Loading…
Diagnostic accuracy of diffusion tensor imaging for pediatric cervical spinal cord injury
Study design: Cross-sectional non-experimental study. Objectives: To examine diagnostic accuracy of diffusion tensor imaging (DTI) for pediatric spinal cord injury (SCI). Setting Pediatric Orthopedic Hospital. Methods: Thirty-five subjects, 10 SCI and 25 controls, mean age 13.38 years underwent two...
Saved in:
| Published in: | Spinal cord 2013-07, Vol.51 (7), p.532-537 |
|---|---|
| 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-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503 |
| container_end_page | 537 |
| container_issue | 7 |
| container_start_page | 532 |
| container_title | Spinal cord |
| container_volume | 51 |
| creator | Mulcahey, M J Samdani, A F Gaughan, J P Barakat, N Faro, S Shah, P Betz, R R Mohamed, F B |
| description | Study design:
Cross-sectional non-experimental study.
Objectives:
To examine diagnostic accuracy of diffusion tensor imaging (DTI) for pediatric spinal cord injury (SCI).
Setting
Pediatric Orthopedic Hospital.
Methods:
Thirty-five subjects, 10 SCI and 25 controls, mean age 13.38 years underwent two scans with 3.0 T MR scanner. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated. Subjects with SCI underwent examination of muscle strength, sensation and sacral sparing. Mean and s.d. values for FA, AD and RD were compared by group (controls, SCI with sacral sparing, SCI without sacral sparing) using analysis of variance for repeated measures. Comparisons were also made of DTI values at the injury site to values from cervical regions outside of the injury site. Specificity, sensitivity, receiver operating characteristics area under the curve (ROC AUC) and corresponding 95% confidence intervals were calculated. Resampling methods were used to validate the estimates from the final models.
Results:
FA values differed among SCI subjects with intact sacral sparing, absent sacral sparing and controls,
P |
| doi_str_mv | 10.1038/sc.2013.36 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1412552053</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1412552053</sourcerecordid><originalsourceid>FETCH-LOGICAL-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503</originalsourceid><addsrcrecordid>eNqFkU1rGzEQhkVpiFMnl_6AstBLaFlH3x_HkI8mYMglOeS0aLUjI2OvXGk34H8fOXZKaQ85zQvzzDvMvAh9JXhGMNMX2c0oJmzG5Cd0QriStZCUfy6aSVpzZtgEfcl5iTE2xOhjNKFMYq0JPUHP18Eu-piH4Crr3Jis21bRV13wfswh9tUAfY6pCmu7CP2i8kVvoAt2SGXEQXoJzq6qvAl9KS6mrgr9ckzbU3Tk7SrD2aFO0dPtzePVXT1_-HV_dTmvHddyqFvBQVmFO69p20rQLTOKdxgL6Zk2xrS2pYCpFxaEagGEw95boxgoKQRmU3S-992k-HuEPDTrkB2sVraHOOaGcEKFoFiwj1FmNGdCSVLQ7_-gyzimcuIbxTlXrDhO0Y895VLMOYFvNqk8Km0bgptdNk12zS6bhskCfztYju0auj_oexgF-LkHcmn1C0h_7fzf7hW0gJeY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1394447305</pqid></control><display><type>article</type><title>Diagnostic accuracy of diffusion tensor imaging for pediatric cervical spinal cord injury</title><source>SPORTDiscus</source><creator>Mulcahey, M J ; Samdani, A F ; Gaughan, J P ; Barakat, N ; Faro, S ; Shah, P ; Betz, R R ; Mohamed, F B</creator><creatorcontrib>Mulcahey, M J ; Samdani, A F ; Gaughan, J P ; Barakat, N ; Faro, S ; Shah, P ; Betz, R R ; Mohamed, F B</creatorcontrib><description>Study design:
Cross-sectional non-experimental study.
Objectives:
To examine diagnostic accuracy of diffusion tensor imaging (DTI) for pediatric spinal cord injury (SCI).
