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  1. Article ; Online: Emerging insights into atypical B cells in pediatric chronic infectious diseases and immune system disorders: T(o)-bet on control of B-cell immune activation.

    Olivieri, Giulio / Cotugno, Nicola / Palma, Paolo

    The Journal of allergy and clinical immunology

    2023  Volume 153, Issue 1, Page(s) 12–27

    Abstract: Repetitive or persistent cellular stimulation in vivo has been associated with the development of a heterogeneous B-cell population that exhibits a distinctive phenotype and, in addition to classical B-cell markers, often expresses the transcription ... ...

    Abstract Repetitive or persistent cellular stimulation in vivo has been associated with the development of a heterogeneous B-cell population that exhibits a distinctive phenotype and, in addition to classical B-cell markers, often expresses the transcription factor T-bet and myeloid marker CD11c. Research suggests that this atypical population consists of B cells with distinct B-cell receptor specificities capable of binding the antigens responsible for their development. The expansion of this population occurs in the presence of chronic inflammatory conditions and autoimmune diseases where different nomenclatures have been used to describe them. However, as a result of the diverse contexts in which they have been investigated, these cells have remained largely enigmatic, with much ambiguity remaining regarding their phenotype and function in humoral immune response as well as their role in autoimmunity. Atypical B cells have garnered considerable interest because of their ability to produce specific antibodies and/or autoantibodies and because of their association with key disease manifestations. Although they have been widely described in the context of adults, little information is present for children. Therefore, the aim of this narrative review is to describe the characteristics of this population, suggest their function in pediatric immune-related diseases and chronic infections, and explore their potential therapeutic avenues.
    MeSH term(s) Adult ; Humans ; Child ; B-Lymphocytes ; Communicable Diseases ; Autoimmune Diseases ; Autoantibodies ; Receptors, Antigen, B-Cell ; Autoimmunity
    Chemical Substances Autoantibodies ; Receptors, Antigen, B-Cell
    Language English
    Publishing date 2023-10-25
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2023.10.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Fragility fractures in lupus patients: Associated factors and comparison of four fracture risk assessment tools.

    Ceccarelli, Fulvia / Olivieri, Giulio / Orefice, Valeria / Picciariello, Licia / Natalucci, Francesco / Conti, Fabrizio

    Lupus

    2023  Volume 32, Issue 11, Page(s) 1320–1327

    Abstract: Objective: Osteoporosis (OP) and fragility fractures (FF) are common comorbidities in patients with systemic lupus erythematosus (SLE). This study aimed to (1) assess the prevalence of these conditions in a cohort of SLE patients (2) evaluate the risk ... ...

    Abstract Objective: Osteoporosis (OP) and fragility fractures (FF) are common comorbidities in patients with systemic lupus erythematosus (SLE). This study aimed to (1) assess the prevalence of these conditions in a cohort of SLE patients (2) evaluate the risk factors associated with FF, and (3) compare the accuracy of four different FF risk assessment algorithms to determine which performs better in this specific rheumatologic population.
    Materials and methods: We conducted a cross-sectional study with SLE women who underwent bone mineral density assessment by dual-energy X-ray absorptiometry (DEXA) within 3 months of their last visit. Conventional radiology methods were used to evaluate the presence of FF. The 10-year risk of osteoporotic fractures was estimated using four tools: DeFRA, FRAX (adjusted for GC dosage), GARVAN, and QFracture. The comparison of these computational tools was analyzed by the area under the receiver operating characteristic (ROC) curves.
    Results: We analyzed 86 SLE patients with a median age of 56 years (IQR 12.1) and a median age at diagnosis of 34 years (IQR 17.2). The median T-score values at the femoral neck and lumbar spine were -1.6 (IQR 0.9) and -1.7 (IQR 1.1), respectively. Of the patients, 33 (38.4%) had OP, with 13 patients (15.1%) experiencing FF. Univariate analysis showed that the presence of FF was associated with thrombocytopenia (
    Conclusions: OP is a common comorbidity in SLE patients, even in younger patients. FF appears to be more frequent in patients with hematologic involvement. The comparison of the four algorithms shows that DeFRA is the most accurate tool and should be applied to SLE patients.
    MeSH term(s) Humans ; Female ; Child ; Cross-Sectional Studies ; Risk Assessment/methods ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/epidemiology ; Osteoporosis/diagnosis ; Osteoporosis/epidemiology ; Osteoporosis/etiology ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/etiology ; Bone Density ; Risk Factors ; Absorptiometry, Photon/methods
    Language English
    Publishing date 2023-09-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/09612033231202701
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  3. Article: Systemic Lupus Erythematosus before and after COVID-19 Lockdown: How the Perception of Disease Changes through the Lenses of Narrative Medicine.

