Loading…
Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target
Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target. An agent-based model developed in 2023 represents each person aged 6–17...
Saved in:
Published in: | American journal of preventive medicine 2024-05, Vol.66 (5), p.760-769 |
---|---|
Main Authors: | , , , , , , , , , , , , , , , , |
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-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3 |
---|---|
cites | cdi_FETCH-LOGICAL-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3 |
container_end_page | 769 |
container_issue | 5 |
container_start_page | 760 |
container_title | American journal of preventive medicine |
container_volume | 66 |
creator | Martinez, Marie F. Weatherwax, Colleen Piercy, Katrina Whitley, Meredith A. Bartsch, Sarah M. Heneghan, Jessie Fox, Martin Bowers, Matthew T. Chin, Kevin L. Velmurugan, Kavya Dibbs, Alexis Smith, Alan L. Pfeiffer, Karin A. Farrey, Tom Tsintsifas, Alexandra Scannell, Sheryl A. Lee, Bruce Y. |
description | Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target.
An agent-based model developed in 2023 represents each person aged 6–17 years in the U.S. On each simulated day, agents can participate in sports that affect their metabolic and mental health in the model. Each agent can develop different physical and mental health outcomes, associated with direct and indirect costs.
Increasing the proportion of youth participating in sports from the most recent participation levels (50.7%) to the Healthy People 2030 target (63.3%) could reduce overweight/obesity prevalence by 3.37% (95% CI=3.35%, 3.39%), resulting in 1.71 million fewer cases of overweight/obesity (95% CI=1.64, 1.77 million). This could avert 352,000 (95% CI=336,200, 367,500) cases of weight-related diseases and gain 1.86 million (95% CI=1.86, 1.87 million) quality-adjusted life years, saving $22.55 billion (95% CI=$22.46, $22.63 billion) in direct medical costs and $25.43 billion (95% CI= $25.25, $25.61 billion) in productivity losses. This would also reduce depression/anxiety symptoms, saving $3.61 billion (95% CI=$3.58, $3.63 billion) in direct medical costs and $28.38 billion (95% CI=$28.20, $28.56 billion) in productivity losses.
This study shows that achieving the Healthy People 2030 objective could save third-party payers, businesses, and society billions of dollars for each cohort of persons aged 6–17 years, savings that would continue to repeat with each new cohort. This suggests that even if a substantial amount is invested toward this objective, such investments could pay for themselves. |
doi_str_mv | 10.1016/j.amepre.2023.12.018 |
format | article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2932940303</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0749379723005172</els_id><sourcerecordid>2932940303</sourcerecordid><originalsourceid>FETCH-LOGICAL-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMoWqv_QCRHL7vmYzfJXgQtfoFFQT14Cmk6sSnbzZqkgv_eLVWPnubyzLzvPAidUFJSQsX5sjQr6COUjDBeUlYSqnbQiCrJCyaI3EUjIqum4LKRB-gwpSUhRCra7KMDrioqiGpGaHoFHTifEw4OTwGy795xXgC-A9PmxRd-gtC3gBnhBL-FdV7g5z7EgX8yMXvre5N96PCLie-Qj9CeM22C4585Rq831y-Tu-Lh8fZ-cvlQWCZlLuymiOKWOga1gLpmwlExV7Zhhs4cUOa4NEzVYkYsJ8LZmjVcVqCMIE4aPkZn27t9DB9rSFmvfLLQtqaDsE56oFlTDZX5gFZb1MaQUgSn--hXJn5pSvRGpF7qrUi9Eakp04PIYe30J2E9W8H8b-nX3ABcbAEY_vz0EHWyHjoLcx_BZj0P_v-Eb4JjhI4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2932940303</pqid></control><display><type>article</type><title>Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Martinez, Marie F. ; Weatherwax, Colleen ; Piercy, Katrina ; Whitley, Meredith A. ; Bartsch, Sarah M. ; Heneghan, Jessie ; Fox, Martin ; Bowers, Matthew T. ; Chin, Kevin L. ; Velmurugan, Kavya ; Dibbs, Alexis ; Smith, Alan L. ; Pfeiffer, Karin A. ; Farrey, Tom ; Tsintsifas, Alexandra ; Scannell, Sheryl A. ; Lee, Bruce Y.</creator><creatorcontrib>Martinez, Marie F. ; Weatherwax, Colleen ; Piercy, Katrina ; Whitley, Meredith A. ; Bartsch, Sarah M. ; Heneghan, Jessie ; Fox, Martin ; Bowers, Matthew T. ; Chin, Kevin L. ; Velmurugan, Kavya ; Dibbs, Alexis ; Smith, Alan L. ; Pfeiffer, Karin A. ; Farrey, Tom ; Tsintsifas, Alexandra ; Scannell, Sheryl A. ; Lee, Bruce Y.</creatorcontrib><description>Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target.
