Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City

Information on respiratory viruses in subtropical region is limited.Incidence, mortality, and seasonality of influenza (Flu) A/B, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza viruses (PIV) 1/2/3 in hospitalized patients were assessed over a 15-year period (1998-2012) in Hon...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Medicine (Baltimore) 2015-11, Vol.94 (46), p.e2024-e2024
Hauptverfasser: Chan, Paul K.S., Tam, Wilson W.S., Lee, Tsz Cheung, Hon, Kam Lun, Lee, Nelson, Chan, Martin C.W., Mok, Hing Yim, Wong, Martin C.S., Leung, Ting Fan, Lai, Raymond W.M., Yeung, Apple C.M., Ho, Wendy C.S., Nelson, E. Anthony S., Hui, David S.C.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page e2024
container_issue 46
container_start_page e2024
container_title Medicine (Baltimore)
container_volume 94
creator Chan, Paul K.S.
Tam, Wilson W.S.
Lee, Tsz Cheung
Hon, Kam Lun
Lee, Nelson
Chan, Martin C.W.
Mok, Hing Yim
Wong, Martin C.S.
Leung, Ting Fan
Lai, Raymond W.M.
Yeung, Apple C.M.
Ho, Wendy C.S.
Nelson, E. Anthony S.
Hui, David S.C.
description Information on respiratory viruses in subtropical region is limited.Incidence, mortality, and seasonality of influenza (Flu) A/B, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza viruses (PIV) 1/2/3 in hospitalized patients were assessed over a 15-year period (1998-2012) in Hong Kong.Male predominance and laterally transversed J-shaped distribution in age-specific incidence was observed. Incidence of Flu A, RSV, and PIV decreased sharply from infants to toddlers; whereas Flu B and ADV increased slowly. RSV conferred higher fatality than Flu, and was the second killer among hospitalized elderly. ADV and PIV were uncommon, but had the highest fatality. RSV, PIV 2/3 admissions increased over the 15 years, whereas ADV had decreased significantly. A "high season," mainly contributed by Flu, was observed in late-winter/early-spring (February-March). The "medium season" in spring/summer (April-August) was due to Flu and RSV. The "low season" in late autumn/winter (October-December) was due to PIV and ADV. Seasonality varied between viruses, but predictable distinctive pattern for each virus existed, and temperature was the most important associating meteorological variable.Respiratory viruses exhibit strong sex- and age-predilection, and with predictable seasonality allowing strategic preparedness planning. Hospital-based surveillance is crucial for real-time assessment on severity of new variants.
doi_str_mv 10.1097/MD.0000000000002024
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4652819</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1735333296</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5165-89225f8afcf965d086ac431b9c248ea556c64243bd927bc2d716855389344f8b3</originalsourceid><addsrcrecordid>eNpdks1u1DAUhS0EokPhCZCQlyya4v_EGyQ0A7RSR0X8Sawsx7lhDEmc2slUwzvwzng6pSp4Y-nc75xr6Rih55ScUqLLV-vVKbl3GGHiAVpQyVUhtRIP0SKLsih1KY7Qk5R-EEJ5ycRjdMSULHVFyQL9Pgtp9JPt_C87-TDg88H5BgYHJ3gd4n4w7U6wHRr8CWwKw42AQ4uXoe8z_xGyP9opxB3-6uOcIOHLLURs8QeIPjR7lkr8DWxM2A9ZX8EWujBCjpzrKYbRO9vhZc59ih61tkvw7PY-Rl_evf28PCsuLt-fL99cFE5SJYtKMybbyrau1Uo2pFLWCU5r7ZiowEqpnBJM8LrRrKwda0qqKil5pbkQbVXzY_T6kDvOdQ-Ng2GKtjNj9L2NOxOsN_9OBr8x38PWCCVZRXUOeHkbEMPVDGkyvU8Ous4OEOZkaMkl55xplVF-QF0MKUVo79ZQYvZFmvXK_F9kdr24_8I7z9_mMiAOwHXoJojpZzdfQzQbsN20ucnLICsYoZJSWpIiK_lv_AEtjKn_</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1735333296</pqid></control><display><type>article</type><title>Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City</title><source>Wolters Kluwer Open Health</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>IngentaConnect Free/Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Chan, Paul K.S. ; Tam, Wilson W.S. ; Lee, Tsz Cheung ; Hon, Kam Lun ; Lee, Nelson ; Chan, Martin C.W. ; Mok, Hing Yim ; Wong, Martin C.S. ; Leung, Ting Fan ; Lai, Raymond W.M. ; Yeung, Apple C.M. ; Ho, Wendy C.S. ; Nelson, E. Anthony S. ; Hui, David S.C.</creator><creatorcontrib>Chan, Paul K.S. ; Tam, Wilson W.S. ; Lee, Tsz Cheung ; Hon, Kam Lun ; Lee, Nelson ; Chan, Martin C.W. ; Mok, Hing Yim ; Wong, Martin C.S. ; Leung, Ting Fan ; Lai, Raymond W.M. ; Yeung, Apple C.M. ; Ho, Wendy C.S. ; Nelson, E. Anthony S. ; Hui, David S.C.