Loading…

Novel methylated DNA markers accurately discriminate Lynch syndrome associated colorectal neoplasia

Acquired molecular changes in Lynch syndrome (LS) colorectal tumors have been largely unstudied. We identified methylated DNA markers (MDMs) for discrimination of colorectal neoplasia in LS and determined if these MDMs were comparably discriminant in sporadic patients. For LS discovery, we evaluated...

Full description

Saved in:
Bibliographic Details
Published in:Epigenomics 2020-12, Vol.12 (24), p.2173-2187
Main Authors: Ballester, Veroushka, Taylor, William R, Slettedahl, Seth W, Mahoney, Douglas W, Yab, Tracy C, Sinicrope, Frank A, Boland, Clement R, Lidgard, Graham P, Cruz-Correa, Marcia R, Smyrk, Thomas C, Boardman, Lisa A, Ahlquist, David A, Kisiel, John B
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-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873
cites cdi_FETCH-LOGICAL-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873
container_end_page 2187
container_issue 24
container_start_page 2173
container_title Epigenomics
container_volume 12
creator Ballester, Veroushka
Taylor, William R
Slettedahl, Seth W
Mahoney, Douglas W
Yab, Tracy C
Sinicrope, Frank A
Boland, Clement R
Lidgard, Graham P
Cruz-Correa, Marcia R
Smyrk, Thomas C
Boardman, Lisa A
Ahlquist, David A
Kisiel, John B
description Acquired molecular changes in Lynch syndrome (LS) colorectal tumors have been largely unstudied. We identified methylated DNA markers (MDMs) for discrimination of colorectal neoplasia in LS and determined if these MDMs were comparably discriminant in sporadic patients. For LS discovery, we evaluated DNA from 53 colorectal case and control tissues using next generation sequencing. For validation, blinded methylation-specific PCR assays to the selected MDMs were performed on 197 cases and controls. was the most discriminant MDM with areas under the receiver operating characteristic curve ≥0.97 for colorectal neoplasia in LS and sporadic tissues. , was uniquely hypermethylated in LS neoplasms. Highly discriminant MDMs for colorectal neoplasia in LS were identified with potential use in screening and surveillance.
doi_str_mv 10.2217/epi-2020-0132
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7923255</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2478336487</sourcerecordid><originalsourceid>FETCH-LOGICAL-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873</originalsourceid><addsrcrecordid>eNp1kc1LHTEUxUOpVFGXbkvATTfTJrnzkdkI4kcVHrppwV3Iy9zpi2aSZzIjzH_fPJ99tAWzSW7u717O4RBywtlXIXjzDde2EEywgnEQH8gBbypW8FY8fNy9Od8nxyk9snxAyLbmn8g-AFRMVnBAzF14QUcHHFez0yN29PLunA46PmFMVBszxfzrZtrZZKIdrM8lXczerGiafRfDgFSnFIx9nTbBhYhm1I56DGunk9VHZK_XLuHx231Ifl5f_bi4KRb3328vzheFKetqLPqyhAp6gSBKNNDUvMUsV3NgUusllLLplrnfdWUPPc9E2ywZYMVFWxvZwCE52-5dT8sBO4N-jNqpdZat46yCturfjrcr9Su8qKYVIKoqL_jytiCG5wnTqIbsGp3T2cuUlCgbwZmUrczo6X_oY5iiz_Y2lASoy1dFxZYyMaQUsd-J4UxtElQ5QbVJUG0SzPznvx3s6D95ZaDdAv00ThGTsegNqm2VJ6yxHt9Z_hud46vR</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2478336487</pqid></control><display><type>article</type><title>Novel methylated DNA markers accurately discriminate Lynch syndrome associated colorectal neoplasia</title><source>Open Access: PubMed Central</source><creator>Ballester, Veroushka ; Taylor, William R ; Slettedahl, Seth W ; Mahoney, Douglas W ; Yab, Tracy C ; Sinicrope, Frank A ; Boland, Clement R ; Lidgard, Graham P ; Cruz-Correa, Marcia R ; Smyrk, Thomas C ; Boardman, Lisa A ; Ahlquist, David A ; Kisiel, John B</creator><creatorcontrib>Ballester, Veroushka ; Taylor, William R ; Slettedahl, Seth W ; Mahoney, Douglas W ; Yab, Tracy C ; Sinicrope, Frank A ; Boland, Clement R ; Lidgard, Graham P ; Cruz-Correa, Marcia R ; Smyrk, Thomas C ; Boardman, Lisa A ; Ahlquist, David A ; Kisiel, John B</creatorcontrib><description>Acquired molecular changes in Lynch syndrome (LS) colorectal tumors have been largely unstudied. We identified methylated DNA markers (MDMs) for discrimination of colorectal neoplasia