Loading…

Investigating the applicability domain of the hiPSC-based PluriLum assay: an embryotoxicity assessment of chemicals and drugs

To meet the growing demand for developmental toxicity assessment of chemicals, New Approach Methodologies (NAMs) are needed. Previously, we developed two 3D in vitro assays based on human-induced pluripotent stem cells (hiPSC) and cardiomyocyte differentiation: the PluriBeat assay, based on assessme...

Full description

Saved in:
Bibliographic Details
Published in:Archives of toxicology 2024-04, Vol.98 (4), p.1209-1224
Main Authors: Treschow, Andreas Frederik, Valente, Maria João, Lauschke, Karin, Holst, Bjørn, Andersen, Anders Reenberg, Vinggaard, Anne Marie
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-c459t-77b7c7d0bb74a47ebb6f890d50b51f2e03b1cb8eb5c2432ceb2e785e5e56c5913
container_end_page 1224
container_issue 4
container_start_page 1209
container_title Archives of toxicology
container_volume 98
creator Treschow, Andreas Frederik
Valente, Maria João
Lauschke, Karin
Holst, Bjørn
Andersen, Anders Reenberg
Vinggaard, Anne Marie
description To meet the growing demand for developmental toxicity assessment of chemicals, New Approach Methodologies (NAMs) are needed. Previously, we developed two 3D in vitro assays based on human-induced pluripotent stem cells (hiPSC) and cardiomyocyte differentiation: the PluriBeat assay, based on assessment of beating differentiated embryoid bodies, and the PluriLum assay, a reporter gene assay based on the expression of the early cardiac marker NKX2.5 ; both promising assays for predicting embryotoxic effects of chemicals and drugs. In this work, we aimed to further describe the predictive power of the PluriLum assay and compare its sensitivity with PluriBeat and similar human stem cell-based assays developed by others. For this purpose, we assessed the toxicity of a panel of ten chemicals from different chemical classes, consisting of the known developmental toxicants 5-fluorouracil, all- trans retinoic acid and valproic acid, as well as the negative control compounds ascorbic acid and folic acid. In addition, the fungicides epoxiconazole and prochloraz, and three perfluoroalkyl substances (PFAS), PFOS, PFOA and GenX were tested. Generally, the PluriLum assay displayed higher sensitivity when compared to the PluriBeat assay. For several compounds the luminescence readout of the PluriLum assay showed effects not detected by the PluriBeat assay, including two PFAS compounds and the two fungicides. Overall, we find that the PluriLum assay has the potential to provide a fast and objective detection of developmental toxicants and has a level of sensitivity that is comparable to or higher than other in vitro assays also based on human stem cells and cardiomyocyte differentiation for assessment of developmental toxicity.
doi_str_mv 10.1007/s00204-023-03675-1
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10944425</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3153805291</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-77b7c7d0bb74a47ebb6f890d50b51f2e03b1cb8eb5c2432ceb2e785e5e56c5913</originalsourceid><addsrcrecordid>eNp9kstu1DAUhi0EokPhBVigSGzYBI5vccIGVSMulUaiErC2bOdkxlUSD3ZSMQveHWemlMui8sKS_-_85-JDyHMKrymAepMAGIgSGC-BV0qW9AFZUcFZCYrXD8kKuIBSqoqekScpXQNQVjf8MTnjNae0EvWK_LwcbzBNfmsmP26LaYeF2e9774z1vZ8ORRsG48cidEdt56--rEtrErbFVT9Hv5mHwqRkDm8LMxY42HgIU_jh3RKbBUxpwHFa4t0Oh-zbp0y2RRvnbXpKHnX5AZ_d3ufk24f3X9efys3nj5fri03phGymUimrnGrBWiWMUGht1dUNtBKspB1D4JY6W6OVjuX2HVqGqpaYT-VkQ_k5eXfy3c92wNbliqLp9T76wcSDDsbrf5XR7_Q23GgKjRCCyezw6tYhhu9znpgefHLY92bEMCfNqeQ1SHZMdj_KGsaEBKUW15f_oddhjmMeRaakqvP_Vk2m2IlyMaQUsbsrnIJeNkGfNkHnTdDHTdBLFS_-bvku5PfXZ4CfgJSlcYvxT-57bH8BzEjA4w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2957802069</pqid></control><display><type>article</type><title>Investigating the applicability domain of the hiPSC-based