An agent-based model developed in 2023 represents each person aged 6–17 years in the U.S. On each simulated day, agents can participate in sports that affect their metabolic and mental health in the model. Each agent can develop different physical and mental health outcomes, associated with direct and indirect costs.
Increasing the proportion of youth participating in sports from the most recent participation levels (50.7%) to the Healthy People 2030 target (63.3%) could reduce overweight/obesity prevalence by 3.37% (95% CI=3.35%, 3.39%), resulting in 1.71 million fewer cases of overweight/obesity (95% CI=1.64, 1.77 million). This could avert 352,000 (95% CI=336,200, 367,500) cases of weight-related diseases and gain 1.86 million (95% CI=1.86, 1.87 million) quality-adjusted life years, saving $22.55 billion (95% CI=$22.46, $22.63 billion) in direct medical costs and $25.43 billion (95% CI= $25.25, $25.61 billion) in productivity losses. This would also reduce depression/anxiety symptoms, saving $3.61 billion (95% CI=$3.58, $3.63 billion) in direct medical costs and $28.38 billion (95% CI=$28.20, $28.56 billion) in productivity losses.
This study shows that achieving the Healthy People 2030 objective could save third-party payers, businesses, and society billions of dollars for each cohort of persons aged 6–17 years, savings that would continue to repeat with each new cohort. This suggests that even if a substantial amount is invested toward this objective, such investments could pay for themselves.</description><identifier>ISSN: 0749-3797</identifier><identifier>ISSN: 1873-2607</identifier><identifier>EISSN: 1873-2607</identifier><identifier>DOI: 10.1016/j.amepre.2023.12.018</identifier><identifier>PMID: 38416089</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Adolescent ; Child ; Female ; Healthy People Programs ; Humans ; Male ; Mental Health ; Overweight - epidemiology ; Overweight - prevention & control ; United States ; Youth Sports</subject><ispartof>American journal of preventive medicine, 2024-05, Vol.66 (5), p.760-769</ispartof><rights>2023 American Journal of Preventive Medicine</rights><rights>Copyright © 2023 American Journal of Preventive Medicine. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3</citedby><cites>FETCH-LOGICAL-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3</cites><orcidid>0000-0001-8982-250X ; 0000-0003-2633-8651 ; 0009-0007-5274-9864 ; 0009-0002-5068-6437 ; 0000-0003-2267-7293 ; 0000-0002-3197-7856 ; 0009-0001-5871-6023 ; 0000-0003-2784-6279 ; 0000-0001-8715-7016 ; 0009-0001-8183-7464 ; 0000-0001-5929-518X ; 0009-0009-8883-1645</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/38416089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez, Marie F.</creatorcontrib><creatorcontrib>Weatherwax, Colleen</creatorcontrib><creatorcontrib>Piercy, Katrina</creatorcontrib><creatorcontrib>Whitley, Meredith A.</creatorcontrib><creatorcontrib>Bartsch, Sarah M.</creatorcontrib><creatorcontrib>Heneghan, Jessie</creatorcontrib><creatorcontrib>Fox, Martin</creatorcontrib><creatorcontrib>Bowers, Matthew T.</creatorcontrib><creatorcontrib>Chin, Kevin L.</creatorcontrib><creatorcontrib>Velmurugan, Kavya</creatorcontrib><creatorcontrib>Dibbs, Alexis</creatorcontrib><creatorcontrib>Smith, Alan L.</creatorcontrib><creatorcontrib>Pfeiffer, Karin A.</creatorcontrib><creatorcontrib>Farrey, Tom</creatorcontrib><creatorcontrib>Tsintsifas, Alexandra</creatorcontrib><creatorcontrib>Scannell, Sheryl A.</creatorcontrib><creatorcontrib>Lee, Bruce Y.</creatorcontrib><title>Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target</title><title>American journal of preventive medicine</title><addtitle>Am J Prev Med</addtitle><description>Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target.
