Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that seriously threatens people's health, with high morbidity and mortality worldwide. At present, the clinical diagnosis methods of COPD are time-consuming, invasive, and radioactive. Therefore, it is urgent to devel...
Gespeichert in:
Veröffentlicht in: | BMC pulmonary medicine 2021-10, Vol.21 (1), p.321-13, Article 321 |
---|---|
Hauptverfasser: | , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 13 |
---|---|
container_issue | 1 |
container_start_page | 321 |
container_title | BMC pulmonary medicine |
container_volume | 21 |
creator | Yu, Hui Zhao, Jing Liu, Dongyi Chen, Zhen Sun, Jinglai Zhao, Xiaoyun |
description | Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that seriously threatens people's health, with high morbidity and mortality worldwide. At present, the clinical diagnosis methods of COPD are time-consuming, invasive, and radioactive. Therefore, it is urgent to develop a non-invasive and rapid COPD severity diagnosis technique suitable for daily screening in clinical practice.
This study established an effective model for the preliminary diagnosis of COPD severity using lung sounds with few channels. Firstly, the time-frequency-energy features of 12 channels lung sounds were extracted by Hilbert-Huang transform. And then, channels and features were screened by the reliefF algorithm. Finally, the feature sets were input into a support vector machine to diagnose COPD severity, and the performance with Bayes, decision tree, and deep belief network was compared. Experimental results show that high classification performance using only 4-channel lung sounds of L1, L2, L3, and L4 channels can be achieved by the proposed model. The accuracy, sensitivity, and specificity of mild COPD and moderate + severe COPD were 89.13%, 87.72%, and 91.01%, respectively. The classification performance rates of moderate COPD and severe COPD were 94.26%, 97.32%, and 89.93% for accuracy, sensitivity, and specificity, respectively.
This model provides a standardized evaluation with high classification performance rates, which can assist doctors to complete the preliminary diagnosis of COPD severity immediately, and has important clinical significance. |
doi_str_mv | 10.1186/s12890-021-01682-5 |
format | Article |
fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_d1363d227e334b5cb55e67d44ea7c1fc</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A681631558</galeid><doaj_id>oai_doaj_org_article_d1363d227e334b5cb55e67d44ea7c1fc</doaj_id><sourcerecordid>A681631558</sourcerecordid><originalsourceid>FETCH-LOGICAL-c563t-82ec1285ae528bc878be571a6ae8808d1c9abeb319f83d93454785e871d504883</originalsourceid><addsrcrecordid>eNptUs1rFDEcHUSxtfoPeJABL16m5ju_vQil-FGoeFHwFjLJb2azzCZrMlPof2-2W2tXJIeE5L2XvJfXNK8pOacU1PtCGaxIRxjtCFXAOvmkOaVC044JpZ4-Wp80L0rZEEI1SP68OeFCSSEIOW1-fl2mOXRubWPEqZ2WOLYlLdGXNsQZpymMGOfWBzvGVEJp09C6dU4xuDb1Zc6Lm8MNtrtl2qZo822FFrQFXzbPBjsVfHU_nzU_Pn38fvmlu_72-ery4rpzUvG5A4au2pAWJYPegYYepaZWWQQg4Klb2R57TlcDcL_iQorqAUFTL4kA4GfN1UHXJ7sxuxy29REm2WDuNlIejc1zcBMaT7ninjGNnIteul5KVNoLgVY7Oriq9eGgtVv6LXpXnWc7HYken8SwNmO6MSApsBWrAu_uBXL6tWCZzTYUV1O0EdNSDJPAgIr6bRX69h_oJi051qj2qOqXaK3_okZbDYQ4pHqv24uaCwVUcSrlPoPz_6Dq8LgNLkUcQt0_IrADweVUSsbhwSMlZt8tc-iWqd0yd90yspLePE7ngfKnTPw3zhLJmQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2583190777</pqid></control><display><type>article</type><title>Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>Springer Nature OA Free Journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Yu, Hui ; Zhao, Jing ; Liu, Dongyi ; Chen, Zhen ; Sun, Jinglai ; Zhao, Xiaoyun</creator><creatorcontrib>Yu, Hui ; Zhao, Jing ; Liu, Dongyi ; Chen, Zhen ; Sun, Jinglai ; Zhao, Xiaoyun</creatorcontrib><description>Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that seriously threatens people's health, with high morbidity and mortality worldwide. At present, the clinical diagnosis methods of COPD are time-consuming, invasive, and radioactive. Therefore, it is urgent to develop a non-invasive and rapid COPD severity diagnosis technique suitable for daily screening in clinical practice.
