Early‐life behavioral features are associated with chronic emesis in rhesus macaques (Macaca mulatta)

Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Early identification of risk factors for the development of CE is likely to improve the ability to manage CE cases successfully and is, therefore, desirable. Using a case‐...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:American journal of primatology 2023-06, Vol.85 (6), p.e23488-n/a
Hauptverfasser: Nakatani, Jamie Y., Pomerantz, Ori, Stockinger, Diane, Christe, Kari, Hopkins, Lincoln, Roberts, Jeffrey A., Reader, Rachel J., Ardeshir, Amir
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page n/a
container_issue 6
container_start_page e23488
container_title American journal of primatology
container_volume 85
creator Nakatani, Jamie Y.
Pomerantz, Ori
Stockinger, Diane
Christe, Kari
Hopkins, Lincoln
Roberts, Jeffrey A.
Reader, Rachel J.
Ardeshir, Amir
description Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Early identification of risk factors for the development of CE is likely to improve the ability to manage CE cases successfully and is, therefore, desirable. Using a case‐control study, we reviewed the necropsy records of the California National Primate Research Center and identified 24 animals with recorded CE, defined as five or more incidents of emesis in 1 month. A group of 89 healthy rhesus macaques (Macaca mulatta), comparable in age and percent time housed indoors, was similarly identified. Next, we investigated the association between the occurrence of CE during later stages of life after infancy and the behavioral temperament scores attained in infancy, age, sex, birth location, rearing condition, history of self‐injurious behavior (SIB), and the number of lifetime sedation events. Our analysis revealed that CE was associated with degrees of temperament constructs obtained in infancy (data was available for n = 113), such as Confidence (odds ratio (OR) = 0.45, 95% CI: 0.18, 1.08, p = 0.07), Gentleness (OR = 0.47, 95% CI: 0.23, 0.96, p = 0.03), Nervousness (OR = 2.04, 95% CI: 0.98, 4.23, p = 0.05), and Vigilance (OR = 0.36, 95% CI: 015, 0.87, p = 0.02), suggesting that CE is linked to behavioral phenomenon measured in early life, long before it becomes a medical concern. Our data suggest that CE was positively correlated with a history of SIB (OR 4.26, 95% CI: 0.98, 18.47, p = 0.04). Accurate prediction of CE can then assist behavioral and colony management professionals in making informed decisions regarding the care of animals at risk of developing CE. Moreover, the novel information we reported here could have valuable implications in human medicine, where gastrointestinal distress is a common complaint affecting a person's quality of life. Early‐life behavioral temperament predicts later‐stage chronic emesis in rhesus macaques, highlighting influential risk factors. Research Highlights Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Our results suggest that features of early‐life behavioral temperaments are linked to the development of chronic emesis in the later stages of life.
