Loading…
Plasma concentrations of cyclic volatile methylsiloxanes (cVMS) in pregnant and postmenopausal Norwegian women and self-reported use of personal care products (PCPs)
Dermal application of personal care products (PCPs) is considered an important human exposure route for siloxanes. Their presence as minor or major constituents in many personal care products (PCPs) and cosmetics is of concern for human exposure. The aim of this study was to quantify cyclic volatile...
Saved in:
Published in: | Environment international 2013-01, Vol.51, p.82-87 |
---|---|
Main Authors: | , , , , , , |
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-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3 |
---|---|
cites | cdi_FETCH-LOGICAL-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3 |
container_end_page | 87 |
container_issue | |
container_start_page | 82 |
container_title | Environment international |
container_volume | 51 |
creator | Hanssen, Linda Warner, Nicholas A. Braathen, Tonje Odland, Jon Ø. Lund, Eiliv Nieboer, Evert Sandanger, Torkjel M. |
description | Dermal application of personal care products (PCPs) is considered an important human exposure route for siloxanes. Their presence as minor or major constituents in many personal care products (PCPs) and cosmetics is of concern for human exposure.
The aim of this study was to quantify cyclic volatile methylsiloxanes (cVMS) in blood plasma of pregnant and postmenopausal women, and to investigate possible links to self-reported use of PCPs for the latter group. Participants were recruited from two studies, namely the Norwegian Women and Cancer Study (NOWAC) and the North Norwegian Mother-and-child Study (MISA). For the NOWAC cohort, 94 plasma samples from postmenopausal women were analyzed (blood drawn in 2005) and information about PCP use and breast implants was derived from a self-administered questionnaire. In the MISA study, the collection of the plasma samples (blood drawn in 2009) constituted a re-sampling because the original serum vacutainers used were contaminated with cVMS. D4 (octamethylcyclotetrasiloxane) was the dominant compound in plasma for both cohorts. For the NOWAC samples, more than 85% of the women had D4 concentrations above the LOQ (2.74ng/mL), while the detection frequency was only 18% for the MISA participants. The highest cVMS plasma concentrations were observed for D4: 12.7ng/mL (NOWAC) and 2.69ng/mL (MISA). For the other cVMS, decamethylcyclopentasiloxane (D5) and dodecamethylcyclohexasiloxane (D6) concentrations were below the detection limit in most samples.
There was no significant correlation between the concentrations of D4 and the reported total body cream use. Sampling time (2005 versus 2009) and age of the donors could explain the differences between the two cohorts.
► First data on cVMS in sub-populations from the general female population showing low concentrations with D4 dominating. ► Percentage detected for D4 was below 20% for pregnant women, and 85% for postmenopausal women. ► There was no association between self-reported use of personal care products and measured cVMS concentrations in plasma. ► Age and sampling time could explain the observed differences between the cohorts. |
doi_str_mv | 10.1016/j.envint.2012.10.008 |
format | article |
fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_532931bad71b4eef9ecbc3e8f6c08c27</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0160412012002322</els_id><doaj_id>oai_doaj_org_article_532931bad71b4eef9ecbc3e8f6c08c27</doaj_id><sourcerecordid>1273114528</sourcerecordid><originalsourceid>FETCH-LOGICAL-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3</originalsourceid><addsrcrecordid>eNp9kktvEzEUhUcIREvhHyDkDVK7mGB7Xp4NEop4VCoQicfWcu5cB0cee7A9KflB_E-cJpQdK0tH3znX18dF8ZzRBaOsfbVdoNsZlxacMp6lBaXiQXHORFeVbdfQh8V5xmhZM07PiicxbimlvBbN4-KMV9kkWH9e_F5ZFUdFwDtAl4JKxrtIvCawB2uA7LzNmkUyYvqxt9FY_0s5jOQSvn_8ckWMI1PAjVMuEeUGMvmYRnR-UnNUlnzy4RY3Rjly67N8h0S0ugw4-ZBwIHPEw7gJQ_QuO0AFzJF-mCHlKavlKl49LR5pZSM-O50Xxbd3b78uP5Q3n99fL9_clNDQOpU9bdpW80FBzZuqqfu-Fl0jmoEqipRXTOm-rrqurQaOnWrbvu0Z1ZzrHjSIdXVRXB9zB6-2cgpmVGEvvTLyTvBhI1VIBizKpuJ9xdZq6Ni6RtQ9whoqFLoFKoB3OevymJV3-TljTHI0EdDa_Hp-jpJlhrG64SKj9RGF4GMMqO9HMyoPZcutPJYtD2Uf1Fx2tr04TZjXIw73pr_tZuDlCVARlNVBOTDxH9eKuheiydzrI4f5bXcGg4xgMH-IwQSElJc3_7_JHzZvzA0</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1273114528</pqid></control><display><type>article</type><title>Plasma concentrations of cyclic volatile methylsiloxanes (cVMS) in pregnant and postmenopausal Norwegian women and self-reported use of personal care products (PCPs)</title><source>ScienceDirect Journals</source><creator>Hanssen, Linda ; Warner, Nicholas A. ; Braathen, Tonje ; Odland, Jon Ø. ; Lund, Eiliv ; Nieboer, Evert ; Sandanger, Torkjel M.</creator><creatorcontrib>Hanssen, Linda ; Warner, Nicholas A. ; Braathen, Tonje ; Odland, Jon Ø. ; Lund, Eiliv ; Nieboer, Evert ; Sandanger, Torkjel M.</creatorcontrib><description>Dermal application of personal care products (PCPs) is considered an important human exposure route for siloxanes. Their presence as minor or major constituents in many personal care products (PCPs) and cosmetics is of concern for human exposure.
The aim of this study was to quantify cyclic volatile methylsiloxanes (cVMS) in blood plasma of pregnant and postmenopausal women, and to investigate possible links to self-reported use of PCPs for the latter group. Participants were recruited from two studies, namely the Norwegian Women and Cancer Study (NOWAC) and the North Norwegian Mother-and-child Study (MISA). For the NOWAC cohort, 94 plasma samples from postmenopausal women were analyzed (blood drawn in 2005) and information about PCP use and breast implants was derived from a self-administered questionnaire. In the MISA study, the collection of the plasma samples (blood drawn in 2009) constituted a re-sampling because the original serum vacutainers used were contaminated with cVMS. D4 (octamethylcyclotetrasiloxane) was the dominant compound in plasma for both cohorts. For the NOWAC samples, more than 85% of the women had D4 concentrations above the LOQ (2.74ng/mL), while the detection frequency was only 18% for the MISA participants. The highest cVMS plasma concentrations were observed for D4: 12.7ng/mL (NOWAC) and 2.69ng/mL (MISA). For the other cVMS, decamethylcyclopentasiloxane (D5) and dodecamethylcyclohexasiloxane (D6) concentrations were below the detection limit in most samples.
There was no significant correlation between the concentrations of D4 and the reported total body cream use. Sampling time (2005 versus 2009) and age of the donors could explain the differences between the two cohorts.