</creatorcontrib><description>Information on respiratory viruses in subtropical region is limited.Incidence, mortality, and seasonality of influenza (Flu) A/B, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza viruses (PIV) 1/2/3 in hospitalized patients were assessed over a 15-year period (1998-2012) in Hong Kong.Male predominance and laterally transversed J-shaped distribution in age-specific incidence was observed. Incidence of Flu A, RSV, and PIV decreased sharply from infants to toddlers; whereas Flu B and ADV increased slowly. RSV conferred higher fatality than Flu, and was the second killer among hospitalized elderly. ADV and PIV were uncommon, but had the highest fatality. RSV, PIV 2/3 admissions increased over the 15 years, whereas ADV had decreased significantly. A "high season," mainly contributed by Flu, was observed in late-winter/early-spring (February-March). The "medium season" in spring/summer (April-August) was due to Flu and RSV. The "low season" in late autumn/winter (October-December) was due to PIV and ADV. Seasonality varied between viruses, but predictable distinctive pattern for each virus existed, and temperature was the most important associating meteorological variable.Respiratory viruses exhibit strong sex- and age-predilection, and with predictable seasonality allowing strategic preparedness planning. Hospital-based surveillance is crucial for real-time assessment on severity of new variants.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000002024</identifier><identifier>PMID: 26579810</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adenovirus Infections, Human - epidemiology ; Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Hong Kong - epidemiology ; Hospitalization - statistics &amp; numerical data ; Humans ; Incidence ; Infant ; Infant, Newborn ; Influenza, Human - epidemiology ; Male ; Middle Aged ; Observational Study ; Paramyxoviridae Infections - epidemiology ; Respiratory Syncytial Virus Infections - epidemiology ; Retrospective Studies ; Seasons ; Sex Distribution ; Urban Health - statistics &amp; numerical data ; Young Adult</subject><ispartof>Medicine (Baltimore), 2015-11, Vol.94 (46), p.e2024-e2024</ispartof><rights>Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5165-89225f8afcf965d086ac431b9c248ea556c64243bd927bc2d716855389344f8b3</citedby><cites>FETCH-LOGICAL-c5165-89225f8afcf965d086ac431b9c248ea556c64243bd927bc2d716855389344f8b3</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/PMC4652819/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652819/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26579810$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Paul K.S.</creatorcontrib><creatorcontrib>Tam, Wilson W.S.</creatorcontrib><creatorcontrib>Lee, Tsz Cheung</creatorcontrib><creatorcontrib>Hon, Kam Lun</creatorcontrib><creatorcontrib>Lee, Nelson</creatorcontrib><creatorcontrib>Chan, Martin C.W.</creatorcontrib><creatorcontrib>Mok, Hing Yim</creatorcontrib><creatorcontrib>Wong, Martin C.S.</creatorcontrib><creatorcontrib>Leung, Ting Fan</creatorcontrib><creatorcontrib>Lai, Raymond W.M.</creatorcontrib><creatorcontrib>Yeung, Apple C.M.</creatorcontrib><creatorcontrib>Ho, Wendy C.S.</creatorcontrib><creatorcontrib>Nelson, E. Anthony S.</creatorcontrib><creatorcontrib>Hui, David S.C.</creatorcontrib><title>Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Information on respiratory viruses in subtropical region is limited.Incidence, mortality, and seasonality of influenza (Flu) A/B, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza viruses (PIV) 1/2/3 in hospitalized patients were assessed over a 15-year period (1998-2012) in Hong Kong.Male predominance and laterally transversed J-shaped distribution in age-specific incidence was observed. Incidence of Flu A, RSV, and PIV decreased sharply from infants to toddlers; whereas Flu B and ADV increased slowly. RSV conferred higher fatality than Flu, and was the second killer among hospitalized elderly. ADV and PIV were uncommon, but