    Ceccarelli, Fulvia / Covelli, Venusia / Olivieri, Giulio / Natalucci, Francesco / Conti, Fabrizio

    Healthcare (Basel, Switzerland)

    2021  Volume 9, Issue 6

    Abstract: Background: The COVID-19 pandemic contributes to the burden of living with different diseases, including Systemic Lupus Erythematosus (SLE). We described, from a narrative point of view, the experiences and perspectives of Italian SLE adults during the ... ...

    Abstract Background: The COVID-19 pandemic contributes to the burden of living with different diseases, including Systemic Lupus Erythematosus (SLE). We described, from a narrative point of view, the experiences and perspectives of Italian SLE adults during the COVID-19 emergency, by distinguishing the illness experience before and after the lockdown.
    Methods: Fifteen patients were invited to participate. Illness narratives were collected between 22 and 29 March 2020 using a written modality to capture patients' perspectives before and after the COVID-19 lockdown. We performed a two-fold analysis of collected data by distinguishing three narrative types and a qualitative analysis of content to identify the relevant themes and sub-themes reported.
    Results: Eight narratives included in the final analysis (mean length 436.9 words) have been written by eight females (mean age 43.3 ± 9.9 years, mean disease duration 13.1 ± 7.4 years). Six patients provided a quest narrative, one a chaos and the remaining one a restitution narrative. By text content analysis, we identified specific themes, temporally distinct before and after the lockdown. Before COVID-19, all the patients referred to a good control of disease, however the unexpected arrival of the COVID-19 emergency broke a balance, and patients perceived the loss of health status control, with anxiety and stress.
    Conclusions: We provided unique insight into the experiences of people with SLE at the time of COVID-19, underlining the perspective of patients in relation to the pandemic.
    Language English
    Publishing date 2021-06-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare9060726
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  4. Article ; Online: SARS-CoV-2 vaccination efficacy and B-cell depletion therapy in systemic lupus erythematosus: Description of a case.

    Ceccarelli, Fulvia / Olivieri, Giulio / Natalucci, Francesco / Alessandri, Cristiano / Conti, Fabrizio

    Lupus

    2021  Volume 30, Issue 10, Page(s) 1698–1699

    MeSH term(s) Aged ; B-Lymphocytes/drug effects ; COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Drug Administration Schedule ; Female ; Humans ; Lupus Erythematosus, Systemic/drug therapy ; Lymphocyte Depletion ; Rituximab/administration & dosage ; Rituximab/adverse effects ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines ; Rituximab (4F4X42SYQ6) ; BNT162 vaccine (N38TVC63NU)
    Language English
    Publishing date 2021-07-01
    Publishing country England
    Document type Case Reports ; Letter
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/09612033211027940
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Evidence of immune response to BNT162b2 COVID-19 vaccine in systemic lupus erythematosus patients treated with Belimumab.

    Schiavoni, Ilaria / Olivetta, Eleonora / Natalucci, Francesco / Olivieri, Giulio / Lo Presti, Alessandra / Fedele, Giorgio / Stefanelli, Paola / Ceccarelli, Fulvia / Conti, Fabrizio

    Lupus

    2023  Volume 32, Issue 3, Page(s) 394–400

    Abstract: Objectives: To evaluate humoral and cell-mediated response after three doses of BNT162b2 SARS-CoV-2 vaccine in patients with systemic lupus erythematosus (SLE) treated with Belimumab (BLM).: Methods: SLE patients were vaccinated with three doses of ... ...