► First data on cVMS in sub-populations from the general female population showing low concentrations with D4 dominating. ► Percentage detected for D4 was below 20% for pregnant women, and 85% for postmenopausal women. ► There was no association between self-reported use of personal care products and measured cVMS concentrations in plasma. ► Age and sampling time could explain the observed differences between the cohorts.</description><identifier>ISSN: 0160-4120</identifier><identifier>EISSN: 1873-6750</identifier><identifier>DOI: 10.1016/j.envint.2012.10.008</identifier><identifier>PMID: 23201819</identifier><identifier>CODEN: ENVIDV</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adult ; Biological and medical sciences ; Cohort Studies ; Cosmetics - metabolism ; Cyclic volatile methylsiloxanes ; Domestic and cosmetic products toxicology ; Environment. Living conditions ; Environmental Exposure - analysis ; Environmental Exposure - statistics & numerical data ; Environmental pollutants toxicology ; Female ; Human biomonitoring ; Human plasma ; Humans ; Limit of Detection ; Maternal Exposure - statistics & numerical data ; Medical sciences ; Middle Aged ; Norway ; Personal care products ; Postmenopause - metabolism ; Pregnancy ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Siloxanes - metabolism ; Toxicology</subject><ispartof>Environment international, 2013-01, Vol.51, p.82-87</ispartof><rights>2012 Elsevier Ltd</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3</citedby><cites>FETCH-LOGICAL-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,4012,27906,27907,27908</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26849885$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23201819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hanssen, Linda</creatorcontrib><creatorcontrib>Warner, Nicholas A.</creatorcontrib><creatorcontrib>Braathen, Tonje</creatorcontrib><creatorcontrib>Odland, Jon Ø.</creatorcontrib><creatorcontrib>Lund, Eiliv</creatorcontrib><creatorcontrib>Nieboer, Evert</creatorcontrib><creatorcontrib>Sandanger, Torkjel M.</creatorcontrib><title>Plasma concentrations of cyclic volatile methylsiloxanes (cVMS) in pregnant and postmenopausal Norwegian women and self-reported use of personal care products (PCPs)</title><title>Environment international</title><addtitle>Environ Int</addtitle><description>Dermal application of personal care products (PCPs) is considered an important human exposure route for siloxanes. Their presence as minor or major constituents in many personal care products (PCPs) and cosmetics is of concern for human exposure.
The aim of this study was to quantify cyclic volatile methylsiloxanes (cVMS) in blood plasma of pregnant and postmenopausal women, and to investigate possible links to self-reported use of PCPs for the latter group. Participants were recruited from two studies, namely the Norwegian Women and Cancer Study (NOWAC) and the North Norwegian Mother-and-child Study (MISA). For the NOWAC cohort, 94 plasma samples from postmenopausal women were analyzed (blood drawn in 2005) and information about PCP use and breast implants was derived from a self-administered questionnaire. In the MISA study, the collection of the plasma samples (blood drawn in 2009) constituted a re-sampling because the original serum vacutainers used were contaminated with cVMS. D4 (octamethylcyclotetrasiloxane) was the dominant compound in plasma for both cohorts. For the NOWAC samples, more than 85% of the women had D4 concentrations above the LOQ (2.74ng/mL), while the detection frequency was only 18% for the MISA participants. The highest cVMS plasma concentrations were observed for D4: 12.7ng/mL (NOWAC) and 2.69ng/mL (MISA). For the other cVMS, decamethylcyclopentasiloxane (D5) and dodecamethylcyclohexasiloxane (D6) concentrations were below the detection limit in most samples.
There was no significant correlation between the concentrations of D4 and the reported total body cream use. Sampling time (2005 versus 2009) and age of the donors could explain the differences between the two cohorts.
