Detecting respiratory chain defects in osteoblasts from osteoarthritic patients using imaging mass cytometry
Osteoporosis is a skeletal disease which is characterised by reduced bone mass and microarchitecture, with a subsequent loss of strength that predisposes to fragility and risk of fractures. The pathogenesis of falling bone mineral density, ultimately leading to a diagnosis of osteoporosis is incompl...
Gespeichert in:
Veröffentlicht in: | Bone (New York, N.Y.) N.Y.), 2022-05, Vol.158, p.116371-116371, Article 116371 |
---|---|
Hauptverfasser: | , , , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 116371 |
---|---|
container_issue | |
container_start_page | 116371 |
container_title | Bone (New York, N.Y.) |
container_volume | 158 |
creator | Hipps, Daniel Dobson, Philip F. Warren, Charlotte McDonald, David Fuller, Andrew Filby, Andrew Bulmer, David Laude, Alex Russell, Oliver Deehan, David J. Turnbull, Doug M. Lawless, Conor |
description | Osteoporosis is a skeletal disease which is characterised by reduced bone mass and microarchitecture, with a subsequent loss of strength that predisposes to fragility and risk of fractures. The pathogenesis of falling bone mineral density, ultimately leading to a diagnosis of osteoporosis is incompletely understood but the disease is currently thought to be multifactorial.
Humans are known to accumulate mitochondrial mutations and respiratory chain deficiency with age and mounting evidence suggests that this may indeed be the overarching cause intrinsic to the changing phenotype in advancing age and age-related disease. Mitochondrial mutations are detectable from the age of about 30 years onwards. Mitochondria contain their own genome which encodes 13 essential mitochondrial proteins and accumulates somatic variants at up to 10 times the rate of the nuclear genome. Once the concentration of any pathogenic mitochondrial genome variant exceeds a threshold, respiratory chain deficiency and cellular dysfunction occur.
The PolgD257A/D257A mouse model is a knock-in mutant that expresses a proof-reading-deficient version of PolgA, a nuclear encoded subunit of mtDNA polymerase. These mice are a useful model of age-related accumulation of mtDNA mutations in humans since their defective proof-reading mechanism leads to a mitochondrial DNA mutation rate 3–5 times higher than in wild-type mice. These mice showed enhanced levels of age-related osteoporosis along with respiratory chain deficiency in osteoblasts. To explore whether respiratory chain deficiency is also seen in human osteoblasts, we developed a protocol and analysis framework for imaging mass cytometry in bone tissue sections to analyse osteoblasts in situ.
By comparing bone tissue sampled at one timepoint from femoral neck of 10 older healthy volunteers aged 40–85 with samples from young patients aged 1–19, we have identified complex I defect in osteoblasts from 6 out of 10 older volunteers, complex II defect in 2 out of 10 older volunteers, complex IV defect in 1 out of 10 older volunteers and complex V defect in 4 out of 10 older volunteers. These observations are consistent with findings from the PolgD257A/D257A mouse model and suggest that respiratory chain deficiency, as a consequence of the accumulation of age-related pathogenic mitochondrial DNA mutations, may play a significant role in the pathogenesis of human age-related osteoporosis.