in LS and determined if these MDMs were comparably discriminant in sporadic patients. For LS discovery, we evaluated DNA from 53 colorectal case and control tissues using next generation sequencing. For validation, blinded methylation-specific PCR assays to the selected MDMs were performed on 197 cases and controls. was the most discriminant MDM with areas under the receiver operating characteristic curve ≥0.97 for colorectal neoplasia in LS and sporadic tissues. , was uniquely hypermethylated in LS neoplasms. Highly discriminant MDMs for colorectal neoplasia in LS were identified with potential use in screening and surveillance.</description><identifier>ISSN: 1750-1911</identifier><identifier>EISSN: 1750-192X</identifier><identifier>DOI: 10.2217/epi-2020-0132</identifier><identifier>PMID: 33350853</identifier><language>eng</language><publisher>England: Future Medicine Ltd</publisher><subject>Archives &amp; records ; biomarkers ; Candidates ; Colonoscopy ; Colorectal cancer ; colorectal neoplasms ; colorectal physiology ; colorectal prevention and control ; Deoxyribonucleic acid ; DNA ; DNA methylation ; DNA sequencing ; Genes ; Genetic disorders ; Genetic testing ; Genomics ; hereditary nonpolyposis ; Markers ; Neoplasia ; Neoplasms ; Next-generation sequencing ; Ovarian cancer ; Prostate cancer ; Surveillance ; Tumors ; Urogenital system</subject><ispartof>Epigenomics, 2020-12, Vol.12 (24), p.2173-2187</ispartof><rights>2020 John B Kisiel</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 John B Kisiel 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873</citedby><cites>FETCH-LOGICAL-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873</cites><orcidid>0000-0002-2907-1000 ; 0000-0003-3398-3608 ; 0000-0002-9116-8428 ; 0000-0002-1330-2054 ; 0000 ; 0000-0003-3093-0658 ; 0000-0001-6194-7853 ; 0000-0002-3840-5324</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923255/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923255/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33350853$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ballester, Veroushka</creatorcontrib><creatorcontrib>Taylor, William R</creatorcontrib><creatorcontrib>Slettedahl, Seth W</creatorcontrib><creatorcontrib>Mahoney, Douglas W</creatorcontrib><creatorcontrib>Yab, Tracy C</creatorcontrib><creatorcontrib>Sinicrope, Frank A</creatorcontrib><creatorcontrib>Boland, Clement R</creatorcontrib><creatorcontrib>Lidgard, Graham P</creatorcontrib><creatorcontrib>Cruz-Correa, Marcia R</creatorcontrib><creatorcontrib>Smyrk, Thomas C</creatorcontrib><creatorcontrib>Boardman, Lisa A</creatorcontrib><creatorcontrib>Ahlquist, David A</creatorcontrib><creatorcontrib>Kisiel, John B</creatorcontrib><title>Novel methylated DNA markers accurately discriminate Lynch syndrome associated colorectal neoplasia</title><title>Epigenomics</title><addtitle>Epigenomics</addtitle><description>Acquired molecular changes in Lynch syndrome (LS) colorectal tumors have been largely unstudied. We identified methylated DNA markers (MDMs) for discrimination of colorectal neoplasia in LS and determined if these MDMs were comparably discriminant in sporadic patients. For LS discovery, we evaluated DNA from 53 colorectal case and control tissues using next generation sequencing. For validation, blinded methylation-specific PCR assays to the selected MDMs were performed on 197 cases and controls. was the most discriminant MDM with areas under the receiver operating characteristic curve ≥0.97 for colorectal neoplasia in LS and sporadic tissues. , was uniquely hypermethylated in LS neoplasms. Highly discriminant MDMs for colorectal neoplasia in LS were identified with potential use in screening and surveillance.