► First data on cVMS in sub-populations from the general female population showing low concentrations with D4 dominating. ► Percentage detected for D4 was below 20% for pregnant women, and 85% for postmenopausal women. ► There was no association between self-reported use of personal care products and measured cVMS concentrations in plasma. ► Age and sampling time could explain the observed differences between the cohorts.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Cosmetics - metabolism</subject><subject>Cyclic volatile methylsiloxanes</subject><subject>Domestic and cosmetic products toxicology</subject><subject>Environment. Living conditions</subject><subject>Environmental Exposure - analysis</subject><subject>Environmental Exposure - statistics & numerical data</subject><subject>Environmental pollutants toxicology</subject><subject>Female</subject><subject>Human biomonitoring</subject><subject>Human plasma</subject><subject>Humans</subject><subject>Limit of Detection</subject><subject>Maternal Exposure - statistics & numerical data</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Norway</subject><subject>Personal care products</subject><subject>Postmenopause - metabolism</subject><subject>Pregnancy</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Siloxanes - metabolism</subject><subject>Toxicology</subject><issn>0160-4120</issn><issn>1873-6750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNp9kktvEzEUhUcIREvhHyDkDVK7mGB7Xp4NEop4VCoQicfWcu5cB0cee7A9KflB_E-cJpQdK0tH3znX18dF8ZzRBaOsfbVdoNsZlxacMp6lBaXiQXHORFeVbdfQh8V5xmhZM07PiicxbimlvBbN4-KMV9kkWH9e_F5ZFUdFwDtAl4JKxrtIvCawB2uA7LzNmkUyYvqxt9FY_0s5jOQSvn_8ckWMI1PAjVMuEeUGMvmYRnR-UnNUlnzy4RY3Rjly67N8h0S0ugw4-ZBwIHPEw7gJQ_QuO0AFzJF-mCHlKavlKl49LR5pZSM-O50Xxbd3b78uP5Q3n99fL9_clNDQOpU9bdpW80FBzZuqqfu-Fl0jmoEqipRXTOm-rrqurQaOnWrbvu0Z1ZzrHjSIdXVRXB9zB6-2cgpmVGEvvTLyTvBhI1VIBizKpuJ9xdZq6Ni6RtQ9whoqFLoFKoB3OevymJV3-TljTHI0EdDa_Hp-jpJlhrG64SKj9RGF4GMMqO9HMyoPZcutPJYtD2Uf1Fx2tr04TZjXIw73pr_tZuDlCVARlNVBOTDxH9eKuheiydzrI4f5bXcGg4xgMH-IwQSElJc3_7_JHzZvzA0</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Hanssen, Linda</creator><creator>Warner, Nicholas A.</creator><creator>Braathen, Tonje</creator><creator>Odland, Jon Ø.</creator><creator>Lund, Eiliv</creator><creator>Nieboer, Evert</creator><creator>Sandanger, Torkjel M.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</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>7X8</scope><scope>DOA</scope></search><sort><creationdate>201301</creationdate><title>Plasma concentrations of cyclic volatile methylsiloxanes (cVMS) in pregnant and postmenopausal Norwegian women and self-reported use of personal care products (PCPs)</title><author>Hanssen, Linda ; Warner, Nicholas A. ; Braathen, Tonje ; Odland, Jon Ø. ; Lund, Eiliv ; Nieboer, Evert ; Sandanger, Torkjel M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Cosmetics - metabolism</topic><topic>Cyclic volatile methylsiloxanes</topic><topic>Domestic and cosmetic products toxicology</topic><topic>Environment. Living conditions</topic><topic>Environmental Exposure - analysis</topic><topic>Environmental Exposure - statistics & numerical data</topic><topic>Environmental pollutants toxicology</topic><topic>Female</topic><topic>Human biomonitoring</topic><topic>Human plasma</topic><topic>Humans</topic><topic>Limit of Detection</topic><topic>Maternal Exposure - statistics & numerical data</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Norway</topic><topic>Personal care products</topic><topic>Postmenopause - metabolism</topic><topic>Pregnancy</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Siloxanes - metabolism</topic><topic>Toxicology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hanssen, Linda</creatorcontrib><creatorcontrib>Warner, Nicholas A.</creatorcontrib><creatorcontrib>Braathen, Tonje</creatorcontrib><creatorcontrib>Odland, Jon Ø.</creatorcontrib><creatorcontrib>Lund, Eiliv</creatorcontrib><creatorcontrib>Nieboer, Evert</creatorcontrib><creatorcontrib>Sandanger, Torkjel M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><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><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Environment international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hanssen, Linda</au><au>Warner, Nicholas A.</au><au>Braathen, Tonje</au><au>Odland, Jon Ø.</au><au>Lund, Eiliv</au><au>Nieboer, Evert</au><au>Sandanger, Torkjel M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Plasma concentrations of cyclic volatile methylsiloxanes (cVMS) in pregnant and postmenopausal Norwegian women and self-reported use of personal care products (PCPs)</atitle><jtitle>Environment international</jtitle><addtitle>Environ Int</addtitle><date>2013-01</date><risdate>2013</risdate><volume>51</volume><spage>82</spage><epage>87</epage><pages>82-87</pages><issn>0160-4120</issn><eissn>1873-6750</eissn><coden>ENVIDV</coden><abstract>Dermal application of personal care products (PCPs) is considered an important human exposure route for siloxanes. Their presence as minor or major constituents in many personal care products (PCPs) and cosmetics is of concern for human exposure.
