Loading…

Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study

Hypogonadism is a common finding of chronic obstructive pulmonary disease (COPD). However, the prevalence of hypogonadism in COPD varies among studies. The aim of this study was to determine and compare the prevalence of hypogonadism in men with and without COPD. We conducted a cross-sectional study...

Full description

Saved in:
Bibliographic Details
Published in:Endocrinología, diabetes y nutrición. diabetes y nutrición., 2024-10, Vol.71 (8), p.348-354
Main Authors: Castro, Horacio Matías, Knoblovits, Pablo, Maritano Furcada, Joaquin, De Vito, Eduardo Luis, Suarez, Sebastían Matias, Costanzo, Pablo Rene
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites cdi_FETCH-LOGICAL-c1567-5c9c0ddbb482464c22986c74281d4bbec005de76db6593aa2aee87040cb38c5c3
container_end_page 354
container_issue 8
container_start_page 348
container_title Endocrinología, diabetes y nutrición.
container_volume 71
creator Castro, Horacio Matías
Knoblovits, Pablo
Maritano Furcada, Joaquin
De Vito, Eduardo Luis
Suarez, Sebastían Matias
Costanzo, Pablo Rene
description Hypogonadism is a common finding of chronic obstructive pulmonary disease (COPD). However, the prevalence of hypogonadism in COPD varies among studies. The aim of this study was to determine and compare the prevalence of hypogonadism in men with and without COPD. We conducted a cross-sectional study with 134 patients with stable COPD and 70 age-matched men with non-COPD. Hypogonadism was defined by the presence of symptoms according to the Androgen Deficiency in Aging Males questionnaire, along with total testosterone deficiency (
doi_str_mv 10.1016/j.endien.2024.09.006
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3114151476</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2530018024000994</els_id><sourcerecordid>3114151476</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1567-5c9c0ddbb482464c22986c74281d4bbec005de76db6593aa2aee87040cb38c5c3</originalsourceid><addsrcrecordid>eNp9kEtrGzEURkVJqYPrf1CCltnM5EqjeWURMKFtAoZ20a6FRrquZWYkR5px8L-v_GjIqitd0Pnu4xDyhUHOgFV32xydsehyDlzk0OYA1QdyzcsCMmANXL2rZ2QR4xYAeCHKmrNPZFa0RS3atr4mLz8D7lWPTiP1a7o57Pwf75SxcaDW0QEdfbXjhipnToWfRqo3wTurqe_iGCY92j3S3dQPKRcONEVRRbynS6qDjzGLmJD019M4TubwmXxcqz7i4vLOye9vX389PmWrH9-fH5erTLOyqrNStxqM6TrRcFEJzXnbVLoWvGFGdB1qgNJgXZmuKttCKa4QmxoE6K5odKmLObk9990F_zJhHOVgo8a-Vw79FGXBmGAlE3WVUHFGTwsHXMtdsEM6RjKQR99yK8--5dG3hFYm3yl2c5kwdQOat9A_uwl4OAOY7txbDDJqe1RtbEhSpPH2_xP-AoFClOo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3114151476</pqid></control><display><type>article</type><title>Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study</title><source>ScienceDirect</source><source>ScienceDirect Journals</source><creator>Castro, Horacio Matías ; Knoblovits, Pablo ; Maritano Furcada, Joaquin ; De Vito, Eduardo Luis ; Suarez, Sebastían Matias ; Costanzo, Pablo Rene</creator><creatorcontrib>Castro, Horacio Matías ; Knoblovits, Pablo ; Maritano Furcada, Joaquin ; De Vito, Eduardo Luis ; Suarez, Sebastían Matias ; Costanzo, Pablo Rene</creatorcontrib><description><![CDATA[Hypogonadism is a common finding of chronic obstructive pulmonary disease (COPD). However, the prevalence of hypogonadism in COPD varies among studies. The aim of this study was to determine and compare the prevalence of hypogonadism in men with and without COPD. We conducted a cross-sectional study with 134 patients with stable COPD and 70 age-matched men with non-COPD. Hypogonadism was defined by the presence of symptoms according to the Androgen Deficiency in Aging Males questionnaire, along with total testosterone deficiency (<300ng/dL). Patients had a mean age of 68 years (SD, 6), a body mass index of 28kg/m2 (SD, 6), and 17% were current smokers. The