</description><subject>Archives &amp; records</subject><subject>biomarkers</subject><subject>Candidates</subject><subject>Colonoscopy</subject><subject>Colorectal cancer</subject><subject>colorectal neoplasms</subject><subject>colorectal physiology</subject><subject>colorectal prevention and control</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>DNA methylation</subject><subject>DNA sequencing</subject><subject>Genes</subject><subject>Genetic disorders</subject><subject>Genetic testing</subject><subject>Genomics</subject><subject>hereditary nonpolyposis</subject><subject>Markers</subject><subject>Neoplasia</subject><subject>Neoplasms</subject><subject>Next-generation sequencing</subject><subject>Ovarian cancer</subject><subject>Prostate cancer</subject><subject>Surveillance</subject><subject>Tumors</subject><subject>Urogenital system</subject><issn>1750-1911</issn><issn>1750-192X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kc1LHTEUxUOpVFGXbkvATTfTJrnzkdkI4kcVHrppwV3Iy9zpi2aSZzIjzH_fPJ99tAWzSW7u717O4RBywtlXIXjzDde2EEywgnEQH8gBbypW8FY8fNy9Od8nxyk9snxAyLbmn8g-AFRMVnBAzF14QUcHHFez0yN29PLunA46PmFMVBszxfzrZtrZZKIdrM8lXczerGiafRfDgFSnFIx9nTbBhYhm1I56DGunk9VHZK_XLuHx231Ifl5f_bi4KRb3328vzheFKetqLPqyhAp6gSBKNNDUvMUsV3NgUusllLLplrnfdWUPPc9E2ywZYMVFWxvZwCE52-5dT8sBO4N-jNqpdZat46yCturfjrcr9Su8qKYVIKoqL_jytiCG5wnTqIbsGp3T2cuUlCgbwZmUrczo6X_oY5iiz_Y2lASoy1dFxZYyMaQUsd-J4UxtElQ5QbVJUG0SzPznvx3s6D95ZaDdAv00ThGTsegNqm2VJ6yxHt9Z_hud46vR</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Ballester, Veroushka</creator><creator>Taylor, William R</creator><creator>Slettedahl, Seth W</creator><creator>Mahoney, Douglas W</creator><creator>Yab, Tracy C</creator><creator>Sinicrope, Frank A</creator><creator>Boland, Clement R</creator><creator>Lidgard, Graham P</creator><creator>Cruz-Correa, Marcia R</creator><creator>Smyrk, Thomas C</creator><creator>Boardman, Lisa A</creator><creator>Ahlquist, David A</creator><creator>Kisiel, John B</creator><general>Future Medicine Ltd</general><scope>FUMOA</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>EHMNL</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2907-1000</orcidid><orcidid>https://orcid.org/0000-0003-3398-3608</orcidid><orcidid>https://orcid.org/0000-0002-9116-8428</orcidid><orcidid>https://orcid.org/0000-0002-1330-2054</orcidid><orcidid>https://orcid.org/0000</orcidid><orcidid>https://orcid.org/0000-0003-3093-0658</orcidid><orcidid>https://orcid.org/0000-0001-6194-7853</orcidid><orcidid>https://orcid.org/0000-0002-3840-5324</orcidid></search><sort><creationdate>20201201</creationdate><title>Novel methylated DNA markers accurately discriminate Lynch syndrome associated colorectal neoplasia</title><author>Ballester, Veroushka ; Taylor, William R ; Slettedahl, Seth W ; Mahoney, Douglas W ; Yab, Tracy C ; Sinicrope, Frank A ; Boland, Clement R ; Lidgard, Graham P ; Cruz-Correa, Marcia R ; Smyrk, Thomas C ; Boardman, Lisa A ; Ahlquist, David A ; Kisiel, John B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Archives &amp; records</topic><topic>biomarkers</topic><topic>Candidates</topic><topic>Colonoscopy</topic><topic>Colorectal cancer</topic><topic>colorectal neoplasms</topic><topic>colorectal physiology</topic><topic>colorectal prevention and control</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>DNA methylation</topic><topic>DNA sequencing</topic><topic>Genes</topic><topic>Genetic disorders</topic><topic>Genetic testing</topic><topic>Genomics</topic><topic>hereditary nonpolyposis</topic><topic>Markers</topic><topic>Neoplasia</topic><topic>Neoplasms</topic><topic>Next-generation sequencing</topic><topic>Ovarian cancer</topic><topic>Prostate cancer</topic><topic>Surveillance</topic><topic>Tumors</topic><topic>Urogenital system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ballester, Veroushka</creatorcontrib><creatorcontrib>Taylor, William R</creatorcontrib><creatorcontrib>Slettedahl, Seth W</creatorcontrib><creatorcontrib>Mahoney, Douglas W</creatorcontrib><creatorcontrib>Yab, Tracy C</creatorcontrib><creatorcontrib>Sinicrope, Frank A</creatorcontrib><creatorcontrib>Boland, Clement R</creatorcontrib><creatorcontrib>Lidgard, Graham P</creatorcontrib><creatorcontrib>Cruz-Correa, Marcia R</creatorcontrib><creatorcontrib>Smyrk, Thomas