Ischemic postconditioning protects against acute kidney injury after limb ischemia reperfusion by regulating HMGB1 release and autophagy

Ischemic postconditioning (I-PostC) has a protective effect against acute kidney injury (AKI) induced by limb ischemia-reperfusion (LIR); however, the exact mechanism remains to be elucidated. Our study aims to investigate the potential involvement of high-mobility group box 1 protein (HMGB1) and au...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Renal failure 2023-12, Vol.45 (1), p.2189482-2189482
Hauptverfasser: Liu, Zhongdi, Chen, Yifan, Du, Zhe, Zhu, Fengxue, Huang, Wei
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 2189482
container_issue 1
container_start_page 2189482
container_title Renal failure
container_volume 45
creator Liu, Zhongdi
Chen, Yifan
Du, Zhe
Zhu, Fengxue
Huang, Wei
description Ischemic postconditioning (I-PostC) has a protective effect against acute kidney injury (AKI) induced by limb ischemia-reperfusion (LIR); however, the exact mechanism remains to be elucidated. Our study aims to investigate the potential involvement of high-mobility group box 1 protein (HMGB1) and autophagy in renoprotection generated by I-PostC. A rat model of LIR-induced AKI was established and rats were randomly assigned to five groups: (i) sham-operated control, (ii) I/R, (iii) I/R + I-PostC, (iv) I/R + I-PostC + rapamycin (autophagy activator), and (v) I/R + I-PostC + 3-methyladenine (autophagy inhibitor). Morphological changes in the kidneys were assessed by histology, and ultrastructural changes in renal tubular epithelial cells and glomerular podocytes were observed by transmission electron microscopy. The levels of kidney function parameters, serum inflammatory factors, and autophagy markers were detected. The results showed that the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines (TNF-α and IL-6) were significantly higher in the I/R group compared to the sham control in serum and in renal tissues. I-PostC significantly reduced the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines in renal tissues and improved renal function. Renal histopathology and ultrastructural observations indicated that I-PostC alleviated renal tissue injury. In addition, rapamycin (autophagy activator) treatment increased the levels of inflammatory cytokine expression levels and decreased renal function, reversed the protective effect of I-PostC against LIR-induced AKI. In conclusion, I-PostC could play a protective role against AKI by regulating the release of HMGB1 and inhibiting autophagy activation.
doi_str_mv 10.1080/0886022X.2023.2189482
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10171135</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_295f13c9ec3e4ec5b1205361915ceb6b</doaj_id><sourcerecordid>2871513955</sourcerecordid><originalsourceid>FETCH-LOGICAL-c511t-c52bd502411e00536bc152a2bc8f7f8ff585c3bae1c90fed706747fb552b25dc3</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEokvhEUCWuHDZxePEm-QEpYJ2pSIuIHGzHGec9ZLYwXZAeQMeG4fdVpQDF_8Zf_Mbj_1l2XOgG6AVfU2raksZ-7phlOUbBlVdVOxBtgLO-HpLi_phtlo060V0lj0J4UAp8Kpkj7OzvEyrnMIq-7ULao-DUWR0ISpnWxONs8Z2ZPQuooqByE4aGyKRaopIvpnW4kyMPUx-JlJH9KQ3Q0PMkSSJxxG9nkLikGZO227qZVyQ1x-v3kEK9CgDEmlbIqfoxr3s5qfZIy37gM9O83n25cP7z5fX65tPV7vLi5u14gAxjaxpOWUFAFLK822jUseSNarSpa605hVXeSMRVE01tiXdlkWpG57yGG9Vfp7tjtzWyYMYvRmkn4WTRvwJON8J6aNRPQpWcw25qlHlWKDiDbClItTAFTbbJrHeHFnj1AzYKrTRy_4e9P6JNXvRuR8CKJQAOU-EVyeCd98nDFEM6Rmx76VFNwXBKgBe0qKskvTlP9KDm7xNb5VU6T8hr_kC5EeV8i4Ej_ruNkDFYhxxaxyxGEecjJPyXvzdyl3WrVOS4O1RYKx2fpA_ne9bEeXcO6-9tMoEkf-_xm8IBdW7</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2871513955</pqid></control><display><type>article</type><title>Ischemic postconditioning protects against acute kidney injury after limb ischemia reperfusion by regulating HMGB1 release and autophagy</title><source>Taylor &amp; Francis Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Liu, Zhongdi ; Chen, Yifan ; Du, Zhe ; Zhu, Fengxue ; Huang, Wei</creator><creatorcontrib>Liu, Zhongdi ; Chen, Yifan ; Du, Zhe ; Zhu, Fengxue ; Huang, Wei</creatorcontrib><description>Ischemic postconditioning (I-PostC) has a protective effect against acute kidney injury (AKI) induced by limb ischemia-reperfusion (LIR); however, the exact mechanism remains to be elucidated. Our study aims to investigate the potential involvement of high-mobility group box 1 protein (HMGB1) and autophagy in renoprotection