Loading…
Synthesis and Evaluation of 99mTc(CO)3 Complexes with Ciprofloxacin Dithiocarbamate for Infection Imaging
Background: The accurate diagnosis of bacterial infections remains a critical challenge in clinical practice. Traditional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) often fail to distinguish bacterial infections from sterile inflammation. Nuclear medicine,...
Saved in:
Published in: | Pharmaceutics 2024-09, Vol.16 (9), p.1210 |
---|---|
Main Authors: | , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | |
---|---|
cites | |
container_end_page | |
container_issue | 9 |
container_start_page | 1210 |
container_title | Pharmaceutics |
container_volume | 16 |
creator | Papasavva, Afroditi Pirmettis, Nektarios N Shegani, Antonio Papadopoulou, Eleni Kiritsis, Christos Georgoutsou-Spyridonos, Maria Mastellos, Dimitrios C Chiotellis, Aristeidis Kyprianidou, Patricia Pelecanou, Maria Papadopoulos, Minas Pirmettis, Ioannis |
description | Background: The accurate diagnosis of bacterial infections remains a critical challenge in clinical practice. Traditional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) often fail to distinguish bacterial infections from sterile inflammation. Nuclear medicine, such as technetium-99m (99mTc) radiopharmaceuticals, offers a promising alternative due to its ideal characteristics. Methods: This study explores the development of [2 + 1] mixed-ligand 99mTc-labeled ciprofloxacin dithiocarbamate (Cip-DTC) complexes combined with various phosphine ligands, including triphenylphosphine (PPh3), tris(4-methoxyphenyl)phosphine (TMPP), methyl(diphenyl)phosphine (MePPh2), dimethylphenylphosphine (DMPP), and 1,3,5-triaza-7-phosphaadamantane (ADAP). The characterization of 99mTc-complexes was conducted using rhenium analogs as structural models to ensure similar coordination. Results: Stability studies demonstrated the high integrity (97–98%) of the complexes under various conditions, including cysteine and histidine challenges. Lipophilicity studies indicated that complexes with higher logD7.4 values (1.6–2.7) exhibited enhanced tissue penetration and prolonged circulation. Biodistribution studies in Swiss Albino mice with induced infections and aseptic inflammation revealed distinct patterns. Specifically, the complex fac-[99mTc(CO)3(Cip-DTC)(PPh3)] (2′) showed high infected/normal muscle ratios (4.62 at 120 min), while the complex fac-[99mTc(CO)3(Cip-DTC)(TMPP)] (3′) demonstrated delayed but effective targeting (infected/normal muscle ratio of 3.32 at 120 min). Conclusions: These findings highlight the potential of 99mTc-labeled complexes as effective radiopharmaceuticals for the differential diagnosis of bacterial infections, advancing nuclear medicine diagnostics. Future studies will focus on optimizing molecular weight, lipophilicity, and stability to further enhance the diagnostic specificity and clinical utility of these radiopharmaceuticals. |
doi_str_mv | 10.3390/pharmaceutics16091210 |
format | article |
fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_d1174247a4d34850822cf8c3390aec40</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_d1174247a4d34850822cf8c3390aec40</doaj_id><sourcerecordid>3110912488</sourcerecordid><originalsourceid>FETCH-LOGICAL-d315t-fb5667bc2ced30b3e760b073f8929be373d687aa46d0a2d26c90289664592bb03</originalsourceid><addsrcrecordid>eNpdkc1r3DAQxUVpacI2f0JB0Et62FbSyLJ1KsX56EIgh6ZnM5bkXS225Ep2Pv77eDc5NJ3LDG8ev8N7hHzm7BuAZt_HHaYBjZsnbzJXTHPB2TtyyrXWa6kFvP_nPiFnOe_ZMgC8Av2RnIBeMEKqU-J_P4Vp57LPFIOll_fYzzj5GGjsqNbDnTmvb78CreMw9u7RZfrgpx2t_Zhi18dHND7Qi0Xy0WBqccDJ0S4mugmdM0fQZsCtD9tP5EOHfXZnr3tF_lxd3tW_1je315v6583aAi-mddcWSpWtEcZZYC24UrGWldBVWujWQQlWVSWiVJahsEIZzUSllZKFFm3LYEU2L1wbcd-MyQ-YnpqIvjkKMW0bTEtuvWss56UUskRpQVYFq4QwXWUOEaMz8sD68cIa53Zw1rgwJezfQN9-gt8123jfcC6hYEvKK3L-Skjx7-zy1Aw-G9f3GFyccwOcH9qTVbVYv_xn3cc5hSWro0stXRYFPAM58Jyp</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3110649255</pqid></control><display><type>article</type><title>Synthesis