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Disinfectant and Antimicrobial Susceptibility Profiles of Campylobacter coli Isolated in 1998 to 1999 and 2015 from Swine and Commercial Pork Chops
Susceptibility profiles were determined for 111 Campylobacter coli strains obtained in 1998 to 1999 and 2015 from market age pigs and pork chops against 22 disinfectants and 9 antimicrobials. Resistance to tetracycline (TET) was observed in 44.4% of 1998 to 1999 strains, and the antibiotic resistanc...
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Published in: | Journal of food science 2019-06, Vol.84 (6), p.1501-1512 |
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creator | Beier, Ross C. Harvey, Roger B. Hernandez, Charles A. Andrews, Kathleen Droleskey, Robert E. Hume, Michael E. Davidson, Maureen K. Bodeis‐Jones, Sonya Young, Shenia Anderson, Robin C. Nisbet, David J. |
description | Susceptibility profiles were determined for 111 Campylobacter coli strains obtained in 1998 to 1999 and 2015 from market age pigs and pork chops against 22 disinfectants and 9 antimicrobials. Resistance to tetracycline (TET) was observed in 44.4% of 1998 to 1999 strains, and the antibiotic resistance profile was TET. But strains obtained in 2015 from swine and retail pork chops had 75% TET resistance and the antibiotic resistance profile was TET, followed by azithromycin‐erythromycin‐TET‐telithromycin‐clindamycin. Antimicrobial resistance increased in 2015 strains. All strains were resistant to triclosan, and 84.1% and 95.8% of strains in 1998 to 1999 and 2015, respectively, were chlorhexidine resistant. All strains were susceptible to benzalkonium chloride. There was a shift toward higher susceptibility to chlorhexidine, triclosan, P‐128, OdoBan, CPB, and CPC in 2015 swine and pork chop strains compared with 1998 to 1999 strains. The disinfectants Tek‐Trol and providone‐iodine, tris(hydroxylmethyl)nitromethane (THN) and formaldehyde demonstrated the highest susceptibilities. Didecyldimethylammonium chloride (C10AC) appeared to be about equally effective as benzyldimethyltetradecylammonium chloride (C14BAC) for inhibiting C. coli, and both were more effective than C8AC and C12BAC, but C16BAC was not efficient at inhibiting C. coli. The BACs, C12BAC and C14BAC, were the most effective ingredients in DC&R. Also, C12BAC and C14BAC, or these two in synergy with C10AC were responsible for inhibition of C. coli at high P‐128 MICs. No cross‐resistance was observed between antibiotics and disinfectants. The continued use of THN and formaldehyde in DC&R should be evaluated since these components are not effective, and their inclusion adds unwanted chemicals in the environment.
Practical Application
Campylobacter species cause diarrheal disease throughout the world. Disinfectants are often used on the farm, in veterinary medicine, by the food processing industry, in restaurants, and in consumer's homes. Limited information is available in the literature showing how disinfectants or disinfectant components may affect the many different foodborne pathogens, and, specifically, Campylobacter coli studied here. The knowledge generated in this study concerning the interactions of a broad array of disinfectants against C. coli may well affect the types of disinfectants and disinfectant formulations allowable for use by medical personnel, producers, food processors, restaur |
doi_str_mv | 10.1111/1750-3841.14622 |
format | article |
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Practical Application
Campylobacter species cause diarrheal disease throughout the world. Disinfectants are often used on the farm, in veterinary medicine, by the food processing industry, in restaurants, and in consumer's homes. Limited information is available in the literature showing how disinfectants or disinfectant components may affect the many different foodborne pathogens, and, specifically, Campylobacter coli studied here. The knowledge generated in this study concerning the interactions of a broad array of disinfectants against C. coli may well affect the types of disinfectants and disinfectant formulations allowable for use by medical personnel, producers, food processors, restaurants, and consumers.