    Abstract Objectives: To evaluate humoral and cell-mediated response after three doses of BNT162b2 SARS-CoV-2 vaccine in patients with systemic lupus erythematosus (SLE) treated with Belimumab (BLM).
    Methods: SLE patients were vaccinated with three doses of BNT162b2-mRNA vaccine (two-dose primary vaccination, third booster dose after 6 months). The humoral immune response was assessed one and 6 months after the second dose (T1, T2), and 6 months after the booster dose (T3). Serological assay was performed (The Liaison® SARS-CoV-2 TrimericS IgG chemiluminescent). Spike-specific T-cell response was monitored 6 months after the second vaccine dose and the percentage of cytokines producing T cells was assessed by flow cytometry.
    Results: Twelve patients [12F; median age 46 years (IQR 8.25); median disease duration 156 months (IQR 188)] were enrolled. At T1, all patients showed seroconversion (median anti-Spike IgG levels 1610 BAU/mL, IQR 1390). At T2--day of the third dose--a significant reduction of median anti-Spike IgG antibodies levels was observed [214 BAU/mL (IQR 94);
    Conclusions: BLM does not impair humoral response to primary BNT162b2 SARS-CoV-2 vaccination. During the follow-up, a decline in antibody levels is evident and the third dose is crucial to increase the specific immune response. Finally, we observed a recall T-cell response to the Spike antigen 6 months after the first vaccination cycle.
    MeSH term(s) Humans ; Middle Aged ; BNT162 Vaccine ; COVID-19 Vaccines ; COVID-19 ; Lupus Erythematosus, Systemic ; SARS-CoV-2 ; Immunoglobulin G ; Antibodies, Viral ; Immunity
    Chemical Substances BNT162 Vaccine ; belimumab (73B0K5S26A) ; COVID-19 Vaccines ; Immunoglobulin G ; Antibodies, Viral
    Language English
    Publishing date 2023-01-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/09612033221151012
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  6. Article: Rheumatic Diseases Development in Patients Treated by Anti-PD1 Immune Checkpoint Inhibitors: A Single-Centre Descriptive Study.

    Ceccarelli, Fulvia / Natalucci, Francesco / Picciariello, Licia / Olivieri, Giulio / Cirillo, Alessio / Gelibter, Alain / Picone, Vincenzo / Botticelli, Andrea / Conti, Fabrizio

    Life (Basel, Switzerland)

    2023  Volume 13, Issue 4

    Abstract: The introduction of the so-called immune checkpoint inhibitors (ICIs) substantially changed the history of cancer therapy. On the other hand, they can induce the development of rheumatic immune-related adverse events (Rh-irAEs). In the scenario of a ... ...

    Abstract The introduction of the so-called immune checkpoint inhibitors (ICIs) substantially changed the history of cancer therapy. On the other hand, they can induce the development of rheumatic immune-related adverse events (Rh-irAEs). In the scenario of a joint oncology/rheumatology outpatient clinic, we conducted a single-centre descriptive study to define from a laboratory, clinical and therapeutic point of view, rheumatic conditions developed during anti-PD1 treatment. The study included 32 patients (M/F 16/16, median age 69, IQR 16.5). According to the international classification criteria, eight patients could be classified as affected by Rheumatoid Arthritis, one by Psoriatic Arthritis, six by Polymyalgia Rheumatica, five by systemic connective tissue diseases (two systemic lupus erythematosus, two Sjögren's syndrome, one undifferentiated connective tissue disease). The remaining patients were diagnosed as having undifferentiated arthritis or inflammatory arthralgia. The median interval between ICIs starting and the onset of symptoms was 14 weeks (IQR 19.75). Moving to treatment, the longitudinal observation revealed that all RA, PsA and CTD patients required the introduction of treatment with DMARDs. In conclusion, the growing use of ICIs in a real-life setting confirmed the possible development of different rheumatological conditions, further emphasising the need for shared oncology/rheumatology management.
    Language English
    Publishing date 2023-03-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13040877
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  7. Article ; Online: Membrane and Soluble CD137 in Systemic Lupus Erythematosus: Role as Biomarkers for Disease Activity.

    Ceccarelli, Fulvia / Natalucci, Francesco / Di Filippo, Alessandra / Olivieri, Giulio / Napoletano, Chiara / Rughetti, Aurelia / Nuti, Marianna / Zizzari, Ilaria Grazia / Conti, Fabrizio

    Journal of immunology research

    2023  Volume 2023, Page(s) 2344239

    Abstract: Objective: The role of T cells in the pathogenesis of systemic lupus erythematosus (SLE) has recently gained attention. Costimulatory molecules are membrane proteins strictly associated with T-cell receptor (TCR), acting by activating or inhibiting T ... ...

