Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study)

Hesperidin exerts cardiovascular beneficial effects, but its mechanisms of action remain undefined. In a previous study we demonstrated that a single dose and a 12-week treatment of hesperidin decreased systolic blood pressure. The aim of this study was to ascertain the action mechanisms of hesperid...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-12, Vol.40 (12), p.5812-5822
Hauptverfasser: Pla-Pagà, Laura, Valls, Rosa M., Pedret, Anna, Calderón-Pérez, Lorena, Llauradó, Elisabet, Companys, Judit, Domenech-Coca, Cristina, Canela, Nuria, del Bas, Josep M., Caimari, Antoni, Puiggròs, Francesc, MI, Covas, Arola, Lluís, Solà, Rosa
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 5822
container_issue 12
container_start_page 5812
container_title Clinical nutrition (Edinburgh, Scotland)
container_volume 40
creator Pla-Pagà, Laura
Valls, Rosa M.
Pedret, Anna
Calderón-Pérez, Lorena
Llauradó, Elisabet
Companys, Judit
Domenech-Coca, Cristina
Canela, Nuria
del Bas, Josep M.
Caimari, Antoni
Puiggròs, Francesc
MI, Covas
Arola, Lluís
Solà, Rosa
description Hesperidin exerts cardiovascular beneficial effects, but its mechanisms of action remain undefined. In a previous study we demonstrated that a single dose and a 12-week treatment of hesperidin decreased systolic blood pressure. The aim of this study was to ascertain the action mechanisms of hesperidin consumption in subjects with elevated blood pressure or with stage 1 hypertension, by determining their transcriptomic profile after a single dose or a 12-week treatment. For transcriptomic analysis, peripheral blood mononuclear cells were obtained from 37 subjects with elevated blood pressure and stage 1 hypertension from CITRUS study who were randomized to receive for 12 weeks: control drink (CD; n = 11), OJ (containing 345 mg of hesperidin; n = 15) or EOJ (containing 600 mg of hesperidin; n = 11). Before starting the 12-weeks treatment, a single dose study with a 6 h of follow-up in each group was performed. After the single dose consumption, EOJ versus OJ, downregulated DHRS9 gene which is related with insulin resistance. Compared to CD, 12-week treatment of EOJ downregulated 6 proinflammatory genes while after OJ consumption only 1 proinflammatory gene was downregulated. Moreover, 12-week treatment of EOJ versus OJ, downregulated acute coronary syndrome gene related (SELENBP1). A single dose consumption of EOJ could protect from insulin resistance. Moreover, EOJ decrease the expression of proinflammatory genes after 12-week treatment providing a possible mechanism of action on inflammation pathway.
doi_str_mv 10.1016/j.clnu.2021.10.009
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2600286902</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0261561421004787</els_id><sourcerecordid>2600286902</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-fc3c7bc5d4b7a32a71ed210b54d67c5c1e29854ffd27f425a86ff3c3232981903</originalsourceid><addsrcrecordid>eNp9kV1rFDEYhYModlv9A15ILuvFrPmYT_GmLK0WCoK210MmeeNmyEzWJFNZ_5__y3fY6qUQSDic87xJDiFvONtyxuv341b7edkKJjgKW8a6Z2TDKykK3rXyOdkwUfOiqnl5Rs5TGhljlWzal-RMli1jLe825Pe1taAzDZbmPVAd5rRMh-zCvEp7SAeIzriZ4gpRzd-BjovTQNGwBjJqSUd3yGFymh5isM7Dmk3LMCI50Z8u7yl4eFQZDB18CAZ9kNISgarZ0JQVYjndH3FYhjnh9A_0iiLaIPUXpvBeOQbv8ZijU55e7m7vvz58w-xiju9ekRdW-QSvn_YL8nBzfb_7XNx9-XS7u7ortKzqXFgtdTPoypRDo6RQDQcjOBuq0tSNrjQH0bVVaa0RjS1FpdraWqmlkKjzjskLcnni4jt_LJByP7mkwXs1Q1hSL2rGRFt3TKBVnKw6hpQi2P4Q3aTiseesX-vrx36tr1_rWzWsD0Nvn_jLMIH5F_nbFxo-ngyAr3x0EPukHcwajIv42b0J7n_8P2tyr_U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2600286902</pqid></control><display><type>article</type><title>Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study)</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Pla-Pagà, Laura ; Valls, Rosa M. ; Pedret, Anna ; Calderón-Pérez, Lorena ; Llauradó, Elisabet ; Companys, Judit ; Domenech-Coca, Cristina ; Canela, Nuria ; del Bas, Josep M. ; Caimari, Antoni ; Puiggròs, Francesc ; MI, Covas ; Arola, Lluís ; Solà, Rosa</creator><creatorcontrib>Pla-Pagà, Laura ; Valls, Rosa M. ; Pedret, Anna ; Calderón-Pérez, Lorena ; Llauradó, Elisabet ; Companys, Judit ; Domenech-Coca, Cristina ; Canela, Nuria ; del Bas, Josep M. ; Caimari, Antoni ; Puiggròs, Francesc ; MI, Covas ; Arola, Lluís ; Solà, Rosa</creatorcontrib><description>Hesperidin exerts cardiovascular beneficial effects, but its mechanisms of action remain undefined. In a previous study we demonstrated that a single dose and a 12-week treatment of hesperidin decreased systolic blood pressure. The aim of this study was to ascertain the action mechanisms of hesperidin consumption in subjects with elevated blood pressure or with stage 1 hypertension, by determining their transcriptomic profile after a single dose or a 12-week treatment. For transcriptomic analysis, peripheral blood mononuclear cells were obtained from 37 subjects with elevated blood pressure and stage 1 hypertension from CITRUS study who were randomized to receive for 12 weeks: control drink (CD; n = 11), OJ (containing 345 mg of hesperidin; n = 15) or EOJ (containing 600 mg of hesperidin; n = 11). Before starting the 12-weeks treatment, a single dose study with a 6 h of follow-up in each group was performed. After the single dose consumption, EOJ versus OJ, downregulated DHRS9 gene which is related with insulin resistance. Compared to CD, 12-week treatment of EOJ downregulated 6 proinflammatory genes while after OJ consumption only 1 proinflammatory gene was downregulated. Moreover, 12-week treatment of EOJ versus OJ, downregulated acute coronary syndrome gene related (SELENBP1). A single dose consumption of EOJ could protect from insulin resistance. Moreover, EOJ decrease the expression of proinflammatory genes after 12-week treatment providing a possible mechanism of action on inflammation pathway.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2021.10.009</identifier><identifier>PMID: 34800819</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>3-Hydroxysteroid Dehydrogenases - metabolism ; Adult ; Blood Pressure - genetics ; Citrus sinensis ; Double-Blind Method ; Down-Regulation ; Female ; Fruit and Vegetable Juices ; Gene Expression - drug effects ; Hesperidin ; Hesperidin - administration &amp; dosage ; Hesperidin - pharmacology ; Humans ; Hypertension - genetics ; Hypertensive subjects ; Leukocytes, Mononuclear - metabolism ; Male ; Middle Aged ; Orange juice ; PBMCs ; Plasma ; Selenium-Binding Proteins - metabolism ; Transcriptome - drug effects ; Transcriptomic analysis</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2021-12, Vol.40 (12), p.5812-5822</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-fc3c7bc5d4b7a32a71ed210b54d67c5c1e29854ffd27f425a86ff3c3232981903</citedby><cites>FETCH-LOGICAL-c356t-fc3c7bc5d4b7a32a71ed210b54d67c5c1e29854ffd27f425a86ff3c3232981903</cites><orcidid>0000-0001-6144-0294 ; 0000-0003-1589-4556 ; 0000-0003-1485-0818</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2021.10.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34800819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pla-Pagà, Laura</creatorcontrib><creatorcontrib>Valls, Rosa M.