had the highest fatality. RSV, PIV 2/3 admissions increased over the 15 years, whereas ADV had decreased significantly. A "high season," mainly contributed by Flu, was observed in late-winter/early-spring (February-March). The "medium season" in spring/summer (April-August) was due to Flu and RSV. The "low season" in late autumn/winter (October-December) was due to PIV and ADV. Seasonality varied between viruses, but predictable distinctive pattern for each virus existed, and temperature was the most important associating meteorological variable.Respiratory viruses exhibit strong sex- and age-predilection, and with predictable seasonality allowing strategic preparedness planning. Hospital-based surveillance is crucial for real-time assessment on severity of new variants.</description><subject>Adenovirus Infections, Human - epidemiology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hong Kong - epidemiology</subject><subject>Hospitalization - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Influenza, Human - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observational Study</subject><subject>Paramyxoviridae Infections - epidemiology</subject><subject>Respiratory Syncytial Virus Infections - epidemiology</subject><subject>Retrospective Studies</subject><subject>Seasons</subject><subject>Sex Distribution</subject><subject>Urban Health - statistics &amp; numerical data</subject><subject>Young Adult</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdks1u1DAUhS0EokPhCZCQlyya4v_EGyQ0A7RSR0X8Sawsx7lhDEmc2slUwzvwzng6pSp4Y-nc75xr6Rih55ScUqLLV-vVKbl3GGHiAVpQyVUhtRIP0SKLsih1KY7Qk5R-EEJ5ycRjdMSULHVFyQL9Pgtp9JPt_C87-TDg88H5BgYHJ3gd4n4w7U6wHRr8CWwKw42AQ4uXoe8z_xGyP9opxB3-6uOcIOHLLURs8QeIPjR7lkr8DWxM2A9ZX8EWujBCjpzrKYbRO9vhZc59ih61tkvw7PY-Rl_evf28PCsuLt-fL99cFE5SJYtKMybbyrau1Uo2pFLWCU5r7ZiowEqpnBJM8LrRrKwda0qqKil5pbkQbVXzY_T6kDvOdQ-Ng2GKtjNj9L2NOxOsN_9OBr8x38PWCCVZRXUOeHkbEMPVDGkyvU8Ous4OEOZkaMkl55xplVF-QF0MKUVo79ZQYvZFmvXK_F9kdr24_8I7z9_mMiAOwHXoJojpZzdfQzQbsN20ucnLICsYoZJSWpIiK_lv_AEtjKn_</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Chan, Paul K.S.</creator><creator>Tam, Wilson W.S.</creator><creator>Lee, Tsz Cheung</creator><creator>Hon, Kam Lun</creator><creator>Lee, Nelson</creator><creator>Chan, Martin C.W.</creator><creator>Mok, Hing Yim</creator><creator>Wong, Martin C.S.</creator><creator>Leung, Ting Fan</creator><creator>Lai, Raymond W.M.</creator><creator>Yeung, Apple C.M.</creator><creator>Ho, Wendy C.S.</creator><creator>Nelson, E. Anthony S.</creator><creator>Hui, David S.C.</creator><general>Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</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><scope>5PM</scope></search><sort><creationdate>20151101</creationdate><title>Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City</title><author>Chan, Paul K.S. ; Tam, Wilson W.S. ; Lee, Tsz Cheung ; Hon, Kam Lun ; Lee, Nelson ; Chan, Martin C.W. ; Mok, Hing Yim ; Wong, Martin C.S. ; Leung, Ting Fan ; Lai, Raymond W.M. ; Yeung, Apple C.M. ; Ho, Wendy C.S. ; Nelson, E. Anthony S. ; Hui, David S.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5165-89225f8afcf965d086ac431b9c248ea556c64243bd927bc2d716855389344f8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenovirus Infections, Human - epidemiology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hong Kong - epidemiology</topic><topic>Hospitalization - statistics &amp; numerical data</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Influenza, Human - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observational Study</topic><topic>Paramyxoviridae Infections - epidemiology</topic><topic>Respiratory Syncytial Virus Infections - epidemiology</topic><topic>Retrospective Studies</topic><topic>Seasons</topic><topic>Sex Distribution</topic><topic>Urban Health - statistics &amp; numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Paul K.S.</creatorcontrib><creatorcontrib>Tam, Wilson W.S.</creatorcontrib><creatorcontrib>Lee, Tsz Cheung</creatorcontrib><creatorcontrib>Hon, Kam Lun</creatorcontrib><creatorcontrib>Lee, Nelson</creatorcontrib><creatorcontrib>Chan, Martin C.W.