The aim of this study was to quantify cyclic volatile methylsiloxanes (cVMS) in blood plasma of pregnant and postmenopausal women, and to investigate possible links to self-reported use of PCPs for the latter group. Participants were recruited from two studies, namely the Norwegian Women and Cancer Study (NOWAC) and the North Norwegian Mother-and-child Study (MISA). For the NOWAC cohort, 94 plasma samples from postmenopausal women were analyzed (blood drawn in 2005) and information about PCP use and breast implants was derived from a self-administered questionnaire. In the MISA study, the collection of the plasma samples (blood drawn in 2009) constituted a re-sampling because the original serum vacutainers used were contaminated with cVMS. D4 (octamethylcyclotetrasiloxane) was the dominant compound in plasma for both cohorts. For the NOWAC samples, more than 85% of the women had D4 concentrations above the LOQ (2.74ng/mL), while the detection frequency was only 18% for the MISA participants. The highest cVMS plasma concentrations were observed for D4: 12.7ng/mL (NOWAC) and 2.69ng/mL (MISA). For the other cVMS, decamethylcyclopentasiloxane (D5) and dodecamethylcyclohexasiloxane (D6) concentrations were below the detection limit in most samples.
There was no significant correlation between the concentrations of D4 and the reported total body cream use. Sampling time (2005 versus 2009) and age of the donors could explain the differences between the two cohorts.
► First data on cVMS in sub-populations from the general female population showing low concentrations with D4 dominating. ► Percentage detected for D4 was below 20% for pregnant women, and 85% for postmenopausal women. ► There was no association between self-reported use of personal care products and measured cVMS concentrations in plasma. ► Age and sampling time could explain the observed differences between the cohorts.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>23201819</pmid><doi>10.1016/j.envint.2012.10.008</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0160-4120 |
ispartof | Environment international, 2013-01, Vol.51, p.82-87 |
issn | 0160-4120 1873-6750 |
language | eng |
recordid | cdi_doaj_primary_oai_doaj_org_article_532931bad71b4eef9ecbc3e8f6c08c27 |
source | ScienceDirect Journals |
subjects | Adult Biological and medical sciences Cohort Studies Cosmetics - metabolism Cyclic volatile methylsiloxanes Domestic and cosmetic products toxicology Environment. Living conditions Environmental Exposure - analysis Environmental Exposure - statistics & numerical data Environmental pollutants toxicology Female Human biomonitoring Human plasma Humans Limit of Detection Maternal Exposure - statistics & numerical data Medical sciences Middle Aged Norway Personal care products Postmenopause - metabolism Pregnancy Public health. Hygiene Public health. Hygiene-occupational medicine Siloxanes - metabolism Toxicology |
title | Plasma concentrations of cyclic volatile methylsiloxanes (cVMS) in pregnant and postmenopausal Norwegian women and self-reported use of personal care products (PCPs) |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T21%3A34%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Plasma%20concentrations%20of%20cyclic%20volatile%20methylsiloxanes%20(cVMS)%20in%20pregnant%20and%20postmenopausal%20Norwegian%20women%20and%20self-reported%20use%20of%20personal%20care%20products%20(PCPs)&rft.jtitle=Environment%20international&rft.au=Hanssen,%20Linda&rft.date=2013-01&rft.volume=51&rft.spage=82&rft.epage=87&rft.pages=82-87&rft.issn=0160-4120&rft.eissn=1873-6750&rft.coden=ENVIDV&rft_id=info:doi/10.1016/j.envint.2012.10.008&rft_dat=%3Cproquest_doaj_%3E1273114528%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c504t-90566f2dac42535499487585d0a0e0231af9437763d2e7a6696910f22f9cfc8b3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1273114528&rft_id=info:pmid/23201819&rfr_iscdi=true |