Loading…
Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: A propensity score-matched analysis
Background The severity of liver fibrosis has been reported to be correlated with the risk of intractable ascites after hepatectomy for hepatocellular carcinoma. Since 2009, we have measured routinely the serum concentrations of type IV collagen 7s domain (7s collagen), a biochemical marker of liver...
Saved in:
| Published in: | Surgery 2016-11, Vol.160 (5), p.1244-1255 |
|---|---|
| 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-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133 |
| container_end_page | 1255 |
| container_issue | 5 |
| container_start_page | 1244 |
| container_title | Surgery |
| container_volume | 160 |
| creator | Shimizu, Akira, MD, PhD Kobayashi, Akira, MD, PhD Yokoyama, Takahide, MD, PhD Motoyama, Hiroaki, MD, PhD Sakai, Hiroshi, MD, PhD Kitagawa, Noriyuki, MD, PhD Notake, Tsuyoshi, MD, PhD Shirota, Tomoki, MD Fukushima, Kentaro, MD Miyagawa, Shin-ichi, MD, PhD |
| description | Background The severity of liver fibrosis has been reported to be correlated with the risk of intractable ascites after hepatectomy for hepatocellular carcinoma. Since 2009, we have measured routinely the serum concentrations of type IV collagen 7s domain (7s collagen), a biochemical marker of liver fibrosis and applied limited resection to patients with elevation of the serum 7s collagen concentrations above the upper limit of normal (6.0 ng/mL). The aim of this study was to assess the potential benefits of our treatment strategy on the postoperative outcomes of patients with hepatocellular carcinoma. Methods A propensity score–matched analysis was performed to compare the outcomes between patients who underwent initial hepatectomy for hepatocellular carcinoma before or after 2009 (2009 to April 2015; period 2) and those who underwent the operation prior to 2009 (1990–2008; period 1; n = 129 in each period). Results The incidence of intractable ascites was significantly lower in period 2 than in period 1 (2.3 vs 14.7%; P |
| doi_str_mv | 10.1016/j.surg.2016.06.024 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835686005</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0039606016302999</els_id><sourcerecordid>1835686005</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133</originalsourceid><addsrcrecordid>eNp9ks2O0zAUhSMEYsrAC7BAXrJJuXYSJ0YIaVTxM9JILPjZWo5z07rj2MV2Ourr8WQ404EFCyRL9uI7517fc4viJYU1Bcrf7NdxDts1y-815MPqR8WKNhUr24rTx8UKoBIlBw4XxbMY9wAgato9LS5Y20DFoFkVvzY-BLQqGe9Ij-kO0ZG0QxIxzBOxeEQbiR9JOh2QXP8g2lurthlqIxn8pIwjyg33kmDi7YIal4LSSfUWiYraJIxkzDJ_Z9yWWHPEQAJG1PdFRx_IDg8qeY3WzlYFolXQxmXzt-SKHII_oIsmnUjUPmA5qaR3OOSyyp6iic-LJ6OyEV883JfF948fvm0-lzdfPl1vrm5KXVOaSqEotEz0OIix1iPW0MMg2p63yKHhrerEOLRYs7HOHBUNq3uOHcWqExxoVV0Wr8--uaOfM8YkJxOXnpVDP0dJu6rhHQdoMsrOqA4-xoCjPAQzqXCSFOSSndzLJTu5ZCchH1Zn0asH_7mfcPgr-RNWBt6dgRwJHg0GmYeLTuNgQh6mHLz5v__7f-TaGme0srd4wrj3c8gTzf-QkUmQX5ftWZaH8gqYEKL6DdJnw_Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835686005</pqid></control><display><type>article</type><title>Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: A propensity score-matched analysis</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Shimizu, Akira, MD, PhD ; Kobayashi, Akira, MD, PhD ; Yokoyama, Takahide, MD, PhD ; Motoyama, Hiroaki, MD, PhD ; Sakai, Hiroshi, MD, PhD ; Kitagawa, Noriyuki, MD, PhD ; Notake, Tsuyoshi, MD, PhD ; Shirota, Tomoki, MD ; Fukushima, Kentaro, MD ; Miyagawa, Shin-ichi, MD, PhD</creator><creatorcontrib>Shimizu, Akira, MD, PhD ; Kobayashi, Akira, MD, PhD ; Yokoyama, Takahide, MD, PhD ; Motoyama, Hiroaki, MD, PhD ; Sakai, Hiroshi, MD, PhD ; Kitagawa, Noriyuki, MD, PhD ; Notake, Tsuyoshi, MD, PhD ; Shirota, Tomoki, MD ; Fukushima, Kentaro, MD ; Miyagawa, Shin-ichi, MD, PhD</creatorcontrib><description>Background The severity of liver fibrosis has been reported to be correlated with the risk of intractable ascites after hepatectomy for hepatocellular carcinoma. Since 2009, we have measured routinely the serum concentrations of type IV collagen 7s domain (7s collagen), a biochemical marker of liver fibrosis and applied limited resection to patients with