</description><identifier>ISSN: 0022-1147</identifier><identifier>EISSN: 1750-3841</identifier><identifier>DOI: 10.1111/1750-3841.14622</identifier><identifier>PMID: 31116418</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Animals ; Anti-Bacterial Agents - pharmacology ; Antibiotic resistance ; Antibiotics ; Antiinfectives and antibacterials ; antimicrobial ; Antimicrobial agents ; Antimicrobial resistance ; Azithromycin ; Benzalkonium chloride ; Benzalkonium Compounds - pharmacology ; Campylobacter ; Campylobacter coli ; Campylobacter coli - drug effects ; Campylobacter coli - genetics ; Campylobacter coli - isolation & purification ; Chlorhexidine ; Clindamycin ; Clindamycin - pharmacology ; Diarrhea ; disinfectant ; Disinfectants ; Disinfectants - pharmacology ; Disinfection & disinfectants ; Drug resistance ; Drug Resistance, Bacterial ; Erythromycin ; Erythromycin - pharmacology ; Food Contamination - analysis ; Food industry ; Food processing ; Food processing industry ; Foodborne pathogens ; Formaldehyde ; Formulations ; Iodine ; Livestock ; Medical personnel ; Microbial Sensitivity Tests ; Nitromethane ; Organic chemistry ; Pork ; Processing industry ; Red Meat - microbiology ; susceptibility ; Swine ; Telithromycin ; Tetracycline - pharmacology ; Triclosan ; Veterinary medicine</subject><ispartof>Journal of food science, 2019-06, Vol.84 (6), p.1501-1512</ispartof><rights>Published 2019. This article is a U.S. Government work and is in the public domain in the USA.</rights><rights>2019 Institute of Food Technologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3722-adb9a680a3af12a0b8022dcbefcdef1c0add64a965b62effcc98d760fa17ee6a3</citedby><cites>FETCH-LOGICAL-c3722-adb9a680a3af12a0b8022dcbefcdef1c0add64a965b62effcc98d760fa17ee6a3</cites><orcidid>0000-0002-3445-1008</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31116418$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beier, Ross C.</creatorcontrib><creatorcontrib>Harvey, Roger B.</creatorcontrib><creatorcontrib>Hernandez, Charles A.</creatorcontrib><creatorcontrib>Andrews, Kathleen</creatorcontrib><creatorcontrib>Droleskey, Robert E.</creatorcontrib><creatorcontrib>Hume, Michael E.</creatorcontrib><creatorcontrib>Davidson, Maureen K.</creatorcontrib><creatorcontrib>Bodeis‐Jones, Sonya</creatorcontrib><creatorcontrib>Young, Shenia</creatorcontrib><creatorcontrib>Anderson, Robin C.</creatorcontrib><creatorcontrib>Nisbet, David J.</creatorcontrib><title>Disinfectant and Antimicrobial Susceptibility Profiles of Campylobacter coli Isolated in 1998 to 1999 and 2015 from Swine and Commercial Pork Chops</title><title>Journal of food science</title><addtitle>J Food Sci</addtitle><description>Susceptibility profiles were determined for 111 Campylobacter coli strains obtained in 1998 to 1999 and 2015 from market age pigs and pork chops against 22 disinfectants and 9 antimicrobials. Resistance to tetracycline (TET) was observed in 44.4% of 1998 to 1999 strains, and the antibiotic resistance profile was TET. But strains obtained in 2015 from swine and retail pork chops had 75% TET resistance and the antibiotic resistance profile was TET, followed by azithromycin‐erythromycin‐TET‐telithromycin‐clindamycin. Antimicrobial resistance increased in 2015 strains. All strains were resistant to triclosan, and 84.1% and 95.8% of strains in 1998 to 1999 and 2015, respectively, were chlorhexidine resistant. All strains were susceptible to benzalkonium chloride. There was a shift toward higher susceptibility to chlorhexidine, triclosan, P‐128, OdoBan, CPB, and CPC in 2015 swine and pork chop strains compared with 1998 to 1999 strains. The disinfectants Tek‐Trol and providone‐iodine, tris(hydroxylmethyl)nitromethane (THN) and formaldehyde demonstrated the highest susceptibilities. Didecyldimethylammonium chloride (C10AC) appeared to be about equally effective as benzyldimethyltetradecylammonium chloride (C14BAC) for inhibiting C. coli, and both were more effective than C8AC and C12BAC, but C16BAC was not efficient at inhibiting C. coli. The BACs, C12BAC and C14BAC, were the most effective ingredients in DC&R. Also, C12BAC and C14BAC, or these two in synergy with C10AC were responsible for inhibition of C. coli at high P‐128 MICs. No cross‐resistance was observed between antibiotics and disinfectants. The continued use of THN and formaldehyde in DC&R should be evaluated since these components are not effective, and their inclusion adds unwanted chemicals in the environment.