doi_str_mv 10.1002/ajp.23488
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10231223</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2814349108</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4048-9d873ceaabe403df228598fb0730b52f6bf99de23af6dbf6c12f413b23062f223</originalsourceid><addsrcrecordid>eNp1kctu1DAUhi0EotPCghdAlti0i7S-JeOsUFW1XFQEC1hbJ85x41ESD3bSanY8As_YJ6mHKVWpxMq2zudP59dPyBvOjjlj4gRW62MhldbPyIKzWhf5UT4nCyaWZSHKqtwj-ymtGONcVeVLsierellyxRfk6hxiv7n99bv3DmmDHVz7EKGnDmGaIyYKESmkFKyHCVt646eO2i6G0VuKAyafqB9p7DDNiQ5g4eecfx1-yTcLdJh7mCY4ekVeOOgTvr4_D8iPi_PvZx-Ly68fPp2dXhZWMaWLutVLaRGgQcVk64TQZa1dw5aSNaVwVePqukUhwVVt4yrLhVNcNkKySmRaHpD3O-96bgZsLY5TTmPW0Q8QNyaAN_9ORt-Zq3BtOBOSZ0E2HN4bYthGmczgk8W-hxHDnIzQnNdS570y-u4JugpzHHO-LaWkqjnTmTraUTaGlCK6h204M9v-TO7P_Okvs28fr_9A_i0sAyc74Mb3uPm_yZx-_rZT3gG3NKbS</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2814349108</pqid></control><display><type>article</type><title>Early‐life behavioral features are associated with chronic emesis in rhesus macaques (Macaca mulatta)</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Nakatani, Jamie Y. ; Pomerantz, Ori ; Stockinger, Diane ; Christe, Kari ; Hopkins, Lincoln ; Roberts, Jeffrey A. ; Reader, Rachel J. ; Ardeshir, Amir</creator><creatorcontrib>Nakatani, Jamie Y. ; Pomerantz, Ori ; Stockinger, Diane ; Christe, Kari ; Hopkins, Lincoln ; Roberts, Jeffrey A. ; Reader, Rachel J. ; Ardeshir, Amir</creatorcontrib><description>Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Early identification of risk factors for the development of CE is likely to improve the ability to manage CE cases successfully and is, therefore, desirable. Using a case‐control study, we reviewed the necropsy records of the California National Primate Research Center and identified 24 animals with recorded CE, defined as five or more incidents of emesis in 1 month. A group of 89 healthy rhesus macaques (Macaca mulatta), comparable in age and percent time housed indoors, was similarly identified. Next, we investigated the association between the occurrence of CE during later stages of life after infancy and the behavioral temperament scores attained in infancy, age, sex, birth location, rearing condition, history of self‐injurious behavior (SIB), and the number of lifetime sedation events. Our analysis revealed that CE was associated with degrees of temperament constructs obtained in infancy (data was available for n = 113), such as Confidence (odds ratio (OR) = 0.45, 95% CI: 0.18, 1.08, p = 0.07), Gentleness (OR = 0.47, 95% CI: 0.23, 0.96, p = 0.03), Nervousness (OR = 2.04, 95% CI: 0.98, 4.23, p = 0.05), and Vigilance (OR = 0.36, 95% CI: 015, 0.87, p = 0.02), suggesting that CE is linked to behavioral phenomenon measured in early life, long before it becomes a medical concern. Our data suggest that CE was positively correlated with a history of SIB (OR 4.26, 95% CI: 0.98, 18.47, p = 0.04). Accurate prediction of CE can then assist behavioral and colony management professionals in making informed decisions regarding the care of animals at risk of developing CE. Moreover, the novel information we reported here could have valuable implications in human medicine, where gastrointestinal distress is a common complaint affecting a person's quality of life. Early‐life behavioral temperament predicts later‐stage chronic emesis in rhesus macaques, highlighting influential risk factors. Research Highlights Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Our results suggest that features of early‐life behavioral temperaments are linked to the development of chronic emesis in the later stages of life.</description><identifier>ISSN: 0275-2565</identifier><identifier>EISSN: 1098-2345</identifier><identifier>DOI: 10.1002/ajp.23488</identifier><identifier>PMID: 36975141</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Animals ; Behavior ; Case-Control Studies ; chronic emesis ; early life biobehavioral temperament ; Humans ; Infancy ; Macaca mulatta ; Necropsy ; Primates ; Psychological distress ; Quality of Life ; Research facilities ; rhesus macaque ; Risk factors ; Sedation ; Temperament ; Vigilance ; Vomiting ; Vomiting - etiology ; Vomiting - veterinary</subject><ispartof>American journal of primatology, 2023-06, Vol.85 (6), p.e23488-n/a</ispartof><rights>2023 The Authors. published by Wiley Periodicals LLC.