PluriLum assay: an embryotoxicity assessment of chemicals and drugs</title><source>Springer Nature</source><creator>Treschow, Andreas Frederik ; Valente, Maria João ; Lauschke, Karin ; Holst, Bjørn ; Andersen, Anders Reenberg ; Vinggaard, Anne Marie</creator><creatorcontrib>Treschow, Andreas Frederik ; Valente, Maria João ; Lauschke, Karin ; Holst, Bjørn ; Andersen, Anders Reenberg ; Vinggaard, Anne Marie</creatorcontrib><description>To meet the growing demand for developmental toxicity assessment of chemicals, New Approach Methodologies (NAMs) are needed. Previously, we developed two 3D in vitro assays based on human-induced pluripotent stem cells (hiPSC) and cardiomyocyte differentiation: the PluriBeat assay, based on assessment of beating differentiated embryoid bodies, and the PluriLum assay, a reporter gene assay based on the expression of the early cardiac marker NKX2.5 ; both promising assays for predicting embryotoxic effects of chemicals and drugs. In this work, we aimed to further describe the predictive power of the PluriLum assay and compare its sensitivity with PluriBeat and similar human stem cell-based assays developed by others. For this purpose, we assessed the toxicity of a panel of ten chemicals from different chemical classes, consisting of the known developmental toxicants 5-fluorouracil, all- trans retinoic acid and valproic acid, as well as the negative control compounds ascorbic acid and folic acid. In addition, the fungicides epoxiconazole and prochloraz, and three perfluoroalkyl substances (PFAS), PFOS, PFOA and GenX were tested. Generally, the PluriLum assay displayed higher sensitivity when compared to the PluriBeat assay. For several compounds the luminescence readout of the PluriLum assay showed effects not detected by the PluriBeat assay, including two PFAS compounds and the two fungicides. Overall, we find that the PluriLum assay has the potential to provide a fast and objective detection of developmental toxicants and has a level of sensitivity that is comparable to or higher than other in vitro assays also based on human stem cells and cardiomyocyte differentiation for assessment of developmental toxicity.</description><identifier>ISSN: 0340-5761</identifier><identifier>ISSN: 1432-0738</identifier><identifier>EISSN: 1432-0738</identifier><identifier>DOI: 10.1007/s00204-023-03675-1</identifier><identifier>PMID: 38311648</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>5-Fluorouracil ; Acids ; Ascorbic acid ; Assaying ; Biomedical and Life Sciences ; Biomedicine ; Cardiomyocytes ; Cell Differentiation ; Chemicals ; Contaminants ; Differentiation ; domain ; Drugs ; Embryoid Bodies ; embryotoxicity ; Environmental Health ; Epoxiconazole ; Fluorocarbons ; fluorouracil ; Folic acid ; Fungicides ; Fungicides, Industrial ; Hazardous Substances ; Human influences ; Humans ; Induced Pluripotent Stem Cells ; luminescence ; Nkx2.5 protein ; Occupational Medicine/Industrial Medicine ; Perfluoroalkyl &amp; polyfluoroalkyl substances ; perfluorocarbons ; Perfluorochemicals ; Perfluorooctane sulfonic acid ; Perfluorooctanoic acid ; Pesticides ; Pharmacology/Toxicology ; Pluripotency ; Prochloraz ; Reporter gene ; reporter genes ; Reproductive Toxicology ; Retinoic acid ; Sensitivity ; Stem cells ; Toxicants ; Toxicity ; Toxicity Tests - methods ; Valproic acid</subject><ispartof>Archives of toxicology, 2024-04, Vol.98 (4), p.1209-1224</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c459t-77b7c7d0bb74a47ebb6f890d50b51f2e03b1cb8eb5c2432ceb2e785e5e56c5913</cites><orcidid>0000-0002-0545-7857</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38311648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Treschow, Andreas Frederik</creatorcontrib><creatorcontrib>Valente, Maria João</creatorcontrib><creatorcontrib>Lauschke, Karin</creatorcontrib><creatorcontrib>Holst, Bjørn</creatorcontrib><creatorcontrib>Andersen, Anders