Indications for a vertical transmission pathway of piscine myocarditis virus in Atlantic salmon (Salmo salar L.)

Losses due to cardiomyopathy syndrome (CMS) keep increasing in salmon‐producing countries in the North‐Atlantic. Recently, Piscine myocarditis virus (PMCV) has been detected in post‐smolts shortly after sea‐transfer, indicating a possible carry‐over from the hatcheries. In addition, there are report...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of fish diseases 2019-06, Vol.42 (6), p.825-833
Hauptverfasser: Bang Jensen, Britt, Nylund, Stian, Svendsen, Julie Christine, Ski, Paul‐Martin R., Takle, Harald
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 833
container_issue 6
container_start_page 825
container_title Journal of fish diseases
container_volume 42
creator Bang Jensen, Britt
Nylund, Stian
Svendsen, Julie Christine
Ski, Paul‐Martin R.
Takle, Harald
description Losses due to cardiomyopathy syndrome (CMS) keep increasing in salmon‐producing countries in the North‐Atlantic. Recently, Piscine myocarditis virus (PMCV) has been detected in post‐smolts shortly after sea‐transfer, indicating a possible carry‐over from the hatcheries. In addition, there are reports of prevalences of PMCV as high as 70%–90% in certain groups of broodfish, and a recent outbreak of CMS in the Faroe Islands has been linked to the importation of eggs from a CMS‐endemic area. Thus, there is a need to investigate whether PMCV can be transmitted vertically from infected broodstock to their progeny. In the present study, samples from eggs, larvae, fingerlings and presmolt originating from PMCV‐positive broodstock from two commercial Atlantic salmon producers were tested for PMCV. The prevalence of PMCV in the broodstock was 98% in the hearts, 69% in the roe and 59% in the milt. Piscine myocarditis virus was detected in all stages of the progeny until and including the 40 g stage. Piscine myocarditis virus was also detected in presmolt sampled for tissue tropism. This provides farmers with several options for minimizing the risk of transfer of PMCV from broodstock to progeny, including screening of broodstock and aiming to use only those that are negative for PMCV or have low levels of virus.
doi_str_mv 10.1111/jfd.12990
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6849753</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2221613021</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4760-6868ef44ca3d1870cde1ccd056f6ca2073b5a0c734d62839e11a66dac86fbe6b3</originalsourceid><addsrcrecordid>eNqFkcFO3DAQhi3UqizQAy-ALPUChyweO7GTSyVEoaVaiQP0bHltB7xK7GAni_bt6-1S1CJV9WXkmW9-zcyP0DGQOeR3vmrNHGjTkD00A8arggoO79CMQEkKIUS1jw5SWhECogL-Ae0z0kDTiGaGhhtvnFajCz7hNkSs8NrGMac6PEblU-9SykU8qPHxWW1waPHgknbe4n4TtIrGjS7htYtTws7ji7FTPvfjpLo-953ebeP2pyJezM-O0PtWdcl-fImH6Mf11f3lt2Jx-_Xm8mJR6FJwUvCa17YtS62YgVoQbSxobUjFW64VJYItK0W0YKXhtGaNBVCcG6Vr3i4tX7JD9HmnO0zL3hptfV6nk0N0vYobGZSTf1e8e5QPYS15XTaiYlng9EUghqfJplHmU2jb5fVsmJKkVOTBOAP-fzQfG-qallvVT2_QVZiiz5fIghQ4MEIhU2c7SseQUrTt69xA5NZymS2XvyzP7Mmfi76Svz3OwPkOeHad3fxbSX6__rKT_AluM7bJ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2221613021</pqid></control><display><type>article</type><title>Indications for a vertical transmission pathway of piscine myocarditis virus in Atlantic salmon (Salmo salar L.)