•We use imaging mass cytometry (IMC) to detect respiratory ch |
doi_str_mv | 10.1016/j.bone.2022.116371 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2632150476</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S8756328222000473</els_id><sourcerecordid>2632150476</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-6cd288ca5b3440be2777b845bef8072a3dd69ace863f1378b51b867ad68922793</originalsourceid><addsrcrecordid>eNp9kMtKxDAUhoMoOo6-gAvp0k3HXNokBTfiHQQ3ug5JeqoZ2mZMMsK8vSlVl67O7T8_53wInRG8Ipjwy_XK-BFWFFO6IoQzQfbQgkjBSio420cLKWpeMirpETqOcY0xZo0gh-iI1aShDW8WqL-FBDa58b0IEDcu6OTDrrAf2o1FC12exSKnPibwptcxl13ww9zQIX0El5wtNjo5GPNwGycvN-j3KQ46xsLukh8ghd0JOuh0H-H0Jy7R2_3d681j-fzy8HRz_VzaCuNUcttSKa2uDasqbIAKIYysagOdxIJq1ra80RYkZx1hQpqaGMmFbrlsKBUNW6KL2XcT_OcWYlKDixb6Xo_gt1FRziipcZUpLRGdpTb4GAN0ahPy8WGnCFYTZbVWE2U1UVYz5bx0_uO_NQO0fyu_WLPgahZA_vLLQVDRZjwWWhcyUdV695__Nzq8kEA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2632150476</pqid></control><display><type>article</type><title>Detecting respiratory chain defects in osteoblasts from osteoarthritic patients using imaging mass cytometry</title><source>Elsevier ScienceDirect Journals Complete - AutoHoldings</source><source>MEDLINE</source><creator>Hipps, Daniel ; Dobson, Philip F. ; Warren, Charlotte ; McDonald, David ; Fuller, Andrew ; Filby, Andrew ; Bulmer, David ; Laude, Alex ; Russell, Oliver ; Deehan, David J. ; Turnbull, Doug M. ; Lawless, Conor</creator><creatorcontrib>Hipps, Daniel ; Dobson, Philip F. ; Warren, Charlotte ; McDonald, David ; Fuller, Andrew ; Filby, Andrew ; Bulmer, David ; Laude, Alex ; Russell, Oliver ; Deehan, David J. ; Turnbull, Doug M. ; Lawless, Conor</creatorcontrib><description>Osteoporosis is a skeletal disease which is characterised by reduced bone mass and microarchitecture, with a subsequent loss of strength that predisposes to fragility and risk of fractures. The pathogenesis of falling bone mineral density, ultimately leading to a diagnosis of osteoporosis is incompletely understood but the disease is currently thought to be multifactorial.
Humans are known to accumulate mitochondrial mutations and respiratory chain deficiency with age and mounting evidence suggests that this may indeed be the overarching cause intrinsic to the changing phenotype in advancing age and age-related disease. Mitochondrial mutations are detectable from the age of about 30 years onwards. Mitochondria contain their own genome which encodes 13 essential mitochondrial proteins and accumulates somatic variants at up to 10 times the rate of the nuclear genome. Once the concentration of any pathogenic mitochondrial genome variant exceeds a threshold, respiratory chain deficiency and cellular dysfunction occur.
The PolgD257A/D257A mouse model is a knock-in mutant that expresses a proof-reading-deficient version of PolgA, a nuclear encoded subunit of mtDNA polymerase. These mice are a useful model of age-related accumulation of mtDNA mutations in humans since their defective proof-reading mechanism leads to a mitochondrial DNA mutation rate 3–5 times higher than in wild-type mice. These mice showed enhanced levels of age-related osteoporosis along with respiratory chain deficiency in osteoblasts. To explore whether respiratory chain deficiency is also seen in human osteoblasts, we developed a protocol and analysis framework for imaging mass cytometry in bone tissue sections to analyse osteoblasts in situ.
By comparing bone tissue sampled at one timepoint from femoral neck of 10 older healthy volunteers aged 40–85 with samples from young patients aged 1–19, we have identified complex I defect in osteoblasts from 6 out of 10 older volunteers, complex II defect in 2 out of 10 older volunteers, complex IV defect in 1 out of 10 older volunteers and complex V defect in 4 out of 10 older volunteers. These observations are consistent with findings from the PolgD257A/D257A mouse model and suggest that respiratory chain deficiency, as a consequence of the accumulation of age-related pathogenic mitochondrial DNA mutations, may play a significant role in the pathogenesis of human age-related osteoporosis.
