Loading…

Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing

Mass screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to prevent the spread of coronavirus disease 2019 (COVID-19). Pooling samples can increase the number of tests processed. LabTurbo AIO 48 is an automated platform that allows ribonucleic acid extraction and...

Full description

Saved in:
Bibliographic Details
Published in:Journal of microbiology, immunology and infection immunology and infection, 2022-12, Vol.55 (6), p.1069-1075
Main Authors: Chung, Hsing-Yi, Jian, Ming-Jr, Chang, Chih-Kai, Lin, Jung-Chung, Yeh, Kuo-Ming, Chen, Chien-Wen, Yang, Ya-Sung, Hsieh, Shan-Shan, Chen, En-Sung, Yang, Mei-Hsiu, Tang, Sheng-Hui, Perng, Cherng-Lih, Yang, Ji-Rong, Liu, Ming-Tsan, Chang, Feng-Yee, Shang, Hung-Sheng
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3
cites cdi_FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3
container_end_page 1075
container_issue 6
container_start_page 1069
container_title Journal of microbiology, immunology and infection
container_volume 55
creator Chung, Hsing-Yi
Jian, Ming-Jr
Chang, Chih-Kai
Lin, Jung-Chung
Yeh, Kuo-Ming
Chen, Chien-Wen
Yang, Ya-Sung
Hsieh, Shan-Shan
Chen, En-Sung
Yang, Mei-Hsiu
Tang, Sheng-Hui
Perng, Cherng-Lih
Yang, Ji-Rong
Liu, Ming-Tsan
Chang, Feng-Yee
Shang, Hung-Sheng
description Mass screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to prevent the spread of coronavirus disease 2019 (COVID-19). Pooling samples can increase the number of tests processed. LabTurbo AIO 48 is an automated platform that allows ribonucleic acid extraction and sample analysis on the same instrument. We created a novel pooling assay on this platform for SARS-CoV-2 detection and demonstrated that the pooling strategy increases testing capacity without affecting accuracy and sensitivity. Comparative limit of detection (LoD) assessment was performed on the LabTurbo AIO 48 platform and the current standard detection system based on real-time reverse transcription polymerase chain reaction (rRT-PCR) using 55 clinically positive samples. An additional 330 primary clinical samples were assessed. Six samples pooled into one reaction tube were detected in approximately 2.5 h using the World Health Organization rRT-PCR protocol. LabTurbo AIO 48 also demonstrated a higher throughput than our reference rRT-PCR assay, with an LoD of 1000 copies/mL. The overall percentage agreement between the methods for the 330 samples was 100%. We created a novel multi-specimen pooling assay using LabTurbo AIO 48 for the robust detection of SARS-CoV-2, allowing high-throughput results; this assay will aid in better control and prevention of COVID-19. The diagnostic assay was cost-effective and time-efficient; thus, the pooling strategy is a practical and effective method for diagnosing large quantities of specimens without compromising precision.