</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Bang Jensen, Britt ; Nylund, Stian ; Svendsen, Julie Christine ; Ski, Paul‐Martin R. ; Takle, Harald</creator><creatorcontrib>Bang Jensen, Britt ; Nylund, Stian ; Svendsen, Julie Christine ; Ski, Paul‐Martin R. ; Takle, Harald</creatorcontrib><description>Losses due to cardiomyopathy syndrome (CMS) keep increasing in salmon‐producing countries in the North‐Atlantic. Recently, Piscine myocarditis virus (PMCV) has been detected in post‐smolts shortly after sea‐transfer, indicating a possible carry‐over from the hatcheries. In addition, there are reports of prevalences of PMCV as high as 70%–90% in certain groups of broodfish, and a recent outbreak of CMS in the Faroe Islands has been linked to the importation of eggs from a CMS‐endemic area. Thus, there is a need to investigate whether PMCV can be transmitted vertically from infected broodstock to their progeny. In the present study, samples from eggs, larvae, fingerlings and presmolt originating from PMCV‐positive broodstock from two commercial Atlantic salmon producers were tested for PMCV. The prevalence of PMCV in the broodstock was 98% in the hearts, 69% in the roe and 59% in the milt. Piscine myocarditis virus was detected in all stages of the progeny until and including the 40 g stage. Piscine myocarditis virus was also detected in presmolt sampled for tissue tropism. This provides farmers with several options for minimizing the risk of transfer of PMCV from broodstock to progeny, including screening of broodstock and aiming to use only those that are negative for PMCV or have low levels of virus.</description><identifier>ISSN: 0140-7775</identifier><identifier>EISSN: 1365-2761</identifier><identifier>DOI: 10.1111/jfd.12990</identifier><identifier>PMID: 30919979</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Animals ; Aquaculture ; Breeding stock ; Cardiomyopathy ; cardiomyopathy syndrome ; Cohort Studies ; Denmark ; Eggs ; epidemiology ; farmers ; Faroe Islands ; Fingerlings ; Fish ; Fish Diseases - transmission ; Fish Diseases - virology ; Fish hatcheries ; Freshwater fishes ; Hatcheries ; Heart ; Heart diseases ; Importation ; Infectious Disease Transmission, Vertical - veterinary ; Larva - virology ; Larvae ; Life Cycle Stages ; Marine fishes ; milt ; Myocarditis ; Myocarditis - veterinary ; Myocarditis - virology ; Offspring ; Original ; Outbreaks ; Ovum - virology ; piscine myocarditis virus ; Progeny ; risk ; Risk reduction ; RNA Virus Infections - transmission ; RNA Virus Infections - veterinary ; Roes ; Salmo salar ; Salmo salar - growth &amp; development ; Salmo salar - virology ; Salmon ; screening ; Smolts ; Tissue ; tissue tropism ; Totiviridae - physiology ; Tropism ; Tropisms ; vertical transmission ; Viral Load ; Viruses</subject><ispartof>Journal of fish diseases, 2019-06, Vol.42 (6), p.825-833</ispartof><rights>2019 The Authors. Published by John Wiley &amp; Sons Ltd</rights><rights>2019 The Authors. Journal of Fish Diseases Published by John Wiley &amp; Sons Ltd.</rights><rights>2019. This article is published under 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><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4760-6868ef44ca3d1870cde1ccd056f6ca2073b5a0c734d62839e11a66dac86fbe6b3</citedby><cites>FETCH-LOGICAL-c4760-6868ef44ca3d1870cde1ccd056f6ca2073b5a0c734d62839e11a66dac86fbe6b3</cites><orcidid>0000-0001-9536-9078</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjfd.12990$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjfd.12990$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30919979$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bang Jensen, Britt</creatorcontrib><creatorcontrib>Nylund, Stian</creatorcontrib><creatorcontrib>Svendsen, Julie Christine</creatorcontrib><creatorcontrib>Ski, Paul‐Martin R.</creatorcontrib><creatorcontrib>Takle, Harald</creatorcontrib><title>Indications for a vertical transmission pathway of piscine myocarditis virus in Atlantic salmon (Salmo salar L.)