and Evaluation of 99mTc(CO)3 Complexes with Ciprofloxacin Dithiocarbamate for Infection Imaging</title><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Papasavva, Afroditi ; Pirmettis, Nektarios N ; Shegani, Antonio ; Papadopoulou, Eleni ; Kiritsis, Christos ; Georgoutsou-Spyridonos, Maria ; Mastellos, Dimitrios C ; Chiotellis, Aristeidis ; Kyprianidou, Patricia ; Pelecanou, Maria ; Papadopoulos, Minas ; Pirmettis, Ioannis</creator><creatorcontrib>Papasavva, Afroditi ; Pirmettis, Nektarios N ; Shegani, Antonio ; Papadopoulou, Eleni ; Kiritsis, Christos ; Georgoutsou-Spyridonos, Maria ; Mastellos, Dimitrios C ; Chiotellis, Aristeidis ; Kyprianidou, Patricia ; Pelecanou, Maria ; Papadopoulos, Minas ; Pirmettis, Ioannis</creatorcontrib><description>Background: The accurate diagnosis of bacterial infections remains a critical challenge in clinical practice. Traditional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) often fail to distinguish bacterial infections from sterile inflammation. Nuclear medicine, such as technetium-99m (99mTc) radiopharmaceuticals, offers a promising alternative due to its ideal characteristics. Methods: This study explores the development of [2 + 1] mixed-ligand 99mTc-labeled ciprofloxacin dithiocarbamate (Cip-DTC) complexes combined with various phosphine ligands, including triphenylphosphine (PPh3), tris(4-methoxyphenyl)phosphine (TMPP), methyl(diphenyl)phosphine (MePPh2), dimethylphenylphosphine (DMPP), and 1,3,5-triaza-7-phosphaadamantane (ADAP). The characterization of 99mTc-complexes was conducted using rhenium analogs as structural models to ensure similar coordination. Results: Stability studies demonstrated the high integrity (97–98%) of the complexes under various conditions, including cysteine and histidine challenges. Lipophilicity studies indicated that complexes with higher logD7.4 values (1.6–2.7) exhibited enhanced tissue penetration and prolonged circulation. Biodistribution studies in Swiss Albino mice with induced infections and aseptic inflammation revealed distinct patterns. Specifically, the complex fac-[99mTc(CO)3(Cip-DTC)(PPh3)] (2′) showed high infected/normal muscle ratios (4.62 at 120 min), while the complex fac-[99mTc(CO)3(Cip-DTC)(TMPP)] (3′) demonstrated delayed but effective targeting (infected/normal muscle ratio of 3.32 at 120 min). Conclusions: These findings highlight the potential of 99mTc-labeled complexes as effective radiopharmaceuticals for the differential diagnosis of bacterial infections, advancing nuclear medicine diagnostics. Future studies will focus on optimizing molecular weight, lipophilicity, and stability to further enhance the diagnostic specificity and clinical utility of these radiopharmaceuticals.</description><identifier>ISSN: 1999-4923</identifier><identifier>EISSN: 1999-4923</identifier><identifier>DOI: 10.3390/pharmaceutics16091210</identifier><identifier>PMID: 39339246</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Antibiotics ; Bacterial infections ; Chromatography ; ciprofloxacin ; Cooling ; infection ; Infections ; Inflammation ; Ligands ; NMR ; Nuclear magnetic resonance ; Nuclear medicine ; Spectrum analysis ; technetium-99m ; Tomography ; tricarbonyl</subject><ispartof>Pharmaceutics, 2024-09, Vol.16 (9), p.1210</ispartof><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3110649255/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3110649255?