Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation

Objectives To evaluate the effect of PBM on the psychological profile and quality of life of patients with oral lichen planus (OLP) in comparison to corticoid and to investigate the cost-effectiveness of both treatments. Materials and methods Patients were randomized into two groups: Control (clobet...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Clinical oral investigations 2022, Vol.26 (1), p.719-728
Hauptverfasser: Sobral, Sérgio Sousa, da Silva Brandão, Eloíza Helena, de Barros Gallo, Camila, Molon, Angela, Sobral, Ana Paula Taboada, de Fátima Teixeira da Silva, Daniela, Motta, Lara Jansiski, dos Santos Franco, Adriana Lino, Rodrigues, Maria Fernanda Setúbal Destro
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 728
container_issue 1
container_start_page 719
container_title Clinical oral investigations
container_volume 26
creator Sobral, Sérgio Sousa
da Silva Brandão, Eloíza Helena
de Barros Gallo, Camila
Molon, Angela
Sobral, Ana Paula Taboada
de Fátima Teixeira da Silva, Daniela
Motta, Lara Jansiski
dos Santos Franco, Adriana Lino
Rodrigues, Maria Fernanda Setúbal Destro
description Objectives To evaluate the effect of PBM on the psychological profile and quality of life of patients with oral lichen planus (OLP) in comparison to corticoid and to investigate the cost-effectiveness of both treatments. Materials and methods Patients were randomized into two groups: Control (clobetasol propionate 0.05%) and Photobiomodulation (660 nm, 100mW, 177 J/cm 2 , 5 s, 0.5 J) twice a week for 30 days. The Hospital Anxiety and Depression Scale (HADS) and OHIP-14 were used in different treatment time points and at follow-up. The cost-effectiveness was calculated using the improvement in OHIP-14 after treatment. Results OLP patients showed detected levels of anxiety, depression, and poor quality of life at baseline. No improvement in anxiety and depression was noticed after treatments. However, PBM and corticoid significantly improved the quality of life of OLP patients, considering the OHIP-14-T and the physical pain domain. The treatment with corticoid was more cost-effective than PBM. Conclusions Psychological distress was not improved after both treatments and PBM is as effective as corticoids in promoting a better quality of life in OLP patients, despite its higher cost. Clinical relevance This study highlights the need for additional therapeutic interventions in OLP patients, to early recognize and to manage the alterations in their psychological profile. Moreover, PBM is an effective therapy in OLP patient’s quality of live and although it was a more expensive, the advantage of being a minimally invasive therapy associated with no side effects must be considered in clinical practice, especially in those patients with refractory disease. Trial registration This study is registered at ClinicalTrials.gov; the registration number is NCT03320460, registered in 17/10/2017.
doi_str_mv 10.1007/s00784-021-04050-z
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2550626003</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2622860923</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-d5630217b7bf715810a24c6d4f2426d86d8e54688371af4f181479a804432a223</originalsourceid><addsrcrecordid>eNp9kc9uVCEUxomxsbX6Ai4MiRsXUvkPs2waW02adKNrwnChl4a53ALXZvoYPrHMTNXERRMCJ_A7H-ecD4B3BJ8RjNXn2jfNEaYEYY4FRo8vwAnhTCKmFHm5jymSK02Oweta7zAmXCr2ChwzTgURjJ2AX-eTTdsaK8wBttHDuW7dmGfbxpzybXQ2wbnkEJP_BO8Xm2Lb7tAUQ7-w0wBdrg35ELxr8aeffN1L5dITU3Sjn-Cc7LRU2DWjn1qFrXjb_AAfYhvhPOaW1zFv8rCkTuTpDTgKNlX_9uk8BT8uv3y_-Iqub66-XZxfI8eUaGgQkvXW1VqtgyJCE2wpd3LggXIqB92XF1xqzRSxgQeiCVcrqzHvU7GUslPw8aDb-7tffG1mE6vzqVfr81INFQJLKjFmHf3wH3qXl9In1ylJqZZ4RXcUPVCu5FqLD2YucWPL1hBsdo6Zg2Oml232jpnHnvT-SXpZb_zwN-WPRR1gB6D2p-nWl39_PyP7G5T_oxY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2622860923</pqid></control><display><type>article</type><title>Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Sobral, Sérgio Sousa ; da Silva Brandão, Eloíza Helena ; de Barros Gallo, Camila ; Molon, Angela ; Sobral, Ana Paula Taboada ; de Fátima Teixeira da Silva, Daniela ; Motta, Lara Jansiski ; dos Santos Franco, Adriana Lino ; Rodrigues, Maria Fernanda Setúbal Destro</creator><creatorcontrib>Sobral, Sérgio Sousa ; da Silva Brandão, Eloíza Helena ; de Barros