Practical Application
Campylobacter species cause diarrheal disease throughout the world. Disinfectants are often used on the farm, in veterinary medicine, by the food processing industry, in restaurants, and in consumer's homes. Limited information is available in the literature showing how disinfectants or disinfectant components may affect the many different foodborne pathogens, and, specifically, Campylobacter coli studied here. The knowledge generated in this study concerning the interactions of a broad array of disinfectants against C. coli may well affect the types of disinfectants and disinfectant formulations allowable for use by medical personnel, producers, food processors, restaurants, and consumers.</description><subject>Animals</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotic resistance</subject><subject>Antibiotics</subject><subject>Antiinfectives and antibacterials</subject><subject>antimicrobial</subject><subject>Antimicrobial agents</subject><subject>Antimicrobial resistance</subject><subject>Azithromycin</subject><subject>Benzalkonium chloride</subject><subject>Benzalkonium Compounds - pharmacology</subject><subject>Campylobacter</subject><subject>Campylobacter coli</subject><subject>Campylobacter coli - drug effects</subject><subject>Campylobacter coli - genetics</subject><subject>Campylobacter coli - isolation & purification</subject><subject>Chlorhexidine</subject><subject>Clindamycin</subject><subject>Clindamycin - pharmacology</subject><subject>Diarrhea</subject><subject>disinfectant</subject><subject>Disinfectants</subject><subject>Disinfectants - pharmacology</subject><subject>Disinfection & disinfectants</subject><subject>Drug resistance</subject><subject>Drug Resistance, Bacterial</subject><subject>Erythromycin</subject><subject>Erythromycin - pharmacology</subject><subject>Food Contamination - analysis</subject><subject>Food industry</subject><subject>Food processing</subject><subject>Food processing industry</subject><subject>Foodborne pathogens</subject><subject>Formaldehyde</subject><subject>Formulations</subject><subject>Iodine</subject><subject>Livestock</subject><subject>Medical personnel</subject><subject>Microbial Sensitivity Tests</subject><subject>Nitromethane</subject><subject>Organic chemistry</subject><subject>Pork</subject><subject>Processing industry</subject><subject>Red Meat - microbiology</subject><subject>susceptibility</subject><subject>Swine</subject><subject>Telithromycin</subject><subject>Tetracycline - pharmacology</subject><subject>Triclosan</subject><subject>Veterinary medicine</subject><issn>0022-1147</issn><issn>1750-3841</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqFkUtP3DAUhS1UVAboml1lqZtuBmwn4yRLFMqjQgJpYG3d-KGaOnFqO0LzO_jDODPAohu8ufLVd4997kHohJJTms8ZrVZkWdQlPaUlZ2wPLT46X9CCEMaWlJbVATqM8YnM94J_RQdFnuUlrRfo5cJGOxgtEwwJw6Dw-ZBsb2XwnQWH11OUeky2s86mDb4P3linI_YGt9CPG-c7kEkHLL2z-CZ6B0krbAdMm6bGyc-12QozQlfYBN_j9bMd9LbX-r7XQc4v3fvwF7d__BiP0b4BF_W3t3qEHi9_PbTXy9u7q5v2_HYpiyobA9U1wGsCBRjKgHR1tqdkp41U2lBJQCleQsNXHWfaGCmbWlWcGKCV1hyKI_RzpzsG_2_SMYneZrfOwaD9FEVeFiM15Q3L6I__0Cc_hSH_bqaagpR1yTN1tqPy9mIM2ogx2B7CRlAi5rzEnI6Y0xHbvPLE9zfdqeu1-uDfA8oA3wHPee2bz_TE78uL9U75FQvVn8Q</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Beier, Ross C.</creator><creator>Harvey, Roger B.</creator><creator>Hernandez, Charles A.</creator><creator>Andrews, Kathleen</creator><creator>Droleskey, Robert E.</creator><creator>Hume, Michael E.</creator><creator>Davidson, Maureen K.</creator><creator>Bodeis‐Jones, Sonya</creator><creator>Young, Shenia</creator><creator>Anderson, Robin C.</creator><creator>Nisbet, David J.</creator><general>Wiley Subscription Services, Inc</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>7QO</scope><scope>7QR</scope><scope>7ST</scope><scope>7T7</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>F28</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope><scope>SOI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3445-1008</orcidid></search><sort><creationdate>201906</creationdate><title>Disinfectant and Antimicrobial Susceptibility Profiles of Campylobacter coli Isolated in 1998 to 1999 and 2015 from Swine and Commercial Pork Chops</title><author>Beier, Ross C. ; Harvey, Roger B. ; Hernandez, Charles A. ; Andrews, Kathleen ; Droleskey, Robert E. ; Hume, Michael E. ; Davidson, Maureen K. ; Bodeis‐Jones, Sonya ; Young, Shenia ; Anderson, Robin C. ; Nisbet, David J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3722-adb9a680a3af12a0b8022dcbefcdef1c0add64a965b62effcc98d760fa17ee6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Animals</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotic resistance</topic><topic>Antibiotics</topic><topic>Antiinfectives and antibacterials</topic><topic>antimicrobial</topic><topic>Antimicrobial agents</topic><topic>Antimicrobial resistance</topic><topic>Azithromycin</topic><topic>Benzalkonium chloride</topic><topic>Benzalkonium Compounds - pharmacology</topic><topic>Campylobacter</topic><topic>Campylobacter coli</topic><topic>Campylobacter coli - drug effects</topic><topic>Campylobacter coli - genetics</topic><topic>Campylobacter coli - isolation & purification</topic><topic>Chlorhexidine</topic><topic>Clindamycin</topic><topic>Clindamycin - pharmacology</topic><topic>Diarrhea</topic><topic>disinfectant</topic><topic>Disinfectants</topic><topic>Disinfectants - pharmacology</topic><topic>Disinfection & disinfectants</topic><topic>Drug resistance</topic><topic>Drug Resistance, Bacterial</topic><topic>Erythromycin</topic><topic>Erythromycin - pharmacology</topic><topic>Food Contamination - analysis</topic><topic>Food industry</topic><topic>Food processing</topic><topic>Food processing industry</topic><topic>Foodborne pathogens</topic><topic>Formaldehyde</topic><topic>Formulations</topic><topic>Iodine</topic><topic>Livestock</topic><topic>Medical personnel</topic><topic>Microbial Sensitivity Tests</topic><topic>Nitromethane</topic><topic>Organic chemistry</topic><topic>Pork</topic><topic>Processing industry</topic><topic>Red Meat - microbiology</topic><topic>susceptibility</topic><topic>Swine</topic><topic>Telithromycin</topic><topic>Tetracycline - pharmacology</topic><topic>Triclosan</topic><topic>Veterinary medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beier, Ross C.</creatorcontrib><creatorcontrib>Harvey, Roger B.</creatorcontrib><creatorcontrib>Hernandez, Charles A.</creatorcontrib><creatorcontrib>Andrews, Kathleen</creatorcontrib><creatorcontrib>Droleskey, Robert E.</creatorcontrib><creatorcontrib>Hume, Michael E.</creatorcontrib><creatorcontrib>Davidson, Maureen K.</creatorcontrib><creatorcontrib>Bodeis‐Jones, Sonya</creatorcontrib><creatorcontrib>Young, Shenia</creatorcontrib><creatorcontrib>Anderson, Robin C.</creatorcontrib><creatorcontrib>Nisbet, David J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Environment Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ANTE: Abstracts in New Technology & Engineering</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>Environment Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of food science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beier, Ross C.</au><au>Harvey, Roger B.</au><au>Hernandez, Charles A.</au><au>Andrews, Kathleen</au><au>Droleskey, Robert E.</au><au>Hume, Michael E.</au><au>Davidson, Maureen K.</au><au>Bodeis‐Jones, Sonya</au><au>Young, Shenia</au><au>Anderson, Robin C.</au><au>Nisbet, David J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disinfectant and Antimicrobial Susceptibility Profiles of Campylobacter coli Isolated in 1998 to 1999 and 2015 from Swine and Commercial Pork Chops</atitle><jtitle>Journal of food science</jtitle><addtitle>J Food Sci</addtitle><date>2019-06</date><risdate>2019</risdate><volume>84</volume><issue>6</issue><spage>1501</spage><epage>1512</epage><pages>1501-1512</pages><issn>0022-1147</issn><eissn>1750-3841</eissn><abstract>Susceptibility profiles were determined for 111 Campylobacter coli strains obtained in 1998 to 1999 and 2015 from market age pigs and pork chops against 22 disinfectants and 9 antimicrobials. Resistance to tetracycline (TET) was observed in 44.4% of 1998 to 1999 strains, and the antibiotic resistance profile was TET. But strains obtained in 2015 from swine and retail pork chops had 75% TET resistance and the antibiotic resistance profile was TET, followed by azithromycin‐erythromycin‐TET‐telithromycin‐clindamycin. Antimicrobial resistance increased in 2015 strains. All strains were resistant to triclosan, and 84.1% and 95.8% of strains in 1998 