Reenberg</creatorcontrib><creatorcontrib>Vinggaard, Anne Marie</creatorcontrib><title>Investigating the applicability domain of the hiPSC-based PluriLum assay: an embryotoxicity assessment of chemicals and drugs</title><title>Archives of toxicology</title><addtitle>Arch Toxicol</addtitle><addtitle>Arch Toxicol</addtitle><description>To meet the growing demand for developmental toxicity assessment of chemicals, New Approach Methodologies (NAMs) are needed. Previously, we developed two 3D in vitro assays based on human-induced pluripotent stem cells (hiPSC) and cardiomyocyte differentiation: the PluriBeat assay, based on assessment of beating differentiated embryoid bodies, and the PluriLum assay, a reporter gene assay based on the expression of the early cardiac marker NKX2.5 ; both promising assays for predicting embryotoxic effects of chemicals and drugs. In this work, we aimed to further describe the predictive power of the PluriLum assay and compare its sensitivity with PluriBeat and similar human stem cell-based assays developed by others. For this purpose, we assessed the toxicity of a panel of ten chemicals from different chemical classes, consisting of the known developmental toxicants 5-fluorouracil, all- trans retinoic acid and valproic acid, as well as the negative control compounds ascorbic acid and folic acid. In addition, the fungicides epoxiconazole and prochloraz, and three perfluoroalkyl substances (PFAS), PFOS, PFOA and GenX were tested. Generally, the PluriLum assay displayed higher sensitivity when compared to the PluriBeat assay. For several compounds the luminescence readout of the PluriLum assay showed effects not detected by the PluriBeat assay, including two PFAS compounds and the two fungicides. Overall, we find that the PluriLum assay has the potential to provide a fast and objective detection of developmental toxicants and has a level of sensitivity that is comparable to or higher than other in vitro assays also based on human stem cells and cardiomyocyte differentiation for assessment of developmental toxicity.</description><subject>5-Fluorouracil</subject><subject>Acids</subject><subject>Ascorbic acid</subject><subject>Assaying</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cardiomyocytes</subject><subject>Cell Differentiation</subject><subject>Chemicals</subject><subject>Contaminants</subject><subject>Differentiation</subject><subject>domain</subject><subject>Drugs</subject><subject>Embryoid Bodies</subject><subject>embryotoxicity</subject><subject>Environmental Health</subject><subject>Epoxiconazole</subject><subject>Fluorocarbons</subject><subject>fluorouracil</subject><subject>Folic acid</subject><subject>Fungicides</subject><subject>Fungicides, Industrial</subject><subject>Hazardous Substances</subject><subject>Human influences</subject><subject>Humans</subject><subject>Induced Pluripotent Stem Cells</subject><subject>luminescence</subject><subject>Nkx2.5 protein</subject><subject>Occupational Medicine/Industrial Medicine</subject><subject>Perfluoroalkyl &amp; polyfluoroalkyl substances</subject><subject>perfluorocarbons</subject><subject>Perfluorochemicals</subject><subject>Perfluorooctane sulfonic acid</subject><subject>Perfluorooctanoic acid</subject><subject>Pesticides</subject><subject>Pharmacology/Toxicology</subject><subject>Pluripotency</subject><subject>Prochloraz</subject><subject>Reporter gene</subject><subject>reporter genes</subject><subject>Reproductive Toxicology</subject><subject>Retinoic acid</subject><subject>Sensitivity</subject><subject>Stem cells</subject><subject>Toxicants</subject><subject>Toxicity</subject><subject>Toxicity Tests - methods</subject><subject>Valproic