elevation of the serum 7s collagen concentrations above the upper limit of normal (6.0 ng/mL). The aim of this study was to assess the potential benefits of our treatment strategy on the postoperative outcomes of patients with hepatocellular carcinoma. Methods A propensity score–matched analysis was performed to compare the outcomes between patients who underwent initial hepatectomy for hepatocellular carcinoma before or after 2009 (2009 to April 2015; period 2) and those who underwent the operation prior to 2009 (1990–2008; period 1; n = 129 in each period). Results The incidence of intractable ascites was significantly lower in period 2 than in period 1 (2.3 vs 14.7%; P < .001), although the other short-term and long-term outcomes were comparable between the 2 groups. A multivariate analysis identified elevation of the serum 7s collagen concentrations to ≥7.4 ng/mL as an independent predictor of IA (odds ratio 14.1, 95% confidence interval 2.8 to 106.7; P = .001), with the area under the receiver-operating characteristic curve of 0.820 (0.648–0.919, P = .005). Conclusion Modification of the surgical procedure according to the serum 7s collagen concentration is beneficial for reducing the risk of development of intractable ascites after hepatectomy for hepatocellular carcinoma.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2016.06.024</identifier><identifier>PMID: 27503205</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Ascites - etiology ; Ascites - physiopathology ; Biomarkers - blood ; Carcinoma, Hepatocellular - blood ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - surgery ; Case-Control Studies ; Collagen Type IV - blood ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hepatectomy - adverse effects ; Hepatectomy - methods ; Humans ; Japan ; Liver Neoplasms - blood ; Liver Neoplasms - mortality ; Liver Neoplasms - surgery ; Male ; Middle Aged ; Postoperative Complications - blood ; Postoperative Complications - mortality ; Postoperative Complications - physiopathology ; Propensity Score ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Surgery ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>Surgery, 2016-11, Vol.160 (5), p.1244-1255</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133</citedby><cites>FETCH-LOGICAL-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27503205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shimizu, Akira, MD, PhD</creatorcontrib><creatorcontrib>Kobayashi, Akira, MD, PhD</creatorcontrib><creatorcontrib>Yokoyama, Takahide, MD, PhD</creatorcontrib><creatorcontrib>Motoyama, Hiroaki, MD, PhD</creatorcontrib><creatorcontrib>Sakai, Hiroshi, MD, PhD</creatorcontrib><creatorcontrib>Kitagawa, Noriyuki, MD, PhD</creatorcontrib><creatorcontrib>Notake, Tsuyoshi, MD, PhD</creatorcontrib><creatorcontrib>Shirota, Tomoki, MD</creatorcontrib><creatorcontrib>Fukushima, Kentaro, MD</creatorcontrib><creatorcontrib>Miyagawa, Shin-ichi, MD, PhD</creatorcontrib><title>Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: A propensity score-matched analysis</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Background The severity of liver fibrosis has been reported to be correlated with the risk of intractable ascites after hepatectomy for hepatocellular carcinoma. Since 2009, we have measured routinely the serum concentrations of type IV collagen 7s domain (7s collagen), a biochemical marker of liver fibrosis and applied limited resection to patients with elevation of the serum 7s collagen concentrations above the upper limit of normal (6.0 ng/mL). The aim of this study was to assess the potential benefits of our treatment strategy on the postoperative outcomes of patients with hepatocellular carcinoma. Methods A propensity score–matched analysis was performed to compare the outcomes between patients who underwent initial hepatectomy for hepatocellular carcinoma before or after 2009 (2009 to April 2015; period 2) and those who underwent the operation prior to 2009 (1990–2008; period 1; n = 129 in each period). Results The incidence of intractable ascites was significantly lower in period 2 than in period 1 (2.3 vs 14.7%; P < .001), although the other short-term and long-term outcomes were comparable between the 2 groups. A multivariate analysis identified elevation of the serum 7s collagen concentrations to ≥7.4 ng/mL as an independent predictor of IA (odds ratio 14.1, 95% confidence interval 2.8 to 106.7; P = .001), with the area under the receiver-operating characteristic curve of 0.820 (0.648–0.919, P = .005). Conclusion Modification of the surgical procedure according to the serum 7s collagen concentration is beneficial for reducing the risk of development of intractable ascites after hepatectomy for hepatocellular carcinoma.