Endometriosis Susceptibility to Dapsone-Hydroxylamine-Induced Alterations Can Be Prevented by Licorice Intake: In Vivo and In Vitro Study
Endometriosis, an estrogen-dependent chronic gynecological disease, is characterized by a systemic inflammation that affects circulating red blood cells (RBC), by reducing anti-oxidant defenses. The aim of this study was to investigate the potential beneficial effects of licorice intake to protect R...
Gespeichert in:
| Veröffentlicht in: | International journal of molecular sciences 2021-08, Vol.22 (16), p.8476 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 16 |
| container_start_page | 8476 |
| container_title | International journal of molecular sciences |
| container_volume | 22 |
| creator | Sabbadin, Chiara Andrisani, Alessandra Donà, Gabriella Tibaldi, Elena Brunati, Anna Maria Dall’Acqua, Stefano Ragazzi, Eugenio Ambrosini, Guido Armanini, Decio Bordin, Luciana |
| description | Endometriosis, an estrogen-dependent chronic gynecological disease, is characterized by a systemic inflammation that affects circulating red blood cells (RBC), by reducing anti-oxidant defenses. The aim of this study was to investigate the potential beneficial effects of licorice intake to protect RBCs from dapsone hydroxylamine (DDS-NHOH), a harmful metabolite of dapsone, commonly used in the treatment of many diseases. A control group (CG, n = 12) and a patient group (PG, n = 18) were treated with licorice extract (25 mg/day), for a week. Blood samples before (T0) and after (T1) treatment were analyzed for: i) band 3 tyrosine phosphorylation and high molecular weight aggregates; and ii) glutathionylation and carbonic anhydrase activity, in the presence or absence of adjunctive oxidative stress induced by DDS-NHOH. Results were correlated with plasma glycyrrhetinic acid (GA) concentrations, measured by HPLC–MS. Results showed that licorice intake decreased the level of DDS-NHOH-related oxidative alterations in RBCs, and the reduction was directly correlated with plasma GA concentration. In conclusion, in PG, the inability to counteract oxidative stress is a serious concern in the evaluation of therapeutic approaches. GA, by protecting RBC from oxidative assault, as in dapsone therapy, might be considered as a new potential tool for preventing further switching into severe endometriosis. |
| doi_str_mv | 10.3390/ijms22168476 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_proquest_miscellaneous_2566041883</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_bf9b5c91d3274f6f90de27a03c4fb712</doaj_id><sourcerecordid>2624240052</sourcerecordid><originalsourceid>FETCH-LOGICAL-c412t-f98fa36ecdee847a5081f4fd2083ed2e7ce223a08d7714945a7e801225f8e6813</originalsourceid><addsrcrecordid>eNpdkstu1DAUhiMEoqWw4wEssWHBgH3sJA4LpDIUOlIlkApsLcc-Lh4Se2o7I_IIvDUpU6GW1bn9-nRuVfWc0decd_SN344ZgDVStM2D6pgJgBWlTfvwjn9UPcl5SylwqLvH1REXQtRM0uPq91mwccSSfMw-k8spG9wV3_vBl5mUSD7oXY4BV-ezTfHXPOjRL9Em2MmgJadDwaSLjyGTtQ7kPZIvCfcYylLsZ3LhTUzeINmEon_i28WS734fiQ724JcUyWWZ7Py0euT0kPHZrT2pvn08-7o-X118_rRZn16sjGBQVq6TTvMGjUVcRtY1lcwJZ4FKjhawNQjANZW2bZnoRK1blJQB1E5iIxk_qTYHro16q3bJjzrNKmqv_iZiulI6FW8GVL3r-tp0zHJohWtcRy1Cqyk3wvUtg4X17sDaTf2I1ixzJz3cg96vBP9DXcW9kryrAdoF8PIWkOL1hLmo0S8XGAYdME5ZQd00VDAp-SJ98Z90G6cUllUpaECAoLS-6ejVQWVSzDmh-9cMo-rmX9Tdf-F_AL9Ds6k</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2624240052</pqid></control><display><type>article</type><title>Endometriosis Susceptibility to Dapsone-Hydroxylamine-Induced Alterations Can Be Prevented by Licorice Intake: In Vivo and In Vitro Study</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Sabbadin, Chiara ; Andrisani, Alessandra ; Donà, Gabriella ; Tibaldi, Elena ; Brunati, Anna Maria ; Dall’Acqua, Stefano ; Ragazzi, Eugenio ; Ambrosini, Guido ; Armanini, Decio ; Bordin, Luciana</creator><creatorcontrib>Sabbadin, Chiara ; Andrisani, Alessandra ; Donà, Gabriella ; Tibaldi, Elena ; Brunati, Anna Maria ; Dall’Acqua, Stefano ; Ragazzi, Eugenio ; Ambrosini, Guido ; Armanini, Decio ; Bordin, Luciana</creatorcontrib><description>Endometriosis, an estrogen-dependent chronic gynecological disease, is characterized by a systemic inflammation that affects circulating red blood cells (RBC), by reducing anti-oxidant defenses. The aim of this study was