Gallo, Camila ; Molon, Angela ; Sobral, Ana Paula Taboada ; de Fátima Teixeira da Silva, Daniela ; Motta, Lara Jansiski ; dos Santos Franco, Adriana Lino ; Rodrigues, Maria Fernanda Setúbal Destro</creatorcontrib><description>Objectives To evaluate the effect of PBM on the psychological profile and quality of life of patients with oral lichen planus (OLP) in comparison to corticoid and to investigate the cost-effectiveness of both treatments. Materials and methods Patients were randomized into two groups: Control (clobetasol propionate 0.05%) and Photobiomodulation (660 nm, 100mW, 177 J/cm 2 , 5 s, 0.5 J) twice a week for 30 days. The Hospital Anxiety and Depression Scale (HADS) and OHIP-14 were used in different treatment time points and at follow-up. The cost-effectiveness was calculated using the improvement in OHIP-14 after treatment. Results OLP patients showed detected levels of anxiety, depression, and poor quality of life at baseline. No improvement in anxiety and depression was noticed after treatments. However, PBM and corticoid significantly improved the quality of life of OLP patients, considering the OHIP-14-T and the physical pain domain. The treatment with corticoid was more cost-effective than PBM. Conclusions Psychological distress was not improved after both treatments and PBM is as effective as corticoids in promoting a better quality of life in OLP patients, despite its higher cost. Clinical relevance This study highlights the need for additional therapeutic interventions in OLP patients, to early recognize and to manage the alterations in their psychological profile. Moreover, PBM is an effective therapy in OLP patient’s quality of live and although it was a more expensive, the advantage of being a minimally invasive therapy associated with no side effects must be considered in clinical practice, especially in those patients with refractory disease. Trial registration This study is registered at ClinicalTrials.gov; the registration number is NCT03320460, registered in 17/10/2017.</description><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-021-04050-z</identifier><identifier>PMID: 34251533</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anxiety ; Corticosteroids ; Cost analysis ; Cost-Benefit Analysis ; Dentistry ; Humans ; Lichen planus ; Lichen Planus, Oral ; Light therapy ; Medicine ; Mental depression ; Mental Disorders ; Original Article ; Patients ; Propionic acid ; Quality of Life ; Therapeutic applications</subject><ispartof>Clinical oral investigations, 2022, Vol.26 (1), p.719-728</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-d5630217b7bf715810a24c6d4f2426d86d8e54688371af4f181479a804432a223</citedby><cites>FETCH-LOGICAL-c375t-d5630217b7bf715810a24c6d4f2426d86d8e54688371af4f181479a804432a223</cites><orcidid>0000-0002-3067-9224</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00784-021-04050-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-021-04050-z$$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/34251533$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sobral, Sérgio Sousa</creatorcontrib><creatorcontrib>da Silva Brandão, Eloíza Helena</creatorcontrib><creatorcontrib>de Barros Gallo, Camila</creatorcontrib><creatorcontrib>Molon, Angela</creatorcontrib><creatorcontrib>Sobral, Ana Paula Taboada</creatorcontrib><creatorcontrib>de Fátima Teixeira da Silva, Daniela</creatorcontrib><creatorcontrib>Motta, Lara Jansiski</creatorcontrib><creatorcontrib>dos Santos Franco, Adriana Lino</creatorcontrib><creatorcontrib>Rodrigues, Maria Fernanda Setúbal Destro</creatorcontrib><title>Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objectives To evaluate the effect of PBM on the psychological profile and quality of life of patients with oral lichen planus (OLP) in comparison to corticoid and to investigate the cost-effectiveness of both treatments. Materials and methods Patients were randomized into two groups: Control (clobetasol propionate 0.05%) and Photobiomodulation (660 nm, 100mW, 177 J/cm 2 , 5 s, 0.5 J) twice a week for 30 days. The Hospital Anxiety and Depression Scale (HADS) and OHIP-14 were used in different treatment time points and at follow-up. The cost-effectiveness was calculated using the improvement in OHIP-14 after treatment. Results OLP patients showed detected levels of anxiety, depression, and