Loading…

Association of aflatoxin with gallbladder cancer in a case‐control study nested within a Chinese cohort

We evaluated whether aflatoxin B1 (AFB1) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1‐lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986‐1989). We included 84 GBC cases with s...

Full description

Saved in:
Bibliographic Details
Published in:International journal of cancer 2024-03, Vol.154 (5), p.801-806
Main Authors: Koshiol, Jill, Zhu, Bin, Wang, Renwei, Hildesheim, Allan, Gao, Yu‐Tang, Egner, Patricia A., Yuan, Jian‐Min, Groopman, John D.
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-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13
cites cdi_FETCH-LOGICAL-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13
container_end_page 806
container_issue 5
container_start_page 801
container_title International journal of cancer
container_volume 154
creator Koshiol, Jill
Zhu, Bin
Wang, Renwei
Hildesheim, Allan
Gao, Yu‐Tang
Egner, Patricia A.
Yuan, Jian‐Min
Groopman, John D.
description We evaluated whether aflatoxin B1 (AFB1) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1‐lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986‐1989). We included 84 GBC cases with sufficient serum and 168 controls matched on age at sample collection, date of blood draw and residence. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for detectable vs non‐detectable AFB1‐lysine albumin adducts and gallbladder cancer. AFB1‐lysine albumin adducts were detected in 50.0% of GBC cases, and risk of GBC was twice as high in those with detectable vs undetectable levels (OR = 2.0, 95% CI = 1.0‐3.9). ORs ranged from 1.8 (95% CI = 0.75‐4.3) for 0.5 to 3.36 pg/mg vs undetectable, suggesting a dose‐response (Ptrend = .05). When restricted to cases diagnosed before the median time to diagnosis after blood draw (18.4 years), results were similar (OR = 2.2, 95% CI = 0.80‐5.8) to those for the entire follow‐up duration. The OR was 9.4 (95% CI = 1.7‐51.1) for individuals with detectable AFB1‐lysine albumin adducts and self‐reported gallstones compared to individuals with neither. Participants with detectable AFB1‐lysine albumin adducts at baseline had increased risk of developing GBC, replicating the previously observed association between AFB1 exposure and providing the first evidence of temporality. What's new? Aflatoxin B1 exposure has been associated with gallbladder cancer, but only in cross‐sectional studies. This case‐control study nested within the Shanghai Cohort Study provides first evidence that exposure precedes disease development. The risk of gallbladder cancer was twice as high among individuals with detectable vs undetectable baseline aflatoxin B1‐lysine albumin adducts. The results suggested a long‐term, persistent effect of aflatoxin B1 exposure on gallbladder cancer risk, and the association was stronger among individuals with self‐reported gallstones. Aflatoxin B1 may contribute to gallbladder cancer development, and aflatoxin abatement programs could help reduce the incidence of gallbladder cancer in high‐risk areas.
doi_str_mv 10.1002/ijc.34755
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2878017959</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2909357004</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13</originalsourceid><addsrcrecordid>eNp1kM1OHDEQhC1EBBvgkBeIRuISDgPtv7XniFbhJ0LKBc5Wj8cDXnnHxJ4R2RuPkGfkSeLsQg5InKql-rpUKkK-UDilAOzML-0pF0rKHTKj0KgaGJW7ZFY8qBXl833yOeclAKUSxB7Z50oL4JLOiD_POVqPo49DFfsK-4Bj_O2H6smPD9U9htAG7DqXKouDLVIsLHd2L89_bBzGFEOVx6lbV4PLo-s2jxtoUcRlV9n4ENN4SD71GLI7etUDcnfx_XZxVd_8vLxenN_Ulksu6zmiUE6jZD1aJ6RWvBeCYcs65JpKrjuJ0jVa90z1LQjGqEA7B6ta7TrKD8i3be5jir-mUsmsfLYuBBxcnLJhWmmgqpFNQY_focs4paG0M6yBhksFIAp1sqVsijkn15vH5FeY1oaC-be_Kfubzf6F_fqaOLUr1_0n3wYvwNkWePLBrT9OMtc_FtvIv9_Gj-Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2909357004</pqid></control><display><type>article</type><title>Association of aflatoxin with gallbladder cancer in a case‐control study nested within a Chinese cohort</title><source>Wiley-Blackwell Read &amp; Publish Collection</source><creator>Koshiol, Jill ; Zhu, Bin ; Wang, Renwei ; Hildesheim, Allan ; Gao, Yu‐Tang ; Egner, Patricia A. ; Yuan, Jian‐Min ; Groopman, John D.</creator><creatorcontrib>Koshiol, Jill ; Zhu, Bin ; Wang, Renwei ; Hildesheim, Allan ; Gao, Yu‐Tang ; Egner, Patricia A. ; Yuan, Jian‐Min ; Groopman, John D.