doi_str_mv 10.1016/j.jmii.2021.08.003
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_6a3867e0e8ac4be1bed13c7e6ae1563b</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1684118221001705</els_id><doaj_id>oai_doaj_org_article_6a3867e0e8ac4be1bed13c7e6ae1563b</doaj_id><sourcerecordid>2574736915</sourcerecordid><originalsourceid>FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhSMEoqXwAiyQl2wS_BM7DkJI1QhopSIkCmwtx7lJPEriwXYizUPwzjhMqeiGlS3fc79rH58se0lwQTARb_bFfrK2oJiSAssCY_YoOyd1zfOaMPY47YUsc0IkPcuehbDHuGSUi6fZGSs5k1zI8-zX52WM1sAcwaMQl_aIYNXjoqOdezS7FUY0bZI8HMDYCWZ0cG7cijoEfUSd8ygOgFqIYKJ1M3Idur38epvv3I-cvkVXth9QgDnYaFcbj0jPLRq2wzh4t_TDYYkoQtgGPs-edHoM8OJuvci-f_zwbXeV33z5dL27vMkNpyTmujNdRxmtMNOkJZyASK-uhTSGCcOqTgBlopFNw6FLEt0YU-maCFYbTSiwi-z6xG2d3quDt5P2R-W0VX8OnO-V9smWEZTQTIoKMEhtygZIAy1hpgKhgXDBmsR6f2IdlmaCdrPS6_EB9GFltoPq3apkSQiXPAFe3wG8-7kkI9Rkg4Fx1DO4JSjKq7JioiablJ6kxrsQPHT3YwhWWybUXm2ZUFsmFJYqZSI1vfr3gvctf0OQBO9OAkiWrxa8CsbCbKC1Pv1p8sT-j_8br2TMvA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2574736915</pqid></control><display><type>article</type><title>Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing</title><source>BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS</source><creator>Chung, Hsing-Yi ; Jian, Ming-Jr ; Chang, Chih-Kai ; Lin, Jung-Chung ; Yeh, Kuo-Ming ; Chen, Chien-Wen ; Yang, Ya-Sung ; Hsieh, Shan-Shan ; Chen, En-Sung ; Yang, Mei-Hsiu ; Tang, Sheng-Hui ; Perng, Cherng-Lih ; Yang, Ji-Rong ; Liu, Ming-Tsan ; Chang, Feng-Yee ; Shang, Hung-Sheng</creator><creatorcontrib>Chung, Hsing-Yi ; Jian, Ming-Jr ; Chang, Chih-Kai ; Lin, Jung-Chung ; Yeh, Kuo-Ming ; Chen, Chien-Wen ; Yang, Ya-Sung ; Hsieh, Shan-Shan ; Chen, En-Sung ; Yang, Mei-Hsiu ; Tang, Sheng-Hui ; Perng, Cherng-Lih ; Yang, Ji-Rong ; Liu, Ming-Tsan ; Chang, Feng-Yee ; Shang, Hung-Sheng</creatorcontrib><description>Mass screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to prevent the spread of coronavirus disease 2019 (COVID-19). Pooling samples can increase the number of tests processed. LabTurbo AIO 48 is an automated platform that allows ribonucleic acid extraction and sample analysis on the same instrument. We created a novel pooling assay on this platform for SARS-CoV-2 detection and demonstrated that the pooling strategy increases testing capacity without affecting accuracy and sensitivity. Comparative limit of detection (LoD) assessment was performed on the LabTurbo AIO 48 platform and the current standard detection system based on real-time reverse transcription polymerase chain reaction (rRT-PCR) using 55 clinically positive samples. An additional 330 primary clinical samples were assessed. Six samples pooled into one reaction tube were detected in approximately 2.5 h using the World Health Organization rRT-PCR protocol. LabTurbo AIO 48 also demonstrated a higher throughput than our reference rRT-PCR assay, with an LoD of 1000 copies/mL. The overall percentage agreement between the methods for the 330 samples was 100%. We created a novel multi-specimen pooling assay using LabTurbo AIO 48 for the robust detection of SARS-CoV-2, allowing high-throughput results; this assay will aid in better control and prevention of COVID-19. The diagnostic assay was cost-effective and time-efficient; thus, the pooling strategy is a practical and effective method for diagnosing large quantities of specimens without compromising precision.