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><creatorcontrib>Papasavva, Afroditi</creatorcontrib><creatorcontrib>Pirmettis, Nektarios N</creatorcontrib><creatorcontrib>Shegani, Antonio</creatorcontrib><creatorcontrib>Papadopoulou, Eleni</creatorcontrib><creatorcontrib>Kiritsis, Christos</creatorcontrib><creatorcontrib>Georgoutsou-Spyridonos, Maria</creatorcontrib><creatorcontrib>Mastellos, Dimitrios C</creatorcontrib><creatorcontrib>Chiotellis, Aristeidis</creatorcontrib><creatorcontrib>Kyprianidou, Patricia</creatorcontrib><creatorcontrib>Pelecanou, Maria</creatorcontrib><creatorcontrib>Papadopoulos, Minas</creatorcontrib><creatorcontrib>Pirmettis, Ioannis</creatorcontrib><title>Synthesis and Evaluation of 99mTc(CO)3 Complexes with Ciprofloxacin Dithiocarbamate for Infection Imaging</title><title>Pharmaceutics</title><description>Background: The accurate diagnosis of bacterial infections remains a critical challenge in clinical practice. Traditional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) often fail to distinguish bacterial infections from sterile inflammation. Nuclear medicine, such as technetium-99m (99mTc) radiopharmaceuticals, offers a promising alternative due to its ideal characteristics. Methods: This study explores the development of [2 + 1] mixed-ligand 99mTc-labeled ciprofloxacin dithiocarbamate (Cip-DTC) complexes combined with various phosphine ligands, including triphenylphosphine (PPh3), tris(4-methoxyphenyl)phosphine (TMPP), methyl(diphenyl)phosphine (MePPh2), dimethylphenylphosphine (DMPP), and 1,3,5-triaza-7-phosphaadamantane (ADAP). The characterization of 99mTc-complexes was conducted using rhenium analogs as structural models to ensure similar coordination. Results: Stability studies demonstrated the high integrity (97–98%) of the complexes under various conditions, including cysteine and histidine challenges. Lipophilicity studies indicated that complexes with higher logD7.4 values (1.6–2.7) exhibited enhanced tissue penetration and prolonged circulation. Biodistribution studies in Swiss Albino mice with induced infections and aseptic inflammation revealed distinct patterns. Specifically, the complex fac-[99mTc(CO)3(Cip-DTC)(PPh3)] (2′) showed high infected/normal muscle ratios (4.62 at 120 min), while the complex fac-[99mTc(CO)3(Cip-DTC)(TMPP)] (3′) demonstrated delayed but effective targeting (infected/normal muscle ratio of 3.32 at 120 min). Conclusions: These findings highlight the potential of 99mTc-labeled complexes as effective radiopharmaceuticals for the differential diagnosis of bacterial infections, advancing nuclear medicine diagnostics. Future studies will focus on optimizing molecular weight, lipophilicity, and stability to further enhance the diagnostic specificity and clinical utility of these radiopharmaceuticals.