An agent-based model developed in 2023 represents each person aged 6–17 years in the U.S. On each simulated day, agents can participate in sports that affect their metabolic and mental health in the model. Each agent can develop different physical and mental health outcomes, associated with direct and indirect costs.
Increasing the proportion of youth participating in sports from the most recent participation levels (50.7%) to the Healthy People 2030 target (63.3%) could reduce overweight/obesity prevalence by 3.37% (95% CI=3.35%, 3.39%), resulting in 1.71 million fewer cases of overweight/obesity (95% CI=1.64, 1.77 million). This could avert 352,000 (95% CI=336,200, 367,500) cases of weight-related diseases and gain 1.86 million (95% CI=1.86, 1.87 million) quality-adjusted life years, saving $22.55 billion (95% CI=$22.46, $22.63 billion) in direct medical costs and $25.43 billion (95% CI= $25.25, $25.61 billion) in productivity losses. This would also reduce depression/anxiety symptoms, saving $3.61 billion (95% CI=$3.58, $3.63 billion) in direct medical costs and $28.38 billion (95% CI=$28.20, $28.56 billion) in productivity losses.
This study shows that achieving the Healthy People 2030 objective could save third-party payers, businesses, and society billions of dollars for each cohort of persons aged 6–17 years, savings that would continue to repeat with each new cohort. This suggests that even if a substantial amount is invested toward this objective, such investments could pay for themselves.</description><subject>Adolescent</subject><subject>Child</subject><subject>Female</subject><subject>Healthy People Programs</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Health</subject><subject>Overweight - epidemiology</subject><subject>Overweight - prevention & control</subject><subject>United States</subject><subject>Youth Sports</subject><issn>0749-3797</issn><issn>1873-2607</issn><issn>1873-2607</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LAzEQhoMoWqv_QCRHL7vmYzfJXgQtfoFFQT14Cmk6sSnbzZqkgv_eLVWPnubyzLzvPAidUFJSQsX5sjQr6COUjDBeUlYSqnbQiCrJCyaI3EUjIqum4LKRB-gwpSUhRCra7KMDrioqiGpGaHoFHTifEw4OTwGy795xXgC-A9PmxRd-gtC3gBnhBL-FdV7g5z7EgX8yMXvre5N96PCLie-Qj9CeM22C4585Rq831y-Tu-Lh8fZ-cvlQWCZlLuymiOKWOga1gLpmwlExV7Zhhs4cUOa4NEzVYkYsJ8LZmjVcVqCMIE4aPkZn27t9DB9rSFmvfLLQtqaDsE56oFlTDZX5gFZb1MaQUgSn--hXJn5pSvRGpF7qrUi9Eakp04PIYe30J2E9W8H8b-nX3ABcbAEY_vz0EHWyHjoLcx_BZj0P_v-Eb4JjhI4</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Martinez, Marie F.</creator><creator>Weatherwax, Colleen</creator><creator>Piercy, Katrina</creator><creator>Whitley, Meredith A.</creator><creator>Bartsch, Sarah M.</creator><creator>Heneghan, Jessie</creator><creator>Fox, Martin</creator><creator>Bowers, Matthew T.</creator><creator>Chin, Kevin L.</creator><creator>Velmurugan, Kavya</creator><creator>Dibbs, Alexis</creator><creator>Smith, Alan L.</creator><creator>Pfeiffer, Karin A.</creator><creator>Farrey, Tom</creator><creator>Tsintsifas, Alexandra</creator><creator>Scannell, Sheryl A.</creator><creator>Lee, Bruce Y.