Setting
Pediatric Orthopedic Hospital.
Methods:
Thirty-five subjects, 10 SCI and 25 controls, mean age 13.38 years underwent two scans with 3.0 T MR scanner. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated. Subjects with SCI underwent examination of muscle strength, sensation and sacral sparing. Mean and s.d. values for FA, AD and RD were compared by group (controls, SCI with sacral sparing, SCI without sacral sparing) using analysis of variance for repeated measures. Comparisons were also made of DTI values at the injury site to values from cervical regions outside of the injury site. Specificity, sensitivity, receiver operating characteristics area under the curve (ROC AUC) and corresponding 95% confidence intervals were calculated. Resampling methods were used to validate the estimates from the final models.
Results:
FA values differed among SCI subjects with intact sacral sparing, absent sacral sparing and controls,
P
<0.003 (adjusted). DTI values in combination showed the strongest diagnostic accuracy for predicting the presence of anal contraction (AD, RD; ROC AUC=0.90), deep anal pressure (FA; ROC AUC=0.88), S4-5 sensation (FA, RD; ROC AUC=0.93), motor level (FA, AD, RD; ROC AUC=0.92) and MRI level (FA, AD, RD; ROC AUC=0.92). Bootstrap and Jackknife median values indicated consistency of the parameter estimates.
Conclusion:
The predictive accuracy of DTI for sacral sparing end points and motor and MRI level of injury was good to strong.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sc.2013.36</identifier><identifier>PMID: 23608812</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/1647/245/2149 ; 692/699/375/1824 ; 692/700/139 ; 692/700/1720 ; Adolescent ; Anatomy ; Biomedical and Life Sciences ; Biomedicine ; Cervical Vertebrae - injuries ; Cervical Vertebrae - pathology ; Child ; Diffusion Tensor Imaging - methods ; Female ; Human Physiology ; Humans ; Male ; Neurochemistry ; Neuropsychology ; Neurosciences ; original-article ; Paralysis - diagnosis ; Paralysis - etiology ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Spinal Cord - pathology ; Spinal Cord Injuries - complications ; Spinal Cord Injuries - pathology ; Young Adult</subject><ispartof>Spinal cord, 2013-07, Vol.51 (7), p.532-537</ispartof><rights>International Spinal Cord Society 2013</rights><rights>Copyright Nature Publishing Group Jul 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503</citedby><cites>FETCH-LOGICAL-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23608812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mulcahey, M J</creatorcontrib><creatorcontrib>Samdani, A F</creatorcontrib><creatorcontrib>Gaughan, J P</creatorcontrib><creatorcontrib>Barakat, N</creatorcontrib><creatorcontrib>Faro, S</creatorcontrib><creatorcontrib>Shah, P</creatorcontrib><creatorcontrib>Betz, R R</creatorcontrib><creatorcontrib>Mohamed, F B</creatorcontrib><title>Diagnostic accuracy of diffusion tensor imaging for pediatric cervical spinal cord injury</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study design:
Cross-sectional non-experimental study.
Objectives:
To examine diagnostic accuracy of diffusion tensor imaging (DTI) for pediatric spinal cord injury (SCI).
Setting
Pediatric Orthopedic Hospital.
Methods:
Thirty-five subjects, 10 SCI and 25 controls, mean age 13.38 years underwent two scans with 3.0 T MR scanner. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated. Subjects with SCI underwent examination of muscle strength, sensation and sacral sparing. Mean and s.d. values for FA, AD and RD were compared by group (controls, SCI with sacral sparing, SCI without sacral sparing) using analysis of variance for repeated measures. Comparisons were also made of DTI values at the injury site to values from cervical regions outside of the injury site. Specificity, sensitivity, receiver operating characteristics area under the curve (ROC AUC) and corresponding 95% confidence intervals were calculated. Resampling methods were used to validate the estimates from the final models.