to investigate the potential beneficial effects of licorice intake to protect RBCs from dapsone hydroxylamine (DDS-NHOH), a harmful metabolite of dapsone, commonly used in the treatment of many diseases. A control group (CG, n = 12) and a patient group (PG, n = 18) were treated with licorice extract (25 mg/day), for a week. Blood samples before (T0) and after (T1) treatment were analyzed for: i) band 3 tyrosine phosphorylation and high molecular weight aggregates; and ii) glutathionylation and carbonic anhydrase activity, in the presence or absence of adjunctive oxidative stress induced by DDS-NHOH. Results were correlated with plasma glycyrrhetinic acid (GA) concentrations, measured by HPLC–MS. Results showed that licorice intake decreased the level of DDS-NHOH-related oxidative alterations in RBCs, and the reduction was directly correlated with plasma GA concentration. In conclusion, in PG, the inability to counteract oxidative stress is a serious concern in the evaluation of therapeutic approaches. GA, by protecting RBC from oxidative assault, as in dapsone therapy, might be considered as a new potential tool for preventing further switching into severe endometriosis.</description><identifier>ISSN: 1422-0067</identifier><identifier>ISSN: 1661-6596</identifier><identifier>EISSN: 1422-0067</identifier><identifier>DOI: 10.3390/ijms22168476</identifier><identifier>PMID: 34445180</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Aging ; Antioxidants ; Blood circulation ; Carbonic anhydrase ; dapsone ; DDS-NHOH ; Diaminodiphenylsulfone ; Endometriosis ; Enzymes ; Erythrocytes ; Estrogens ; glycyrrhetinic acid ; Gynecological diseases ; Health services ; Homeostasis ; In vivo methods and tests ; Membranes ; Metabolites ; Molecular weight ; Oxidative stress ; Oxidizing agents ; Proteins ; red blood cell ; Severe acute respiratory syndrome coronavirus 2 ; Tyrosine</subject><ispartof>International journal of molecular sciences, 2021-08, Vol.22 (16), p.8476</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c412t-f98fa36ecdee847a5081f4fd2083ed2e7ce223a08d7714945a7e801225f8e6813</cites><orcidid>0000-0001-8264-6953 ; 0000-0003-4238-3153 ; 0000-0002-0390-6823</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/PMC8395227/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395227/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Sabbadin, Chiara</creatorcontrib><creatorcontrib>Andrisani, Alessandra</creatorcontrib><creatorcontrib>Donà, Gabriella</creatorcontrib><creatorcontrib>Tibaldi, Elena</creatorcontrib><creatorcontrib>Brunati, Anna Maria</creatorcontrib><creatorcontrib>Dall’Acqua, Stefano</creatorcontrib><creatorcontrib>Ragazzi, Eugenio</creatorcontrib><creatorcontrib>Ambrosini, Guido</creatorcontrib><creatorcontrib>Armanini, Decio</creatorcontrib><creatorcontrib>Bordin, Luciana</creatorcontrib><title>Endometriosis Susceptibility to Dapsone-Hydroxylamine-Induced Alterations Can Be Prevented by Licorice Intake: In Vivo and In Vitro Study</title><title>International journal of molecular sciences</title><description>Endometriosis, an estrogen-dependent chronic gynecological disease, is characterized by a systemic inflammation that affects circulating red blood cells (RBC), by reducing anti-oxidant defenses. The aim of this study was to investigate the potential beneficial effects of licorice intake to protect RBCs from dapsone hydroxylamine (DDS-NHOH), a harmful metabolite of dapsone, commonly used in the treatment of many diseases. A control group (CG, n = 12) and a patient group (PG, n = 18) were treated with licorice extract (25 mg/day), for a week. Blood samples before (T0) and after (T1) treatment were analyzed for: i) band 3 tyrosine phosphorylation and high molecular weight aggregates; and ii) glutathionylation and carbonic anhydrase activity, in the presence or absence of adjunctive oxidative stress induced by DDS-NHOH. Results were correlated with plasma glycyrrhetinic acid (GA) concentrations, measured by HPLC–MS. Results showed that licorice intake decreased the level of DDS-NHOH-related oxidative alterations in RBCs, and the reduction was directly correlated with plasma GA concentration. In conclusion, in PG, the inability to counteract oxidative stress is a serious concern in the evaluation of therapeutic approaches. GA, by protecting RBC from oxidative assault, as in dapsone therapy, might be considered as a new potential tool for preventing further switching into severe endometriosis.