Loading…

Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving

Body condition score (BCS) around calving, and the typical BCS loss for up to 100 d after parturition, is associated with both production and reproductive performance of dairy cattle. In addition, there is public concern that thin cows may have impaired welfare, particularly in early lactation where...

Full description

Saved in:
Bibliographic Details
Published in:Journal of dairy science 2013-07, Vol.96 (7), p.4465-4476
Main Authors: Schütz, K.E., Cox, N.R., Macdonald, K.A., Roche, J.R., Verkerk, G.A., Rogers, A.R., Tucker, C.B., Matthews, L.R., Meier, S., Webster, J.R.
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-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43
cites cdi_FETCH-LOGICAL-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43
container_end_page 4476
container_issue 7
container_start_page 4465
container_title Journal of dairy science
container_volume 96
creator Schütz, K.E.
Cox, N.R.
Macdonald, K.A.
Roche, J.R.
Verkerk, G.A.
Rogers, A.R.
Tucker, C.B.
Matthews, L.R.
Meier, S.
Webster, J.R.
description Body condition score (BCS) around calving, and the typical BCS loss for up to 100 d after parturition, is associated with both production and reproductive performance of dairy cattle. In addition, there is public concern that thin cows may have impaired welfare, particularly in early lactation where feed demand exceeds pasture growth, and a lag exists between peak milk energy requirements and intake. The aim of this experiment was to determine how BCS at calving influences behavioral and physiological responses to a short-term feed restriction at 47 DIM. Body condition score (on a 10-point scale) at calving was manipulated by modifying the diets in the previous lactation of healthy dairy cattle to generate 3 treatment groups: low BCS (3.4; n=17), medium BCS (4.6; n=18), or high BCS (5.4; n=20). Cows were tested in 4 groups for 8 consecutive days; testing consisted of different levels of feed allocation (d 1 and 2: 100%; d 3 and 4: 75%; d 5: 50%; d 6 to 8: 125%), where 100% was 15kg of DM/cow per day. All BCS groups had similar and marked behavioral and physiological responses to feed restriction. For example, they increased vocalization, time spent eating silage and grazing, aggressive behavior, and fat metabolism (as measured by concentrations of β–hydroxybutyrate and nonesterified fatty acids), and reduced milk production. Body condition affected some of these responses. Fewer cows with low BCS engaged in aggressive interactions in a feed competition test (trough filled with silage that could be consumed in 15 min) on the first day of feed restriction (low: 32%; medium: 74%; high: 64%; standard error of difference=15.4%). High BCS cows had greater concentrations of β–hydroxybutyrate and nonesterified fatty acids throughout the experimental period, which suggests more fat mobilization; however, plasma leptin and fecal glucocorticosteroid metabolite concentrations were unaffected by BCS. Whereas cows demonstrated marked responses to feed restriction, the results suggest that a BCS of 3.4, 4.6, or 5.4 in healthy cows at calving does not overwhelmingly influence this response at 47 DIM.