</title><title>Journal of fish diseases</title><addtitle>J Fish Dis</addtitle><description>Losses due to cardiomyopathy syndrome (CMS) keep increasing in salmon‐producing countries in the North‐Atlantic. Recently, Piscine myocarditis virus (PMCV) has been detected in post‐smolts shortly after sea‐transfer, indicating a possible carry‐over from the hatcheries. In addition, there are reports of prevalences of PMCV as high as 70%–90% in certain groups of broodfish, and a recent outbreak of CMS in the Faroe Islands has been linked to the importation of eggs from a CMS‐endemic area. Thus, there is a need to investigate whether PMCV can be transmitted vertically from infected broodstock to their progeny. In the present study, samples from eggs, larvae, fingerlings and presmolt originating from PMCV‐positive broodstock from two commercial Atlantic salmon producers were tested for PMCV. The prevalence of PMCV in the broodstock was 98% in the hearts, 69% in the roe and 59% in the milt. Piscine myocarditis virus was detected in all stages of the progeny until and including the 40 g stage. Piscine myocarditis virus was also detected in presmolt sampled for tissue tropism. This provides farmers with several options for minimizing the risk of transfer of PMCV from broodstock to progeny, including screening of broodstock and aiming to use only those that are negative for PMCV or have low levels of virus.</description><subject>Animals</subject><subject>Aquaculture</subject><subject>Breeding stock</subject><subject>Cardiomyopathy</subject><subject>cardiomyopathy syndrome</subject><subject>Cohort Studies</subject><subject>Denmark</subject><subject>Eggs</subject><subject>epidemiology</subject><subject>farmers</subject><subject>Faroe Islands</subject><subject>Fingerlings</subject><subject>Fish</subject><subject>Fish Diseases - transmission</subject><subject>Fish Diseases - virology</subject><subject>Fish hatcheries</subject><subject>Freshwater fishes</subject><subject>Hatcheries</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Importation</subject><subject>Infectious Disease Transmission, Vertical - veterinary</subject><subject>Larva - virology</subject><subject>Larvae</subject><subject>Life Cycle Stages</subject><subject>Marine fishes</subject><subject>milt</subject><subject>Myocarditis</subject><subject>Myocarditis - veterinary</subject><subject>Myocarditis - virology</subject><subject>Offspring</subject><subject>Original</subject><subject>Outbreaks</subject><subject>Ovum - virology</subject><subject>piscine myocarditis virus</subject><subject>Progeny</subject><subject>risk</subject><subject>Risk reduction</subject><subject>RNA Virus Infections - transmission</subject><subject>RNA Virus Infections - veterinary</subject><subject>Roes</subject><subject>Salmo salar</subject><subject>Salmo salar - growth &amp; development</subject><subject>Salmo salar - virology</subject><subject>Salmon</subject><subject>screening</subject><subject>Smolts</subject><subject>Tissue</subject><subject>tissue tropism</subject><subject>Totiviridae - physiology</subject><subject>Tropism</subject><subject>Tropisms</subject><subject>vertical transmission</subject><subject>Viral Load</subject><subject>Viruses</subject><issn>0140-7775</issn><issn>1365-2761</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNqFkcFO3DAQhi3UqizQAy-ALPUChyweO7GTSyVEoaVaiQP0bHltB7xK7GAni_bt6-1S1CJV9WXkmW9-zcyP0DGQOeR3vmrNHGjTkD00A8arggoO79CMQEkKIUS1jw5SWhECogL-Ae0z0kDTiGaGhhtvnFajCz7hNkSs8NrGMac6PEblU-9SykU8qPHxWW1waPHgknbe4n4TtIrGjS7htYtTws7ji7FTPvfjpLo-953ebeP2pyJezM-O0PtWdcl-fImH6Mf11f3lt2Jx-_Xm8mJR6FJwUvCa17YtS62YgVoQbSxobUjFW64VJYItK0W0YKXhtGaNBVCcG6Vr3i4tX7JD9HmnO0zL3hptfV6nk0N0vYobGZSTf1e8e5QPYS15XTaiYlng9EUghqfJplHmU2jb5fVsmJKkVOTBOAP-fzQfG-qallvVT2_QVZiiz5fIghQ4MEIhU2c7SseQUrTt69xA5NZymS2XvyzP7Mmfi76Svz3OwPkOeHad3fxbSX6__rKT_AluM7bJ</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Bang Jensen, Britt</creator><creator>Nylund, Stian</creator><creator>Svendsen, Julie Christine</creator><creator>Ski, Paul‐Martin R.