</description><subject>Aging</subject><subject>Antioxidants</subject><subject>Blood circulation</subject><subject>Carbonic anhydrase</subject><subject>dapsone</subject><subject>DDS-NHOH</subject><subject>Diaminodiphenylsulfone</subject><subject>Endometriosis</subject><subject>Enzymes</subject><subject>Erythrocytes</subject><subject>Estrogens</subject><subject>glycyrrhetinic acid</subject><subject>Gynecological diseases</subject><subject>Health services</subject><subject>Homeostasis</subject><subject>In vivo methods and tests</subject><subject>Membranes</subject><subject>Metabolites</subject><subject>Molecular weight</subject><subject>Oxidative stress</subject><subject>Oxidizing agents</subject><subject>Proteins</subject><subject>red blood cell</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Tyrosine</subject><issn>1422-0067</issn><issn>1661-6596</issn><issn>1422-0067</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>DOA</sourceid><recordid>eNpdkstu1DAUhiMEoqWw4wEssWHBgH3sJA4LpDIUOlIlkApsLcc-Lh4Se2o7I_IIvDUpU6GW1bn9-nRuVfWc0decd_SN344ZgDVStM2D6pgJgBWlTfvwjn9UPcl5SylwqLvH1REXQtRM0uPq91mwccSSfMw-k8spG9wV3_vBl5mUSD7oXY4BV-ezTfHXPOjRL9Em2MmgJadDwaSLjyGTtQ7kPZIvCfcYylLsZ3LhTUzeINmEon_i28WS734fiQ724JcUyWWZ7Py0euT0kPHZrT2pvn08-7o-X118_rRZn16sjGBQVq6TTvMGjUVcRtY1lcwJZ4FKjhawNQjANZW2bZnoRK1blJQB1E5iIxk_qTYHro16q3bJjzrNKmqv_iZiulI6FW8GVL3r-tp0zHJohWtcRy1Cqyk3wvUtg4X17sDaTf2I1ixzJz3cg96vBP9DXcW9kryrAdoF8PIWkOL1hLmo0S8XGAYdME5ZQd00VDAp-SJ98Z90G6cUllUpaECAoLS-6ejVQWVSzDmh-9cMo-rmX9Tdf-F_AL9Ds6k</recordid><startdate>20210806</startdate><enddate>20210806</enddate><creator>Sabbadin, Chiara</creator><creator>Andrisani, Alessandra</creator><creator>Donà, Gabriella</creator><creator>Tibaldi, Elena</creator><creator>Brunati, Anna Maria</creator><creator>Dall’Acqua, Stefano</creator><creator>Ragazzi, Eugenio</creator><creator>Ambrosini, Guido</creator><creator>Armanini, Decio</creator><creator>Bordin, Luciana</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8264-6953</orcidid><orcidid>https://orcid.org/0000-0003-4238-3153</orcidid><orcidid>https://orcid.org/0000-0002-0390-6823</orcidid></search><sort><creationdate>20210806</creationdate><title>Endometriosis Susceptibility to Dapsone-Hydroxylamine-Induced Alterations Can Be Prevented by Licorice Intake: In Vivo and In Vitro Study</title><author>Sabbadin, Chiara ; Andrisani, Alessandra ; Donà, Gabriella ; Tibaldi, Elena ; Brunati, Anna Maria ; Dall’Acqua, Stefano ; Ragazzi, Eugenio ; Ambrosini, Guido ; Armanini, Decio ; Bordin, Luciana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-f98fa36ecdee847a5081f4fd2083ed2e7ce223a08d7714945a7e801225f8e6813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aging</topic><topic>Antioxidants</topic><topic>Blood circulation</topic><topic>Carbonic anhydrase</topic><topic>dapsone</topic><topic>DDS-NHOH</topic><topic>Diaminodiphenylsulfone</topic><topic>Endometriosis</topic><topic>Enzymes</topic><topic>Erythrocytes</topic><topic>Estrogens</topic><topic>glycyrrhetinic acid</topic><topic>Gynecological diseases</topic><topic>Health services</topic><topic>Homeostasis</topic><topic>In vivo methods and tests</topic><topic>Membranes</topic><topic>Metabolites</topic><topic>Molecular weight</topic><topic>Oxidative stress</topic><topic>Oxidizing agents</topic><topic>Proteins</topic><topic>red blood cell</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Tyrosine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sabbadin, Chiara</creatorcontrib><creatorcontrib>Andrisani, Alessandra</creatorcontrib><creatorcontrib>Donà, Gabriella</creatorcontrib><creatorcontrib>Tibaldi, Elena</creatorcontrib><creatorcontrib>Brunati, Anna Maria</creatorcontrib><creatorcontrib>Dall’Acqua, Stefano</creatorcontrib><creatorcontrib>Ragazzi, Eugenio</creatorcontrib><creatorcontrib>Ambrosini, Guido</creatorcontrib><creatorcontrib>Armanini, Decio</creatorcontrib><creatorcontrib>Bordin, Luciana</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</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>Coronavirus Research