poor quality of life at baseline. No improvement in anxiety and depression was noticed after treatments. However, PBM and corticoid significantly improved the quality of life of OLP patients, considering the OHIP-14-T and the physical pain domain. The treatment with corticoid was more cost-effective than PBM. Conclusions Psychological distress was not improved after both treatments and PBM is as effective as corticoids in promoting a better quality of life in OLP patients, despite its higher cost. Clinical relevance This study highlights the need for additional therapeutic interventions in OLP patients, to early recognize and to manage the alterations in their psychological profile. Moreover, PBM is an effective therapy in OLP patient’s quality of live and although it was a more expensive, the advantage of being a minimally invasive therapy associated with no side effects must be considered in clinical practice, especially in those patients with refractory disease. Trial registration This study is registered at ClinicalTrials.gov; the registration number is NCT03320460, registered in 17/10/2017.</description><subject>Anxiety</subject><subject>Corticosteroids</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>Dentistry</subject><subject>Humans</subject><subject>Lichen planus</subject><subject>Lichen Planus, Oral</subject><subject>Light therapy</subject><subject>Medicine</subject><subject>Mental depression</subject><subject>Mental Disorders</subject><subject>Original Article</subject><subject>Patients</subject><subject>Propionic acid</subject><subject>Quality of Life</subject><subject>Therapeutic applications</subject><issn>1432-6981</issn><issn>1436-3771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc9uVCEUxomxsbX6Ai4MiRsXUvkPs2waW02adKNrwnChl4a53ALXZvoYPrHMTNXERRMCJ_A7H-ecD4B3BJ8RjNXn2jfNEaYEYY4FRo8vwAnhTCKmFHm5jymSK02Oweta7zAmXCr2ChwzTgURjJ2AX-eTTdsaK8wBttHDuW7dmGfbxpzybXQ2wbnkEJP_BO8Xm2Lb7tAUQ7-w0wBdrg35ELxr8aeffN1L5dITU3Sjn-Cc7LRU2DWjn1qFrXjb_AAfYhvhPOaW1zFv8rCkTuTpDTgKNlX_9uk8BT8uv3y_-Iqub66-XZxfI8eUaGgQkvXW1VqtgyJCE2wpd3LggXIqB92XF1xqzRSxgQeiCVcrqzHvU7GUslPw8aDb-7tffG1mE6vzqVfr81INFQJLKjFmHf3wH3qXl9In1ylJqZZ4RXcUPVCu5FqLD2YucWPL1hBsdo6Zg2Oml232jpnHnvT-SXpZb_zwN-WPRR1gB6D2p-nWl39_PyP7G5T_oxY</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Sobral, Sérgio Sousa</creator><creator>da Silva Brandão, Eloíza Helena</creator><creator>de Barros Gallo, Camila</creator><creator>Molon, Angela</creator><creator>Sobral, Ana Paula Taboada</creator><creator>de Fátima Teixeira da Silva, Daniela</creator><creator>Motta, Lara Jansiski</creator><creator>dos Santos Franco, Adriana Lino</creator><creator>Rodrigues, Maria Fernanda Setúbal Destro</creator><general>Springer Berlin Heidelberg</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>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3067-9224</orcidid></search><sort><creationdate>2022</creationdate><title>Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation</title><author>Sobral, Sérgio Sousa ; da Silva Brandão, Eloíza Helena ; de Barros Gallo, Camila ; Molon, Angela ; Sobral, Ana Paula Taboada ; de Fátima Teixeira da Silva, Daniela ; Motta, Lara Jansiski ; dos Santos Franco, Adriana Lino ; Rodrigues, Maria Fernanda Setúbal Destro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-d5630217b7bf715810a24c6d4f2426d86d8e54688371af4f181479a804432a223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anxiety</topic><topic>Corticosteroids</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>Dentistry</topic><topic>Humans</topic><topic>Lichen planus</topic><topic>Lichen Planus, Oral</topic><topic>Light therapy</topic><topic>Medicine</topic><topic>Mental depression</topic><topic>Mental Disorders</topic><topic>Original Article</topic><topic>Patients</topic><topic>Propionic acid</topic><topic>Quality of Life</topic><topic>Therapeutic applications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sobral, Sérgio Sousa</creatorcontrib><creatorcontrib>da Silva Brandão, Eloíza Helena</creatorcontrib><creatorcontrib>de Barros Gallo, Camila</creatorcontrib><creatorcontrib>Molon, Angela</creatorcontrib><creatorcontrib>Sobral, Ana Paula Taboada</creatorcontrib><creatorcontrib>de Fátima Teixeira da Silva, Daniela</creatorcontrib><creatorcontrib>Motta, Lara Jansiski</creatorcontrib><creatorcontrib>dos Santos Franco, Adriana