</creatorcontrib><creatorcontrib>Pedret, Anna</creatorcontrib><creatorcontrib>Calderón-Pérez, Lorena</creatorcontrib><creatorcontrib>Llauradó, Elisabet</creatorcontrib><creatorcontrib>Companys, Judit</creatorcontrib><creatorcontrib>Domenech-Coca, Cristina</creatorcontrib><creatorcontrib>Canela, Nuria</creatorcontrib><creatorcontrib>del Bas, Josep M.</creatorcontrib><creatorcontrib>Caimari, Antoni</creatorcontrib><creatorcontrib>Puiggròs, Francesc</creatorcontrib><creatorcontrib>MI, Covas</creatorcontrib><creatorcontrib>Arola, Lluís</creatorcontrib><creatorcontrib>Solà, Rosa</creatorcontrib><title>Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study)</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>Hesperidin exerts cardiovascular beneficial effects, but its mechanisms of action remain undefined. In a previous study we demonstrated that a single dose and a 12-week treatment of hesperidin decreased systolic blood pressure. The aim of this study was to ascertain the action mechanisms of hesperidin consumption in subjects with elevated blood pressure or with stage 1 hypertension, by determining their transcriptomic profile after a single dose or a 12-week treatment. For transcriptomic analysis, peripheral blood mononuclear cells were obtained from 37 subjects with elevated blood pressure and stage 1 hypertension from CITRUS study who were randomized to receive for 12 weeks: control drink (CD; n = 11), OJ (containing 345 mg of hesperidin; n = 15) or EOJ (containing 600 mg of hesperidin; n = 11). Before starting the 12-weeks treatment, a single dose study with a 6 h of follow-up in each group was performed. After the single dose consumption, EOJ versus OJ, downregulated DHRS9 gene which is related with insulin resistance. Compared to CD, 12-week treatment of EOJ downregulated 6 proinflammatory genes while after OJ consumption only 1 proinflammatory gene was downregulated. Moreover, 12-week treatment of EOJ versus OJ, downregulated acute coronary syndrome gene related (SELENBP1). A single dose consumption of EOJ could protect from insulin resistance. Moreover, EOJ decrease the expression of proinflammatory genes after 12-week treatment providing a possible mechanism of action on inflammation pathway.</description><subject>3-Hydroxysteroid Dehydrogenases - metabolism</subject><subject>Adult</subject><subject>Blood Pressure - genetics</subject><subject>Citrus sinensis</subject><subject>Double-Blind Method</subject><subject>Down-Regulation</subject><subject>Female</subject><subject>Fruit and Vegetable Juices</subject><subject>Gene Expression - drug effects</subject><subject>Hesperidin</subject><subject>Hesperidin - administration &amp; dosage</subject><subject>Hesperidin - pharmacology</subject><subject>Humans</subject><subject>Hypertension - genetics</subject><subject>Hypertensive subjects</subject><subject>Leukocytes, Mononuclear - metabolism</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Orange juice</subject><subject>PBMCs</subject><subject>Plasma</subject><subject>Selenium-Binding Proteins - metabolism</subject><subject>Transcriptome - drug effects</subject><subject>Transcriptomic analysis</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV1rFDEYhYModlv9A15ILuvFrPmYT_GmLK0WCoK210MmeeNmyEzWJFNZ_5__y3fY6qUQSDic87xJDiFvONtyxuv341b7edkKJjgKW8a6Z2TDKykK3rXyOdkwUfOiqnl5Rs5TGhljlWzal-RMli1jLe825Pe1taAzDZbmPVAd5rRMh-zCvEp7SAeIzriZ4gpRzd-BjovTQNGwBjJqSUd3yGFymh5isM7Dmk3LMCI50Z8u7yl4eFQZDB18CAZ9kNISgarZ0JQVYjndH3FYhjnh9A_0iiLaIPUXpvBeOQbv8ZijU55e7m7vvz58w-xiju9ekRdW-QSvn_YL8nBzfb_7XNx9-XS7u7ortKzqXFgtdTPoypRDo6RQDQcjOBuq0tSNrjQH0bVVaa0RjS1FpdraWqmlkKjzjskLcnni4jt_LJByP7mkwXs1Q1hSL2rGRFt3TKBVnKw6hpQi2P4Q3aTiseesX-vrx36tr1_rWzWsD0Nvn_jLMIH5F_nbFxo-ngyAr3x0EPukHcwajIv42b0J7n_8P2tyr_U</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Pla-Pagà, Laura</creator><creator>Valls, Rosa M.