•We use imaging mass cytometry (IMC) to detect respiratory chain defects in osteoblasts sampled from human bone tissue.•IMC overcomes difficulties with measuring fluorescent signals that arise due to the autofluorescence of human bone.•IMC allows observation of up to 40 proteins simultaneously in single cells within their natural tissue micro-architecture.•We confirm results from mtDNA mutator mouse models: that respiratory chain defects arise alongside osteoporosis in humans.</description><identifier>ISSN: 8756-3282</identifier><identifier>EISSN: 1873-2763</identifier><identifier>DOI: 10.1016/j.bone.2022.116371</identifier><identifier>PMID: 35192969</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aging ; Animals ; DNA, Mitochondrial - genetics ; DNA, Mitochondrial - metabolism ; Electron Transport ; Humans ; Image Cytometry ; Imaging mass cytometry ; Mice ; Mitochondria ; Mitochondria - metabolism ; Mutation - genetics ; Osteoblasts - metabolism ; Osteoporosis ; Respiratory chain defect</subject><ispartof>Bone (New York, N.Y.), 2022-05, Vol.158, p.116371-116371, Article 116371</ispartof><rights>2022 The Authors</rights><rights>Copyright © 2022. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-6cd288ca5b3440be2777b845bef8072a3dd69ace863f1378b51b867ad68922793</citedby><cites>FETCH-LOGICAL-c400t-6cd288ca5b3440be2777b845bef8072a3dd69ace863f1378b51b867ad68922793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.bone.2022.116371$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35192969$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hipps, Daniel</creatorcontrib><creatorcontrib>Dobson, Philip F.</creatorcontrib><creatorcontrib>Warren, Charlotte</creatorcontrib><creatorcontrib>McDonald, David</creatorcontrib><creatorcontrib>Fuller, Andrew</creatorcontrib><creatorcontrib>Filby, Andrew</creatorcontrib><creatorcontrib>Bulmer, David</creatorcontrib><creatorcontrib>Laude, Alex</creatorcontrib><creatorcontrib>Russell, Oliver</creatorcontrib><creatorcontrib>Deehan, David J.</creatorcontrib><creatorcontrib>Turnbull, Doug M.</creatorcontrib><creatorcontrib>Lawless, Conor</creatorcontrib><title>Detecting respiratory chain defects in osteoblasts from osteoarthritic patients using imaging mass cytometry</title><title>Bone (New York, N.Y.)</title><addtitle>Bone</addtitle><description>Osteoporosis is a skeletal disease which is characterised by reduced bone mass and microarchitecture, with a subsequent loss of strength that predisposes to fragility and risk of fractures. The pathogenesis of falling bone mineral density, ultimately leading to a diagnosis of osteoporosis is incompletely understood but the disease is currently thought to be multifactorial.
Humans are known to accumulate mitochondrial mutations and respiratory chain deficiency with age and mounting evidence suggests that this may indeed be the overarching cause intrinsic to the changing phenotype in advancing age and age-related disease. Mitochondrial mutations are detectable from the age of about 30 years onwards. Mitochondria contain their own genome which encodes 13 essential mitochondrial proteins and accumulates somatic variants at up to 10 times the rate of the nuclear genome. Once the concentration of any pathogenic mitochondrial genome variant exceeds a threshold, respiratory chain deficiency and cellular dysfunction occur.
The PolgD257A/D257A mouse model is a knock-in mutant that expresses a proof-reading-deficient version of PolgA, a nuclear encoded subunit of mtDNA polymerase. These mice are a useful model of age-related accumulation of mtDNA mutations in humans since their defective proof-reading mechanism leads to a mitochondrial DNA mutation rate 3–5 times higher than in wild-type mice. These mice showed enhanced levels of age-related osteoporosis along with respiratory chain deficiency in osteoblasts. To explore whether respiratory chain deficiency is also seen in human osteoblasts, we developed a protocol and analysis framework for imaging mass cytometry in bone tissue sections to analyse osteoblasts in situ.
By comparing bone tissue sampled at one timepoint from femoral neck of 10 older healthy volunteers aged 40–85 with samples from young patients aged 1–19, we have identified complex I defect in osteoblasts from 6 out of 10 older volunteers, complex II defect in 2 out of 10 older volunteers, complex IV defect in 1 out of 10 older volunteers and complex V defect in 4 out of 10 older volunteers. These observations are consistent with findings from the PolgD257A/D257A mouse model and suggest that respiratory chain deficiency, as a consequence of the accumulation of age-related pathogenic mitochondrial DNA mutations, may play a significant role in the pathogenesis of human age-related osteoporosis.