generated by I-PostC. A rat model of LIR-induced AKI was established and rats were randomly assigned to five groups: (i) sham-operated control, (ii) I/R, (iii) I/R + I-PostC, (iv) I/R + I-PostC + rapamycin (autophagy activator), and (v) I/R + I-PostC + 3-methyladenine (autophagy inhibitor). Morphological changes in the kidneys were assessed by histology, and ultrastructural changes in renal tubular epithelial cells and glomerular podocytes were observed by transmission electron microscopy. The levels of kidney function parameters, serum inflammatory factors, and autophagy markers were detected. The results showed that the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines (TNF-α and IL-6) were significantly higher in the I/R group compared to the sham control in serum and in renal tissues. I-PostC significantly reduced the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines in renal tissues and improved renal function. Renal histopathology and ultrastructural observations indicated that I-PostC alleviated renal tissue injury. In addition, rapamycin (autophagy activator) treatment increased the levels of inflammatory cytokine expression levels and decreased renal function, reversed the protective effect of I-PostC against LIR-induced AKI. In conclusion, I-PostC could play a protective role against AKI by regulating the release of HMGB1 and inhibiting autophagy activation.</description><identifier>ISSN: 0886-022X</identifier><identifier>EISSN: 1525-6049</identifier><identifier>DOI: 10.1080/0886022X.2023.2189482</identifier><identifier>PMID: 37158301</identifier><language>eng</language><publisher>England: Taylor &amp; Francis</publisher><subject>Acute Kidney Injury - etiology ; Acute Kidney Injury - prevention &amp; control ; Animals ; Autophagy ; Beclin-1 - metabolism ; Clinical Study ; Cytokines ; Epithelial cells ; HMGB1 ; HMGB1 Protein ; Inflammation ; Ischemia ; ischemic postconditioning ; Ischemic Postconditioning - methods ; kidney ; Kidneys ; Limb ischemia ; Rapamycin ; Rats ; Renal function ; Reperfusion ; Reperfusion Injury - complications ; Reperfusion Injury - prevention &amp; control ; Sirolimus - pharmacology ; Transmission electron microscopy ; Tumor necrosis factor-α</subject><ispartof>Renal failure, 2023-12, Vol.45 (1), p.2189482-2189482</ispartof><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor &amp; Francis Group. 2023</rights><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor &amp; Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor &amp; Francis Group. 2023 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c511t-c52bd502411e00536bc152a2bc8f7f8ff585c3bae1c90fed706747fb552b25dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171135/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171135/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27502,27924,27925,53791,53793,59143,59144</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37158301$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Zhongdi</creatorcontrib><creatorcontrib>Chen, Yifan</creatorcontrib><creatorcontrib>Du, Zhe</creatorcontrib><creatorcontrib>Zhu, Fengxue</creatorcontrib><creatorcontrib>Huang, Wei</creatorcontrib><title>Ischemic postconditioning protects against acute kidney injury after limb ischemia reperfusion by regulating HMGB1 release and autophagy</title><title>Renal failure</title><addtitle>Ren Fail</addtitle><description>Ischemic postconditioning (I-PostC) has a protective effect against acute kidney injury (AKI) induced by limb ischemia-reperfusion (LIR); however, the exact mechanism remains to be elucidated. Our study aims to investigate the potential involvement of high-mobility group box 1 protein (HMGB1) and autophagy in renoprotection generated by I-PostC. A rat model of LIR-induced AKI was established and rats were randomly assigned to five groups: (i) sham-operated control, (ii) I/R, (iii) I/R + I-PostC, (iv) I/R + I-PostC + rapamycin (autophagy activator), and (v) I/R + I-PostC + 3-methyladenine (autophagy inhibitor). Morphological changes in the kidneys were assessed by histology, and ultrastructural changes in renal tubular epithelial cells and glomerular podocytes were observed by transmission electron microscopy. The levels of kidney function parameters, serum inflammatory factors, and autophagy markers were detected. The results showed that the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines (TNF-α and IL-6) were