</creator><creator>Pedret, Anna</creator><creator>Calderón-Pérez, Lorena</creator><creator>Llauradó, Elisabet</creator><creator>Companys, Judit</creator><creator>Domenech-Coca, Cristina</creator><creator>Canela, Nuria</creator><creator>del Bas, Josep M.</creator><creator>Caimari, Antoni</creator><creator>Puiggròs, Francesc</creator><creator>MI, Covas</creator><creator>Arola, Lluís</creator><creator>Solà, Rosa</creator><general>Elsevier Ltd</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><orcidid>https://orcid.org/0000-0001-6144-0294</orcidid><orcidid>https://orcid.org/0000-0003-1589-4556</orcidid><orcidid>https://orcid.org/0000-0003-1485-0818</orcidid></search><sort><creationdate>202112</creationdate><title>Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study)</title><author>Pla-Pagà, Laura ; Valls, Rosa M. ; Pedret, Anna ; Calderón-Pérez, Lorena ; Llauradó, Elisabet ; Companys, Judit ; Domenech-Coca, Cristina ; Canela, Nuria ; del Bas, Josep M. ; Caimari, Antoni ; Puiggròs, Francesc ; MI, Covas ; Arola, Lluís ; Solà, Rosa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-fc3c7bc5d4b7a32a71ed210b54d67c5c1e29854ffd27f425a86ff3c3232981903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>3-Hydroxysteroid Dehydrogenases - metabolism</topic><topic>Adult</topic><topic>Blood Pressure - genetics</topic><topic>Citrus sinensis</topic><topic>Double-Blind Method</topic><topic>Down-Regulation</topic><topic>Female</topic><topic>Fruit and Vegetable Juices</topic><topic>Gene Expression - drug effects</topic><topic>Hesperidin</topic><topic>Hesperidin - administration &amp; dosage</topic><topic>Hesperidin - pharmacology</topic><topic>Humans</topic><topic>Hypertension - genetics</topic><topic>Hypertensive subjects</topic><topic>Leukocytes, Mononuclear - metabolism</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Orange juice</topic><topic>PBMCs</topic><topic>Plasma</topic><topic>Selenium-Binding Proteins - metabolism</topic><topic>Transcriptome - drug effects</topic><topic>Transcriptomic analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pla-Pagà, Laura</creatorcontrib><creatorcontrib>Valls, Rosa M.</creatorcontrib><creatorcontrib>Pedret, Anna</creatorcontrib><creatorcontrib>Calderón-Pérez, Lorena</creatorcontrib><creatorcontrib>Llauradó, Elisabet</creatorcontrib><creatorcontrib>Companys, Judit</creatorcontrib><creatorcontrib>Domenech-Coca, Cristina</creatorcontrib><creatorcontrib>Canela, Nuria</creatorcontrib><creatorcontrib>del Bas, Josep M.</creatorcontrib><creatorcontrib>Caimari, Antoni</creatorcontrib><creatorcontrib>Puiggròs, Francesc</creatorcontrib><creatorcontrib>MI, Covas</creatorcontrib><creatorcontrib>Arola, Lluís</creatorcontrib><creatorcontrib>Solà, Rosa</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>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pla-Pagà, Laura</au><au>Valls, Rosa M.</au><au>Pedret, Anna</au><au>Calderón-Pérez, Lorena</au><au>Llauradó, Elisabet</au><au>Companys, Judit</au><au>Domenech-Coca, Cristina</au><au>Canela, Nuria</au><au>del Bas, Josep M.