Database</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>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content 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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>International journal of molecular sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sabbadin, Chiara</au><au>Andrisani, Alessandra</au><au>Donà, Gabriella</au><au>Tibaldi, Elena</au><au>Brunati, Anna Maria</au><au>Dall’Acqua, Stefano</au><au>Ragazzi, Eugenio</au><au>Ambrosini, Guido</au><au>Armanini, Decio</au><au>Bordin, Luciana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endometriosis Susceptibility to Dapsone-Hydroxylamine-Induced Alterations Can Be Prevented by Licorice Intake: In Vivo and In Vitro Study</atitle><jtitle>International journal of molecular sciences</jtitle><date>2021-08-06</date><risdate>2021</risdate><volume>22</volume><issue>16</issue><spage>8476</spage><pages>8476-</pages><issn>1422-0067</issn><issn>1661-6596</issn><eissn>1422-0067</eissn><abstract>Endometriosis, an estrogen-dependent chronic gynecological disease, is characterized by a systemic inflammation that affects circulating red blood cells (RBC), by reducing anti-oxidant defenses. The aim of this study was to investigate the potential beneficial effects of licorice intake to protect RBCs from dapsone hydroxylamine (DDS-NHOH), a harmful metabolite of dapsone, commonly used in the treatment of many diseases. A control group (CG, n = 12) and a patient group (PG, n = 18) were treated with licorice extract (25 mg/day), for a week. Blood samples before (T0) and after (T1) treatment were analyzed for: i) band 3 tyrosine phosphorylation and high molecular weight aggregates; and ii) glutathionylation and carbonic anhydrase activity, in the presence or absence of adjunctive oxidative stress induced by DDS-NHOH. Results were correlated with plasma glycyrrhetinic acid (GA) concentrations, measured by HPLC–MS. Results showed that licorice intake decreased the level of DDS-NHOH-related oxidative alterations in RBCs, and the reduction was directly correlated with plasma GA concentration. In conclusion, in PG, the inability to counteract oxidative stress is a serious concern in the evaluation of therapeutic approaches. GA, by protecting RBC from oxidative assault, as in dapsone therapy, might be considered as a new potential tool for preventing further switching into severe endometriosis.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34445180</pmid><doi>10.3390/ijms22168476</doi><orcidid>https://orcid.org/0000-0001-8264-6953</orcidid><orcidid>https://orcid.org/0000-0003-4238-3153</orcidid><orcidid>https://orcid.org/0000-0002-0390-6823</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1422-0067 |
| ispartof | International journal of molecular sciences, 2021-08, Vol.22 (16), p.8476 |
| issn | 1422-0067 1661-6596 1422-0067 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2566041883 |
| source | MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aging Antioxidants Blood circulation Carbonic anhydrase dapsone DDS-NHOH Diaminodiphenylsulfone Endometriosis Enzymes Erythrocytes Estrogens glycyrrhetinic acid Gynecological diseases Health services Homeostasis In vivo methods and tests Membranes Metabolites Molecular weight Oxidative stress Oxidizing agents Proteins red blood cell Severe acute respiratory syndrome coronavirus 2 Tyrosine |
| title | Endometriosis Susceptibility to Dapsone-Hydroxylamine-Induced Alterations Can Be Prevented by Licorice Intake: In Vivo and In Vitro Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T02%3A23%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Endometriosis%20Susceptibility%20to%20Dapsone-Hydroxylamine-Induced%20Alterations%20Can%20Be%20Prevented%20by%20Licorice%20Intake:%20In%20Vivo%20and%20In%20Vitro%20Study&rft.jtitle=International%20journal%20of%20molecular%20sciences&rft.au=Sabbadin,%20Chiara&rft.date=2021-08-06&rft.volume=22&rft.issue=16&rft.spage=8476&rft.pages=8476-&rft.issn=1422-0067&rft.eissn=1422-0067&rft_id=info:doi/10.3390/ijms22168476&rft_dat=%3Cproquest_doaj_%3E2624240052%3C/proquest_doaj_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2624240052&rft_id=info:pmid/34445180&rft_doaj_id=oai_doaj_org_article_bf9b5c91d3274f6f90de27a03c4fb712&rfr_iscdi=true |