Loading…

Biodegradation of Emerging Pharmaceuticals from Domestic Wastewater by Membrane Bioreactor: The Effect of Solid Retention Time

Although conventional biological treatment plants can remove basic pollutants, they are ineffective at removing recalcitrant pollutants. Membrane bioreactors contain promising technology and have the advantages of better effluent quality and lower sludge production compared to those of conventional...

Full description

Saved in:
Bibliographic Details
Published in:International journal of environmental research and public health 2021-03, Vol.18 (7), p.3395
Main Authors: Alobaidi, Raghad Asad Kadhim, Ulucan-Altuntas, Kubra, Mhemid, Rasha Khalid Sabri, Manav-Demir, Neslihan, Cinar, Ozer
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-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453
cites cdi_FETCH-LOGICAL-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453
container_end_page
container_issue 7
container_start_page 3395
container_title International journal of environmental research and public health
container_volume 18
creator Alobaidi, Raghad Asad Kadhim
Ulucan-Altuntas, Kubra
Mhemid, Rasha Khalid Sabri
Manav-Demir, Neslihan
Cinar, Ozer
description Although conventional biological treatment plants can remove basic pollutants, they are ineffective at removing recalcitrant pollutants. Membrane bioreactors contain promising technology and have the advantages of better effluent quality and lower sludge production compared to those of conventional biological treatment processes. In this study, the removal of pharmaceutical compounds by membrane bioreactors under different solid retention times (SRTs) was investigated. To study the effect of SRT on the removal of emerging pharmaceuticals, the levels of pharmaceuticals were measured over 96 days for the following retention times: 20, 30, and 40-day SRT. It was found that the 40-day SRT had the optimum performance in terms of the pharmaceuticals' elimination. The removal efficiencies of the chemical oxygen demand (COD) for each selected SRT were higher than 96% at steady-state conditions. The highest degradation efficiency was observed for paracetamol. Paracetamol was the most removed compound followed by ranitidine, atenolol, bezafibrate, diclofenac, and carbamazepine. The microbial community at the phylum level was also analyzed to understand the biodegradability of pharmaceuticals. It was noticed that the Proteobacteria phylum increased from 46.8% to 60.0% after 96 days with the pharmaceuticals. The Actinobacteria class, which can metabolize paracetamol, carbamazepine, and atenolol, was also increased from 9.1% to 17.9% after adding pharmaceuticals. The by-products of diclofenac, bezafibrate, and carbamazepine were observed in the effluent samples.
doi_str_mv 10.3390/ijerph18073395
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8036512</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2566026460</sourcerecordid><originalsourceid>FETCH-LOGICAL-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453</originalsourceid><addsrcrecordid>eNpVkctPGzEQxq2qqDzaa4-VpZ4T_Fg7uz1UKiE8JBBVm6pHa9YeJ46y6-DdgHLhb8cQiOBke-bzbz59Q8hXzoZSVuw4LDCt5rxko_xUH8gB15oNCs34xzf3fXLYdQvGZFno6hPZl7JkqlLqgDychOhwlsBBH2JLo6eTBtMstDP6ew6pAYvrPlhYdtSn2NDT2GCXC_Q_dD3eQ4-J1ht6jU2doEWaeQnB9jH9oNM50on3aPsn7t-4DI7-wR7b51HT0OBnsuczGr-8nEfk39lkOr4YXN2cX45_XQ1swct-4CWWFgpQwvHS-7pyruK8AitG3jEP4NB7K7TyyhZaaCF5LqKotSv1qFDyiPzcclfrukFns4UES7NKoYG0MRGCed9pw9zM4p0pmdSKiwz4_gJI8XadEzCLuE5t9myEyjELnXPOquFWZVPsuoR-N4Ez87Qv835f-cO3t7528tcFyUdEwpX-</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2566026460</pqid></control><display><type>article</type><title>Biodegradation of Emerging Pharmaceuticals from Domestic Wastewater by Membrane Bioreactor: The Effect of Solid Retention Time</title><source>Publicly Available Content (ProQuest)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Alobaidi, Raghad Asad Kadhim ; Ulucan-Altuntas, Kubra ; Mhemid, Rasha Khalid Sabri ; Manav-Demir, Neslihan ; Cinar, Ozer</creator><creatorcontrib>Alobaidi, Raghad Asad Kadhim ; Ulucan-Altuntas, Kubra ; Mhemid, Rasha Khalid Sabri ; Manav-Demir, Neslihan ; Cinar, Ozer</creatorcontrib><description>Although conventional biological treatment plants can remove basic pollutants, they are ineffective at removing recalcitrant pollutants. Membrane bioreactors contain promising technology and have the advantages of