</creatorcontrib><creatorcontrib>Mok, Hing Yim</creatorcontrib><creatorcontrib>Wong, Martin C.S.</creatorcontrib><creatorcontrib>Leung, Ting Fan</creatorcontrib><creatorcontrib>Lai, Raymond W.M.</creatorcontrib><creatorcontrib>Yeung, Apple C.M.</creatorcontrib><creatorcontrib>Ho, Wendy C.S.</creatorcontrib><creatorcontrib>Nelson, E. Anthony S.</creatorcontrib><creatorcontrib>Hui, David S.C.</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Paul K.S.</au><au>Tam, Wilson W.S.</au><au>Lee, Tsz Cheung</au><au>Hon, Kam Lun</au><au>Lee, Nelson</au><au>Chan, Martin C.W.</au><au>Mok, Hing Yim</au><au>Wong, Martin C.S.</au><au>Leung, Ting Fan</au><au>Lai, Raymond W.M.</au><au>Yeung, Apple C.M.</au><au>Ho, Wendy C.S.</au><au>Nelson, E. Anthony S.</au><au>Hui, David S.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>94</volume><issue>46</issue><spage>e2024</spage><epage>e2024</epage><pages>e2024-e2024</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Information on respiratory viruses in subtropical region is limited.Incidence, mortality, and seasonality of influenza (Flu) A/B, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza viruses (PIV) 1/2/3 in hospitalized patients were assessed over a 15-year period (1998-2012) in Hong Kong.Male predominance and laterally transversed J-shaped distribution in age-specific incidence was observed. Incidence of Flu A, RSV, and PIV decreased sharply from infants to toddlers; whereas Flu B and ADV increased slowly. RSV conferred higher fatality than Flu, and was the second killer among hospitalized elderly. ADV and PIV were uncommon, but had the highest fatality. RSV, PIV 2/3 admissions increased over the 15 years, whereas ADV had decreased significantly. A "high season," mainly contributed by Flu, was observed in late-winter/early-spring (February-March). The "medium season" in spring/summer (April-August) was due to Flu and RSV. The "low season" in late autumn/winter (October-December) was due to PIV and ADV. Seasonality varied between viruses, but predictable distinctive pattern for each virus existed, and temperature was the most important associating meteorological variable.Respiratory viruses exhibit strong sex- and age-predilection, and with predictable seasonality allowing strategic preparedness planning. Hospital-based surveillance is crucial for real-time assessment on severity of new variants.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>26579810</pmid><doi>10.1097/MD.0000000000002024</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0025-7974
ispartof Medicine (Baltimore), 2015-11, Vol.94 (46), p.e2024-e2024
issn 0025-7974
1536-5964
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4652819
source Wolters Kluwer Open Health; MEDLINE; DOAJ Directory of Open Access Journals; IngentaConnect Free/Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection
subjects Adenovirus Infections, Human - epidemiology
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Hong Kong - epidemiology
Hospitalization - statistics & numerical data
Humans
Incidence
Infant
Infant, Newborn
Influenza, Human - epidemiology
Male
Middle Aged
Observational Study
Paramyxoviridae Infections - epidemiology
Respiratory Syncytial Virus Infections - epidemiology
Retrospective Studies
Seasons
Sex Distribution
Urban Health - statistics & numerical data
Young Adult
title Hospitalization Incidence, Mortality, and Seasonality of Common Respiratory Viruses Over a Period of 15 Years in a Developed Subtropical City
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T07%3A52%3A53IST&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=Hospitalization%20Incidence,%20Mortality,%20and%20Seasonality%20of%20Common%20Respiratory%20Viruses%20Over%20a%20Period%20of%2015%20Years%20in%20a%20Developed%20Subtropical%20City&rft.jtitle=Medicine%20(Baltimore)&rft.au=Chan,%20Paul%20K.S.&rft.date=2015-11-01&rft.volume=94&rft.issue=46&rft.spage=e2024&rft.epage=e2024&rft.pages=e2024-e2024&rft.issn=0025-7974&rft.eissn=1536-5964&rft_id=info:doi/10.1097/MD.0000000000002024&rft_dat=%3Cproquest_pubme%3E1735333296%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=1735333296&rft_id=info:pmid/26579810&rfr_iscdi=true