</description><subject>Antibiotics</subject><subject>Bacterial infections</subject><subject>Chromatography</subject><subject>ciprofloxacin</subject><subject>Cooling</subject><subject>infection</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Ligands</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Nuclear medicine</subject><subject>Spectrum analysis</subject><subject>technetium-99m</subject><subject>Tomography</subject><subject>tricarbonyl</subject><issn>1999-4923</issn><issn>1999-4923</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdkc1r3DAQxUVpacI2f0JB0Et62FbSyLJ1KsX56EIgh6ZnM5bkXS225Ep2Pv77eDc5NJ3LDG8ev8N7hHzm7BuAZt_HHaYBjZsnbzJXTHPB2TtyyrXWa6kFvP_nPiFnOe_ZMgC8Av2RnIBeMEKqU-J_P4Vp57LPFIOll_fYzzj5GGjsqNbDnTmvb78CreMw9u7RZfrgpx2t_Zhi18dHND7Qi0Xy0WBqccDJ0S4mugmdM0fQZsCtD9tP5EOHfXZnr3tF_lxd3tW_1je315v6583aAi-mddcWSpWtEcZZYC24UrGWldBVWujWQQlWVSWiVJahsEIZzUSllZKFFm3LYEU2L1wbcd-MyQ-YnpqIvjkKMW0bTEtuvWss56UUskRpQVYFq4QwXWUOEaMz8sD68cIa53Zw1rgwJezfQN9-gt8123jfcC6hYEvKK3L-Skjx7-zy1Aw-G9f3GFyccwOcH9qTVbVYv_xn3cc5hSWro0stXRYFPAM58Jyp</recordid><startdate>20240914</startdate><enddate>20240914</enddate><creator>Papasavva, Afroditi</creator><creator>Pirmettis, Nektarios N</creator><creator>Shegani, Antonio</creator><creator>Papadopoulou, Eleni</creator><creator>Kiritsis, Christos</creator><creator>Georgoutsou-Spyridonos, Maria</creator><creator>Mastellos, Dimitrios C</creator><creator>Chiotellis, Aristeidis</creator><creator>Kyprianidou, Patricia</creator><creator>Pelecanou, Maria</creator><creator>Papadopoulos, Minas</creator><creator>Pirmettis, Ioannis</creator><general>MDPI AG</general><general>MDPI</general><scope>3V.</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20240914</creationdate><title>Synthesis and Evaluation of 99mTc(CO)3 Complexes with Ciprofloxacin Dithiocarbamate for Infection Imaging</title><author>Papasavva, Afroditi ; Pirmettis, Nektarios N ; Shegani, Antonio ; Papadopoulou, Eleni ; Kiritsis, Christos ; Georgoutsou-Spyridonos, Maria ; Mastellos, Dimitrios C ; Chiotellis, Aristeidis ; Kyprianidou, Patricia ; Pelecanou, Maria ; Papadopoulos, Minas ; Pirmettis, Ioannis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-d315t-fb5667bc2ced30b3e760b073f8929be373d687aa46d0a2d26c90289664592bb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antibiotics</topic><topic>Bacterial infections</topic><topic>Chromatography</topic><topic>ciprofloxacin</topic><topic>Cooling</topic><topic>infection</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Ligands</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Nuclear medicine</topic><topic>Spectrum analysis</topic><topic>technetium-99m</topic><topic>Tomography</topic><topic>tricarbonyl</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Papasavva, Afroditi</creatorcontrib><creatorcontrib>Pirmettis, Nektarios N</creatorcontrib><creatorcontrib>Shegani, Antonio</creatorcontrib><creatorcontrib>Papadopoulou, Eleni</creatorcontrib><creatorcontrib>Kiritsis, Christos</creatorcontrib><creatorcontrib>Georgoutsou-Spyridonos, Maria</creatorcontrib><creatorcontrib>Mastellos, Dimitrios C</creatorcontrib><creatorcontrib>Chiotellis, Aristeidis</creatorcontrib><creatorcontrib>Kyprianidou, Patricia</creatorcontrib><creatorcontrib>Pelecanou, Maria</creatorcontrib><creatorcontrib>Papadopoulos, Minas</creatorcontrib><creatorcontrib>Pirmettis, Ioannis</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Pharmaceutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Papasavva, Afroditi</au><au>Pirmettis, Nektarios N</au><au>Shegani, Antonio</au><au>Papadopoulou, Eleni</au><au>Kiritsis, Christos</au><au>Georgoutsou-Spyridonos, Maria</au><au>Mastellos, Dimitrios C</au><au>Chiotellis, Aristeidis</au><au>Kyprianidou, Patricia</au><au>Pelecanou, Maria</au><au>Papadopoulos, Minas</au><au>Pirmettis, Ioannis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Synthesis and Evaluation of 99mTc(CO)3 Complexes with Ciprofloxacin Dithiocarbamate for Infection Imaging</atitle><jtitle>Pharmaceutics</jtitle><date>2024-09-14</date><risdate>2024</risdate><volume>16</volume><issue>9</issue><spage>1210</spage><pages>1210-</pages><issn>1999-4923</issn><eissn>1999-4923</eissn><abstract>Background: The accurate diagnosis of bacterial infections remains a critical challenge in clinical practice. Traditional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) often fail to distinguish bacterial infections from sterile inflammation. Nuclear medicine, such as technetium-99m (99mTc) radiopharmaceuticals, offers a promising alternative due to its ideal characteristics. Methods: This study explores the development of [2 + 1] mixed-ligand 99mTc-labeled ciprofloxacin dithiocarbamate (Cip-DTC) complexes combined with various phosphine ligands, including triphenylphosphine (PPh3), tris(4-methoxyphenyl)phosphine (TMPP), methyl(diphenyl)phosphine (MePPh2), dimethylphenylphosphine (DMPP), and 1,3,5-triaza-7-phosphaadamantane (ADAP). The characterization of 99mTc-complexes was conducted using rhenium analogs as structural models to ensure similar coordination. Results: Stability studies demonstrated the high integrity (97–98%) of the complexes under various conditions, including cysteine and histidine challenges. Lipophilicity studies indicated that complexes with higher logD7.4 values (1.6–2.7) exhibited enhanced tissue penetration and prolonged circulation. Biodistribution studies in Swiss Albino mice with induced infections and aseptic inflammation revealed distinct patterns. Specifically, the complex fac-[99mTc(CO)3(Cip-DTC)(PPh3)] (2′) showed high infected/normal muscle ratios (4.62 at 120 min), while the complex fac-[99mTc(CO)3(Cip-DTC)(TMPP)] (3′) demonstrated delayed but effective targeting (infected/normal muscle ratio of 3.32 at 120 min). Conclusions: These findings highlight the potential of 99mTc-labeled complexes as effective radiopharmaceuticals for the differential diagnosis of bacterial infections, advancing nuclear medicine diagnostics. Future studies will focus on optimizing molecular weight, lipophilicity, and stability to further enhance the diagnostic specificity and clinical utility of these radiopharmaceuticals.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>39339246</pmid><doi>10.3390/pharmaceutics16091210</doi><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1999-4923 |
ispartof | Pharmaceutics, 2024-09, Vol.16 (9), p.1210 |
issn | 1999-4923 1999-4923 |
language | eng |
recordid | cdi_doaj_primary_oai_doaj_org_article_d1174247a4d34850822cf8c3390aec40 |
source | Publicly Available Content Database; PubMed Central |
subjects | Antibiotics Bacterial infections Chromatography ciprofloxacin Cooling infection Infections Inflammation Ligands NMR Nuclear magnetic resonance Nuclear medicine Spectrum analysis technetium-99m Tomography tricarbonyl |
title | Synthesis and Evaluation of 99mTc(CO)3 Complexes with Ciprofloxacin Dithiocarbamate for Infection Imaging |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T14%3A57%3A52IST&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=Synthesis%20and%20Evaluation%20of%2099mTc(CO)3%20Complexes%20with%20Ciprofloxacin%20Dithiocarbamate%20for%20Infection%20Imaging&rft.jtitle=Pharmaceutics&rft.au=Papasavva,%20Afroditi&rft.date=2024-09-14&rft.volume=16&rft.issue=9&rft.spage=1210&rft.pages=1210-&rft.issn=1999-4923&rft.eissn=1999-4923&rft_id=info:doi/10.3390/pharmaceutics16091210&rft_dat=%3Cproquest_doaj_%3E3110912488%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-d315t-fb5667bc2ced30b3e760b073f8929be373d687aa46d0a2d26c90289664592bb03%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3110649255&rft_id=info:pmid/39339246&rfr_iscdi=true |