prevalence of hypogonadism was 41.8% in COPD men (N=56, 95%CI, 33–51) and 10.0% in non-COPD men (N=7, 95%CI, 4–20), with a prevalence ratio of 4.2 (95%CI, 2.0–8.7, p<0.001). The prevalence of low total testosterone concentrations (<300ng/dL) were significantly higher in COPD patients vs the control group (47.0% vs 15.7%, p=<0.001). In the COPD group, 89.3% of patients had hypogonadotropic hypogonadism and 10.7%, hypergonadotropic hypogonadism. The prevalence of hypogonadism was higher in severe vs non-severe COPD patients (55.8% vs 35.2%; p=0.024). The prevalence of hypogonadism was high and greater in COPD vs non-COPD men. This study suggests that COPD patients should be screened for hypogonadism. El hipogonadismo es frecuente en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Sin embargo, la prevalencia de hipogonadismo varía entre estudios. El objetivo del estudio fue determinar y comparar la prevalencia de hipogonadismo en hombres con y sin EPOC. Se realizó un estudio de corte transversal que incluyó a 134 pacientes con EPOC estable y 70 hombres sin EPOC pareados por edad. Se definió el hipogonadismo por la presencia de síntomas según el cuestionario de Androgen Deficiency in Aging Males y una deficiencia de testosterona total (<300ng/dL). Los pacientes tenían una edad media de 68 años (DE 6), un índice de masa corporal de 28kg/m2 (DE 6) y el 17% eran fumadores. La prevalencia de hipogonadismo fue del 41,8% en hombres con EPOC (N=56, IC 95% 33-51) y del 10,0% en hombres sin EPOC (N=7, IC 95% 4-20), con una razón de prevalencia de 4,2 (IC 95% 2,0-8,7, p<0,001). La prevalencia de concentraciones bajas de testosterona total (<300ng/dL) fue significativamente mayor en los pacientes con EPOC que en el grupo de control (47,0% frente a 15,7%, p=<0,001). En el grupo de pacientes con EPOC, el 89,3% presento un hipogonadismo hipogonadotropo y el 10.7% un hipogonadismo hipergonadotropo. La prevalencia de hipogonadismo fue mayor en pacientes con EPOC grave que en los no graves (55,8% versus 35,2%, p=0,024). La prevalencia de hipogonadismo fue alta y mayor en hombres con EPOC que en hombres sin EPOC. Este estudio sugiere que los pacientes con EPOC deben ser evaluados para detectar hipogonadismo.]]></description><identifier>ISSN: 2530-0180</identifier><identifier>EISSN: 2530-0180</identifier><identifier>DOI: 10.1016/j.endien.2024.09.006</identifier><identifier>PMID: 39374997</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Aged ; Chronic obstructive pulmonary disease ; Comorbidities ; Comorbilidades ; Cross-Sectional Studies ; Enfermedad pulmonar obstructiva cronica ; Hipogonadismo ; Hormonas ; Hormones ; Humans ; Hypogonadism ; Hypogonadism - epidemiology ; Male ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive - complications ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Testosterona ; Testosterone ; Testosterone - blood ; Testosterone - deficiency</subject><ispartof>Endocrinología, diabetes y nutrición., 2024-10, Vol.71 (8), p.348-354</ispartof><rights>2024 SEEN and SED</rights><rights>Copyright © 2024 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1567-5c9c0ddbb482464c22986c74281d4bbec005de76db6593aa2aee87040cb38c5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2530018024000994$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45759</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39374997$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Castro, Horacio Matías</creatorcontrib><creatorcontrib>Knoblovits, Pablo</creatorcontrib><creatorcontrib>Maritano Furcada, Joaquin</creatorcontrib><creatorcontrib>De Vito, Eduardo Luis</creatorcontrib><creatorcontrib>Suarez, Sebastían Matias</creatorcontrib><creatorcontrib>Costanzo, Pablo Rene</creatorcontrib><title>Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study</title><title>Endocrinología, diabetes y nutrición.