</description><identifier>ISSN: 1684-1182</identifier><identifier>EISSN: 1995-9133</identifier><identifier>DOI: 10.1016/j.jmii.2021.08.003</identifier><identifier>PMID: 34538568</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Coronavirus disease 2019 ; COVID-19 - diagnosis ; COVID-19 Testing ; High throughput ; Humans ; Original ; Pooled specimen ; Real-Time Polymerase Chain Reaction - methods ; RNA, Viral - genetics ; SARS-CoV-2 ; Sensitivity and Specificity ; Severe acute respiratory coronavirus 2 ; Specimen Handling - methods</subject><ispartof>Journal of microbiology, immunology and infection, 2022-12, Vol.55 (6), p.1069-1075</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier B.V.</rights><rights>2021 Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3</citedby><cites>FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34538568$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chung, Hsing-Yi</creatorcontrib><creatorcontrib>Jian, Ming-Jr</creatorcontrib><creatorcontrib>Chang, Chih-Kai</creatorcontrib><creatorcontrib>Lin, Jung-Chung</creatorcontrib><creatorcontrib>Yeh, Kuo-Ming</creatorcontrib><creatorcontrib>Chen, Chien-Wen</creatorcontrib><creatorcontrib>Yang, Ya-Sung</creatorcontrib><creatorcontrib>Hsieh, Shan-Shan</creatorcontrib><creatorcontrib>Chen, En-Sung</creatorcontrib><creatorcontrib>Yang, Mei-Hsiu</creatorcontrib><creatorcontrib>Tang, Sheng-Hui</creatorcontrib><creatorcontrib>Perng, Cherng-Lih</creatorcontrib><creatorcontrib>Yang, Ji-Rong</creatorcontrib><creatorcontrib>Liu, Ming-Tsan</creatorcontrib><creatorcontrib>Chang, Feng-Yee</creatorcontrib><creatorcontrib>Shang, Hung-Sheng</creatorcontrib><title>Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing</title><title>Journal of microbiology, immunology and infection</title><addtitle>J Microbiol Immunol Infect</addtitle><description>Mass screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to prevent the spread of coronavirus disease 2019 (COVID-19). Pooling samples can increase the number of tests processed. LabTurbo AIO 48 is an automated platform that allows ribonucleic acid extraction and sample analysis on the same instrument. We created a novel pooling assay on this platform for SARS-CoV-2 detection and demonstrated that the pooling strategy increases testing capacity without affecting accuracy and sensitivity. Comparative limit of detection (LoD) assessment was performed on the LabTurbo AIO 48 platform and the current standard detection system based on real-time reverse transcription polymerase chain reaction (rRT-PCR) using 55 clinically positive samples. An additional 330 primary clinical samples were assessed. Six samples pooled into one reaction tube were detected in approximately 2.5 h using the World Health Organization rRT-PCR protocol. LabTurbo AIO 48 also demonstrated a higher throughput than our reference rRT-PCR assay, with an LoD of 1000 copies/mL. The overall percentage agreement between the methods for the 330 samples was 100%. We created a novel multi-specimen pooling assay using LabTurbo AIO 48 for the robust detection of SARS-CoV-2, allowing high-throughput results; this assay will aid in better control and prevention of COVID-19. The diagnostic assay was cost-effective and time-efficient; thus, the pooling strategy is a practical and effective method for diagnosing large quantities of specimens without compromising precision.