</creator><general>Elsevier 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>7X8</scope><orcidid>https://orcid.org/0000-0001-8982-250X</orcidid><orcidid>https://orcid.org/0000-0003-2633-8651</orcidid><orcidid>https://orcid.org/0009-0007-5274-9864</orcidid><orcidid>https://orcid.org/0009-0002-5068-6437</orcidid><orcidid>https://orcid.org/0000-0003-2267-7293</orcidid><orcidid>https://orcid.org/0000-0002-3197-7856</orcidid><orcidid>https://orcid.org/0009-0001-5871-6023</orcidid><orcidid>https://orcid.org/0000-0003-2784-6279</orcidid><orcidid>https://orcid.org/0000-0001-8715-7016</orcidid><orcidid>https://orcid.org/0009-0001-8183-7464</orcidid><orcidid>https://orcid.org/0000-0001-5929-518X</orcidid><orcidid>https://orcid.org/0009-0009-8883-1645</orcidid></search><sort><creationdate>202405</creationdate><title>Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target</title><author>Martinez, Marie F. ; Weatherwax, Colleen ; Piercy, Katrina ; Whitley, Meredith A. ; Bartsch, Sarah M. ; Heneghan, Jessie ; Fox, Martin ; Bowers, Matthew T. ; Chin, Kevin L. ; Velmurugan, Kavya ; Dibbs, Alexis ; Smith, Alan L. ; Pfeiffer, Karin A. ; Farrey, Tom ; Tsintsifas, Alexandra ; Scannell, Sheryl A. ; Lee, Bruce Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Female</topic><topic>Healthy People Programs</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Health</topic><topic>Overweight - epidemiology</topic><topic>Overweight - prevention & control</topic><topic>United States</topic><topic>Youth Sports</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez, Marie F.</creatorcontrib><creatorcontrib>Weatherwax, Colleen</creatorcontrib><creatorcontrib>Piercy, Katrina</creatorcontrib><creatorcontrib>Whitley, Meredith A.</creatorcontrib><creatorcontrib>Bartsch, Sarah M.</creatorcontrib><creatorcontrib>Heneghan, Jessie</creatorcontrib><creatorcontrib>Fox, Martin</creatorcontrib><creatorcontrib>Bowers, Matthew T.</creatorcontrib><creatorcontrib>Chin, Kevin L.</creatorcontrib><creatorcontrib>Velmurugan, Kavya</creatorcontrib><creatorcontrib>Dibbs, Alexis</creatorcontrib><creatorcontrib>Smith, Alan L.</creatorcontrib><creatorcontrib>Pfeiffer, Karin A.</creatorcontrib><creatorcontrib>Farrey, Tom</creatorcontrib><creatorcontrib>Tsintsifas, Alexandra</creatorcontrib><creatorcontrib>Scannell, Sheryl A.</creatorcontrib><creatorcontrib>Lee, Bruce Y.</creatorcontrib><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><jtitle>American journal of preventive medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez, Marie F.</au><au>Weatherwax, Colleen</au><au>Piercy, Katrina</au><au>Whitley, Meredith A.</au><au>Bartsch, Sarah M.</au><au>Heneghan, Jessie</au><au>Fox, Martin</au><au>Bowers, Matthew T.</au><au>Chin, Kevin L.</au><au>Velmurugan, Kavya</au><au>Dibbs, Alexis</au><au>Smith, Alan L.</au><au>Pfeiffer, Karin A.</au><au>Farrey, Tom</au><au>Tsintsifas, Alexandra</au><au>Scannell, Sheryl A.</au><au>Lee, Bruce Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target</atitle><jtitle>American journal of preventive medicine</jtitle><addtitle>Am J Prev Med</addtitle><date>2024-05</date><risdate>2024</risdate><volume>66</volume><issue>5</issue><spage>760</spage><epage>769</epage><pages>760-769</pages><issn>0749-3797</issn><issn>1873-2607</issn><eissn>1873-2607</eissn><abstract>Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target.