</description><subject>Adult</subject><subject>Aged</subject><subject>Ascites - etiology</subject><subject>Ascites - physiopathology</subject><subject>Biomarkers - blood</subject><subject>Carcinoma, Hepatocellular - blood</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Case-Control Studies</subject><subject>Collagen Type IV - blood</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Japan</subject><subject>Liver Neoplasms - blood</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - blood</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - physiopathology</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9ks2O0zAUhSMEYsrAC7BAXrJJuXYSJ0YIaVTxM9JILPjZWo5z07rj2MV2Ourr8WQ404EFCyRL9uI7517fc4viJYU1Bcrf7NdxDts1y-815MPqR8WKNhUr24rTx8UKoBIlBw4XxbMY9wAgato9LS5Y20DFoFkVvzY-BLQqGe9Ij-kO0ZG0QxIxzBOxeEQbiR9JOh2QXP8g2lurthlqIxn8pIwjyg33kmDi7YIal4LSSfUWiYraJIxkzDJ_Z9yWWHPEQAJG1PdFRx_IDg8qeY3WzlYFolXQxmXzt-SKHII_oIsmnUjUPmA5qaR3OOSyyp6iic-LJ6OyEV883JfF948fvm0-lzdfPl1vrm5KXVOaSqEotEz0OIix1iPW0MMg2p63yKHhrerEOLRYs7HOHBUNq3uOHcWqExxoVV0Wr8--uaOfM8YkJxOXnpVDP0dJu6rhHQdoMsrOqA4-xoCjPAQzqXCSFOSSndzLJTu5ZCchH1Zn0asH_7mfcPgr-RNWBt6dgRwJHg0GmYeLTuNgQh6mHLz5v__7f-TaGme0srd4wrj3c8gTzf-QkUmQX5ftWZaH8gqYEKL6DdJnw_Q</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Shimizu, Akira, MD, PhD</creator><creator>Kobayashi, Akira, MD, PhD</creator><creator>Yokoyama, Takahide, MD, PhD</creator><creator>Motoyama, Hiroaki, MD, PhD</creator><creator>Sakai, Hiroshi, MD, PhD</creator><creator>Kitagawa, Noriyuki, MD, PhD</creator><creator>Notake, Tsuyoshi, MD, PhD</creator><creator>Shirota, Tomoki, MD</creator><creator>Fukushima, Kentaro, MD</creator><creator>Miyagawa, Shin-ichi, MD, PhD</creator><general>Elsevier Inc</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>7X8</scope></search><sort><creationdate>20161101</creationdate><title>Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: A propensity score-matched analysis</title><author>Shimizu, Akira, MD, PhD ; Kobayashi, Akira, MD, PhD ; Yokoyama, Takahide, MD, PhD ; Motoyama, Hiroaki, MD, PhD ; Sakai, Hiroshi, MD, PhD ; Kitagawa, Noriyuki, MD, PhD ; Notake, Tsuyoshi, MD, PhD ; Shirota, Tomoki, MD ; Fukushima, Kentaro, MD ; Miyagawa, Shin-ichi, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ascites - etiology</topic><topic>Ascites - physiopathology</topic><topic>Biomarkers - blood</topic><topic>Carcinoma, Hepatocellular - blood</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Case-Control Studies</topic><topic>Collagen Type IV - blood</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Japan</topic><topic>Liver Neoplasms - blood</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - blood</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - physiopathology</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shimizu, Akira, MD, PhD</creatorcontrib><creatorcontrib>Kobayashi, Akira, MD, PhD</creatorcontrib><creatorcontrib>Yokoyama, Takahide, MD, PhD</creatorcontrib><creatorcontrib>Motoyama, Hiroaki, MD, PhD</creatorcontrib><creatorcontrib>Sakai, Hiroshi, MD, PhD</creatorcontrib><creatorcontrib>Kitagawa, Noriyuki, MD, PhD</creatorcontrib><creatorcontrib>Notake, Tsuyoshi, MD, PhD</creatorcontrib><creatorcontrib>Shirota, Tomoki, MD</creatorcontrib><creatorcontrib>Fukushima, Kentaro, MD</creatorcontrib><creatorcontrib>Miyagawa, Shin-ichi, MD, PhD</creatorcontrib><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>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shimizu, Akira, MD, PhD</au><au>Kobayashi, Akira, MD, PhD</au><au>Yokoyama, Takahide, MD, PhD</au><au>Motoyama, Hiroaki, MD, PhD</au><au>Sakai, Hiroshi, MD, PhD</au><au>Kitagawa, Noriyuki, MD, PhD</au><au>Notake, Tsuyoshi, MD, PhD</au><au>Shirota, Tomoki, MD</au><au>Fukushima, Kentaro, MD</au><au>Miyagawa, Shin-ichi, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: A propensity score-matched analysis</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>160</volume><issue>5</issue><spage>1244</spage><epage>1255</epage><pages>1244-1255</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>Background The severity of liver fibrosis has been reported to be correlated with the risk of intractable ascites after hepatectomy for hepatocellular carcinoma. Since 2009, we have measured routinely the serum concentrations of type IV collagen 7s domain (7s collagen), a biochemical marker of liver fibrosis and applied limited resection to patients with elevation of the serum 7s collagen concentrations above the upper limit of normal (6.0 ng/mL). The aim of this study was to assess the potential benefits of our treatment strategy on the postoperative outcomes of patients with hepatocellular carcinoma. Methods A propensity score–matched analysis was performed to compare the outcomes between patients who underwent initial hepatectomy for hepatocellular carcinoma before or after 2009 (2009 to April 2015; period 2) and those who underwent the operation prior to 2009 (1990–2008; period 1; n = 129 in each period). Results The incidence of intractable ascites was significantly lower in period 2 than in period 1 (2.3 vs 14.7%; P < .001), although the other short-term and long-term outcomes were comparable between the 2 groups. A multivariate analysis identified elevation of the serum 7s collagen concentrations to ≥7.4 ng/mL as an independent predictor of IA (odds ratio 14.1, 95% confidence interval 2.8 to 106.7; P = .001), with the area under the receiver-operating characteristic curve of 0.820 (0.648–0.919, P = .005). Conclusion Modification of the surgical procedure according to the serum 7s collagen concentration is beneficial for reducing the risk of development of intractable ascites after hepatectomy for hepatocellular carcinoma.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27503205</pmid><doi>10.1016/j.surg.2016.06.024</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0039-6060 |
| ispartof | Surgery, 2016-11, Vol.160 (5), p.1244-1255 |
| issn | 0039-6060 1532-7361 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1835686005 |
| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Adult Aged Ascites - etiology Ascites - physiopathology Biomarkers - blood Carcinoma, Hepatocellular - blood Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - surgery Case-Control Studies Collagen Type IV - blood Disease-Free Survival Female Follow-Up Studies Hepatectomy - adverse effects Hepatectomy - methods Humans Japan Liver Neoplasms - blood Liver Neoplasms - mortality Liver Neoplasms - surgery Male Middle Aged Postoperative Complications - blood Postoperative Complications - mortality Postoperative Complications - physiopathology Propensity Score Retrospective Studies Risk Assessment Severity of Illness Index Surgery Survival Analysis Time Factors Treatment Outcome |
| title | Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: A propensity score-matched analysis |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T12%3A14%3A12IST&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=Correlation%20between%20the%20serum%20levels%20of%20type%20IV%20collagen%207s%20domain%20and%20the%20risk%20of%20intractable%20ascites%20following%20liver%20resection%20for%20hepatocellular%20carcinoma:%20A%20propensity%20score-matched%20analysis&rft.jtitle=Surgery&rft.au=Shimizu,%20Akira,%20MD,%20PhD&rft.date=2016-11-01&rft.volume=160&rft.issue=5&rft.spage=1244&rft.epage=1255&rft.pages=1244-1255&rft.issn=0039-6060&rft.eissn=1532-7361&rft_id=info:doi/10.1016/j.surg.2016.06.024&rft_dat=%3Cproquest_cross%3E1835686005%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c411t-9a10729bed9f4cfe40b0d97b67e60567a89fd7e42f407219524b6e81e38960133%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1835686005&rft_id=info:pmid/27503205&rfr_iscdi=true |