doi_str_mv 10.3168/jds.2012-6507
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1371270335</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022030213003767</els_id><sourcerecordid>1371270335</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43</originalsourceid><addsrcrecordid>eNp1kUtvUzEQhS0EomlhyRa8ZHOLH_fhLKECilSJRdu15WuPk6luroPtBOVX9C8zIYVdV6OZ-c6xPIexd1JcatmbTw-hXCohVdN3YnjBFrJTXaPl0rxkCyGUaoQW6oydl_JArVSie83OlO5NS4sFe_wCa7fHlN3E3Rz4dn0omKa0Qk8TiBF8LTxF7nhZp1ybCnnDI0DgGUrN6CummePMJ-erqziveHCYD9y7Wifgv7GueUAyyjBXPqZAqzQH_KsrPpENd5XwaU_iN-xVdFOBt0_1gt1_-3p3dd3c_Pz-4-rzTeNb0damFSMEYUatfYxOCaVNiG3s21YNwukeumGkoQpOdnFpxn5Y-jEYE00AZ0KrL9jHk-82p187-ondYPEwTW6GtCtW6kGSldYdoc0J9TmVkiHabcaNywcrhT1mYCkDe8zAHjMg_v2T9W7cQPhP_zs6AR9OQHTJulXGYu9vSd8JIYXs9ZKI4UQAnWCPkG3xCLOHgJkCsSHhM4__ARbtoSQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1371270335</pqid></control><display><type>article</type><title>Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving</title><source>ScienceDirect Journals</source><source>EZB Electronic Journals Library</source><creator>Schütz, K.E. ; Cox, N.R. ; Macdonald, K.A. ; Roche, J.R. ; Verkerk, G.A. ; Rogers, A.R. ; Tucker, C.B. ; Matthews, L.R. ; Meier, S. ; Webster, J.R.</creator><creatorcontrib>Schütz, K.E. ; Cox, N.R. ; Macdonald, K.A. ; Roche, J.R. ; Verkerk, G.A. ; Rogers, A.R. ; Tucker, C.B. ; Matthews, L.R. ; Meier, S. ; Webster, J.R.</creatorcontrib><description>Body condition score (BCS) around calving, and the typical BCS loss for up to 100 d after parturition, is associated with both production and reproductive performance of dairy cattle. In addition, there is public concern that thin cows may have impaired welfare, particularly in early lactation where feed demand exceeds pasture growth, and a lag exists between peak milk energy requirements and intake. The aim of this experiment was to determine how BCS at calving influences behavioral and physiological responses to a short-term feed restriction at 47 DIM. Body condition score (on a 10-point scale) at calving was manipulated by modifying the diets in the previous lactation of healthy dairy cattle to generate 3 treatment groups: low BCS (3.4; n=17), medium BCS (4.6; n=18), or high BCS (5.4; n=20). Cows were tested in 4 groups for 8 consecutive days; testing consisted of different levels of feed allocation (d 1 and 2: 100%; d 3 and 4: 75%; d 5: 50%; d 6 to 8: 125%), where 100% was 15kg of DM/cow per day. All BCS groups had similar and marked behavioral and physiological responses to feed restriction. For example, they increased vocalization, time spent eating silage and grazing, aggressive behavior, and fat metabolism (as measured by concentrations of β–hydroxybutyrate and nonesterified fatty acids), and reduced milk production. Body condition affected some of these responses. Fewer cows with low BCS engaged in aggressive interactions in a feed competition test (trough filled with silage that could be consumed in 15 min) on the first day of feed restriction (low: 32%; medium: 74%; high: 64%; standard error of difference=15.4%). High BCS cows had greater concentrations of β–hydroxybutyrate and nonesterified fatty acids throughout the experimental period, which suggests more fat mobilization; however, plasma leptin and fecal glucocorticosteroid metabolite concentrations were unaffected by BCS. Whereas cows demonstrated marked responses to feed restriction, the results suggest that a BCS of 3.4, 4.6, or 5.4 in healthy cows at calving does not overwhelmingly influence this response at 47 DIM.