</description><subject>Coronavirus disease 2019</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 Testing</subject><subject>High throughput</subject><subject>Humans</subject><subject>Original</subject><subject>Pooled specimen</subject><subject>Real-Time Polymerase Chain Reaction - methods</subject><subject>RNA, Viral - genetics</subject><subject>SARS-CoV-2</subject><subject>Sensitivity and Specificity</subject><subject>Severe acute respiratory coronavirus 2</subject><subject>Specimen Handling - methods</subject><issn>1684-1182</issn><issn>1995-9133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNp9ks1u1DAUhSMEoqXwAiyQl2wS_BM7DkJI1QhopSIkCmwtx7lJPEriwXYizUPwzjhMqeiGlS3fc79rH58se0lwQTARb_bFfrK2oJiSAssCY_YoOyd1zfOaMPY47YUsc0IkPcuehbDHuGSUi6fZGSs5k1zI8-zX52WM1sAcwaMQl_aIYNXjoqOdezS7FUY0bZI8HMDYCWZ0cG7cijoEfUSd8ygOgFqIYKJ1M3Idur38epvv3I-cvkVXth9QgDnYaFcbj0jPLRq2wzh4t_TDYYkoQtgGPs-edHoM8OJuvci-f_zwbXeV33z5dL27vMkNpyTmujNdRxmtMNOkJZyASK-uhTSGCcOqTgBlopFNw6FLEt0YU-maCFYbTSiwi-z6xG2d3quDt5P2R-W0VX8OnO-V9smWEZTQTIoKMEhtygZIAy1hpgKhgXDBmsR6f2IdlmaCdrPS6_EB9GFltoPq3apkSQiXPAFe3wG8-7kkI9Rkg4Fx1DO4JSjKq7JioiablJ6kxrsQPHT3YwhWWybUXm2ZUFsmFJYqZSI1vfr3gvctf0OQBO9OAkiWrxa8CsbCbKC1Pv1p8sT-j_8br2TMvA</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Chung, Hsing-Yi</creator><creator>Jian, Ming-Jr</creator><creator>Chang, Chih-Kai</creator><creator>Lin, Jung-Chung</creator><creator>Yeh, Kuo-Ming</creator><creator>Chen, Chien-Wen</creator><creator>Yang, Ya-Sung</creator><creator>Hsieh, Shan-Shan</creator><creator>Chen, En-Sung</creator><creator>Yang, Mei-Hsiu</creator><creator>Tang, Sheng-Hui</creator><creator>Perng, Cherng-Lih</creator><creator>Yang, Ji-Rong</creator><creator>Liu, Ming-Tsan</creator><creator>Chang, Feng-Yee</creator><creator>Shang, Hung-Sheng</creator><general>Elsevier B.V</general><general>Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</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>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20221201</creationdate><title>Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing</title><author>Chung, Hsing-Yi ; Jian, Ming-Jr ; Chang, Chih-Kai ; Lin, Jung-Chung ; Yeh, Kuo-Ming ; Chen, Chien-Wen ; Yang, Ya-Sung ; Hsieh, Shan-Shan ; Chen, En-Sung ; Yang, Mei-Hsiu ; Tang, Sheng-Hui ; Perng, Cherng-Lih ; Yang, Ji-Rong ; Liu, Ming-Tsan ; Chang, Feng-Yee ; Shang, Hung-Sheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Coronavirus disease 2019</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 Testing</topic><topic>High throughput</topic><topic>Humans</topic><topic>Original</topic><topic>Pooled specimen</topic><topic>Real-Time Polymerase Chain Reaction - methods</topic><topic>RNA, Viral - genetics</topic><topic>SARS-CoV-2</topic><topic>Sensitivity and Specificity</topic><topic>Severe acute respiratory coronavirus 2</topic><topic>Specimen Handling - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chung, Hsing-Yi</creatorcontrib><creatorcontrib>Jian, Ming-Jr</creatorcontrib><creatorcontrib>Chang, Chih-Kai</creatorcontrib><creatorcontrib>Lin, Jung-Chung</creatorcontrib><creatorcontrib>Yeh, Kuo-Ming</creatorcontrib><creatorcontrib>Chen, Chien-Wen</creatorcontrib><creatorcontrib>Yang, Ya-Sung</creatorcontrib><creatorcontrib>Hsieh, Shan-Shan</creatorcontrib><creatorcontrib>Chen, En-Sung</creatorcontrib><creatorcontrib>Yang, Mei-Hsiu</creatorcontrib><creatorcontrib>Tang, Sheng-Hui</creatorcontrib><creatorcontrib>Perng, Cherng-Lih</creatorcontrib><creatorcontrib>Yang, Ji-Rong</creatorcontrib><creatorcontrib>Liu, Ming-Tsan</creatorcontrib><creatorcontrib>Chang, Feng-Yee</creatorcontrib><creatorcontrib>Shang, Hung-Sheng</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect: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>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of microbiology, immunology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chung, Hsing-Yi</au><au>Jian, Ming-Jr</au><au>Chang, Chih-Kai</au><au>Lin, Jung-Chung</au><au>Yeh, Kuo-Ming</au><au>Chen, Chien-Wen</au><au>Yang, Ya-Sung</au><au>Hsieh, Shan-Shan</au><au>Chen, En-Sung</au><au>Yang, Mei-Hsiu</au><au>Tang, Sheng-Hui</au><au>Perng, Cherng-Lih</au><au>Yang, Ji-Rong</au><au>Liu, Ming-Tsan</au><au>Chang, Feng-Yee</au><au>Shang, Hung-Sheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing</atitle><jtitle>Journal