</title><addtitle>Endocrinol Diabetes Nutr (Engl Ed)</addtitle><description><![CDATA[Hypogonadism is a common finding of chronic obstructive pulmonary disease (COPD). However, the prevalence of hypogonadism in COPD varies among studies. The aim of this study was to determine and compare the prevalence of hypogonadism in men with and without COPD. We conducted a cross-sectional study with 134 patients with stable COPD and 70 age-matched men with non-COPD. Hypogonadism was defined by the presence of symptoms according to the Androgen Deficiency in Aging Males questionnaire, along with total testosterone deficiency (<300ng/dL). Patients had a mean age of 68 years (SD, 6), a body mass index of 28kg/m2 (SD, 6), and 17% were current smokers. The prevalence of hypogonadism was 41.8% in COPD men (N=56, 95%CI, 33–51) and 10.0% in non-COPD men (N=7, 95%CI, 4–20), with a prevalence ratio of 4.2 (95%CI, 2.0–8.7, p<0.001). The prevalence of low total testosterone concentrations (<300ng/dL) were significantly higher in COPD patients vs the control group (47.0% vs 15.7%, p=<0.001). In the COPD group, 89.3% of patients had hypogonadotropic hypogonadism and 10.7%, hypergonadotropic hypogonadism. The prevalence of hypogonadism was higher in severe vs non-severe COPD patients (55.8% vs 35.2%; p=0.024). The prevalence of hypogonadism was high and greater in COPD vs non-COPD men. This study suggests that COPD patients should be screened for hypogonadism. El hipogonadismo es frecuente en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Sin embargo, la prevalencia de hipogonadismo varía entre estudios. El objetivo del estudio fue determinar y comparar la prevalencia de hipogonadismo en hombres con y sin EPOC. Se realizó un estudio de corte transversal que incluyó a 134 pacientes con EPOC estable y 70 hombres sin EPOC pareados por edad. Se definió el hipogonadismo por la presencia de síntomas según el cuestionario de Androgen Deficiency in Aging Males y una deficiencia de testosterona total (<300ng/dL). Los pacientes tenían una edad media de 68 años (DE 6), un índice de masa corporal de 28kg/m2 (DE 6) y el 17% eran fumadores. La prevalencia de hipogonadismo fue del 41,8% en hombres con EPOC (N=56, IC 95% 33-51) y del 10,0% en hombres sin EPOC (N=7, IC 95% 4-20), con una razón de prevalencia de 4,2 (IC 95% 2,0-8,7, p<0,001). La prevalencia de concentraciones bajas de testosterona total (<300ng/dL) fue significativamente mayor en los pacientes con EPOC que en el grupo de control (47,0% frente a 15,7%, p=<0,001). En el grupo de pacientes con EPOC, el 89,3% presento un hipogonadismo hipogonadotropo y el 10.7% un hipogonadismo hipergonadotropo. La prevalencia de hipogonadismo fue mayor en pacientes con EPOC grave que en los no graves (55,8% versus 35,2%, p=0,024). La prevalencia de hipogonadismo fue alta y mayor en hombres con EPOC que en hombres sin EPOC. Este estudio sugiere que los pacientes con EPOC deben ser evaluados para detectar hipogonadismo.]]></description><subject>Aged</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Comorbidities</subject><subject>Comorbilidades</subject><subject>Cross-Sectional Studies</subject><subject>Enfermedad pulmonar obstructiva cronica</subject><subject>Hipogonadismo</subject><subject>Hormonas</subject><subject>Hormones</subject><subject>Humans</subject><subject>Hypogonadism</subject><subject>Hypogonadism - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Pulmonary Disease, Chronic Obstructive - complications</subject><subject>Pulmonary Disease, Chronic Obstructive - epidemiology</subject><subject>Testosterona</subject><subject>Testosterone</subject><subject>Testosterone - blood</subject><subject>Testosterone - deficiency</subject><issn>2530-0180</issn><issn>2530-0180</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kEtrGzEURkVJqYPrf1CCltnM5EqjeWURMKFtAoZ20a6FRrquZWYkR5px8L-v_GjIqitd0Pnu4xDyhUHOgFV32xydsehyDlzk0OYA1QdyzcsCMmANXL2rZ2QR4xYAeCHKmrNPZFa0RS3atr4mLz8D7lWPTiP1a7o57Pwf75SxcaDW0QEdfbXjhipnToWfRqo3wTurqe_iGCY92j3S3dQPKRcONEVRRbynS6qDjzGLmJD019M4TubwmXxcqz7i4vLOye9vX389PmWrH9-fH5erTLOyqrNStxqM6TrRcFEJzXnbVLoWvGFGdB1qgNJgXZmuKttCKa4QmxoE6K5odKmLObk9990F_zJhHOVgo8a-Vw79FGXBmGAlE3WVUHFGTwsHXMtdsEM6RjKQR99yK8--5dG3hFYm3yl2c5kwdQOat9A_uwl4OAOY7txbDDJqe1RtbEhSpPH2_xP-AoFClOo</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Castro, Horacio Matías</creator><creator>Knoblovits, Pablo</creator><creator>Maritano Furcada, Joaquin</creator><creator>De Vito, Eduardo Luis</creator><creator>Suarez, Sebastían Matias</creator><creator>Costanzo, Pablo Rene</creator><general>Elsevier España, S.L.U</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></search><sort><creationdate>202410</creationdate><title>Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study</title><author>Castro, Horacio Matías ; Knoblovits, Pablo ; Maritano Furcada, Joaquin ; De Vito, Eduardo Luis ; Suarez, Sebastían Matias ; Costanzo, Pablo Rene</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1567-5c9c0ddbb482464c22986c74281d4bbec005de76db6593aa2aee87040cb38c5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Comorbidities</topic><topic>Comorbilidades</topic><topic>Cross-Sectional Studies</topic><topic>Enfermedad pulmonar obstructiva cronica</topic><topic>Hipogonadismo</topic><topic>Hormonas</topic><topic>Hormones</topic><topic>Humans</topic><topic>Hypogonadism</topic><topic>Hypogonadism - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Pulmonary Disease, Chronic Obstructive - complications</topic><topic>Pulmonary Disease, Chronic Obstructive - epidemiology</topic><topic>Testosterona</topic><topic>Testosterone</topic><topic>Testosterone - blood</topic><topic>Testosterone - deficiency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Castro, Horacio Matías</creatorcontrib><creatorcontrib>Knoblovits, Pablo</creatorcontrib><creatorcontrib>Maritano Furcada, Joaquin</creatorcontrib><creatorcontrib>De Vito, Eduardo Luis</creatorcontrib><creatorcontrib>Suarez, Sebastían Matias</creatorcontrib><creatorcontrib>Costanzo, Pablo Rene</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>Endocrinología, diabetes y nutrición.</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Castro, Horacio Matías</au><au>Knoblovits, Pablo</au><au>Maritano Furcada, Joaquin</au><au>De Vito, Eduardo Luis</au><au>Suarez, Sebastían Matias</au><au>Costanzo, Pablo Rene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study</atitle><jtitle>Endocrinología, diabetes y nutrición.</jtitle><addtitle>Endocrinol Diabetes Nutr (Engl Ed)</addtitle><date>2024-10</date><risdate>2024</risdate><volume>71</volume><issue>8</issue><spage>348</spage><epage>354</epage><pages>348-354</pages><issn>2530-0180</issn><eissn>2530-0180</eissn><abstract><![CDATA[Hypogonadism is a common finding of chronic obstructive pulmonary disease (COPD). However, the prevalence of hypogonadism in COPD varies among studies. The aim of this study was to determine and compare the prevalence of hypogonadism in men with and without COPD. We conducted a cross-sectional study with 134 patients with stable COPD and 70 age-matched men with non-COPD. Hypogonadism was defined by the presence of symptoms according to the Androgen Deficiency in Aging Males questionnaire, along with total testosterone deficiency (<300ng/dL). Patients had a mean age of 68 years (SD, 6), a body mass index of 28kg/m2 (SD, 6), and 17% were current smokers. The prevalence of hypogonadism was 41.8% in COPD men (N=56, 95%CI, 33–51) and 10.0% in