better effluent quality and lower sludge production compared to those of conventional biological treatment processes. In this study, the removal of pharmaceutical compounds by membrane bioreactors under different solid retention times (SRTs) was investigated. To study the effect of SRT on the removal of emerging pharmaceuticals, the levels of pharmaceuticals were measured over 96 days for the following retention times: 20, 30, and 40-day SRT. It was found that the 40-day SRT had the optimum performance in terms of the pharmaceuticals' elimination. The removal efficiencies of the chemical oxygen demand (COD) for each selected SRT were higher than 96% at steady-state conditions. The highest degradation efficiency was observed for paracetamol. Paracetamol was the most removed compound followed by ranitidine, atenolol, bezafibrate, diclofenac, and carbamazepine. The microbial community at the phylum level was also analyzed to understand the biodegradability of pharmaceuticals. It was noticed that the Proteobacteria phylum increased from 46.8% to 60.0% after 96 days with the pharmaceuticals. The Actinobacteria class, which can metabolize paracetamol, carbamazepine, and atenolol, was also increased from 9.1% to 17.9% after adding pharmaceuticals. The by-products of diclofenac, bezafibrate, and carbamazepine were observed in the effluent samples.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph18073395</identifier><identifier>PMID: 33805955</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Analgesics ; Atenolol ; Bezafibrate ; Biodegradability ; Biodegradation ; Biodegradation, Environmental ; Biological activity ; Bioreactors ; Carbamazepine ; Chemical oxygen demand ; Cooperation ; Diclofenac ; Domestic wastewater ; Drugs ; Effluents ; Membranes ; Methods ; Microorganisms ; Nonsteroidal anti-inflammatory drugs ; Paracetamol ; Pharmaceutical Preparations ; Pharmaceuticals ; Pollutant removal ; Pollutants ; Pore size ; Ranitidine ; Retention ; Retention time ; Sewage ; Sludge ; Waste Disposal, Fluid ; Waste Water ; Wastewater ; Water Pollutants, Chemical - analysis ; Water treatment</subject><ispartof>International journal of environmental research and public health, 2021-03, Vol.18 (7), p.3395</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453</citedby><cites>FETCH-LOGICAL-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453</cites><orcidid>0000-0001-8811-7948 ; 0000-0002-3023-0734 ; 0000-0001-9444-8081</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2566026460/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2566026460?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,44569,53769,53771,74872</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33805955$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alobaidi, Raghad Asad Kadhim</creatorcontrib><creatorcontrib>Ulucan-Altuntas, Kubra</creatorcontrib><creatorcontrib>Mhemid, Rasha Khalid Sabri</creatorcontrib><creatorcontrib>Manav-Demir, Neslihan</creatorcontrib><creatorcontrib>Cinar, Ozer</creatorcontrib><title>Biodegradation of Emerging Pharmaceuticals from Domestic Wastewater by Membrane Bioreactor: The Effect of Solid Retention Time</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>Although conventional biological treatment plants can remove basic pollutants, they are ineffective at removing recalcitrant pollutants. Membrane bioreactors contain promising technology and have the advantages of better effluent quality and lower sludge production compared to those of conventional biological treatment processes. In this study, the removal of pharmaceutical compounds by membrane bioreactors under different solid retention times (SRTs) was investigated. To study the effect of SRT on the removal of emerging pharmaceuticals, the levels of pharmaceuticals were measured over 96 days for the following retention times: 20, 30, and 40-day SRT. It was found that the 40-day SRT had the optimum performance in terms of the pharmaceuticals' elimination. The removal efficiencies of the chemical oxygen demand (COD) for each selected SRT were higher than 96% at steady-state conditions. The highest degradation efficiency was observed for paracetamol. Paracetamol was the most removed compound followed by ranitidine, atenolol, bezafibrate, diclofenac, and carbamazepine. The microbial community at the phylum level was also analyzed to understand the biodegradability of pharmaceuticals. It was noticed that the Proteobacteria phylum increased from 46.8% to 60.0% after 96 days with the pharmaceuticals. The Actinobacteria class, which can metabolize paracetamol, carbamazepine, and atenolol, was also increased from 9.1% to 17.9% after adding pharmaceuticals. The by-products of diclofenac, bezafibrate, and carbamazepine were observed in the effluent samples.