Loading…

Ultrafiltration improves ELISA and Endopep MS analysis of botulinum neurotoxin type A in drinking water

The objective of this study was to adapt and evaluate two in vitro botulinum neurotoxin (BoNT) detection methods, including the Botulinum Toxin ELISA and the Endopep MS (a mass spectrometric-based endopeptidase method), for use with drinking water samples. The method detection limits (MDL) of the EL...

Full description

Saved in:
Bibliographic Details
Published in:Journal of microbiological methods 2012-09, Vol.90 (3), p.267-272
Main Authors: Raphael, Brian H., Lautenschlager, Matthew, Kahler, Amy, Pai, Suresh, Parks, Bryan A., Kalb, Suzanne R., Maslanka, Susan E., Shah, Sanjiv, Magnuson, Matthew, Hill, Vincent 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-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23
cites cdi_FETCH-LOGICAL-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23
container_end_page 272
container_issue 3
container_start_page 267
container_title Journal of microbiological methods
container_volume 90
creator Raphael, Brian H.
Lautenschlager, Matthew
Kahler, Amy
Pai, Suresh
Parks, Bryan A.
Kalb, Suzanne R.
Maslanka, Susan E.
Shah, Sanjiv
Magnuson, Matthew
Hill, Vincent R.
description The objective of this study was to adapt and evaluate two in vitro botulinum neurotoxin (BoNT) detection methods, including the Botulinum Toxin ELISA and the Endopep MS (a mass spectrometric-based endopeptidase method), for use with drinking water samples. The method detection limits (MDL) of the ELISA and Endopep MS were 260pg/mL and 21pg/mL of BoNT/A complex toxin, respectively. Since toxin could be present in water samples at highly dilute concentrations, large volume (100-L) samples of municipal tap water from five US municipalities having distinct water compositions were dechlorinated, spiked with 5μg BoNT/A, and subjected to tangential-flow ultrafiltration (UF) using hollow fiber dialyzers. The recovery efficiency of BoNT/A using UF and quantified by ELISA ranged from 11% to 36% while efficiencies quantified by MS ranged from 26% to 55%. BoNT/A was shown to be stable in dechlorinated municipal tap water stored at 4°C for up to four weeks. In addition, toxin present in UF-concentrated water samples was also shown to be stable at 4°C for up to four weeks, allowing holding of samples prior to analysis. Finally, UF was used to concentrate a level of toxin (7pg/mL) which is below the MDL for direct analysis by both ELISA and Endopep MS. Following UF, toxin was detectable in these samples using both in vitro analysis methods. These data demonstrate that UF-concentration of toxin from large volume water samples followed by use of existing analytical methods for detection of BoNT/A can be used in support of a monitoring program for contaminants in drinking water. ► ELISA and MS methods were adapted for quantification of botulinum toxin type A in water. ► Toxin in highly dilute water samples was concentrated using ultrafiltration. ► Recovered toxin was stable up to 4weeks at 4°C. ► Various water quality parameters are correlated with toxin recovery.
doi_str_mv 10.1016/j.mimet.2012.05.020
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11302440</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167701212002096</els_id><sourcerecordid>1027836635</sourcerecordid><originalsourceid>FETCH-LOGICAL-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23</originalsourceid><addsrcrecordid>eNp9kcGO0zAQhi0EYruFJ0ACX5C4JNiOk7QHtKpWBVYq4lB6thxnXFwSO9hOoW-_Di0LXLiMPZpv_hn7R-gFJTkltHp7yHvTQ8wZoSwnZU4YeYRmdFGzbFGUy8dolqg6q1P5Cl2HcCCElgVfPEVXjFV1XZF6hva7LnqpzRSjcRabfvDuCAGvN3fbFZa2xWvbugEG_GmbUtmdggnYady4OHbGjj22MHoX3U9jcTwNgFc43Vpv7Ddj9_iHjOCfoSdadgGeX8452r1ff7n9mG0-f7i7XW0yVVIeM651A1CWSw664S3UesFpAVJCraq2AsmYhlbSljRMVRwAGFUKOKuZUo1ixRzdnHWHsemhVWDTwzoxeNNLfxJOGvFvxZqvYu-OgtKCMM5JUnhzUfDu-wghit4EBV0nLbgxCEpYvSiqqigTWpxR5V0IHvTDHErE5JE4iF8eickjQUqRPEpdL_9e8aHntykJeH0BZFCy015aZcIfrqLLkheT0Kszp6UTcu8Ts9umSRUhpOBTmKN3ZwLSlx8NeBGUAaugNR5UFK0z_131Hk-SvbA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1027836635</pqid></control><display><type>article</type><title>Ultrafiltration improves ELISA and Endopep MS analysis of botulinum neurotoxin type A in drinking water</title><source>Elsevier</source><creator>Raphael, Brian H. ; Lautenschlager, Matthew ; Kahler, Amy ; Pai, Suresh ; Parks, Bryan A. ; Kalb, Suzanne R. ; Maslanka, Susan E. ; Shah, Sanjiv ; Magnuson, Matthew ; Hill, Vincent R.