to 1999 and 2015, respectively, were chlorhexidine resistant. All strains were susceptible to benzalkonium chloride. There was a shift toward higher susceptibility to chlorhexidine, triclosan, P‐128, OdoBan, CPB, and CPC in 2015 swine and pork chop strains compared with 1998 to 1999 strains. The disinfectants Tek‐Trol and providone‐iodine, tris(hydroxylmethyl)nitromethane (THN) and formaldehyde demonstrated the highest susceptibilities. Didecyldimethylammonium chloride (C10AC) appeared to be about equally effective as benzyldimethyltetradecylammonium chloride (C14BAC) for inhibiting C. coli, and both were more effective than C8AC and C12BAC, but C16BAC was not efficient at inhibiting C. coli. The BACs, C12BAC and C14BAC, were the most effective ingredients in DC&R. Also, C12BAC and C14BAC, or these two in synergy with C10AC were responsible for inhibition of C. coli at high P‐128 MICs. No cross‐resistance was observed between antibiotics and disinfectants. The continued use of THN and formaldehyde in DC&R should be evaluated since these components are not effective, and their inclusion adds unwanted chemicals in the environment.
Practical Application
Campylobacter species cause diarrheal disease throughout the world. Disinfectants are often used on the farm, in veterinary medicine, by the food processing industry, in restaurants, and in consumer's homes. Limited information is available in the literature showing how disinfectants or disinfectant components may affect the many different foodborne pathogens, and, specifically, Campylobacter coli studied here. The knowledge generated in this study concerning the interactions of a broad array of disinfectants against C. coli may well affect the types of disinfectants and disinfectant formulations allowable for use by medical personnel, producers, food processors, restaurants, and consumers.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31116418</pmid><doi>10.1111/1750-3841.14622</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-3445-1008</orcidid></addata></record> |
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ispartof | Journal of food science, 2019-06, Vol.84 (6), p.1501-1512 |
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language | eng |
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source | Wiley |
subjects | Animals Anti-Bacterial Agents - pharmacology Antibiotic resistance Antibiotics Antiinfectives and antibacterials antimicrobial Antimicrobial agents Antimicrobial resistance Azithromycin Benzalkonium chloride Benzalkonium Compounds - pharmacology Campylobacter Campylobacter coli Campylobacter coli - drug effects Campylobacter coli - genetics Campylobacter coli - isolation & purification Chlorhexidine Clindamycin Clindamycin - pharmacology Diarrhea disinfectant Disinfectants Disinfectants - pharmacology Disinfection & disinfectants Drug resistance Drug Resistance, Bacterial Erythromycin Erythromycin - pharmacology Food Contamination - analysis Food industry Food processing Food processing industry Foodborne pathogens Formaldehyde Formulations Iodine Livestock Medical personnel Microbial Sensitivity Tests Nitromethane Organic chemistry Pork Processing industry Red Meat - microbiology susceptibility Swine Telithromycin Tetracycline - pharmacology Triclosan Veterinary medicine |
title | Disinfectant and Antimicrobial Susceptibility Profiles of Campylobacter coli Isolated in 1998 to 1999 and 2015 from Swine and Commercial Pork Chops |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T17%3A54%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Disinfectant%20and%20Antimicrobial%20Susceptibility%20Profiles%20of%20Campylobacter%20coli%20Isolated%20in%201998%20to%201999%20and%202015%20from%20Swine%20and%20Commercial%20Pork%20Chops&rft.jtitle=Journal%20of%20food%20science&rft.au=Beier,%20Ross%20C.&rft.date=2019-06&rft.volume=84&rft.issue=6&rft.spage=1501&rft.epage=1512&rft.pages=1501-1512&rft.issn=0022-1147&rft.eissn=1750-3841&rft_id=info:doi/10.1111/1750-3841.14622&rft_dat=%3Cproquest_cross%3E2232081692%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3722-adb9a680a3af12a0b8022dcbefcdef1c0add64a965b62effcc98d760fa17ee6a3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2239304846&rft_id=info:pmid/31116418&rfr_iscdi=true |