</rights><rights>2023 The Authors. American Journal of Primatology published by Wiley Periodicals LLC.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4048-9d873ceaabe403df228598fb0730b52f6bf99de23af6dbf6c12f413b23062f223</cites><orcidid>0000-0002-3874-3585 ; 0000-0002-6031-8251 ; 0000-0002-3339-6772 ; 0000-0002-4330-4659</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fajp.23488$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fajp.23488$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36975141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakatani, Jamie Y.</creatorcontrib><creatorcontrib>Pomerantz, Ori</creatorcontrib><creatorcontrib>Stockinger, Diane</creatorcontrib><creatorcontrib>Christe, Kari</creatorcontrib><creatorcontrib>Hopkins, Lincoln</creatorcontrib><creatorcontrib>Roberts, Jeffrey A.</creatorcontrib><creatorcontrib>Reader, Rachel J.</creatorcontrib><creatorcontrib>Ardeshir, Amir</creatorcontrib><title>Early‐life behavioral features are associated with chronic emesis in rhesus macaques (Macaca mulatta)</title><title>American journal of primatology</title><addtitle>Am J Primatol</addtitle><description>Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Early identification of risk factors for the development of CE is likely to improve the ability to manage CE cases successfully and is, therefore, desirable. Using a case‐control study, we reviewed the necropsy records of the California National Primate Research Center and identified 24 animals with recorded CE, defined as five or more incidents of emesis in 1 month. A group of 89 healthy rhesus macaques (Macaca mulatta), comparable in age and percent time housed indoors, was similarly identified. Next, we investigated the association between the occurrence of CE during later stages of life after infancy and the behavioral temperament scores attained in infancy, age, sex, birth location, rearing condition, history of self‐injurious behavior (SIB), and the number of lifetime sedation events. Our analysis revealed that CE was associated with degrees of temperament constructs obtained in infancy (data was available for n = 113), such as Confidence (odds ratio (OR) = 0.45, 95% CI: 0.18, 1.08, p = 0.07), Gentleness (OR = 0.47, 95% CI: 0.23, 0.96, p = 0.03), Nervousness (OR = 2.04, 95% CI: 0.98, 4.23, p = 0.05), and Vigilance (OR = 0.36, 95% CI: 015, 0.87, p = 0.02), suggesting that CE is linked to behavioral phenomenon measured in early life, long before it becomes a medical concern. Our data suggest that CE was positively correlated with a history of SIB (OR 4.26, 95% CI: 0.98, 18.47, p = 0.04). Accurate prediction of CE can then assist behavioral and colony management professionals in making informed decisions regarding the care of animals at risk of developing CE. Moreover, the novel information we reported here could have valuable implications in human medicine, where gastrointestinal distress is a common complaint affecting a person's quality of life. Early‐life behavioral temperament predicts later‐stage chronic emesis in rhesus macaques, highlighting influential risk factors. Research Highlights Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Our results suggest that features of early‐life behavioral temperaments are linked to the development of chronic emesis in the later stages of life.