</creator><creatorcontrib>Raphael, Brian H. ; Lautenschlager, Matthew ; Kahler, Amy ; Pai, Suresh ; Parks, Bryan A. ; Kalb, Suzanne R. ; Maslanka, Susan E. ; Shah, Sanjiv ; Magnuson, Matthew ; Hill, Vincent R.</creatorcontrib><description>The objective of this study was to adapt and evaluate two in vitro botulinum neurotoxin (BoNT) detection methods, including the Botulinum Toxin ELISA and the Endopep MS (a mass spectrometric-based endopeptidase method), for use with drinking water samples. The method detection limits (MDL) of the ELISA and Endopep MS were 260pg/mL and 21pg/mL of BoNT/A complex toxin, respectively. Since toxin could be present in water samples at highly dilute concentrations, large volume (100-L) samples of municipal tap water from five US municipalities having distinct water compositions were dechlorinated, spiked with 5μg BoNT/A, and subjected to tangential-flow ultrafiltration (UF) using hollow fiber dialyzers. The recovery efficiency of BoNT/A using UF and quantified by ELISA ranged from 11% to 36% while efficiencies quantified by MS ranged from 26% to 55%. BoNT/A was shown to be stable in dechlorinated municipal tap water stored at 4°C for up to four weeks. In addition, toxin present in UF-concentrated water samples was also shown to be stable at 4°C for up to four weeks, allowing holding of samples prior to analysis. Finally, UF was used to concentrate a level of toxin (7pg/mL) which is below the MDL for direct analysis by both ELISA and Endopep MS. Following UF, toxin was detectable in these samples using both in vitro analysis methods. These data demonstrate that UF-concentration of toxin from large volume water samples followed by use of existing analytical methods for detection of BoNT/A can be used in support of a monitoring program for contaminants in drinking water. ► ELISA and MS methods were adapted for quantification of botulinum toxin type A in water. ► Toxin in highly dilute water samples was concentrated using ultrafiltration. ► Recovered toxin was stable up to 4weeks at 4°C. ► Various water quality parameters are correlated with toxin recovery.</description><identifier>ISSN: 0167-7012</identifier><identifier>ISSN: 1872-8359</identifier><identifier>EISSN: 1872-8359</identifier><identifier>DOI: 10.1016/j.mimet.2012.05.020</identifier><identifier>PMID: 22677607</identifier><identifier>CODEN: JMIMDQ</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>analytical methods ; Animals ; Biological and medical sciences ; botulinum toxin ; Botulinum Toxins, Type A - analysis ; Botulinum Toxins, Type A - chemistry ; Botulism ; Calibration ; Detection ; detection limit ; Drinking Water - analysis ; ELISA ; Enzyme Assays ; Enzyme Stability ; enzyme-linked immunosorbent assay ; Enzyme-Linked Immunosorbent Assay - standards ; Fundamental and applied biological sciences. Psychology ; Limit of Detection ; Linear Models ; Mass Spectrometry ; Mice ; Mice, Inbred ICR ; Microbiology ; monitoring ; Reference Standards ; tap water ; Toxin ; Ultrafiltration ; Water Microbiology ; Water quality</subject><ispartof>Journal of microbiological methods, 2012-09, Vol.90 (3), p.267-272</ispartof><rights>2012</rights><rights>2015 INIST-CNRS</rights><rights>Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23</citedby><cites>FETCH-LOGICAL-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=26195430$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22677607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raphael, Brian H.