</description><identifier>ISSN: 0022-0302</identifier><identifier>EISSN: 1525-3198</identifier><identifier>DOI: 10.3168/jds.2012-6507</identifier><identifier>PMID: 23684030</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>3-hydroxybutyric acid ; 3-Hydroxybutyric Acid - blood ; aggression ; animal welfare ; Animals ; Behavior, Animal - physiology ; Body Composition - physiology ; body condition ; calving ; Cattle - physiology ; cows ; dairy cattle ; diet ; early lactation ; energy requirements ; Fatty Acids, Nonesterified - blood ; feed restriction ; Female ; Food Deprivation - physiology ; free fatty acids ; grazing ; ingestion ; Lactation - physiology ; leptin ; lipid metabolism ; milk ; milk production ; Parturition - physiology ; pasture ; pastures ; physiological response ; Pregnancy ; Reproduction - physiology ; reproductive performance ; restricted feeding ; silage ; vocalization</subject><ispartof>Journal of dairy science, 2013-07, Vol.96 (7), p.4465-4476</ispartof><rights>2013 American Dairy Science Association</rights><rights>Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43</citedby><cites>FETCH-LOGICAL-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022030213003767$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3549,27924,27925,45780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23684030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schütz, K.E.</creatorcontrib><creatorcontrib>Cox, N.R.</creatorcontrib><creatorcontrib>Macdonald, K.A.</creatorcontrib><creatorcontrib>Roche, J.R.</creatorcontrib><creatorcontrib>Verkerk, G.A.</creatorcontrib><creatorcontrib>Rogers, A.R.</creatorcontrib><creatorcontrib>Tucker, C.B.</creatorcontrib><creatorcontrib>Matthews, L.R.</creatorcontrib><creatorcontrib>Meier, S.</creatorcontrib><creatorcontrib>Webster, J.R.</creatorcontrib><title>Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving</title><title>Journal of dairy science</title><addtitle>J Dairy Sci</addtitle><description>Body condition score (BCS) around calving, and the typical BCS loss for up to 100 d after parturition, is associated with both production and reproductive performance of dairy cattle. In addition, there is public concern that thin cows may have impaired welfare, particularly in early lactation where feed demand exceeds pasture growth, and a lag exists between peak milk energy requirements and intake. The aim of this experiment was to determine how BCS at calving influences behavioral and physiological responses to a short-term feed restriction at 47 DIM. Body condition score (on a 10-point scale) at calving was manipulated by modifying the diets in the previous lactation of healthy dairy cattle to generate 3 treatment groups: low BCS (3.4; n=17), medium BCS (4.6; n=18), or high BCS (5.4; n=20). Cows were tested in 4 groups for 8 consecutive days; testing consisted of different levels of feed allocation (d 1 and 2: 100%; d 3 and 4: 75%; d 5: 50%; d 6 to 8: 125%), where 100% was 15kg of DM/cow per day. All BCS groups had similar and marked behavioral and physiological responses to feed restriction. For example, they increased vocalization, time spent eating silage and grazing, aggressive behavior, and fat metabolism (as measured by concentrations of β–hydroxybutyrate and nonesterified fatty acids), and reduced milk production. Body condition affected some of these responses. Fewer cows with low BCS engaged in aggressive interactions in a feed competition test (trough filled with silage that could be consumed in 15 min) on the first day of feed restriction (low: 32%; medium: 74%; high: 64%; standard error of difference=15.4%). High BCS cows had greater concentrations of β–hydroxybutyrate and nonesterified fatty acids throughout the experimental period, which suggests more fat mobilization; however, plasma leptin and fecal glucocorticosteroid metabolite concentrations were unaffected by BCS. Whereas cows demonstrated marked responses to feed restriction, the results suggest that a BCS of 3.4, 4.6, or 5.4 in healthy cows at calving does not overwhelmingly influence this response at 47 DIM.