significantly higher in the I/R group compared to the sham control in serum and in renal tissues. I-PostC significantly reduced the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines in renal tissues and improved renal function. Renal histopathology and ultrastructural observations indicated that I-PostC alleviated renal tissue injury. In addition, rapamycin (autophagy activator) treatment increased the levels of inflammatory cytokine expression levels and decreased renal function, reversed the protective effect of I-PostC against LIR-induced AKI. In conclusion, I-PostC could play a protective role against AKI by regulating the release of HMGB1 and inhibiting autophagy activation.</description><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - prevention &amp; control</subject><subject>Animals</subject><subject>Autophagy</subject><subject>Beclin-1 - metabolism</subject><subject>Clinical Study</subject><subject>Cytokines</subject><subject>Epithelial cells</subject><subject>HMGB1</subject><subject>HMGB1 Protein</subject><subject>Inflammation</subject><subject>Ischemia</subject><subject>ischemic postconditioning</subject><subject>Ischemic Postconditioning - methods</subject><subject>kidney</subject><subject>Kidneys</subject><subject>Limb ischemia</subject><subject>Rapamycin</subject><subject>Rats</subject><subject>Renal function</subject><subject>Reperfusion</subject><subject>Reperfusion Injury - complications</subject><subject>Reperfusion Injury - prevention &amp; control</subject><subject>Sirolimus - pharmacology</subject><subject>Transmission electron microscopy</subject><subject>Tumor necrosis factor-α</subject><issn>0886-022X</issn><issn>1525-6049</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><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>eNp9ks9u1DAQxiMEokvhEUCWuHDZxePEm-QEpYJ2pSIuIHGzHGec9ZLYwXZAeQMeG4fdVpQDF_8Zf_Mbj_1l2XOgG6AVfU2raksZ-7phlOUbBlVdVOxBtgLO-HpLi_phtlo060V0lj0J4UAp8Kpkj7OzvEyrnMIq-7ULao-DUWR0ISpnWxONs8Z2ZPQuooqByE4aGyKRaopIvpnW4kyMPUx-JlJH9KQ3Q0PMkSSJxxG9nkLikGZO227qZVyQ1x-v3kEK9CgDEmlbIqfoxr3s5qfZIy37gM9O83n25cP7z5fX65tPV7vLi5u14gAxjaxpOWUFAFLK822jUseSNarSpa605hVXeSMRVE01tiXdlkWpG57yGG9Vfp7tjtzWyYMYvRmkn4WTRvwJON8J6aNRPQpWcw25qlHlWKDiDbClItTAFTbbJrHeHFnj1AzYKrTRy_4e9P6JNXvRuR8CKJQAOU-EVyeCd98nDFEM6Rmx76VFNwXBKgBe0qKskvTlP9KDm7xNb5VU6T8hr_kC5EeV8i4Ej_ruNkDFYhxxaxyxGEecjJPyXvzdyl3WrVOS4O1RYKx2fpA_ne9bEeXcO6-9tMoEkf-_xm8IBdW7</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Liu, Zhongdi</creator><creator>Chen, Yifan</creator><creator>Du, Zhe</creator><creator>Zhu, Fengxue</creator><creator>Huang, Wei</creator><general>Taylor &amp; Francis</general><general>Taylor &amp; Francis Ltd</general><general>Taylor &amp; Francis Group</general><scope>0YH</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>3V.</scope><scope>7T5</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</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></search><sort><creationdate>202312</creationdate><title>Ischemic postconditioning protects against acute kidney injury after limb ischemia reperfusion by regulating HMGB1 release and autophagy</title><author>Liu, Zhongdi ; Chen, Yifan ; Du, Zhe ; Zhu, Fengxue ; Huang, Wei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-c52bd502411e00536bc152a2bc8f7f8ff585c3bae1c90fed706747fb552b25dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - prevention &amp; control</topic><topic>Animals</topic><topic>Autophagy</topic><topic>Beclin-1 - metabolism</topic><topic>Clinical Study</topic><topic>Cytokines</topic><topic>Epithelial cells</topic><topic>HMGB1</topic><topic>HMGB1 Protein</topic><topic>Inflammation</topic><topic>Ischemia</topic><topic>ischemic postconditioning</topic><topic>Ischemic Postconditioning - methods</topic><topic>kidney</topic><topic>Kidneys</topic><topic>Limb ischemia</topic><topic>Rapamycin</topic><topic>Rats</topic><topic>Renal function</topic><topic>Reperfusion</topic><topic>Reperfusion Injury - complications</topic><topic>Reperfusion Injury - prevention &amp; control</topic><topic>Sirolimus - pharmacology</topic><topic>Transmission electron microscopy</topic><topic>Tumor necrosis factor-α</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Zhongdi</creatorcontrib><creatorcontrib>Chen, Yifan</creatorcontrib><creatorcontrib>Du, Zhe</creatorcontrib><creatorcontrib>Zhu, Fengxue</creatorcontrib><creatorcontrib>Huang, Wei</creatorcontrib><collection>Taylor &amp; Francis 