</creatorcontrib><creatorcontrib>Lautenschlager, Matthew</creatorcontrib><creatorcontrib>Kahler, Amy</creatorcontrib><creatorcontrib>Pai, Suresh</creatorcontrib><creatorcontrib>Parks, Bryan A.</creatorcontrib><creatorcontrib>Kalb, Suzanne R.</creatorcontrib><creatorcontrib>Maslanka, Susan E.</creatorcontrib><creatorcontrib>Shah, Sanjiv</creatorcontrib><creatorcontrib>Magnuson, Matthew</creatorcontrib><creatorcontrib>Hill, Vincent R.</creatorcontrib><title>Ultrafiltration improves ELISA and Endopep MS analysis of botulinum neurotoxin type A in drinking water</title><title>Journal of microbiological methods</title><addtitle>J Microbiol Methods</addtitle><description>The objective of this study was to adapt and evaluate two in vitro botulinum neurotoxin (BoNT) detection methods, including the Botulinum Toxin ELISA and the Endopep MS (a mass spectrometric-based endopeptidase method), for use with drinking water samples. The method detection limits (MDL) of the ELISA and Endopep MS were 260pg/mL and 21pg/mL of BoNT/A complex toxin, respectively. Since toxin could be present in water samples at highly dilute concentrations, large volume (100-L) samples of municipal tap water from five US municipalities having distinct water compositions were dechlorinated, spiked with 5μg BoNT/A, and subjected to tangential-flow ultrafiltration (UF) using hollow fiber dialyzers. The recovery efficiency of BoNT/A using UF and quantified by ELISA ranged from 11% to 36% while efficiencies quantified by MS ranged from 26% to 55%. BoNT/A was shown to be stable in dechlorinated municipal tap water stored at 4°C for up to four weeks. In addition, toxin present in UF-concentrated water samples was also shown to be stable at 4°C for up to four weeks, allowing holding of samples prior to analysis. Finally, UF was used to concentrate a level of toxin (7pg/mL) which is below the MDL for direct analysis by both ELISA and Endopep MS. Following UF, toxin was detectable in these samples using both in vitro analysis methods. These data demonstrate that UF-concentration of toxin from large volume water samples followed by use of existing analytical methods for detection of BoNT/A can be used in support of a monitoring program for contaminants in drinking water. ► ELISA and MS methods were adapted for quantification of botulinum toxin type A in water. ► Toxin in highly dilute water samples was concentrated using ultrafiltration. ► Recovered toxin was stable up to 4weeks at 4°C. ► Various water quality parameters are correlated with toxin recovery.</description><subject>analytical methods</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>botulinum toxin</subject><subject>Botulinum Toxins, Type A - analysis</subject><subject>Botulinum Toxins, Type A - chemistry</subject><subject>Botulism</subject><subject>Calibration</subject><subject>Detection</subject><subject>detection limit</subject><subject>Drinking Water - analysis</subject><subject>ELISA</subject><subject>Enzyme Assays</subject><subject>Enzyme Stability</subject><subject>enzyme-linked immunosorbent assay</subject><subject>Enzyme-Linked Immunosorbent Assay - standards</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Limit of Detection</subject><subject>Linear Models</subject><subject>Mass Spectrometry</subject><subject>Mice</subject><subject>Mice, Inbred ICR</subject><subject>Microbiology</subject><subject>monitoring</subject><subject>Reference Standards</subject><subject>tap water</subject><subject>Toxin</subject><subject>Ultrafiltration</subject><subject>Water Microbiology</subject><subject>Water quality</subject><issn>0167-7012</issn><issn>1872-8359</issn><issn>1872-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp9kcGO0zAQhi0EYruFJ0ACX5C4JNiOk7QHtKpWBVYq4lB6thxnXFwSO9hOoW-_Di0LXLiMPZpv_hn7R-gFJTkltHp7yHvTQ8wZoSwnZU4YeYRmdFGzbFGUy8dolqg6q1P5Cl2HcCCElgVfPEVXjFV1XZF6hva7LnqpzRSjcRabfvDuCAGvN3fbFZa2xWvbugEG_GmbUtmdggnYady4OHbGjj22MHoX3U9jcTwNgFc43Vpv7Ddj9_iHjOCfoSdadgGeX8452r1ff7n9mG0-f7i7XW0yVVIeM651A1CWSw664S3UesFpAVJCraq2AsmYhlbSljRMVRwAGFUKOKuZUo1ixRzdnHWHsemhVWDTwzoxeNNLfxJOGvFvxZqvYu-OgtKCMM5JUnhzUfDu-wghit4EBV0nLbgxCEpYvSiqqigTWpxR5V0IHvTDHErE5JE4iF8eickjQUqRPEpdL_9e8aHntykJeH0BZFCy015aZcIfrqLLkheT0Kszp6UTcu8Ts9umSRUhpOBTmKN3ZwLSlx8NeBGUAaugNR5UFK0z_131Hk-SvbA</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Raphael, Brian H.