    Abstract Objective: The role of T cells in the pathogenesis of systemic lupus erythematosus (SLE) has recently gained attention. Costimulatory molecules are membrane proteins strictly associated with T-cell receptor (TCR), acting by activating or inhibiting T cells and antigen-presenting cells (APC) through direct and reverse signaling, thus becoming responsible for the development of effector T cells or regulatory T cells. The primary objective of the present case-control study was to evaluate the cell membrane expression of CD137 on T cells and the serum concentration of CD137 (sCD137) in a SLE cohort.
    Materials: We enrolled SLE patients and sex/age-matched healthy subjects (HS). Disease activity was assessed by SLEDAI-2K. By application of flow cytometry, we evaluated the expression of CD137 on CD4+ and CD8+ lymphocytes. ELISA test was performed to evaluate serum levels of sCD137.
    Results: Twenty-one SLE patients (M/F 1/20; median age 48 years (IQR 17); median disease duration 144 months (IQR 204)) were evaluated. SLE patients showed %CD3+CD137+ cells significantly higher compared to HS (median 5.32 (IQR 6.11) versus 3.3 (IQR 1.8),
    Conclusion: Our results suggest a possible involvement of CD137-CD137L axis in SLE pathogenesis, as demonstrated by higher expression of CD137 on CD4+ cells in SLE compared with HS. Furthermore, the positive correlation between SLEDAI-2K and membrane CD137 expression on CD4+ cells, as well as soluble CD137, indicates a possible use as biomarkers for disease activity.
    MeSH term(s) Humans ; Middle Aged ; Biomarkers/metabolism ; CD4-Positive T-Lymphocytes/metabolism ; CD8-Positive T-Lymphocytes/metabolism ; Lupus Erythematosus, Systemic/metabolism ; T-Lymphocytes, Regulatory/metabolism ; Tumor Necrosis Factor Receptor Superfamily, Member 9/metabolism
    Chemical Substances Biomarkers ; Tumor Necrosis Factor Receptor Superfamily, Member 9
    Language English
    Publishing date 2023-04-18
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 2817541-4
    ISSN 2314-7156 ; 2314-7156
    ISSN (online) 2314-7156
    ISSN 2314-7156
    DOI 10.1155/2023/2344239
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  8. Article ; Online: Organ damage in Systemic Lupus Erythematosus patients: A multifactorial phenomenon.

    Ceccarelli, Fulvia / Perricone, Carlo / Natalucci, Francesco / Picciariello, Licia / Olivieri, Giulio / Cafaro, Giacomo / Bartoloni, Elena / Roberto, Gerli / Conti, Fabrizio

    Autoimmunity reviews

    2023  Volume 22, Issue 8, Page(s) 103374

    Abstract: The prevention of chronic damage, especially in early disease phases, remains an unmet need in the management of Systemic Lupus Erythematous (SLE) patients, despite the application of a so-called treat-to-target strategy. The high proportion of SLE ... ...

    Abstract The prevention of chronic damage, especially in early disease phases, remains an unmet need in the management of Systemic Lupus Erythematous (SLE) patients, despite the application of a so-called treat-to-target strategy. The high proportion of SLE patients developing chronic damage suggests a multifactorial aetiology. Thus, besides disease activity, other factors may contribute to the development of damage. The revision of data published so far underlines that, next to disease activity, it is possible to identify other factors playing a relevant role in damage development and progression. In summary, the presence of antiphospholipid antibodies and drugs used to treat SLE patients, in particular glucocorticoids, is strongly associated with SLE-related damage. Furthermore, recent data suggests the possible role of genetic background in determining the development of specific organ damage, in particular renal and neurological. Nonetheless, demographic factors, such as age, sex and disease duration could exert a role along with the presence of comorbidities. The contribution of different factors in determining damage development suggests the need for new outcomes to assess a comprehensive disease control including not only the assessment of disease activity, but also the evaluation of chronic damage development.
    MeSH term(s) Humans ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/genetics ; Lupus Erythematosus, Systemic/drug therapy ; Antibodies, Antiphospholipid ; Glucocorticoids/therapeutic use ; Severity of Illness Index
    Chemical Substances Antibodies, Antiphospholipid ; Glucocorticoids
    Language English
    Publishing date 2023-06-09
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2144145-5
    ISSN 1873-0183 ; 1568-9972
    ISSN (online) 1873-0183
    ISSN 1568-9972
    DOI 10.1016/j.autrev.2023.103374
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  9. Article ; Online: Antinuclear antibodies may predict the development of immune-related adverse events in asymptomatic patients treated with immune checkpoint inhibitors: results from a single-center cohort.

    Ceccarelli, Fulvia / Natalucci, Francesco / Picciariello, Licia / Cirillo, Alessio / Olivieri, Giulio / Veroli, Margherita / Pisegna, Simona / Ciancarella, Claudia / Gelibter, Alain / Picone, Vincenzo / Santini, Daniele / Botticelli, Andrea / Conti, Fabrizio

    Clinical and experimental medicine

    2024  Volume 24, Issue 1, Page(s) 72

    Abstract: We aim at investigating the association between subclinical autoimmunity and immune-related adverse events (irAEs) in a cohort of patients treated by immune checkpoint inhibitors for solid metastatic cancer. In the context of an oncology/rheumatology ... ...