This study established an effective model for the preliminary diagnosis of COPD severity using lung sounds with few channels. Firstly, the time-frequency-energy features of 12 channels lung sounds were extracted by Hilbert-Huang transform. And then, channels and features were screened by the reliefF algorithm. Finally, the feature sets were input into a support vector machine to diagnose COPD severity, and the performance with Bayes, decision tree, and deep belief network was compared. Experimental results show that high classification performance using only 4-channel lung sounds of L1, L2, L3, and L4 channels can be achieved by the proposed model. The accuracy, sensitivity, and specificity of mild COPD and moderate + severe COPD were 89.13%, 87.72%, and 91.01%, respectively. The classification performance rates of moderate COPD and severe COPD were 94.26%, 97.32%, and 89.93% for accuracy, sensitivity, and specificity, respectively.
This model provides a standardized evaluation with high classification performance rates, which can assist doctors to complete the preliminary diagnosis of COPD severity immediately, and has important clinical significance.</description><identifier>ISSN: 1471-2466</identifier><identifier>EISSN: 1471-2466</identifier><identifier>DOI: 10.1186/s12890-021-01682-5</identifier><identifier>PMID: 34654400</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Accuracy ; Algorithms ; Auscultation ; Bayes Theorem ; Bayesian analysis ; China ; Chronic obstructive pulmonary disease ; Classification ; Clinical medicine ; Databases, Factual ; Decision Support Systems, Clinical ; Decision Trees ; Diagnosis ; Disease ; Hilbert–Huang tansform ; Humans ; Lung diseases ; Lung diseases, Obstructive ; Medical testing products ; Models, Statistical ; Morbidity ; Neural networks ; Obstructive lung disease ; Physiology ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonology ; ReliefF algorithm ; Respiratory diseases ; Respiratory organs ; Respiratory Sounds - diagnosis ; RespiratoryDatabase @ TR ; Sensitivity and Specificity ; Sounds ; Support Vector Machine ; Technology application ; Wavelet transforms</subject><ispartof>BMC pulmonary medicine, 2021-10, Vol.21 (1), p.321-13, Article 321</ispartof><rights>2021. The Author(s).</rights><rights>COPYRIGHT 2021 BioMed Central Ltd.</rights><rights>2021. This work is licensed 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><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c563t-82ec1285ae528bc878be571a6ae8808d1c9abeb319f83d93454785e871d504883</citedby><cites>FETCH-LOGICAL-c563t-82ec1285ae528bc878be571a6ae8808d1c9abeb319f83d93454785e871d504883</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/PMC8518292/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518292/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34654400$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Hui</creatorcontrib><creatorcontrib>Zhao, Jing</creatorcontrib><creatorcontrib>Liu, Dongyi</creatorcontrib><creatorcontrib>Chen, Zhen</creatorcontrib><creatorcontrib>Sun, Jinglai</creatorcontrib><creatorcontrib>Zhao, Xiaoyun</creatorcontrib><title>Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease</title><title>BMC pulmonary medicine</title><addtitle>BMC Pulm Med</addtitle><description>Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that seriously threatens people's health, with high morbidity and mortality worldwide. At present, the clinical diagnosis methods of COPD are time-consuming, invasive, and radioactive. Therefore, it is urgent to develop a non-invasive and rapid COPD severity diagnosis technique suitable for daily screening in clinical practice.
This study established an effective model for the preliminary diagnosis of COPD severity using lung sounds with few channels. Firstly, the time-frequency-energy features of 12 channels lung sounds were extracted by Hilbert-Huang transform. And then, channels and features were screened by the reliefF algorithm. Finally, the feature sets were input into a support vector machine to diagnose COPD severity, and the performance with Bayes, decision tree, and deep belief network was compared. Experimental results show that high classification performance using only 4-channel lung sounds of L1, L2, L3, and L4 channels can be achieved by the proposed model. The accuracy, sensitivity, and specificity of mild COPD and moderate + severe COPD were 89.13%, 87.72%, and 91.01%, respectively. The classification performance rates of moderate COPD and severe COPD were 94.26%, 97.32%, and 89.93% for accuracy, sensitivity, and specificity, respectively.