</creator><creator>Takle, Harald</creator><general>Blackwell Publishing Ltd</general><general>John Wiley and Sons Inc</general><scope>24P</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>7QL</scope><scope>7TN</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>F1W</scope><scope>FR3</scope><scope>H94</scope><scope>H95</scope><scope>H98</scope><scope>H99</scope><scope>L.F</scope><scope>L.G</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9536-9078</orcidid></search><sort><creationdate>201906</creationdate><title>Indications for a vertical transmission pathway of piscine myocarditis virus in Atlantic salmon (Salmo salar L.)</title><author>Bang Jensen, Britt ; Nylund, Stian ; Svendsen, Julie Christine ; Ski, Paul‐Martin R. ; Takle, Harald</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4760-6868ef44ca3d1870cde1ccd056f6ca2073b5a0c734d62839e11a66dac86fbe6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Animals</topic><topic>Aquaculture</topic><topic>Breeding stock</topic><topic>Cardiomyopathy</topic><topic>cardiomyopathy syndrome</topic><topic>Cohort Studies</topic><topic>Denmark</topic><topic>Eggs</topic><topic>epidemiology</topic><topic>farmers</topic><topic>Faroe Islands</topic><topic>Fingerlings</topic><topic>Fish</topic><topic>Fish Diseases - transmission</topic><topic>Fish Diseases - virology</topic><topic>Fish hatcheries</topic><topic>Freshwater fishes</topic><topic>Hatcheries</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Importation</topic><topic>Infectious Disease Transmission, Vertical - veterinary</topic><topic>Larva - virology</topic><topic>Larvae</topic><topic>Life Cycle Stages</topic><topic>Marine fishes</topic><topic>milt</topic><topic>Myocarditis</topic><topic>Myocarditis - veterinary</topic><topic>Myocarditis - virology</topic><topic>Offspring</topic><topic>Original</topic><topic>Outbreaks</topic><topic>Ovum - virology</topic><topic>piscine myocarditis virus</topic><topic>Progeny</topic><topic>risk</topic><topic>Risk reduction</topic><topic>RNA Virus Infections - transmission</topic><topic>RNA Virus Infections - veterinary</topic><topic>Roes</topic><topic>Salmo salar</topic><topic>Salmo salar - growth &amp; development</topic><topic>Salmo salar - virology</topic><topic>Salmon</topic><topic>screening</topic><topic>Smolts</topic><topic>Tissue</topic><topic>tissue tropism</topic><topic>Totiviridae - physiology</topic><topic>Tropism</topic><topic>Tropisms</topic><topic>vertical transmission</topic><topic>Viral Load</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bang Jensen, Britt</creatorcontrib><creatorcontrib>Nylund, Stian</creatorcontrib><creatorcontrib>Svendsen, Julie Christine</creatorcontrib><creatorcontrib>Ski, Paul‐Martin R.</creatorcontrib><creatorcontrib>Takle, Harald</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Oceanic Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science &amp; Fisheries Abstracts (ASFA) 1: Biological Sciences &amp; Living Resources</collection><collection>Aquatic Science &amp; Fisheries Abstracts (ASFA) Aquaculture Abstracts</collection><collection>ASFA: Marine Biotechnology Abstracts</collection><collection>Aquatic Science &amp; Fisheries Abstracts (ASFA) Marine Biotechnology Abstracts</collection><collection>Aquatic Science &amp; Fisheries Abstracts (ASFA) Professional</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of fish diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bang Jensen, Britt</au><au>Nylund, Stian</au><au>Svendsen, Julie Christine</au><au>Ski, Paul‐Martin R.