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>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</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>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</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>Renal failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Zhongdi</au><au>Chen, Yifan</au><au>Du, Zhe</au><au>Zhu, Fengxue</au><au>Huang, Wei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ischemic postconditioning protects against acute kidney injury after limb ischemia reperfusion by regulating HMGB1 release and autophagy</atitle><jtitle>Renal failure</jtitle><addtitle>Ren Fail</addtitle><date>2023-12</date><risdate>2023</risdate><volume>45</volume><issue>1</issue><spage>2189482</spage><epage>2189482</epage><pages>2189482-2189482</pages><issn>0886-022X</issn><eissn>1525-6049</eissn><abstract>Ischemic postconditioning (I-PostC) has a protective effect against acute kidney injury (AKI) induced by limb ischemia-reperfusion (LIR); however, the exact mechanism remains to be elucidated. Our study aims to investigate the potential involvement of high-mobility group box 1 protein (HMGB1) and autophagy in renoprotection generated by I-PostC. A rat model of LIR-induced AKI was established and rats were randomly assigned to five groups: (i) sham-operated control, (ii) I/R, (iii) I/R + I-PostC, (iv) I/R + I-PostC + rapamycin (autophagy activator), and (v) I/R + I-PostC + 3-methyladenine (autophagy inhibitor). Morphological changes in the kidneys were assessed by histology, and ultrastructural changes in renal tubular epithelial cells and glomerular podocytes were observed by transmission electron microscopy. The levels of kidney function parameters, serum inflammatory factors, and autophagy markers were detected. The results showed that the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines (TNF-α and IL-6) were significantly higher in the I/R group compared to the sham control in serum and in renal tissues. I-PostC significantly reduced the levels of HMGB1, Beclin1, LC3-II/LC3-I, and inflammatory cytokines in renal tissues and improved renal function. Renal histopathology and ultrastructural observations indicated that I-PostC alleviated renal tissue injury. In addition, rapamycin (autophagy activator) treatment increased the levels of inflammatory cytokine expression levels and decreased renal function, reversed the protective effect of I-PostC against LIR-induced AKI. In conclusion, I-PostC could play a protective role against AKI by regulating the release of HMGB1 and inhibiting autophagy activation.</abstract><cop>England</cop><pub>Taylor &amp; Francis</pub><pmid>37158301</pmid><doi>10.1080/0886022X.2023.2189482</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0886-022X
ispartof Renal failure, 2023-12, Vol.45 (1), p.2189482-2189482
issn 0886-022X
1525-6049
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10171135
source Taylor & Francis Open Access; MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central; Alma/SFX Local Collection
subjects Acute Kidney Injury - etiology
Acute Kidney Injury - prevention & control
Animals
Autophagy
Beclin-1 - metabolism
Clinical Study
Cytokines
Epithelial cells
HMGB1
HMGB1 Protein
Inflammation
Ischemia
ischemic postconditioning
Ischemic Postconditioning - methods
kidney
Kidneys
Limb ischemia
Rapamycin
Rats
Renal function
Reperfusion
Reperfusion Injury - complications
Reperfusion Injury - prevention & control
Sirolimus - pharmacology
Transmission electron microscopy
Tumor necrosis factor-α
title Ischemic postconditioning protects against acute kidney injury after limb ischemia reperfusion by regulating HMGB1 release and autophagy
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T23%3A56%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ischemic%20postconditioning%20protects%20against%20acute%20kidney%20injury%20after%20limb%20ischemia%20reperfusion%20by%20regulating%20HMGB1%20release%20and%20autophagy&rft.jtitle=Renal%20failure&rft.au=Liu,%20Zhongdi&rft.date=2023-12&rft.volume=45&rft.issue=1&rft.spage=2189482&rft.epage=2189482&rft.pages=2189482-2189482&rft.issn=0886-022X&rft.eissn=1525-6049&rft_id=info:doi/10.1080/0886022X.2023.2189482&rft_dat=%3Cproquest_pubme%3E2871513955%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2871513955&rft_id=info:pmid/37158301&rft_doaj_id=oai_doaj_org_article_295f13c9ec3e4ec5b1205361915ceb6b&rfr_iscdi=true