•We use imaging mass cytometry (IMC) to detect respiratory chain defects in osteoblasts sampled from human bone tissue.•IMC overcomes difficulties with measuring fluorescent signals that arise due to the autofluorescence of human bone.•IMC allows observation of up to 40 proteins simultaneously in single cells within their natural tissue micro-architecture.•We confirm results from mtDNA mutator mouse models: that respiratory chain defects arise alongside osteoporosis in humans.</description><subject>Aging</subject><subject>Animals</subject><subject>DNA, Mitochondrial - genetics</subject><subject>DNA, Mitochondrial - metabolism</subject><subject>Electron Transport</subject><subject>Humans</subject><subject>Image Cytometry</subject><subject>Imaging mass cytometry</subject><subject>Mice</subject><subject>Mitochondria</subject><subject>Mitochondria - metabolism</subject><subject>Mutation - genetics</subject><subject>Osteoblasts - metabolism</subject><subject>Osteoporosis</subject><subject>Respiratory chain defect</subject><issn>8756-3282</issn><issn>1873-2763</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKxDAUhoMoOo6-gAvp0k3HXNokBTfiHQQ3ug5JeqoZ2mZMMsK8vSlVl67O7T8_53wInRG8Ipjwy_XK-BFWFFO6IoQzQfbQgkjBSio420cLKWpeMirpETqOcY0xZo0gh-iI1aShDW8WqL-FBDa58b0IEDcu6OTDrrAf2o1FC12exSKnPibwptcxl13ww9zQIX0El5wtNjo5GPNwGycvN-j3KQ46xsLukh8ghd0JOuh0H-H0Jy7R2_3d681j-fzy8HRz_VzaCuNUcttSKa2uDasqbIAKIYysagOdxIJq1ra80RYkZx1hQpqaGMmFbrlsKBUNW6KL2XcT_OcWYlKDixb6Xo_gt1FRziipcZUpLRGdpTb4GAN0ahPy8WGnCFYTZbVWE2U1UVYz5bx0_uO_NQO0fyu_WLPgahZA_vLLQVDRZjwWWhcyUdV695__Nzq8kEA</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Hipps, Daniel</creator><creator>Dobson, Philip F.</creator><creator>Warren, Charlotte</creator><creator>McDonald, David</creator><creator>Fuller, Andrew</creator><creator>Filby, Andrew</creator><creator>Bulmer, David</creator><creator>Laude, Alex</creator><creator>Russell, Oliver</creator><creator>Deehan, David J.</creator><creator>Turnbull, Doug M.</creator><creator>Lawless, Conor</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><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>202205</creationdate><title>Detecting respiratory chain defects in osteoblasts from osteoarthritic patients using imaging mass cytometry</title><author>Hipps, Daniel ; Dobson, Philip F. ; Warren, Charlotte ; McDonald, David ; Fuller, Andrew ; Filby, Andrew ; Bulmer, David ; Laude, Alex ; Russell, Oliver ; Deehan, David J. ; Turnbull, Doug M. ; Lawless, Conor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-6cd288ca5b3440be2777b845bef8072a3dd69ace863f1378b51b867ad68922793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aging</topic><topic>Animals</topic><topic>DNA, Mitochondrial - genetics</topic><topic>DNA, Mitochondrial - metabolism</topic><topic>Electron Transport</topic><topic>Humans</topic><topic>Image Cytometry</topic><topic>Imaging mass cytometry</topic><topic>Mice</topic><topic>Mitochondria</topic><topic>Mitochondria - metabolism</topic><topic>Mutation - genetics</topic><topic>Osteoblasts - metabolism</topic><topic>Osteoporosis</topic><topic>Respiratory chain defect</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hipps, Daniel</creatorcontrib><creatorcontrib>Dobson, Philip F.</creatorcontrib><creatorcontrib>Warren, Charlotte</creatorcontrib><creatorcontrib>McDonald, David</creatorcontrib><creatorcontrib>Fuller, Andrew</creatorcontrib><creatorcontrib>Filby, Andrew</creatorcontrib><creatorcontrib>Bulmer, David</creatorcontrib><creatorcontrib>Laude, Alex</creatorcontrib><creatorcontrib>Russell, Oliver</creatorcontrib><creatorcontrib>Deehan, David J.</creatorcontrib><creatorcontrib>Turnbull, Doug M.</creatorcontrib><creatorcontrib>Lawless, Conor</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>Bone (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hipps, Daniel</au><au>Dobson, Philip F.</au><au>Warren, Charlotte</au><au>McDonald, David</au><au>Fuller, Andrew</au><au>Filby, Andrew</au><au>Bulmer, David</au><au>Laude, Alex</au><au>Russell, Oliver</au><au>Deehan, David J.</au><au>Turnbull, Doug M.</au><au>Lawless, Conor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detecting respiratory chain defects in osteoblasts from osteoarthritic patients using imaging mass cytometry</atitle><jtitle>Bone (New York, N.Y.)</jtitle><addtitle>Bone</addtitle><date>2022-05</date><risdate>2022</risdate><volume>158</volume><spage>116371</spage><epage>116371</epage><pages>116371-116371</pages><artnum>116371</artnum><issn>8756-3282</issn><eissn>1873-2763</eissn><abstract>Osteoporosis is a skeletal disease which is characterised by reduced bone mass and microarchitecture, with a subsequent loss of strength that predisposes to fragility and risk of fractures. The pathogenesis of falling bone mineral density, ultimately leading to a diagnosis of osteoporosis is incompletely understood but the disease is currently thought to be multifactorial.