</description><subject>Animals</subject><subject>Behavior</subject><subject>Case-Control Studies</subject><subject>chronic emesis</subject><subject>early life biobehavioral temperament</subject><subject>Humans</subject><subject>Infancy</subject><subject>Macaca mulatta</subject><subject>Necropsy</subject><subject>Primates</subject><subject>Psychological distress</subject><subject>Quality of Life</subject><subject>Research facilities</subject><subject>rhesus macaque</subject><subject>Risk factors</subject><subject>Sedation</subject><subject>Temperament</subject><subject>Vigilance</subject><subject>Vomiting</subject><subject>Vomiting - etiology</subject><subject>Vomiting - veterinary</subject><issn>0275-2565</issn><issn>1098-2345</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhi0EotPCghdAlti0i7S-JeOsUFW1XFQEC1hbJ85x41ESD3bSanY8As_YJ6mHKVWpxMq2zudP59dPyBvOjjlj4gRW62MhldbPyIKzWhf5UT4nCyaWZSHKqtwj-ymtGONcVeVLsierellyxRfk6hxiv7n99bv3DmmDHVz7EKGnDmGaIyYKESmkFKyHCVt646eO2i6G0VuKAyafqB9p7DDNiQ5g4eecfx1-yTcLdJh7mCY4ekVeOOgTvr4_D8iPi_PvZx-Ly68fPp2dXhZWMaWLutVLaRGgQcVk64TQZa1dw5aSNaVwVePqukUhwVVt4yrLhVNcNkKySmRaHpD3O-96bgZsLY5TTmPW0Q8QNyaAN_9ORt-Zq3BtOBOSZ0E2HN4bYthGmczgk8W-hxHDnIzQnNdS570y-u4JugpzHHO-LaWkqjnTmTraUTaGlCK6h204M9v-TO7P_Okvs28fr_9A_i0sAyc74Mb3uPm_yZx-_rZT3gG3NKbS</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Nakatani, Jamie Y.</creator><creator>Pomerantz, Ori</creator><creator>Stockinger, Diane</creator><creator>Christe, Kari</creator><creator>Hopkins, Lincoln</creator><creator>Roberts, Jeffrey A.</creator><creator>Reader, Rachel J.</creator><creator>Ardeshir, Amir</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</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>7QG</scope><scope>7SN</scope><scope>7TK</scope><scope>8BJ</scope><scope>8FD</scope><scope>C1K</scope><scope>FQK</scope><scope>FR3</scope><scope>JBE</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3874-3585</orcidid><orcidid>https://orcid.org/0000-0002-6031-8251</orcidid><orcidid>https://orcid.org/0000-0002-3339-6772</orcidid><orcidid>https://orcid.org/0000-0002-4330-4659</orcidid></search><sort><creationdate>202306</creationdate><title>Early‐life behavioral features are associated with chronic emesis in rhesus macaques (Macaca mulatta)</title><author>Nakatani, Jamie Y. ; Pomerantz, Ori ; Stockinger, Diane ; Christe, Kari ; Hopkins, Lincoln ; Roberts, Jeffrey A. ; Reader, Rachel J. ; Ardeshir, Amir</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4048-9d873ceaabe403df228598fb0730b52f6bf99de23af6dbf6c12f413b23062f223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Animals</topic><topic>Behavior</topic><topic>Case-Control Studies</topic><topic>chronic emesis</topic><topic>early life biobehavioral temperament</topic><topic>Humans</topic><topic>Infancy</topic><topic>Macaca mulatta</topic><topic>Necropsy</topic><topic>Primates</topic><topic>Psychological distress</topic><topic>Quality of Life</topic><topic>Research facilities</topic><topic>rhesus macaque</topic><topic>Risk factors</topic><topic>Sedation</topic><topic>Temperament</topic><topic>Vigilance</topic><topic>Vomiting</topic><topic>Vomiting - etiology</topic><topic>Vomiting - veterinary</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakatani, Jamie Y.</creatorcontrib><creatorcontrib>Pomerantz, Ori</creatorcontrib><creatorcontrib>Stockinger, Diane</creatorcontrib><creatorcontrib>Christe, Kari</creatorcontrib><creatorcontrib>Hopkins, Lincoln</creatorcontrib><creatorcontrib>Roberts, Jeffrey A.</creatorcontrib><creatorcontrib>Reader, Rachel J.</creatorcontrib><creatorcontrib>Ardeshir, Amir</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley 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>Animal Behavior Abstracts</collection><collection>Ecology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>International Bibliography of the Social Sciences</collection><collection>Engineering Research Database</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of primatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakatani, Jamie Y.</au><au>Pomerantz, Ori</au><au>Stockinger, Diane</au><au>Christe, Kari</au><au>Hopkins, Lincoln</au><au>Roberts, Jeffrey A.</au><au>Reader, Rachel J.