</description><subject>3-hydroxybutyric acid</subject><subject>3-Hydroxybutyric Acid - blood</subject><subject>aggression</subject><subject>animal welfare</subject><subject>Animals</subject><subject>Behavior, Animal - physiology</subject><subject>Body Composition - physiology</subject><subject>body condition</subject><subject>calving</subject><subject>Cattle - physiology</subject><subject>cows</subject><subject>dairy cattle</subject><subject>diet</subject><subject>early lactation</subject><subject>energy requirements</subject><subject>Fatty Acids, Nonesterified - blood</subject><subject>feed restriction</subject><subject>Female</subject><subject>Food Deprivation - physiology</subject><subject>free fatty acids</subject><subject>grazing</subject><subject>ingestion</subject><subject>Lactation - physiology</subject><subject>leptin</subject><subject>lipid metabolism</subject><subject>milk</subject><subject>milk production</subject><subject>Parturition - physiology</subject><subject>pasture</subject><subject>pastures</subject><subject>physiological response</subject><subject>Pregnancy</subject><subject>Reproduction - physiology</subject><subject>reproductive performance</subject><subject>restricted feeding</subject><subject>silage</subject><subject>vocalization</subject><issn>0022-0302</issn><issn>1525-3198</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNp1kUtvUzEQhS0EomlhyRa8ZHOLH_fhLKECilSJRdu15WuPk6luroPtBOVX9C8zIYVdV6OZ-c6xPIexd1JcatmbTw-hXCohVdN3YnjBFrJTXaPl0rxkCyGUaoQW6oydl_JArVSie83OlO5NS4sFe_wCa7fHlN3E3Rz4dn0omKa0Qk8TiBF8LTxF7nhZp1ybCnnDI0DgGUrN6CummePMJ-erqziveHCYD9y7Wifgv7GueUAyyjBXPqZAqzQH_KsrPpENd5XwaU_iN-xVdFOBt0_1gt1_-3p3dd3c_Pz-4-rzTeNb0damFSMEYUatfYxOCaVNiG3s21YNwukeumGkoQpOdnFpxn5Y-jEYE00AZ0KrL9jHk-82p187-ondYPEwTW6GtCtW6kGSldYdoc0J9TmVkiHabcaNywcrhT1mYCkDe8zAHjMg_v2T9W7cQPhP_zs6AR9OQHTJulXGYu9vSd8JIYXs9ZKI4UQAnWCPkG3xCLOHgJkCsSHhM4__ARbtoSQ</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Schütz, K.E.</creator><creator>Cox, N.R.</creator><creator>Macdonald, K.A.</creator><creator>Roche, J.R.</creator><creator>Verkerk, G.A.</creator><creator>Rogers, A.R.</creator><creator>Tucker, C.B.</creator><creator>Matthews, L.R.</creator><creator>Meier, S.</creator><creator>Webster, J.R.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>FBQ</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></search><sort><creationdate>20130701</creationdate><title>Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving</title><author>Schütz, K.E. ; Cox, N.R. ; Macdonald, K.A. ; Roche, J.R. ; Verkerk, G.A. ; Rogers, A.R. ; Tucker, C.B. ; Matthews, L.R. ; Meier, S. ; Webster, J.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>3-hydroxybutyric acid</topic><topic>3-Hydroxybutyric Acid - blood</topic><topic>aggression</topic><topic>animal welfare</topic><topic>Animals</topic><topic>Behavior, Animal - physiology</topic><topic>Body Composition - physiology</topic><topic>body condition</topic><topic>calving</topic><topic>Cattle - physiology</topic><topic>cows</topic><topic>dairy cattle</topic><topic>diet</topic><topic>early lactation</topic><topic>energy requirements</topic><topic>Fatty Acids, Nonesterified - blood</topic><topic>feed restriction</topic><topic>Female</topic><topic>Food Deprivation - physiology</topic><topic>free fatty acids</topic><topic>grazing</topic><topic>ingestion</topic><topic>Lactation - physiology</topic><topic>leptin</topic><topic>lipid metabolism</topic><topic>milk</topic><topic>milk production</topic><topic>Parturition - physiology</topic><topic>pasture</topic><topic>pastures</topic><topic>physiological response</topic><topic>Pregnancy</topic><topic>Reproduction - physiology</topic><topic>reproductive performance</topic><topic>restricted feeding</topic><topic>silage</topic><topic>vocalization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schütz, K.E.</creatorcontrib><creatorcontrib>Cox, N.R.</creatorcontrib><creatorcontrib>Macdonald, K.A.</creatorcontrib><creatorcontrib>Roche, J.R.</creatorcontrib><creatorcontrib>Verkerk, G.A.</creatorcontrib><creatorcontrib>Rogers, A.R.</creatorcontrib><creatorcontrib>Tucker, C.B.</creatorcontrib><creatorcontrib>Matthews, L.R.</creatorcontrib><creatorcontrib>Meier, S.</creatorcontrib><creatorcontrib>Webster, J.R.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>AGRIS</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><jtitle>Journal of dairy science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schütz, K.E.</au><au>Cox, N.R.</au><au>Macdonald, K.A.</au><au>Roche, J.R.</au><au>Verkerk, G.A.</au><au>Rogers, A.R.</au><au>Tucker, C.B.</au><au>Matthews, L.R.</au><au>Meier, S.</au><au>Webster, J.