontrib>Li, Xiaoqiang</creatorcontrib><creatorcontrib>Huiwang</creatorcontrib><creatorcontrib>Zeng, Yaqing</creatorcontrib><creatorcontrib>Qinwang</creatorcontrib><creatorcontrib>Meiqi</creatorcontrib><creatorcontrib>He, Jianli</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luo, Linting</au><au>Song, Zhibin</au><au>Li, Xiaoqiang</au><au>Huiwang</au><au>Zeng, Yaqing</au><au>Qinwang</au><au>Meiqi</au><au>He, Jianli</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis</atitle><jtitle>Neurological sciences</jtitle><stitle>Neurol Sci</stitle><addtitle>Neurol Sci</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>40</volume><issue>2</issue><spage>235</spage><epage>241</epage><pages>235-241</pages><issn>1590-1874</issn><eissn>1590-3478</eissn><abstract>Background
Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this disease.
Methods
We searched PubMed, the Cochrane Library, and Embase from the inception of electronic data to April 2018. We included randomized, double-blind, placebo-controlled trials reporting amyotrophic lateral sclerosis patients receiving 60-mg intravenous edaravone or intravenous saline placebo for 24 weeks. The primary efficacy evaluation was changed in Amyotrophic Lateral Sclerosis Functional Rating Scale score from baseline to after the trial. Measure of safety was the frequency of investigated adverse events and serious adverse events. Data synthesis and analysis and evaluation of risk of bias were performed using RevMan 5.3 software. Heterogeneity among studies was evaluated with the
I
2
statistic.
Results
A total of 367 patients were analyzed across three randomized controlled trials (183 patients receiving intravenous edaravone; 184 receiving placebo). A difference in ALSFRS-R score between groups at 24 weeks was found (mean difference [MD] = 1.63, 95% confidence interval [CI] 0.26–3.00,
P
= .02). No differences in the frequency of adverse events (odds ratio [OR] = 1.22, 95% CI 0.68–2.19,
P
= .50) or serious adverse events (OR = 0.71, 95% CI 0.43–1.19,
P
= .20) were found.
Conclusion
Intravenous edaravone is efficacious in amyotrophic lateral sclerosis patients, with no severe adverse effects. Additional reliable randomized controlled trials with larger sample sizes will further assess the efficacy and safety of edaravone in amyotrophic lateral sclerosis.
Clinical trial registration
The systematic review and meta-analysis was registered in the international prospective register of systematic reviews. (PROSPERO registration number: CRD42018096191;
http://www.crd.york.ac.uk/PROSPERO
.)</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30483992</pmid><doi>10.1007/s10072-018-3653-2</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Neurological sciences, 2019-02, Vol.40 (2), p.235-241 |
| issn | 1590-1874 1590-3478 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Amyotrophic lateral sclerosis Amyotrophic Lateral Sclerosis - drug therapy Clinical trials Data processing Double-blind studies Edaravone - adverse effects Edaravone - therapeutic use Humans Intravenous administration Medicine Medicine & Public Health Meta-analysis Neurology Neuroprotective Agents - adverse effects Neuroprotective Agents - therapeutic use Neuroradiology Neurosciences Neurosurgery Patients Psychiatry Randomized Controlled Trials as Topic Review Article Safety Systematic review |
| title | Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis |
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