non-COPD men (N=7, 95%CI, 4–20), with a prevalence ratio of 4.2 (95%CI, 2.0–8.7, p<0.001). The prevalence of low total testosterone concentrations (<300ng/dL) were significantly higher in COPD patients vs the control group (47.0% vs 15.7%, p=<0.001). In the COPD group, 89.3% of patients had hypogonadotropic hypogonadism and 10.7%, hypergonadotropic hypogonadism. The prevalence of hypogonadism was higher in severe vs non-severe COPD patients (55.8% vs 35.2%; p=0.024). The prevalence of hypogonadism was high and greater in COPD vs non-COPD men. This study suggests that COPD patients should be screened for hypogonadism. El hipogonadismo es frecuente en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Sin embargo, la prevalencia de hipogonadismo varía entre estudios. El objetivo del estudio fue determinar y comparar la prevalencia de hipogonadismo en hombres con y sin EPOC. Se realizó un estudio de corte transversal que incluyó a 134 pacientes con EPOC estable y 70 hombres sin EPOC pareados por edad. Se definió el hipogonadismo por la presencia de síntomas según el cuestionario de Androgen Deficiency in Aging Males y una deficiencia de testosterona total (<300ng/dL). Los pacientes tenían una edad media de 68 años (DE 6), un índice de masa corporal de 28kg/m2 (DE 6) y el 17% eran fumadores. La prevalencia de hipogonadismo fue del 41,8% en hombres con EPOC (N=56, IC 95% 33-51) y del 10,0% en hombres sin EPOC (N=7, IC 95% 4-20), con una razón de prevalencia de 4,2 (IC 95% 2,0-8,7, p<0,001). La prevalencia de concentraciones bajas de testosterona total (<300ng/dL) fue significativamente mayor en los pacientes con EPOC que en el grupo de control (47,0% frente a 15,7%, p=<0,001). En el grupo de pacientes con EPOC, el 89,3% presento un hipogonadismo hipogonadotropo y el 10.7% un hipogonadismo hipergonadotropo. La prevalencia de hipogonadismo fue mayor en pacientes con EPOC grave que en los no graves (55,8% versus 35,2%, p=0,024). La prevalencia de hipogonadismo fue alta y mayor en hombres con EPOC que en hombres sin EPOC. Este estudio sugiere que los pacientes con EPOC deben ser evaluados para detectar hipogonadismo.]]></abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>39374997</pmid><doi>10.1016/j.endien.2024.09.006</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 2530-0180
ispartof Endocrinología, diabetes y nutrición., 2024-10, Vol.71 (8), p.348-354
issn 2530-0180
2530-0180
language eng
recordid cdi_proquest_miscellaneous_3114151476
source ScienceDirect; ScienceDirect Journals
subjects Aged
Chronic obstructive pulmonary disease
Comorbidities
Comorbilidades
Cross-Sectional Studies
Enfermedad pulmonar obstructiva cronica
Hipogonadismo
Hormonas
Hormones
Humans
Hypogonadism
Hypogonadism - epidemiology
Male
Middle Aged
Prevalence
Pulmonary Disease, Chronic Obstructive - complications
Pulmonary Disease, Chronic Obstructive - epidemiology
Testosterona
Testosterone
Testosterone - blood
Testosterone - deficiency
title Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T23%3A37%3A53IST&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=Prevalence%20of%20hypogonadism%20in%20men%20with%20and%20without%20chronic%20obstructive%20pulmonary%20disease:%20A%20cross-sectional%20study&rft.jtitle=Endocrinolog%C3%ADa,%20diabetes%20y%20nutrici%C3%B3n.&rft.au=Castro,%20Horacio%20Mat%C3%ADas&rft.date=2024-10&rft.volume=71&rft.issue=8&rft.spage=348&rft.epage=354&rft.pages=348-354&rft.issn=2530-0180&rft.eissn=2530-0180&rft_id=info:doi/10.1016/j.endien.2024.09.006&rft_dat=%3Cproquest_cross%3E3114151476%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c1567-5c9c0ddbb482464c22986c74281d4bbec005de76db6593aa2aee87040cb38c5c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3114151476&rft_id=info:pmid/39374997&rfr_iscdi=true