</au><au>Caimari, Antoni</au><au>Puiggròs, Francesc</au><au>MI, Covas</au><au>Arola, Lluís</au><au>Solà, Rosa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study)</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2021-12</date><risdate>2021</risdate><volume>40</volume><issue>12</issue><spage>5812</spage><epage>5822</epage><pages>5812-5822</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract>Hesperidin exerts cardiovascular beneficial effects, but its mechanisms of action remain undefined. In a previous study we demonstrated that a single dose and a 12-week treatment of hesperidin decreased systolic blood pressure. The aim of this study was to ascertain the action mechanisms of hesperidin consumption in subjects with elevated blood pressure or with stage 1 hypertension, by determining their transcriptomic profile after a single dose or a 12-week treatment. For transcriptomic analysis, peripheral blood mononuclear cells were obtained from 37 subjects with elevated blood pressure and stage 1 hypertension from CITRUS study who were randomized to receive for 12 weeks: control drink (CD; n = 11), OJ (containing 345 mg of hesperidin; n = 15) or EOJ (containing 600 mg of hesperidin; n = 11). Before starting the 12-weeks treatment, a single dose study with a 6 h of follow-up in each group was performed. After the single dose consumption, EOJ versus OJ, downregulated DHRS9 gene which is related with insulin resistance. Compared to CD, 12-week treatment of EOJ downregulated 6 proinflammatory genes while after OJ consumption only 1 proinflammatory gene was downregulated. Moreover, 12-week treatment of EOJ versus OJ, downregulated acute coronary syndrome gene related (SELENBP1). A single dose consumption of EOJ could protect from insulin resistance. Moreover, EOJ decrease the expression of proinflammatory genes after 12-week treatment providing a possible mechanism of action on inflammation pathway.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34800819</pmid><doi>10.1016/j.clnu.2021.10.009</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6144-0294</orcidid><orcidid>https://orcid.org/0000-0003-1589-4556</orcidid><orcidid>https://orcid.org/0000-0003-1485-0818</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0261-5614
ispartof Clinical nutrition (Edinburgh, Scotland), 2021-12, Vol.40 (12), p.5812-5822
issn 0261-5614
1532-1983
language eng
recordid cdi_proquest_miscellaneous_2600286902
source MEDLINE; Elsevier ScienceDirect Journals
subjects 3-Hydroxysteroid Dehydrogenases - metabolism
Adult
Blood Pressure - genetics
Citrus sinensis
Double-Blind Method
Down-Regulation
Female
Fruit and Vegetable Juices
Gene Expression - drug effects
Hesperidin
Hesperidin - administration & dosage
Hesperidin - pharmacology
Humans
Hypertension - genetics
Hypertensive subjects
Leukocytes, Mononuclear - metabolism
Male
Middle Aged
Orange juice
PBMCs
Plasma
Selenium-Binding Proteins - metabolism
Transcriptome - drug effects
Transcriptomic analysis
title Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study)
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T17%3A05%3A17IST&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=Effect%20of%20the%20consumption%20of%20hesperidin%20in%20orange%20juice%20on%20the%20transcriptomic%20profile%20of%20subjects%20with%20elevated%20blood%20pressure%20and%20stage%201%20hypertension:%20A%20randomized%20controlled%20trial%20(CITRUS%20study)&rft.jtitle=Clinical%20nutrition%20(Edinburgh,%20Scotland)&rft.au=Pla-Pag%C3%A0,%20Laura&rft.date=2021-12&rft.volume=40&rft.issue=12&rft.spage=5812&rft.epage=5822&rft.pages=5812-5822&rft.issn=0261-5614&rft.eissn=1532-1983&rft_id=info:doi/10.1016/j.clnu.2021.10.009&rft_dat=%3Cproquest_cross%3E2600286902%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=2600286902&rft_id=info:pmid/34800819&rft_els_id=S0261561421004787&rfr_iscdi=true