Results:
FA values differed among SCI subjects with intact sacral sparing, absent sacral sparing and controls,
P
<0.003 (adjusted). DTI values in combination showed the strongest diagnostic accuracy for predicting the presence of anal contraction (AD, RD; ROC AUC=0.90), deep anal pressure (FA; ROC AUC=0.88), S4-5 sensation (FA, RD; ROC AUC=0.93), motor level (FA, AD, RD; ROC AUC=0.92) and MRI level (FA, AD, RD; ROC AUC=0.92). Bootstrap and Jackknife median values indicated consistency of the parameter estimates.
Conclusion:
The predictive accuracy of DTI for sacral sparing end points and motor and MRI level of injury was good to strong.</description><subject>631/1647/245/2149</subject><subject>692/699/375/1824</subject><subject>692/700/139</subject><subject>692/700/1720</subject><subject>Adolescent</subject><subject>Anatomy</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cervical Vertebrae - injuries</subject><subject>Cervical Vertebrae - pathology</subject><subject>Child</subject><subject>Diffusion Tensor Imaging - methods</subject><subject>Female</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Neurochemistry</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>original-article</subject><subject>Paralysis - diagnosis</subject><subject>Paralysis - etiology</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Spinal Cord - pathology</subject><subject>Spinal Cord Injuries - complications</subject><subject>Spinal Cord Injuries - pathology</subject><subject>Young Adult</subject><issn>1362-4393</issn><issn>1476-5624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqFkU1rGzEQhkVpiFMnl_6AstBLaFlH3x_HkI8mYMglOeS0aLUjI2OvXGk34H8fOXZKaQ85zQvzzDvMvAh9JXhGMNMX2c0oJmzG5Cd0QriStZCUfy6aSVpzZtgEfcl5iTE2xOhjNKFMYq0JPUHP18Eu-piH4Crr3Jis21bRV13wfswh9tUAfY6pCmu7CP2i8kVvoAt2SGXEQXoJzq6qvAl9KS6mrgr9ckzbU3Tk7SrD2aFO0dPtzePVXT1_-HV_dTmvHddyqFvBQVmFO69p20rQLTOKdxgL6Zk2xrS2pYCpFxaEagGEw95boxgoKQRmU3S-992k-HuEPDTrkB2sVraHOOaGcEKFoFiwj1FmNGdCSVLQ7_-gyzimcuIbxTlXrDhO0Y895VLMOYFvNqk8Km0bgptdNk12zS6bhskCfztYju0auj_oexgF-LkHcmn1C0h_7fzf7hW0gJeY</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Mulcahey, M J</creator><creator>Samdani, A F</creator><creator>Gaughan, J P</creator><creator>Barakat, N</creator><creator>Faro, S</creator><creator>Shah, P</creator><creator>Betz, R R</creator><creator>Mohamed, F B</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</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>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>Diagnostic accuracy of diffusion tensor imaging for pediatric cervical spinal cord injury</title><author>Mulcahey, M J ; Samdani, A F ; Gaughan, J P ; Barakat, N ; Faro, S ; Shah, P ; Betz, R R ; Mohamed, F B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>631/1647/245/2149</topic><topic>692/699/375/1824</topic><topic>692/700/139</topic><topic>692/700/1720</topic><topic>Adolescent</topic><topic>Anatomy</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cervical Vertebrae - injuries</topic><topic>Cervical Vertebrae - pathology</topic><topic>Child</topic><topic>Diffusion Tensor Imaging - methods</topic><topic>Female</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Neurochemistry</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>original-article</topic><topic>Paralysis - diagnosis</topic><topic>Paralysis - etiology</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Spinal Cord - pathology</topic><topic>Spinal Cord Injuries - complications</topic><topic>Spinal Cord Injuries - pathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mulcahey, M J</creatorcontrib><creatorcontrib>Samdani, A F</creatorcontrib><creatorcontrib>Gaughan, J P</creatorcontrib><creatorcontrib>Barakat, N</creatorcontrib><creatorcontrib>Faro, S</creatorcontrib><creatorcontrib>Shah, P</creatorcontrib><creatorcontrib>Betz, R R</creatorcontrib><creatorcontrib>Mohamed, F B</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>Bacteriology Abstracts (Microbiology B)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mulcahey, M J</au><au>Samdani, A F</au><au>Gaughan, J P</au><au>Barakat, N</au><au>Faro, S</au><au>Shah, P</au><au>Betz, R R</au><au>Mohamed, F B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic accuracy of diffusion tensor imaging for pediatric cervical spinal cord injury</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>51</volume><issue>7</issue><spage>532</spage><epage>537</epage><pages>532-537</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study design:
Cross-sectional non-experimental study.