This model provides a standardized evaluation with high classification performance rates, which can assist doctors to complete the preliminary diagnosis of COPD severity immediately, and has important clinical significance.</description><subject>Accuracy</subject><subject>Algorithms</subject><subject>Auscultation</subject><subject>Bayes Theorem</subject><subject>Bayesian analysis</subject><subject>China</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>Databases, Factual</subject><subject>Decision Support Systems, Clinical</subject><subject>Decision Trees</subject><subject>Diagnosis</subject><subject>Disease</subject><subject>Hilbert–Huang tansform</subject><subject>Humans</subject><subject>Lung diseases</subject><subject>Lung diseases, Obstructive</subject><subject>Medical testing products</subject><subject>Models, Statistical</subject><subject>Morbidity</subject><subject>Neural networks</subject><subject>Obstructive lung disease</subject><subject>Physiology</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonology</subject><subject>ReliefF algorithm</subject><subject>Respiratory diseases</subject><subject>Respiratory organs</subject><subject>Respiratory Sounds - diagnosis</subject><subject>RespiratoryDatabase @ TR</subject><subject>Sensitivity and Specificity</subject><subject>Sounds</subject><subject>Support Vector Machine</subject><subject>Technology application</subject><subject>Wavelet transforms</subject><issn>1471-2466</issn><issn>1471-2466</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptUs1rFDEcHUSxtfoPeJABL16m5ju_vQil-FGoeFHwFjLJb2azzCZrMlPof2-2W2tXJIeE5L2XvJfXNK8pOacU1PtCGaxIRxjtCFXAOvmkOaVC044JpZ4-Wp80L0rZEEI1SP68OeFCSSEIOW1-fl2mOXRubWPEqZ2WOLYlLdGXNsQZpymMGOfWBzvGVEJp09C6dU4xuDb1Zc6Lm8MNtrtl2qZo822FFrQFXzbPBjsVfHU_nzU_Pn38fvmlu_72-ery4rpzUvG5A4au2pAWJYPegYYepaZWWQQg4Klb2R57TlcDcL_iQorqAUFTL4kA4GfN1UHXJ7sxuxy29REm2WDuNlIejc1zcBMaT7ninjGNnIteul5KVNoLgVY7Oriq9eGgtVv6LXpXnWc7HYken8SwNmO6MSApsBWrAu_uBXL6tWCZzTYUV1O0EdNSDJPAgIr6bRX69h_oJi051qj2qOqXaK3_okZbDYQ4pHqv24uaCwVUcSrlPoPz_6Dq8LgNLkUcQt0_IrADweVUSsbhwSMlZt8tc-iWqd0yd90yspLePE7ngfKnTPw3zhLJmQ</recordid><startdate>20211015</startdate><enddate>20211015</enddate><creator>Yu, Hui</creator><creator>Zhao, Jing</creator><creator>Liu, Dongyi</creator><creator>Chen, Zhen</creator><creator>Sun, Jinglai</creator><creator>Zhao, Xiaoyun</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</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>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20211015</creationdate><title>Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease</title><author>Yu, Hui ; Zhao, Jing ; Liu, Dongyi ; Chen, Zhen ; Sun, Jinglai ; Zhao, Xiaoyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c563t-82ec1285ae528bc878be571a6ae8808d1c9abeb319f83d93454785e871d504883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Accuracy</topic><topic>Algorithms</topic><topic>Auscultation</topic><topic>Bayes Theorem</topic><topic>Bayesian analysis</topic><topic>China</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Classification</topic><topic>Clinical medicine</topic><topic>Databases, Factual</topic><topic>Decision Support Systems, Clinical</topic><topic>Decision Trees</topic><topic>Diagnosis</topic><topic>Disease</topic><topic>Hilbert–Huang tansform</topic><topic>Humans</topic><topic>Lung diseases</topic><topic>Lung diseases, Obstructive</topic><topic>Medical testing products</topic><topic>Models, Statistical</topic><topic>Morbidity</topic><topic>Neural networks</topic><topic>Obstructive lung disease</topic><topic>Physiology</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnosis</topic><topic>Pulmonology</topic><topic>ReliefF algorithm</topic><topic>Respiratory diseases</topic><topic>Respiratory organs</topic><topic>Respiratory Sounds - diagnosis</topic><topic>RespiratoryDatabase @ TR</topic><topic>Sensitivity and Specificity</topic><topic>Sounds</topic><topic>Support Vector Machine</topic><topic>Technology application</topic><topic>Wavelet transforms</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Hui</creatorcontrib><creatorcontrib>Zhao, Jing</creatorcontrib><creatorcontrib>Liu, Dongyi</creatorcontrib><creatorcontrib>Chen, Zhen</creatorcontrib><creatorcontrib>Sun, Jinglai</creatorcontrib><creatorcontrib>Zhao, Xiaoyun</creatorcontrib><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>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</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>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</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>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC pulmonary medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Hui</au><au>Zhao, Jing</au><au>Liu, Dongyi</au><au>Chen, Zhen</au><au>Sun, Jinglai</au><au>Zhao, Xiaoyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease</atitle><jtitle>BMC pulmonary medicine</jtitle><addtitle>BMC Pulm Med</addtitle><date>2021-10-15</date><risdate>2021</risdate><volume>21</volume><issue>1</issue><spage>321</spage><epage>13</epage><pages>321-13</pages><artnum>321</artnum><issn>1471-2466</issn><eissn>1471-2466</eissn><abstract>Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that seriously threatens people's health, with high morbidity and mortality worldwide. At present, the clinical diagnosis methods of COPD are time-consuming, invasive, and radioactive. Therefore, it is urgent to develop a non-invasive and rapid COPD severity diagnosis technique suitable for daily screening in clinical practice.
This study established an effective model for the preliminary diagnosis of COPD severity using lung sounds with few channels. Firstly, the time-frequency-energy features of 12 channels lung sounds were extracted by Hilbert-Huang transform. And then, channels and features were screened by the reliefF algorithm. Finally, the feature sets were input into a support vector machine to diagnose COPD severity, and the performance with Bayes, decision tree, and deep belief network was compared. Experimental results show that high classification performance using only 4-channel lung sounds of L1, L2, L3, and L4 channels can be achieved by the proposed model. The accuracy, sensitivity, and specificity of mild COPD and moderate + severe COPD were 89.13%, 87.72%, and 91.01%, respectively. The classification performance rates of moderate COPD and severe COPD were 94.26%, 97.32%, and 89.93% for accuracy, sensitivity, and specificity, respectively.
This model provides a standardized evaluation with high classification performance rates, which can assist doctors to complete the preliminary diagnosis of COPD severity immediately, and has important clinical significance.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>34654400</pmid><doi>10.1186/s12890-021-01682-5</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1471-2466 |
ispartof | BMC pulmonary medicine, 2021-10, Vol.21 (1), p.321-13, Article 321 |
issn | 1471-2466 1471-2466 |
language | eng |
recordid | cdi_doaj_primary_oai_doaj_org_article_d1363d227e334b5cb55e67d44ea7c1fc |
source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Springer Nature OA Free Journals; PubMed Central; SpringerLink Journals - AutoHoldings |
subjects | Accuracy Algorithms Auscultation Bayes Theorem Bayesian analysis China Chronic obstructive pulmonary disease Classification Clinical medicine Databases, Factual Decision Support Systems, Clinical Decision Trees Diagnosis Disease Hilbert–Huang tansform Humans Lung diseases Lung diseases, Obstructive Medical testing products Models, Statistical Morbidity Neural networks Obstructive lung disease Physiology Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonology ReliefF algorithm Respiratory diseases Respiratory organs Respiratory Sounds - diagnosis RespiratoryDatabase @ TR Sensitivity and Specificity Sounds Support Vector Machine Technology application Wavelet transforms |
title | Multi-channel lung sounds intelligent diagnosis of chronic obstructive pulmonary disease |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T23%3A55%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Multi-channel%20lung%20sounds%20intelligent%20diagnosis%20of%20chronic%20obstructive%20pulmonary%20disease&rft.jtitle=BMC%20pulmonary%20medicine&rft.au=Yu,%20Hui&rft.date=2021-10-15&rft.volume=21&rft.issue=1&rft.spage=321&rft.epage=13&rft.pages=321-13&rft.artnum=321&rft.issn=1471-2466&rft.eissn=1471-2466&rft_id=info:doi/10.1186/s12890-021-01682-5&rft_dat=%3Cgale_doaj_%3EA681631558%3C/gale_doaj_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2583190777&rft_id=info:pmid/34654400&rft_galeid=A681631558&rft_doaj_id=oai_doaj_org_article_d1363d227e334b5cb55e67d44ea7c1fc&rfr_iscdi=true |