Lino</creatorcontrib><creatorcontrib>Rodrigues, Maria Fernanda Setúbal Destro</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>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science 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>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</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>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</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>MEDLINE - Academic</collection><jtitle>Clinical oral investigations</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sobral, Sérgio Sousa</au><au>da Silva Brandão, Eloíza Helena</au><au>de Barros Gallo, Camila</au><au>Molon, Angela</au><au>Sobral, Ana Paula Taboada</au><au>de Fátima Teixeira da Silva, Daniela</au><au>Motta, Lara Jansiski</au><au>dos Santos Franco, Adriana Lino</au><au>Rodrigues, Maria Fernanda Setúbal Destro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2022</date><risdate>2022</risdate><volume>26</volume><issue>1</issue><spage>719</spage><epage>728</epage><pages>719-728</pages><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objectives To evaluate the effect of PBM on the psychological profile and quality of life of patients with oral lichen planus (OLP) in comparison to corticoid and to investigate the cost-effectiveness of both treatments. Materials and methods Patients were randomized into two groups: Control (clobetasol propionate 0.05%) and Photobiomodulation (660 nm, 100mW, 177 J/cm 2 , 5 s, 0.5 J) twice a week for 30 days. The Hospital Anxiety and Depression Scale (HADS) and OHIP-14 were used in different treatment time points and at follow-up. The cost-effectiveness was calculated using the improvement in OHIP-14 after treatment. Results OLP patients showed detected levels of anxiety, depression, and poor quality of life at baseline. No improvement in anxiety and depression was noticed after treatments. However, PBM and corticoid significantly improved the quality of life of OLP patients, considering the OHIP-14-T and the physical pain domain. The treatment with corticoid was more cost-effective than PBM. Conclusions Psychological distress was not improved after both treatments and PBM is as effective as corticoids in promoting a better quality of life in OLP patients, despite its higher cost. Clinical relevance This study highlights the need for additional therapeutic interventions in OLP patients, to early recognize and to manage the alterations in their psychological profile. Moreover, PBM is an effective therapy in OLP patient’s quality of live and although it was a more expensive, the advantage of being a minimally invasive therapy associated with no side effects must be considered in clinical practice, especially in those patients with refractory disease. Trial registration This study is registered at ClinicalTrials.gov; the registration number is NCT03320460, registered in 17/10/2017.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34251533</pmid><doi>10.1007/s00784-021-04050-z</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3067-9224</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 1432-6981
ispartof Clinical oral investigations, 2022, Vol.26 (1), p.719-728
issn 1432-6981
1436-3771
language eng
recordid cdi_proquest_miscellaneous_2550626003
source MEDLINE; Springer Nature - Complete Springer Journals
subjects Anxiety
Corticosteroids
Cost analysis
Cost-Benefit Analysis
Dentistry
Humans
Lichen planus
Lichen Planus, Oral
Light therapy
Medicine
Mental depression
Mental Disorders
Original Article
Patients
Propionic acid
Quality of Life
Therapeutic applications
title Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T08%3A34%3A26IST&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=Analysis%20of%20the%20psychopathological%20profile,%20quality%20of%20life,%20and%20cost-effectiveness%20of%20oral%20lichen%20planus%20patients%20treated%20with%20photobiomodulation&rft.jtitle=Clinical%20oral%20investigations&rft.au=Sobral,%20S%C3%A9rgio%20Sousa&rft.date=2022&rft.volume=26&rft.issue=1&rft.spage=719&rft.epage=728&rft.pages=719-728&rft.issn=1432-6981&rft.eissn=1436-3771&rft_id=info:doi/10.1007/s00784-021-04050-z&rft_dat=%3Cproquest_cross%3E2622860923%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=2622860923&rft_id=info:pmid/34251533&rfr_iscdi=true