</creatorcontrib><description>We evaluated whether aflatoxin B1 (AFB1) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1‐lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986‐1989). We included 84 GBC cases with sufficient serum and 168 controls matched on age at sample collection, date of blood draw and residence. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for detectable vs non‐detectable AFB1‐lysine albumin adducts and gallbladder cancer. AFB1‐lysine albumin adducts were detected in 50.0% of GBC cases, and risk of GBC was twice as high in those with detectable vs undetectable levels (OR = 2.0, 95% CI = 1.0‐3.9). ORs ranged from 1.8 (95% CI = 0.75‐4.3) for 0.5 to &lt;1.75 pg/mg vs undetectable adduct levels to 2.2 (95% CI = 0.91‐5.6) for &gt;3.36 pg/mg vs undetectable, suggesting a dose‐response (Ptrend = .05). When restricted to cases diagnosed before the median time to diagnosis after blood draw (18.4 years), results were similar (OR = 2.2, 95% CI = 0.80‐5.8) to those for the entire follow‐up duration. The OR was 9.4 (95% CI = 1.7‐51.1) for individuals with detectable AFB1‐lysine albumin adducts and self‐reported gallstones compared to individuals with neither. Participants with detectable AFB1‐lysine albumin adducts at baseline had increased risk of developing GBC, replicating the previously observed association between AFB1 exposure and providing the first evidence of temporality. What's new? Aflatoxin B1 exposure has been associated with gallbladder cancer, but only in cross‐sectional studies. This case‐control study nested within the Shanghai Cohort Study provides first evidence that exposure precedes disease development. The risk of gallbladder cancer was twice as high among individuals with detectable vs undetectable baseline aflatoxin B1‐lysine albumin adducts. The results suggested a long‐term, persistent effect of aflatoxin B1 exposure on gallbladder cancer risk, and the association was stronger among individuals with self‐reported gallstones. Aflatoxin B1 may contribute to gallbladder cancer development, and aflatoxin abatement programs could help reduce the incidence of gallbladder cancer in high‐risk areas.</description><identifier>ISSN: 0020-7136</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.34755</identifier><identifier>PMID: 37840351</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Adducts ; aflatoxin ; Aflatoxin B1 ; Aflatoxin B1 - adverse effects ; Aflatoxin B1 - analysis ; Aflatoxins - analysis ; Aflatoxins - toxicity ; Albumin ; Albumins ; Cancer ; Case-Control Studies ; China - epidemiology ; Cohort Studies ; Epidemiology ; Gallbladder cancer ; Gallbladder Neoplasms - chemically induced ; Gallbladder Neoplasms - epidemiology ; gallstones ; Health risk assessment ; Humans ; incidence ; Lysine ; Male ; Medical research</subject><ispartof>International journal of cancer, 2024-03, Vol.154 (5), p.801-806</ispartof><rights>2023 UICC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.</rights><rights>2024 UICC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13</citedby><cites>FETCH-LOGICAL-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13</cites><orcidid>0000-0002-3832-6204 ; 0000-0002-4620-3108</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/37840351$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koshiol, Jill</creatorcontrib><creatorcontrib>Zhu, Bin</creatorcontrib><creatorcontrib>Wang, Renwei</creatorcontrib><creatorcontrib>Hildesheim, Allan</creatorcontrib><creatorcontrib>Gao, Yu‐Tang</creatorcontrib><creatorcontrib>Egner, Patricia A.</creatorcontrib><creatorcontrib>Yuan, Jian‐Min</creatorcontrib><creatorcontrib>Groopman, John D.</creatorcontrib><title>Association of aflatoxin with gallbladder cancer in a case‐control study nested within a Chinese cohort</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>We evaluated whether aflatoxin B1 (AFB1) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1‐lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986‐1989). We included 84 GBC cases with sufficient serum and 168 controls matched on age at sample collection, date of blood draw and residence. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for detectable vs non‐detectable AFB1‐lysine albumin adducts and gallbladder cancer. AFB1‐lysine albumin adducts were detected in 50.0% of GBC cases, and risk of GBC was twice as high in those with detectable vs undetectable levels (OR = 2.0, 95% CI = 1.0‐3.9). ORs ranged from 1.8 (95% CI = 0.75‐4.3) for 0.5 to &lt;1.75 pg/mg vs undetectable adduct levels to 2.2 (95% CI = 0.91‐5.6) for &gt;3.36 pg/mg vs undetectable, suggesting a dose‐response (Ptrend = .05). When restricted to cases diagnosed before the median time to diagnosis after blood draw (18.4 years), results were similar (OR = 2.2, 95% CI = 0.80‐5.8) to those for the entire follow‐up duration. The OR was 9.4 (95% CI = 1.7‐51.1) for individuals with detectable AFB1‐lysine albumin adducts and self‐reported gallstones compared to individuals with neither. Participants with detectable AFB1‐lysine albumin adducts at baseline had increased risk of developing GBC, replicating the previously observed association between AFB1 exposure and providing the first evidence of temporality. What's new? Aflatoxin B1 exposure has been associated with gallbladder cancer, but only in cross‐sectional studies. This case‐control study nested within the Shanghai Cohort Study provides first evidence that exposure precedes disease development. The risk of gallbladder cancer was twice as high among individuals with detectable vs undetectable baseline aflatoxin B1‐lysine albumin adducts. The results suggested a long‐term, persistent effect of aflatoxin B1 exposure on gallbladder cancer risk, and the association was stronger among individuals with self‐reported gallstones. Aflatoxin B1 may contribute to gallbladder cancer development, and aflatoxin abatement programs could help reduce the incidence of gallbladder cancer in high‐risk areas.</description><subject>Adducts</subject><subject>aflatoxin</subject><subject>Aflatoxin B1</subject><subject>Aflatoxin B1 - adverse effects</subject><subject>Aflatoxin B1 - analysis</subject><subject>Aflatoxins - analysis</subject><subject>Aflatoxins - toxicity</subject><subject>Albumin</subject><subject>Albumins</subject><subject>Cancer</subject><subject>Case-Control Studies</subject><subject>China - epidemiology</subject><subject>Cohort Studies</subject><subject>Epidemiology</subject><subject>Gallbladder cancer</subject><subject>Gallbladder Neoplasms - chemically induced</subject><subject>Gallbladder Neoplasms - epidemiology</subject><subject>gallstones</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>incidence</subject><subject>Lysine</subject><subject>Male</subject><subject>Medical research</subject><issn>0020-7136</issn><issn>1097-0215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kM1OHDEQhC1EBBvgkBeIRuISDgPtv7XniFbhJ0LKBc5Wj8cDXnnHxJ4R2RuPkGfkSeLsQg5InKql-rpUKkK-UDilAOzML-0pF0rKHTKj0KgaGJW7ZFY8qBXl833yOeclAKUSxB7Z50oL4JLOiD_POVqPo49DFfsK-4Bj_O2H6smPD9U9htAG7DqXKouDLVIsLHd2L89_bBzGFEOVx6lbV4PLo-s2jxtoUcRlV9n4ENN4SD71GLI7etUDcnfx_XZxVd_8vLxenN_Ulksu6zmiUE6jZD1aJ6RWvBeCYcs65JpKrjuJ0jVa90z1LQjGqEA7B6ta7TrKD8i3be5jir-mUsmsfLYuBBxcnLJhWmmgqpFNQY_focs4paG0M6yBhksFIAp1sqVsijkn15vH5FeY1oaC-be_Kfubzf6F_fqaOLUr1_0n3wYvwNkWePLBrT9OMtc_FtvIv9_Gj-Q</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Koshiol, Jill</creator><creator>Zhu, Bin</creator><creator>Wang, Renwei</creator><creator>Hildesheim, Allan</creator><creator>Gao, Yu‐Tang</creator><creator>Egner, Patricia A.</creator><creator>Yuan, Jian‐Min</creator><creator>Groopman, John D.</creator><general>John Wiley &amp; Sons, Inc</general><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>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3832-6204</orcidid><orcidid>https://orcid.org/0000-0002-4620-3108</orcidid></search><sort><creationdate>20240301</creationdate><title>Association of aflatoxin with gallbladder cancer in a case‐control study nested within a Chinese cohort</title><author>Koshiol, Jill ; Zhu, Bin ; Wang, Renwei ; Hildesheim, Allan ; Gao, Yu‐Tang ; Egner, Patricia A. ; Yuan, Jian‐Min ; Groopman, John D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adducts</topic><topic>aflatoxin</topic><topic>Aflatoxin B1</topic><topic>Aflatoxin B1 - adverse effects</topic><topic>Aflatoxin B1 - analysis</topic><topic>Aflatoxins - analysis</topic><topic>Aflatoxins - toxicity</topic><topic>Albumin</topic><topic>Albumins</topic><topic>Cancer</topic><topic>Case-Control Studies</topic><topic>China - epidemiology</topic><topic>Cohort Studies</topic><topic>Epidemiology</topic><topic>Gallbladder cancer</topic><topic>Gallbladder Neoplasms - chemically induced</topic><topic>Gallbladder Neoplasms - epidemiology</topic><topic>gallstones</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>incidence</topic><topic>Lysine</topic><topic>Male</topic><topic>Medical research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koshiol, Jill</creatorcontrib><creatorcontrib>Zhu, Bin</creatorcontrib><creatorcontrib>Wang, Renwei</creatorcontrib><creatorcontrib>Hildesheim, Allan</creatorcontrib><creatorcontrib>Gao, Yu‐Tang</creatorcontrib><creatorcontrib>Egner, Patricia A.