Objectives:
To examine diagnostic accuracy of diffusion tensor imaging (DTI) for pediatric spinal cord injury (SCI).
Setting
Pediatric Orthopedic Hospital.
Methods:
Thirty-five subjects, 10 SCI and 25 controls, mean age 13.38 years underwent two scans with 3.0 T MR scanner. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated. Subjects with SCI underwent examination of muscle strength, sensation and sacral sparing. Mean and s.d. values for FA, AD and RD were compared by group (controls, SCI with sacral sparing, SCI without sacral sparing) using analysis of variance for repeated measures. Comparisons were also made of DTI values at the injury site to values from cervical regions outside of the injury site. Specificity, sensitivity, receiver operating characteristics area under the curve (ROC AUC) and corresponding 95% confidence intervals were calculated. Resampling methods were used to validate the estimates from the final models.
Results:
FA values differed among SCI subjects with intact sacral sparing, absent sacral sparing and controls,
P
<0.003 (adjusted). DTI values in combination showed the strongest diagnostic accuracy for predicting the presence of anal contraction (AD, RD; ROC AUC=0.90), deep anal pressure (FA; ROC AUC=0.88), S4-5 sensation (FA, RD; ROC AUC=0.93), motor level (FA, AD, RD; ROC AUC=0.92) and MRI level (FA, AD, RD; ROC AUC=0.92). Bootstrap and Jackknife median values indicated consistency of the parameter estimates.
Conclusion:
The predictive accuracy of DTI for sacral sparing end points and motor and MRI level of injury was good to strong.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>23608812</pmid><doi>10.1038/sc.2013.36</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1362-4393 |
| ispartof | Spinal cord, 2013-07, Vol.51 (7), p.532-537 |
| issn | 1362-4393 1476-5624 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1412552053 |
| source | SPORTDiscus |
| subjects | 631/1647/245/2149 692/699/375/1824 692/700/139 692/700/1720 Adolescent Anatomy Biomedical and Life Sciences Biomedicine Cervical Vertebrae - injuries Cervical Vertebrae - pathology Child Diffusion Tensor Imaging - methods Female Human Physiology Humans Male Neurochemistry Neuropsychology Neurosciences original-article Paralysis - diagnosis Paralysis - etiology Prognosis Reproducibility of Results Sensitivity and Specificity Spinal Cord - pathology Spinal Cord Injuries - complications Spinal Cord Injuries - pathology Young Adult |
| title | Diagnostic accuracy of diffusion tensor imaging for pediatric cervical spinal cord injury |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T18%3A24%3A15IST&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=Diagnostic%20accuracy%20of%20diffusion%20tensor%20imaging%20for%20pediatric%20cervical%20spinal%20cord%20injury&rft.jtitle=Spinal%20cord&rft.au=Mulcahey,%20M%20J&rft.date=2013-07-01&rft.volume=51&rft.issue=7&rft.spage=532&rft.epage=537&rft.pages=532-537&rft.issn=1362-4393&rft.eissn=1476-5624&rft.coden=SPCOFM&rft_id=info:doi/10.1038/sc.2013.36&rft_dat=%3Cproquest_cross%3E1412552053%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c486t-b54e7a70df82bb6e8b3974d0056f38999bab2e02f5ae57bee5c0ffa973e765503%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1394447305&rft_id=info:pmid/23608812&rfr_iscdi=true |