An agent-based model developed in 2023 represents each person aged 6–17 years in the U.S. On each simulated day, agents can participate in sports that affect their metabolic and mental health in the model. Each agent can develop different physical and mental health outcomes, associated with direct and indirect costs.
Increasing the proportion of youth participating in sports from the most recent participation levels (50.7%) to the Healthy People 2030 target (63.3%) could reduce overweight/obesity prevalence by 3.37% (95% CI=3.35%, 3.39%), resulting in 1.71 million fewer cases of overweight/obesity (95% CI=1.64, 1.77 million). This could avert 352,000 (95% CI=336,200, 367,500) cases of weight-related diseases and gain 1.86 million (95% CI=1.86, 1.87 million) quality-adjusted life years, saving $22.55 billion (95% CI=$22.46, $22.63 billion) in direct medical costs and $25.43 billion (95% CI= $25.25, $25.61 billion) in productivity losses. This would also reduce depression/anxiety symptoms, saving $3.61 billion (95% CI=$3.58, $3.63 billion) in direct medical costs and $28.38 billion (95% CI=$28.20, $28.56 billion) in productivity losses.
This study shows that achieving the Healthy People 2030 objective could save third-party payers, businesses, and society billions of dollars for each cohort of persons aged 6–17 years, savings that would continue to repeat with each new cohort. This suggests that even if a substantial amount is invested toward this objective, such investments could pay for themselves.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>38416089</pmid><doi>10.1016/j.amepre.2023.12.018</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8982-250X</orcidid><orcidid>https://orcid.org/0000-0003-2633-8651</orcidid><orcidid>https://orcid.org/0009-0007-5274-9864</orcidid><orcidid>https://orcid.org/0009-0002-5068-6437</orcidid><orcidid>https://orcid.org/0000-0003-2267-7293</orcidid><orcidid>https://orcid.org/0000-0002-3197-7856</orcidid><orcidid>https://orcid.org/0009-0001-5871-6023</orcidid><orcidid>https://orcid.org/0000-0003-2784-6279</orcidid><orcidid>https://orcid.org/0000-0001-8715-7016</orcidid><orcidid>https://orcid.org/0009-0001-8183-7464</orcidid><orcidid>https://orcid.org/0000-0001-5929-518X</orcidid><orcidid>https://orcid.org/0009-0009-8883-1645</orcidid></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0749-3797 |
ispartof | American journal of preventive medicine, 2024-05, Vol.66 (5), p.760-769 |
issn | 0749-3797 1873-2607 1873-2607 |
language | eng |
recordid | cdi_proquest_miscellaneous_2932940303 |
source | ScienceDirect Freedom Collection 2022-2024 |
subjects | Adolescent Child Female Healthy People Programs Humans Male Mental Health Overweight - epidemiology Overweight - prevention & control United States Youth Sports |
title | Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T12%3A26%3A11IST&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=Benefits%20of%20Meeting%20the%20Healthy%20People%202030%20Youth%20Sports%20Participation%20Target&rft.jtitle=American%20journal%20of%20preventive%20medicine&rft.au=Martinez,%20Marie%20F.&rft.date=2024-05&rft.volume=66&rft.issue=5&rft.spage=760&rft.epage=769&rft.pages=760-769&rft.issn=0749-3797&rft.eissn=1873-2607&rft_id=info:doi/10.1016/j.amepre.2023.12.018&rft_dat=%3Cproquest_cross%3E2932940303%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c277t-c007883c1f2e56e5526f16d8c92a1bfe12f37a2856b0c306fc529374e8a60f7a3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2932940303&rft_id=info:pmid/38416089&rfr_iscdi=true |