</creatorcontrib><creatorcontrib>Yuan, Jian‐Min</creatorcontrib><creatorcontrib>Groopman, John D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koshiol, Jill</au><au>Zhu, Bin</au><au>Wang, Renwei</au><au>Hildesheim, Allan</au><au>Gao, Yu‐Tang</au><au>Egner, Patricia A.</au><au>Yuan, Jian‐Min</au><au>Groopman, John D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of aflatoxin with gallbladder cancer in a case‐control study nested within a Chinese cohort</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>154</volume><issue>5</issue><spage>801</spage><epage>806</epage><pages>801-806</pages><issn>0020-7136</issn><eissn>1097-0215</eissn><abstract>We evaluated whether aflatoxin B1 (AFB1) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1‐lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986‐1989). We included 84 GBC cases with sufficient serum and 168 controls matched on age at sample collection, date of blood draw and residence. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for detectable vs non‐detectable AFB1‐lysine albumin adducts and gallbladder cancer. AFB1‐lysine albumin adducts were detected in 50.0% of GBC cases, and risk of GBC was twice as high in those with detectable vs undetectable levels (OR = 2.0, 95% CI = 1.0‐3.9). ORs ranged from 1.8 (95% CI = 0.75‐4.3) for 0.5 to &lt;1.75 pg/mg vs undetectable adduct levels to 2.2 (95% CI = 0.91‐5.6) for &gt;3.36 pg/mg vs undetectable, suggesting a dose‐response (Ptrend = .05). When restricted to cases diagnosed before the median time to diagnosis after blood draw (18.4 years), results were similar (OR = 2.2, 95% CI = 0.80‐5.8) to those for the entire follow‐up duration. The OR was 9.4 (95% CI = 1.7‐51.1) for individuals with detectable AFB1‐lysine albumin adducts and self‐reported gallstones compared to individuals with neither. Participants with detectable AFB1‐lysine albumin adducts at baseline had increased risk of developing GBC, replicating the previously observed association between AFB1 exposure and providing the first evidence of temporality. What's new? Aflatoxin B1 exposure has been associated with gallbladder cancer, but only in cross‐sectional studies. This case‐control study nested within the Shanghai Cohort Study provides first evidence that exposure precedes disease development. The risk of gallbladder cancer was twice as high among individuals with detectable vs undetectable baseline aflatoxin B1‐lysine albumin adducts. The results suggested a long‐term, persistent effect of aflatoxin B1 exposure on gallbladder cancer risk, and the association was stronger among individuals with self‐reported gallstones. Aflatoxin B1 may contribute to gallbladder cancer development, and aflatoxin abatement programs could help reduce the incidence of gallbladder cancer in high‐risk areas.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>37840351</pmid><doi>10.1002/ijc.34755</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3832-6204</orcidid><orcidid>https://orcid.org/0000-0002-4620-3108</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0020-7136
ispartof International journal of cancer, 2024-03, Vol.154 (5), p.801-806
issn 0020-7136
1097-0215
language eng
recordid cdi_proquest_miscellaneous_2878017959
source Wiley-Blackwell Read & Publish Collection
subjects Adducts
aflatoxin
Aflatoxin B1
Aflatoxin B1 - adverse effects
Aflatoxin B1 - analysis
Aflatoxins - analysis
Aflatoxins - toxicity
Albumin
Albumins
Cancer
Case-Control Studies
China - epidemiology
Cohort Studies
Epidemiology
Gallbladder cancer
Gallbladder Neoplasms - chemically induced
Gallbladder Neoplasms - epidemiology
gallstones
Health risk assessment
Humans
incidence
Lysine
Male
Medical research
title Association of aflatoxin with gallbladder cancer in a case‐control study nested within a Chinese cohort
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T16%3A04%3A38IST&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=Association%20of%20aflatoxin%20with%20gallbladder%20cancer%20in%20a%20case%E2%80%90control%20study%20nested%20within%20a%20Chinese%20cohort&rft.jtitle=International%20journal%20of%20cancer&rft.au=Koshiol,%20Jill&rft.date=2024-03-01&rft.volume=154&rft.issue=5&rft.spage=801&rft.epage=806&rft.pages=801-806&rft.issn=0020-7136&rft.eissn=1097-0215&rft_id=info:doi/10.1002/ijc.34755&rft_dat=%3Cproquest_cross%3E2909357004%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3535-6aa47e8a52face45873f442ab2da381538d5a5e988f27fb042214ac60c7b8ed13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2909357004&rft_id=info:pmid/37840351&rfr_iscdi=true