</description><subject>Analgesics</subject><subject>Atenolol</subject><subject>Bezafibrate</subject><subject>Biodegradability</subject><subject>Biodegradation</subject><subject>Biodegradation, Environmental</subject><subject>Biological activity</subject><subject>Bioreactors</subject><subject>Carbamazepine</subject><subject>Chemical oxygen demand</subject><subject>Cooperation</subject><subject>Diclofenac</subject><subject>Domestic wastewater</subject><subject>Drugs</subject><subject>Effluents</subject><subject>Membranes</subject><subject>Methods</subject><subject>Microorganisms</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Paracetamol</subject><subject>Pharmaceutical Preparations</subject><subject>Pharmaceuticals</subject><subject>Pollutant removal</subject><subject>Pollutants</subject><subject>Pore size</subject><subject>Ranitidine</subject><subject>Retention</subject><subject>Retention time</subject><subject>Sewage</subject><subject>Sludge</subject><subject>Waste Disposal, Fluid</subject><subject>Waste Water</subject><subject>Wastewater</subject><subject>Water Pollutants, Chemical - analysis</subject><subject>Water treatment</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpVkctPGzEQxq2qqDzaa4-VpZ4T_Fg7uz1UKiE8JBBVm6pHa9YeJ46y6-DdgHLhb8cQiOBke-bzbz59Q8hXzoZSVuw4LDCt5rxko_xUH8gB15oNCs34xzf3fXLYdQvGZFno6hPZl7JkqlLqgDychOhwlsBBH2JLo6eTBtMstDP6ew6pAYvrPlhYdtSn2NDT2GCXC_Q_dD3eQ4-J1ht6jU2doEWaeQnB9jH9oNM50on3aPsn7t-4DI7-wR7b51HT0OBnsuczGr-8nEfk39lkOr4YXN2cX45_XQ1swct-4CWWFgpQwvHS-7pyruK8AitG3jEP4NB7K7TyyhZaaCF5LqKotSv1qFDyiPzcclfrukFns4UES7NKoYG0MRGCed9pw9zM4p0pmdSKiwz4_gJI8XadEzCLuE5t9myEyjELnXPOquFWZVPsuoR-N4Ez87Qv835f-cO3t7528tcFyUdEwpX-</recordid><startdate>20210325</startdate><enddate>20210325</enddate><creator>Alobaidi, Raghad Asad Kadhim</creator><creator>Ulucan-Altuntas, Kubra</creator><creator>Mhemid, Rasha Khalid Sabri</creator><creator>Manav-Demir, Neslihan</creator><creator>Cinar, Ozer</creator><general>MDPI AG</general><general>MDPI</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8811-7948</orcidid><orcidid>https://orcid.org/0000-0002-3023-0734</orcidid><orcidid>https://orcid.org/0000-0001-9444-8081</orcidid></search><sort><creationdate>20210325</creationdate><title>Biodegradation of Emerging Pharmaceuticals from Domestic Wastewater by Membrane Bioreactor: The Effect of Solid Retention Time</title><author>Alobaidi, Raghad Asad Kadhim ; Ulucan-Altuntas, Kubra ; Mhemid, Rasha Khalid Sabri ; Manav-Demir, Neslihan ; Cinar, Ozer</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analgesics</topic><topic>Atenolol</topic><topic>Bezafibrate</topic><topic>Biodegradability</topic><topic>Biodegradation</topic><topic>Biodegradation, Environmental</topic><topic>Biological activity</topic><topic>Bioreactors</topic><topic>Carbamazepine</topic><topic>Chemical oxygen demand</topic><topic>Cooperation</topic><topic>Diclofenac</topic><topic>Domestic wastewater</topic><topic>Drugs</topic><topic>Effluents</topic><topic>Membranes</topic><topic>Methods</topic><topic>Microorganisms</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Paracetamol</topic><topic>Pharmaceutical Preparations</topic><topic>Pharmaceuticals</topic><topic>Pollutant removal</topic><topic>Pollutants</topic><topic>Pore size</topic><topic>Ranitidine</topic><topic>Retention</topic><topic>Retention time</topic><topic>Sewage</topic><topic>Sludge</topic><topic>Waste Disposal, Fluid</topic><topic>Waste Water</topic><topic>Wastewater</topic><topic>Water Pollutants, Chemical - analysis</topic><topic>Water treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alobaidi, Raghad Asad Kadhim</creatorcontrib><creatorcontrib>Ulucan-Altuntas, Kubra</creatorcontrib><creatorcontrib>Mhemid, Rasha Khalid Sabri</creatorcontrib><creatorcontrib>Manav-Demir, Neslihan</creatorcontrib><creatorcontrib>Cinar, Ozer</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Public Health Database</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 UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content (ProQuest)</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>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alobaidi, Raghad Asad Kadhim</au><au>Ulucan-Altuntas, Kubra</au><au>Mhemid, Rasha Khalid Sabri</au><au>Manav-Demir, Neslihan</au><au>Cinar, Ozer</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Biodegradation of Emerging Pharmaceuticals from Domestic Wastewater by Membrane Bioreactor: The Effect of Solid Retention Time</atitle><jtitle>International journal of environmental research and public health</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2021-03-25</date><risdate>2021</risdate><volume>18</volume><issue>7</issue><spage>3395</spage><pages>3395-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>Although conventional biological treatment plants can remove basic pollutants, they are ineffective at removing recalcitrant pollutants. Membrane bioreactors contain promising technology and have the advantages of better effluent quality and lower sludge production compared to those of conventional biological treatment processes. In this study, the removal of pharmaceutical compounds by membrane bioreactors under different solid retention times (SRTs) was investigated. To study the effect of SRT on the removal of emerging pharmaceuticals, the levels of pharmaceuticals were measured over 96 days for the following retention times: 20, 30, and 40-day SRT. It was found that the 40-day SRT had the optimum performance in terms of the pharmaceuticals' elimination. The removal efficiencies of the chemical oxygen demand (COD) for each selected SRT were higher than 96% at steady-state conditions. The highest degradation efficiency was observed for paracetamol. Paracetamol was the most removed compound followed by ranitidine, atenolol, bezafibrate, diclofenac, and carbamazepine. The microbial community at the phylum level was also analyzed to understand the biodegradability of pharmaceuticals. It was noticed that the Proteobacteria phylum increased from 46.8% to 60.0% after 96 days with the pharmaceuticals. The Actinobacteria class, which can metabolize paracetamol, carbamazepine, and atenolol, was also increased from 9.1% to 17.9% after adding pharmaceuticals. The by-products of diclofenac, bezafibrate, and carbamazepine were observed in the effluent samples.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>33805955</pmid><doi>10.3390/ijerph18073395</doi><orcidid>https://orcid.org/0000-0001-8811-7948</orcidid><orcidid>https://orcid.org/0000-0002-3023-0734</orcidid><orcidid>https://orcid.org/0000-0001-9444-8081</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1660-4601
ispartof International journal of environmental research and public health, 2021-03, Vol.18 (7), p.3395
issn 1660-4601
1661-7827
1660-4601
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8036512
source Publicly Available Content (ProQuest); PubMed Central; Free Full-Text Journals in Chemistry
subjects Analgesics
Atenolol
Bezafibrate
Biodegradability
Biodegradation
Biodegradation, Environmental
Biological activity
Bioreactors
Carbamazepine
Chemical oxygen demand
Cooperation
Diclofenac
Domestic wastewater
Drugs
Effluents
Membranes
Methods
Microorganisms
Nonsteroidal anti-inflammatory drugs
Paracetamol
Pharmaceutical Preparations
Pharmaceuticals
Pollutant removal
Pollutants
Pore size
Ranitidine
Retention
Retention time
Sewage
Sludge
Waste Disposal, Fluid
Waste Water
Wastewater
Water Pollutants, Chemical - analysis
Water treatment
title Biodegradation of Emerging Pharmaceuticals from Domestic Wastewater by Membrane Bioreactor: The Effect of Solid Retention Time
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T19%3A43%3A56IST&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=Biodegradation%20of%20Emerging%20Pharmaceuticals%20from%20Domestic%20Wastewater%20by%20Membrane%20Bioreactor:%20The%20Effect%20of%20Solid%20Retention%20Time&rft.jtitle=International%20journal%20of%20environmental%20research%20and%20public%20health&rft.au=Alobaidi,%20Raghad%20Asad%20Kadhim&rft.date=2021-03-25&rft.volume=18&rft.issue=7&rft.spage=3395&rft.pages=3395-&rft.issn=1660-4601&rft.eissn=1660-4601&rft_id=info:doi/10.3390/ijerph18073395&rft_dat=%3Cproquest_pubme%3E2566026460%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c418t-f3e8ca4a52d18ffb9dd9119ac27fd0faadeffc265f5c4626231faae2b6d867453%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2566026460&rft_id=info:pmid/33805955&rfr_iscdi=true