acid</subject><issn>0340-5761</issn><issn>1432-0738</issn><issn>1432-0738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kstu1DAUhi0EokPhBVigSGzYBI5vccIGVSMulUaiErC2bOdkxlUSD3ZSMQveHWemlMui8sKS_-_85-JDyHMKrymAepMAGIgSGC-BV0qW9AFZUcFZCYrXD8kKuIBSqoqekScpXQNQVjf8MTnjNae0EvWK_LwcbzBNfmsmP26LaYeF2e9774z1vZ8ORRsG48cidEdt56--rEtrErbFVT9Hv5mHwqRkDm8LMxY42HgIU_jh3RKbBUxpwHFa4t0Oh-zbp0y2RRvnbXpKHnX5AZ_d3ufk24f3X9efys3nj5fri03phGymUimrnGrBWiWMUGht1dUNtBKspB1D4JY6W6OVjuX2HVqGqpaYT-VkQ_k5eXfy3c92wNbliqLp9T76wcSDDsbrf5XR7_Q23GgKjRCCyezw6tYhhu9znpgefHLY92bEMCfNqeQ1SHZMdj_KGsaEBKUW15f_oddhjmMeRaakqvP_Vk2m2IlyMaQUsbsrnIJeNkGfNkHnTdDHTdBLFS_-bvku5PfXZ4CfgJSlcYvxT-57bH8BzEjA4w</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Treschow, Andreas Frederik</creator><creator>Valente, Maria João</creator><creator>Lauschke, Karin</creator><creator>Holst, Bjørn</creator><creator>Andersen, Anders Reenberg</creator><creator>Vinggaard, Anne Marie</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0545-7857</orcidid></search><sort><creationdate>20240401</creationdate><title>Investigating the applicability domain of the hiPSC-based PluriLum assay: an embryotoxicity assessment of chemicals and drugs</title><author>Treschow, Andreas Frederik ; Valente, Maria João ; Lauschke, Karin ; Holst, Bjørn ; Andersen, Anders Reenberg ; Vinggaard, Anne Marie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-77b7c7d0bb74a47ebb6f890d50b51f2e03b1cb8eb5c2432ceb2e785e5e56c5913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>5-Fluorouracil</topic><topic>Acids</topic><topic>Ascorbic acid</topic><topic>Assaying</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cardiomyocytes</topic><topic>Cell Differentiation</topic><topic>Chemicals</topic><topic>Contaminants</topic><topic>Differentiation</topic><topic>domain</topic><topic>Drugs</topic><topic>Embryoid Bodies</topic><topic>embryotoxicity</topic><topic>Environmental Health</topic><topic>Epoxiconazole</topic><topic>Fluorocarbons</topic><topic>fluorouracil</topic><topic>Folic acid</topic><topic>Fungicides</topic><topic>Fungicides, Industrial</topic><topic>Hazardous Substances</topic><topic>Human influences</topic><topic>Humans</topic><topic>Induced Pluripotent Stem Cells</topic><topic>luminescence</topic><topic>Nkx2.5 protein</topic><topic>Occupational Medicine/Industrial Medicine</topic><topic>Perfluoroalkyl &amp; polyfluoroalkyl substances</topic><topic>perfluorocarbons</topic><topic>Perfluorochemicals</topic><topic>Perfluorooctane sulfonic acid</topic><topic>Perfluorooctanoic acid</topic><topic>Pesticides</topic><topic>Pharmacology/Toxicology</topic><topic>Pluripotency</topic><topic>Prochloraz</topic><topic>Reporter gene</topic><topic>reporter genes</topic><topic>Reproductive Toxicology</topic><topic>Retinoic acid</topic><topic>Sensitivity</topic><topic>Stem cells</topic><topic>Toxicants</topic><topic>Toxicity</topic><topic>Toxicity Tests - methods</topic><topic>Valproic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Treschow, Andreas Frederik</creatorcontrib><creatorcontrib>Valente, Maria João</creatorcontrib><creatorcontrib>Lauschke, Karin</creatorcontrib><creatorcontrib>Holst, Bjørn</creatorcontrib><creatorcontrib>Andersen, Anders Reenberg</creatorcontrib><creatorcontrib>Vinggaard, Anne Marie</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of toxicology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Treschow, Andreas Frederik</au><au>Valente, Maria João</au><au>Lauschke, Karin</au><au>Holst, Bjørn</au><au>Andersen, Anders Reenberg</au><au>Vinggaard, Anne Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Investigating the applicability domain of the hiPSC-based PluriLum assay: an embryotoxicity assessment of chemicals and drugs</atitle><jtitle>Archives of toxicology</jtitle><stitle>Arch Toxicol</stitle><addtitle>Arch Toxicol</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>98</volume><issue>4</issue><spage>1209</spage><epage>1224</epage><pages>1209-1224</pages><issn>0340-5761</issn><issn>1432-0738</issn><eissn>1432-0738</eissn><abstract>To