of microbiology, immunology and infection</jtitle><addtitle>J Microbiol Immunol Infect</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>55</volume><issue>6</issue><spage>1069</spage><epage>1075</epage><pages>1069-1075</pages><issn>1684-1182</issn><eissn>1995-9133</eissn><abstract>Mass screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important to prevent the spread of coronavirus disease 2019 (COVID-19). Pooling samples can increase the number of tests processed. LabTurbo AIO 48 is an automated platform that allows ribonucleic acid extraction and sample analysis on the same instrument. We created a novel pooling assay on this platform for SARS-CoV-2 detection and demonstrated that the pooling strategy increases testing capacity without affecting accuracy and sensitivity. Comparative limit of detection (LoD) assessment was performed on the LabTurbo AIO 48 platform and the current standard detection system based on real-time reverse transcription polymerase chain reaction (rRT-PCR) using 55 clinically positive samples. An additional 330 primary clinical samples were assessed. Six samples pooled into one reaction tube were detected in approximately 2.5 h using the World Health Organization rRT-PCR protocol. LabTurbo AIO 48 also demonstrated a higher throughput than our reference rRT-PCR assay, with an LoD of 1000 copies/mL. The overall percentage agreement between the methods for the 330 samples was 100%. We created a novel multi-specimen pooling assay using LabTurbo AIO 48 for the robust detection of SARS-CoV-2, allowing high-throughput results; this assay will aid in better control and prevention of COVID-19. The diagnostic assay was cost-effective and time-efficient; thus, the pooling strategy is a practical and effective method for diagnosing large quantities of specimens without compromising precision.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>34538568</pmid><doi>10.1016/j.jmii.2021.08.003</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1684-1182
ispartof Journal of microbiology, immunology and infection, 2022-12, Vol.55 (6), p.1069-1075
issn 1684-1182
1995-9133
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_6a3867e0e8ac4be1bed13c7e6ae1563b
source BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS
subjects Coronavirus disease 2019
COVID-19 - diagnosis
COVID-19 Testing
High throughput
Humans
Original
Pooled specimen
Real-Time Polymerase Chain Reaction - methods
RNA, Viral - genetics
SARS-CoV-2
Sensitivity and Specificity
Severe acute respiratory coronavirus 2
Specimen Handling - methods
title Multicenter study evaluating novel multi-specimen pooling assay for the detection of SARS-CoV-2: High sensitivity and high throughput testing
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T21%3A20%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Multicenter%20study%20evaluating%20novel%20multi-specimen%20pooling%20assay%20for%20the%20detection%20of%20SARS-CoV-2:%20High%20sensitivity%20and%20high%20throughput%20testing&rft.jtitle=Journal%20of%20microbiology,%20immunology%20and%20infection&rft.au=Chung,%20Hsing-Yi&rft.date=2022-12-01&rft.volume=55&rft.issue=6&rft.spage=1069&rft.epage=1075&rft.pages=1069-1075&rft.issn=1684-1182&rft.eissn=1995-9133&rft_id=info:doi/10.1016/j.jmii.2021.08.003&rft_dat=%3Cproquest_doaj_%3E2574736915%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c521t-afcff232703a1d151e6995968cc36c37f6e236b8bb5ef3a1abcc7a91639ca12e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2574736915&rft_id=info:pmid/34538568&rfr_iscdi=true