    Abstract We aim at investigating the association between subclinical autoimmunity and immune-related adverse events (irAEs) in a cohort of patients treated by immune checkpoint inhibitors for solid metastatic cancer. In the context of an oncology/rheumatology outpatient clinic, we evaluated patients treated with anti-PD-1 or anti-PD-L1. Before treatment, each patient underwent a physical evaluation and a blood sample to identify the presence of a set of autoantibodies. Indeed, all the patients were followed during treatment to identify irAEs and to assess the association with autoantibodies. Fifty-one patients (M/F 16/35; median age 70 years, IQR 16.5) were evaluated; 34.8% of patients showed ANA positivity, 6.5% ENA positivity (anti-SSA), 4.3% Ratest positivity, and 2.1% (one patient) ACPA positivity. During a median period of 21 months (IQR 38.75), 39.2% of patients developed irAEs. Musculo-skeletal manifestations, in particular arthritis, were the most frequent. We found a significant association between the positivity for ANA and the development of irAES (p = 0.03, RR 2.01, 95% CI 1.03-3.92). Furthermore, the progression-free survival was significantly longer in patients developing irAEs compared to those who are not experiencing these events (p = 0.007). This study underlines the potential role of ANA positivity as a predictive biomarker for the development of irAEs.
    MeSH term(s) Humans ; Aged ; Antibodies, Antinuclear ; Immune Checkpoint Inhibitors/adverse effects ; Autoantibodies ; Arthritis ; Autoimmunity
    Chemical Substances Antibodies, Antinuclear ; Immune Checkpoint Inhibitors ; Autoantibodies
    Language English
    Publishing date 2024-04-10
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2053018-3
    ISSN 1591-9528 ; 1591-8890
    ISSN (online) 1591-9528
    ISSN 1591-8890
    DOI 10.1007/s10238-024-01317-z
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  10. Article ; Online: Science and visual Arts: Binomial or Dichotomy? A Pilot study in Systemic Lupus Erythematosus patients.

    Ferrara, Vincenza / Perrone, Maria Elisabetta / Mina, Concetta / Ceccarelli, Fulvia / Olivieri, Giulio / Fattapposta, Francesco / Conti, Fabrizio

    Lupus

    2022  Volume 31, Issue 14, Page(s) 1744–1749

    Abstract: Scientific literature demonstrated the impairment in cognitive/executive functions and pragmatic language in SLE patients, potentially involving also asymptomatic subjects. The present study focuses on the assessment in an SLE cohort of emotional ... ...

    Abstract Scientific literature demonstrated the impairment in cognitive/executive functions and pragmatic language in SLE patients, potentially involving also asymptomatic subjects. The present study focuses on the assessment in an SLE cohort of emotional intelligence, which is an ability regulated by the network of the executive functions, cognitive abilities involved in the initiation, planning, organization, and regulation of achievement-oriented behaviors: with emotional. Thus, emotional intelligence, defined as the ability to reason with emotions, was evaluated in a SLE cohort diagnosed according to the 1997 American College of Rheumatology criteria. As control healthy subjects were enrolled. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), a skill-scale that measures the ability to perform tasks and solve emotional problems, was administered to patients and controls. Second, a group of SLE patients underwent the Visual Thinking Strategies (VTS) method in order to assess the potential impact of art in cognitive skills like critical thinking, problem solving, and emotional intelligence quotient. The protocol also included the evaluation of the improvement of some skills using a validated VTS skill grid. Self-reported scales for anxiety and depression were performed to rule out the influence of mood disorders on emotional intelligence. The present study demonstrated similar quotient scores of emotional intelligence in SLE patients and healthy controls. Furthermore, VTS method could help in improving this cognitive ability in patients, by implementing critical thinking and problem solving, promoting empathy, and improving tolerance to ambiguity and relational capacity.
    MeSH term(s) Humans ; Pilot Projects ; Lupus Erythematosus, Systemic ; Intelligence Tests ; Emotional Intelligence ; Emotions
    Language English
    Publishing date 2022-10-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1154407-7
    ISSN 1477-0962 ; 0961-2033
    ISSN (online) 1477-0962
    ISSN 0961-2033
    DOI 10.1177/09612033221131179
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