meet the growing demand for developmental toxicity assessment of chemicals, New Approach Methodologies (NAMs) are needed. Previously, we developed two 3D in vitro assays based on human-induced pluripotent stem cells (hiPSC) and cardiomyocyte differentiation: the PluriBeat assay, based on assessment of beating differentiated embryoid bodies, and the PluriLum assay, a reporter gene assay based on the expression of the early cardiac marker NKX2.5 ; both promising assays for predicting embryotoxic effects of chemicals and drugs. In this work, we aimed to further describe the predictive power of the PluriLum assay and compare its sensitivity with PluriBeat and similar human stem cell-based assays developed by others. For this purpose, we assessed the toxicity of a panel of ten chemicals from different chemical classes, consisting of the known developmental toxicants 5-fluorouracil, all- trans retinoic acid and valproic acid, as well as the negative control compounds ascorbic acid and folic acid. In addition, the fungicides epoxiconazole and prochloraz, and three perfluoroalkyl substances (PFAS), PFOS, PFOA and GenX were tested. Generally, the PluriLum assay displayed higher sensitivity when compared to the PluriBeat assay. For several compounds the luminescence readout of the PluriLum assay showed effects not detected by the PluriBeat assay, including two PFAS compounds and the two fungicides. Overall, we find that the PluriLum assay has the potential to provide a fast and objective detection of developmental toxicants and has a level of sensitivity that is comparable to or higher than other in vitro assays also based on human stem cells and cardiomyocyte differentiation for assessment of developmental toxicity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38311648</pmid><doi>10.1007/s00204-023-03675-1</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-0545-7857</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0340-5761
ispartof Archives of toxicology, 2024-04, Vol.98 (4), p.1209-1224
issn 0340-5761
1432-0738
1432-0738
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10944425
source Springer Nature
subjects 5-Fluorouracil
Acids
Ascorbic acid
Assaying
Biomedical and Life Sciences
Biomedicine
Cardiomyocytes
Cell Differentiation
Chemicals
Contaminants
Differentiation
domain
Drugs
Embryoid Bodies
embryotoxicity
Environmental Health
Epoxiconazole
Fluorocarbons
fluorouracil
Folic acid
Fungicides
Fungicides, Industrial
Hazardous Substances
Human influences
Humans
Induced Pluripotent Stem Cells
luminescence
Nkx2.5 protein
Occupational Medicine/Industrial Medicine
Perfluoroalkyl & polyfluoroalkyl substances
perfluorocarbons
Perfluorochemicals
Perfluorooctane sulfonic acid
Perfluorooctanoic acid
Pesticides
Pharmacology/Toxicology
Pluripotency
Prochloraz
Reporter gene
reporter genes
Reproductive Toxicology
Retinoic acid
Sensitivity
Stem cells
Toxicants
Toxicity
Toxicity Tests - methods
Valproic acid
title Investigating the applicability domain of the hiPSC-based PluriLum assay: an embryotoxicity assessment of chemicals and drugs
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T18%3A57%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Investigating%20the%20applicability%20domain%20of%20the%20hiPSC-based%20PluriLum%20assay:%20an%20embryotoxicity%20assessment%20of%20chemicals%20and%20drugs&rft.jtitle=Archives%20of%20toxicology&rft.au=Treschow,%20Andreas%20Frederik&rft.date=2024-04-01&rft.volume=98&rft.issue=4&rft.spage=1209&rft.epage=1224&rft.pages=1209-1224&rft.issn=0340-5761&rft.eissn=1432-0738&rft_id=info:doi/10.1007/s00204-023-03675-1&rft_dat=%3Cproquest_pubme%3E3153805291%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c459t-77b7c7d0bb74a47ebb6f890d50b51f2e03b1cb8eb5c2432ceb2e785e5e56c5913%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2957802069&rft_id=info:pmid/38311648&rfr_iscdi=true