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving</atitle><jtitle>Journal of dairy science</jtitle><addtitle>J Dairy Sci</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>96</volume><issue>7</issue><spage>4465</spage><epage>4476</epage><pages>4465-4476</pages><issn>0022-0302</issn><eissn>1525-3198</eissn><abstract>Body condition score (BCS) around calving, and the typical BCS loss for up to 100 d after parturition, is associated with both production and reproductive performance of dairy cattle. In addition, there is public concern that thin cows may have impaired welfare, particularly in early lactation where feed demand exceeds pasture growth, and a lag exists between peak milk energy requirements and intake. The aim of this experiment was to determine how BCS at calving influences behavioral and physiological responses to a short-term feed restriction at 47 DIM. Body condition score (on a 10-point scale) at calving was manipulated by modifying the diets in the previous lactation of healthy dairy cattle to generate 3 treatment groups: low BCS (3.4; n=17), medium BCS (4.6; n=18), or high BCS (5.4; n=20). Cows were tested in 4 groups for 8 consecutive days; testing consisted of different levels of feed allocation (d 1 and 2: 100%; d 3 and 4: 75%; d 5: 50%; d 6 to 8: 125%), where 100% was 15kg of DM/cow per day. All BCS groups had similar and marked behavioral and physiological responses to feed restriction. For example, they increased vocalization, time spent eating silage and grazing, aggressive behavior, and fat metabolism (as measured by concentrations of β–hydroxybutyrate and nonesterified fatty acids), and reduced milk production. Body condition affected some of these responses. Fewer cows with low BCS engaged in aggressive interactions in a feed competition test (trough filled with silage that could be consumed in 15 min) on the first day of feed restriction (low: 32%; medium: 74%; high: 64%; standard error of difference=15.4%). High BCS cows had greater concentrations of β–hydroxybutyrate and nonesterified fatty acids throughout the experimental period, which suggests more fat mobilization; however, plasma leptin and fecal glucocorticosteroid metabolite concentrations were unaffected by BCS. Whereas cows demonstrated marked responses to feed restriction, the results suggest that a BCS of 3.4, 4.6, or 5.4 in healthy cows at calving does not overwhelmingly influence this response at 47 DIM.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23684030</pmid><doi>10.3168/jds.2012-6507</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-0302
ispartof Journal of dairy science, 2013-07, Vol.96 (7), p.4465-4476
issn 0022-0302
1525-3198
language eng
recordid cdi_proquest_miscellaneous_1371270335
source ScienceDirect Journals; EZB Electronic Journals Library
subjects 3-hydroxybutyric acid
3-Hydroxybutyric Acid - blood
aggression
animal welfare
Animals
Behavior, Animal - physiology
Body Composition - physiology
body condition
calving
Cattle - physiology
cows
dairy cattle
diet
early lactation
energy requirements
Fatty Acids, Nonesterified - blood
feed restriction
Female
Food Deprivation - physiology
free fatty acids
grazing
ingestion
Lactation - physiology
leptin
lipid metabolism
milk
milk production
Parturition - physiology
pasture
pastures
physiological response
Pregnancy
Reproduction - physiology
reproductive performance
restricted feeding
silage
vocalization
title Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T04%3A58%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Behavioral%20and%20physiological%20effects%20of%20a%20short-term%20feed%20restriction%20in%20lactating%20dairy%20cattle%20with%20different%20body%20condition%20scores%20at%20calving&rft.jtitle=Journal%20of%20dairy%20science&rft.au=Sch%C3%BCtz,%20K.E.&rft.date=2013-07-01&rft.volume=96&rft.issue=7&rft.spage=4465&rft.epage=4476&rft.pages=4465-4476&rft.issn=0022-0302&rft.eissn=1525-3198&rft_id=info:doi/10.3168/jds.2012-6507&rft_dat=%3Cproquest_cross%3E1371270335%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c404t-40bed08b33cffa20238df4f644270a36e57b0232da15f98b679cbd88f8dea8d43%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1371270335&rft_id=info:pmid/23684030&rfr_iscdi=true