C</creatorcontrib><creatorcontrib>Boardman, Lisa A</creatorcontrib><creatorcontrib>Ahlquist, David A</creatorcontrib><creatorcontrib>Kisiel, John B</creatorcontrib><collection>Future Medicine (Open Access)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>UK &amp; Ireland Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epigenomics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ballester, Veroushka</au><au>Taylor, William R</au><au>Slettedahl, Seth W</au><au>Mahoney, Douglas W</au><au>Yab, Tracy C</au><au>Sinicrope, Frank A</au><au>Boland, Clement R</au><au>Lidgard, Graham P</au><au>Cruz-Correa, Marcia R</au><au>Smyrk, Thomas C</au><au>Boardman, Lisa A</au><au>Ahlquist, David A</au><au>Kisiel, John B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel methylated DNA markers accurately discriminate Lynch syndrome associated colorectal neoplasia</atitle><jtitle>Epigenomics</jtitle><addtitle>Epigenomics</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>12</volume><issue>24</issue><spage>2173</spage><epage>2187</epage><pages>2173-2187</pages><issn>1750-1911</issn><eissn>1750-192X</eissn><abstract>Acquired molecular changes in Lynch syndrome (LS) colorectal tumors have been largely unstudied. We identified methylated DNA markers (MDMs) for discrimination of colorectal neoplasia in LS and determined if these MDMs were comparably discriminant in sporadic patients. For LS discovery, we evaluated DNA from 53 colorectal case and control tissues using next generation sequencing. For validation, blinded methylation-specific PCR assays to the selected MDMs were performed on 197 cases and controls. was the most discriminant MDM with areas under the receiver operating characteristic curve ≥0.97 for colorectal neoplasia in LS and sporadic tissues. , was uniquely hypermethylated in LS neoplasms. Highly discriminant MDMs for colorectal neoplasia in LS were identified with potential use in screening and surveillance.</abstract><cop>England</cop><pub>Future Medicine Ltd</pub><pmid>33350853</pmid><doi>10.2217/epi-2020-0132</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-2907-1000</orcidid><orcidid>https://orcid.org/0000-0003-3398-3608</orcidid><orcidid>https://orcid.org/0000-0002-9116-8428</orcidid><orcidid>https://orcid.org/0000-0002-1330-2054</orcidid><orcidid>https://orcid.org/0000</orcidid><orcidid>https://orcid.org/0000-0003-3093-0658</orcidid><orcidid>https://orcid.org/0000-0001-6194-7853</orcidid><orcidid>https://orcid.org/0000-0002-3840-5324</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1750-1911
ispartof Epigenomics, 2020-12, Vol.12 (24), p.2173-2187
issn 1750-1911
1750-192X
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7923255
source Open Access: PubMed Central
subjects Archives & records
biomarkers
Candidates
Colonoscopy
Colorectal cancer
colorectal neoplasms
colorectal physiology
colorectal prevention and control
Deoxyribonucleic acid
DNA
DNA methylation
DNA sequencing
Genes
Genetic disorders
Genetic testing
Genomics
hereditary nonpolyposis
Markers
Neoplasia
Neoplasms
Next-generation sequencing
Ovarian cancer
Prostate cancer
Surveillance
Tumors
Urogenital system
title Novel methylated DNA markers accurately discriminate Lynch syndrome associated colorectal neoplasia
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T18%3A13%3A16IST&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=Novel%20methylated%20DNA%20markers%20accurately%20discriminate%20Lynch%20syndrome%20associated%20colorectal%20neoplasia&rft.jtitle=Epigenomics&rft.au=Ballester,%20Veroushka&rft.date=2020-12-01&rft.volume=12&rft.issue=24&rft.spage=2173&rft.epage=2187&rft.pages=2173-2187&rft.issn=1750-1911&rft.eissn=1750-192X&rft_id=info:doi/10.2217/epi-2020-0132&rft_dat=%3Cproquest_pubme%3E2478336487%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c465t-f44353f2e324ec37619e961a1308aab3487db3f2dd4f3f1c3797b03e51296c873%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2478336487&rft_id=info:pmid/33350853&rfr_iscdi=true