</au><au>Ardeshir, Amir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early‐life behavioral features are associated with chronic emesis in rhesus macaques (Macaca mulatta)</atitle><jtitle>American journal of primatology</jtitle><addtitle>Am J Primatol</addtitle><date>2023-06</date><risdate>2023</risdate><volume>85</volume><issue>6</issue><spage>e23488</spage><epage>n/a</epage><pages>e23488-n/a</pages><issn>0275-2565</issn><eissn>1098-2345</eissn><abstract>Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Early identification of risk factors for the development of CE is likely to improve the ability to manage CE cases successfully and is, therefore, desirable. Using a case‐control study, we reviewed the necropsy records of the California National Primate Research Center and identified 24 animals with recorded CE, defined as five or more incidents of emesis in 1 month. A group of 89 healthy rhesus macaques (Macaca mulatta), comparable in age and percent time housed indoors, was similarly identified. Next, we investigated the association between the occurrence of CE during later stages of life after infancy and the behavioral temperament scores attained in infancy, age, sex, birth location, rearing condition, history of self‐injurious behavior (SIB), and the number of lifetime sedation events. Our analysis revealed that CE was associated with degrees of temperament constructs obtained in infancy (data was available for n = 113), such as Confidence (odds ratio (OR) = 0.45, 95% CI: 0.18, 1.08, p = 0.07), Gentleness (OR = 0.47, 95% CI: 0.23, 0.96, p = 0.03), Nervousness (OR = 2.04, 95% CI: 0.98, 4.23, p = 0.05), and Vigilance (OR = 0.36, 95% CI: 015, 0.87, p = 0.02), suggesting that CE is linked to behavioral phenomenon measured in early life, long before it becomes a medical concern. Our data suggest that CE was positively correlated with a history of SIB (OR 4.26, 95% CI: 0.98, 18.47, p = 0.04). Accurate prediction of CE can then assist behavioral and colony management professionals in making informed decisions regarding the care of animals at risk of developing CE. Moreover, the novel information we reported here could have valuable implications in human medicine, where gastrointestinal distress is a common complaint affecting a person's quality of life. Early‐life behavioral temperament predicts later‐stage chronic emesis in rhesus macaques, highlighting influential risk factors. Research Highlights Chronic emesis (CE) is a poorly understood condition in human and nonhuman primates that negatively impacts the quality of life. Our results suggest that features of early‐life behavioral temperaments are linked to the development of chronic emesis in the later stages of life.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36975141</pmid><doi>10.1002/ajp.23488</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3874-3585</orcidid><orcidid>https://orcid.org/0000-0002-6031-8251</orcidid><orcidid>https://orcid.org/0000-0002-3339-6772</orcidid><orcidid>https://orcid.org/0000-0002-4330-4659</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0275-2565
ispartof American journal of primatology, 2023-06, Vol.85 (6), p.e23488-n/a
issn 0275-2565
1098-2345
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10231223
source Wiley-Blackwell Journals; MEDLINE
subjects Animals
Behavior
Case-Control Studies
chronic emesis
early life biobehavioral temperament
Humans
Infancy
Macaca mulatta
Necropsy
Primates
Psychological distress
Quality of Life
Research facilities
rhesus macaque
Risk factors
Sedation
Temperament
Vigilance
Vomiting
Vomiting - etiology
Vomiting - veterinary
title Early‐life behavioral features are associated with chronic emesis in rhesus macaques (Macaca mulatta)
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T06%3A41%3A39IST&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=Early%E2%80%90life%20behavioral%20features%20are%20associated%20with%20chronic%20emesis%20in%20rhesus%20macaques%20(Macaca%20mulatta)&rft.jtitle=American%20journal%20of%20primatology&rft.au=Nakatani,%20Jamie%20Y.&rft.date=2023-06&rft.volume=85&rft.issue=6&rft.spage=e23488&rft.epage=n/a&rft.pages=e23488-n/a&rft.issn=0275-2565&rft.eissn=1098-2345&rft_id=info:doi/10.1002/ajp.23488&rft_dat=%3Cproquest_pubme%3E2814349108%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=2814349108&rft_id=info:pmid/36975141&rfr_iscdi=true