</au><au>Takle, Harald</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Indications for a vertical transmission pathway of piscine myocarditis virus in Atlantic salmon (Salmo salar L.)</atitle><jtitle>Journal of fish diseases</jtitle><addtitle>J Fish Dis</addtitle><date>2019-06</date><risdate>2019</risdate><volume>42</volume><issue>6</issue><spage>825</spage><epage>833</epage><pages>825-833</pages><issn>0140-7775</issn><eissn>1365-2761</eissn><abstract>Losses due to cardiomyopathy syndrome (CMS) keep increasing in salmon‐producing countries in the North‐Atlantic. Recently, Piscine myocarditis virus (PMCV) has been detected in post‐smolts shortly after sea‐transfer, indicating a possible carry‐over from the hatcheries. In addition, there are reports of prevalences of PMCV as high as 70%–90% in certain groups of broodfish, and a recent outbreak of CMS in the Faroe Islands has been linked to the importation of eggs from a CMS‐endemic area. Thus, there is a need to investigate whether PMCV can be transmitted vertically from infected broodstock to their progeny. In the present study, samples from eggs, larvae, fingerlings and presmolt originating from PMCV‐positive broodstock from two commercial Atlantic salmon producers were tested for PMCV. The prevalence of PMCV in the broodstock was 98% in the hearts, 69% in the roe and 59% in the milt. Piscine myocarditis virus was detected in all stages of the progeny until and including the 40 g stage. Piscine myocarditis virus was also detected in presmolt sampled for tissue tropism. This provides farmers with several options for minimizing the risk of transfer of PMCV from broodstock to progeny, including screening of broodstock and aiming to use only those that are negative for PMCV or have low levels of virus.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>30919979</pmid><doi>10.1111/jfd.12990</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9536-9078</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0140-7775
ispartof Journal of fish diseases, 2019-06, Vol.42 (6), p.825-833
issn 0140-7775
1365-2761
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6849753
source Wiley-Blackwell Journals; MEDLINE
subjects Animals
Aquaculture
Breeding stock
Cardiomyopathy
cardiomyopathy syndrome
Cohort Studies
Denmark
Eggs
epidemiology
farmers
Faroe Islands
Fingerlings
Fish
Fish Diseases - transmission
Fish Diseases - virology
Fish hatcheries
Freshwater fishes
Hatcheries
Heart
Heart diseases
Importation
Infectious Disease Transmission, Vertical - veterinary
Larva - virology
Larvae
Life Cycle Stages
Marine fishes
milt
Myocarditis
Myocarditis - veterinary
Myocarditis - virology
Offspring
Original
Outbreaks
Ovum - virology
piscine myocarditis virus
Progeny
risk
Risk reduction
RNA Virus Infections - transmission
RNA Virus Infections - veterinary
Roes
Salmo salar
Salmo salar - growth & development
Salmo salar - virology
Salmon
screening
Smolts
Tissue
tissue tropism
Totiviridae - physiology
Tropism
Tropisms
vertical transmission
Viral Load
Viruses
title Indications for a vertical transmission pathway of piscine myocarditis virus in Atlantic salmon (Salmo salar L.)
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T04%3A33%3A16IST&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=Indications%20for%20a%20vertical%20transmission%20pathway%20of%20piscine%20myocarditis%20virus%20in%20Atlantic%20salmon%20(Salmo%20salar%20L.)&rft.jtitle=Journal%20of%20fish%20diseases&rft.au=Bang%20Jensen,%20Britt&rft.date=2019-06&rft.volume=42&rft.issue=6&rft.spage=825&rft.epage=833&rft.pages=825-833&rft.issn=0140-7775&rft.eissn=1365-2761&rft_id=info:doi/10.1111/jfd.12990&rft_dat=%3Cproquest_pubme%3E2221613021%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=2221613021&rft_id=info:pmid/30919979&rfr_iscdi=true