Humans are known to accumulate mitochondrial mutations and respiratory chain deficiency with age and mounting evidence suggests that this may indeed be the overarching cause intrinsic to the changing phenotype in advancing age and age-related disease. Mitochondrial mutations are detectable from the age of about 30 years onwards. Mitochondria contain their own genome which encodes 13 essential mitochondrial proteins and accumulates somatic variants at up to 10 times the rate of the nuclear genome. Once the concentration of any pathogenic mitochondrial genome variant exceeds a threshold, respiratory chain deficiency and cellular dysfunction occur.
The PolgD257A/D257A mouse model is a knock-in mutant that expresses a proof-reading-deficient version of PolgA, a nuclear encoded subunit of mtDNA polymerase. These mice are a useful model of age-related accumulation of mtDNA mutations in humans since their defective proof-reading mechanism leads to a mitochondrial DNA mutation rate 3–5 times higher than in wild-type mice. These mice showed enhanced levels of age-related osteoporosis along with respiratory chain deficiency in osteoblasts. To explore whether respiratory chain deficiency is also seen in human osteoblasts, we developed a protocol and analysis framework for imaging mass cytometry in bone tissue sections to analyse osteoblasts in situ.
By comparing bone tissue sampled at one timepoint from femoral neck of 10 older healthy volunteers aged 40–85 with samples from young patients aged 1–19, we have identified complex I defect in osteoblasts from 6 out of 10 older volunteers, complex II defect in 2 out of 10 older volunteers, complex IV defect in 1 out of 10 older volunteers and complex V defect in 4 out of 10 older volunteers. These observations are consistent with findings from the PolgD257A/D257A mouse model and suggest that respiratory chain deficiency, as a consequence of the accumulation of age-related pathogenic mitochondrial DNA mutations, may play a significant role in the pathogenesis of human age-related osteoporosis.
•We use imaging mass cytometry (IMC) to detect respiratory chain defects in osteoblasts sampled from human bone tissue.•IMC overcomes difficulties with measuring fluorescent signals that arise due to the autofluorescence of human bone.•IMC allows observation of up to 40 proteins simultaneously in single cells within their natural tissue micro-architecture.•We confirm results from mtDNA mutator mouse models: that respiratory chain defects arise alongside osteoporosis in humans.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35192969</pmid><doi>10.1016/j.bone.2022.116371</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 8756-3282 |
ispartof | Bone (New York, N.Y.), 2022-05, Vol.158, p.116371-116371, Article 116371 |
issn | 8756-3282 1873-2763 |
language | eng |
recordid | cdi_proquest_miscellaneous_2632150476 |
source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE |
subjects | Aging Animals DNA, Mitochondrial - genetics DNA, Mitochondrial - metabolism Electron Transport Humans Image Cytometry Imaging mass cytometry Mice Mitochondria Mitochondria - metabolism Mutation - genetics Osteoblasts - metabolism Osteoporosis Respiratory chain defect |
title | Detecting respiratory chain defects in osteoblasts from osteoarthritic patients using imaging mass cytometry |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-05T04%3A03%3A32IST&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=Detecting%20respiratory%20chain%20defects%20in%20osteoblasts%20from%20osteoarthritic%20patients%20using%20imaging%20mass%20cytometry&rft.jtitle=Bone%20(New%20York,%20N.Y.)&rft.au=Hipps,%20Daniel&rft.date=2022-05&rft.volume=158&rft.spage=116371&rft.epage=116371&rft.pages=116371-116371&rft.artnum=116371&rft.issn=8756-3282&rft.eissn=1873-2763&rft_id=info:doi/10.1016/j.bone.2022.116371&rft_dat=%3Cproquest_cross%3E2632150476%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=2632150476&rft_id=info:pmid/35192969&rft_els_id=S8756328222000473&rfr_iscdi=true |