</creator><creator>Lautenschlager, Matthew</creator><creator>Kahler, Amy</creator><creator>Pai, Suresh</creator><creator>Parks, Bryan A.</creator><creator>Kalb, Suzanne R.</creator><creator>Maslanka, Susan E.</creator><creator>Shah, Sanjiv</creator><creator>Magnuson, Matthew</creator><creator>Hill, Vincent R.</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>FBQ</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>5PM</scope></search><sort><creationdate>20120901</creationdate><title>Ultrafiltration improves ELISA and Endopep MS analysis of botulinum neurotoxin type A in drinking water</title><author>Raphael, Brian H. ; Lautenschlager, Matthew ; Kahler, Amy ; Pai, Suresh ; Parks, Bryan A. ; Kalb, Suzanne R. ; Maslanka, Susan E. ; Shah, Sanjiv ; Magnuson, Matthew ; Hill, Vincent R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>analytical methods</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>botulinum toxin</topic><topic>Botulinum Toxins, Type A - analysis</topic><topic>Botulinum Toxins, Type A - chemistry</topic><topic>Botulism</topic><topic>Calibration</topic><topic>Detection</topic><topic>detection limit</topic><topic>Drinking Water - analysis</topic><topic>ELISA</topic><topic>Enzyme Assays</topic><topic>Enzyme Stability</topic><topic>enzyme-linked immunosorbent assay</topic><topic>Enzyme-Linked Immunosorbent Assay - standards</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Limit of Detection</topic><topic>Linear Models</topic><topic>Mass Spectrometry</topic><topic>Mice</topic><topic>Mice, Inbred ICR</topic><topic>Microbiology</topic><topic>monitoring</topic><topic>Reference Standards</topic><topic>tap water</topic><topic>Toxin</topic><topic>Ultrafiltration</topic><topic>Water Microbiology</topic><topic>Water quality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raphael, Brian H.</creatorcontrib><creatorcontrib>Lautenschlager, Matthew</creatorcontrib><creatorcontrib>Kahler, Amy</creatorcontrib><creatorcontrib>Pai, Suresh</creatorcontrib><creatorcontrib>Parks, Bryan A.</creatorcontrib><creatorcontrib>Kalb, Suzanne R.</creatorcontrib><creatorcontrib>Maslanka, Susan E.</creatorcontrib><creatorcontrib>Shah, Sanjiv</creatorcontrib><creatorcontrib>Magnuson, Matthew</creatorcontrib><creatorcontrib>Hill, Vincent R.</creatorcontrib><collection>AGRIS</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>PubMed Central (Full Participant titles)</collection><jtitle>Journal of microbiological methods</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raphael, Brian H.</au><au>Lautenschlager, Matthew</au><au>Kahler, Amy</au><au>Pai, Suresh</au><au>Parks, Bryan A.</au><au>Kalb, Suzanne R.</au><au>Maslanka, Susan E.</au><au>Shah, Sanjiv</au><au>Magnuson, Matthew</au><au>Hill, Vincent R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrafiltration improves ELISA and Endopep MS analysis of botulinum neurotoxin type A in drinking water</atitle><jtitle>Journal of microbiological methods</jtitle><addtitle>J Microbiol Methods</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>90</volume><issue>3</issue><spage>267</spage><epage>272</epage><pages>267-272</pages><issn>0167-7012</issn><issn>1872-8359</issn><eissn>1872-8359</eissn><coden>JMIMDQ</coden><abstract>The objective of this study was to adapt and evaluate two in vitro botulinum neurotoxin (BoNT) detection methods, including the Botulinum Toxin ELISA and the Endopep MS (a mass spectrometric-based endopeptidase method), for use with drinking water samples. The method detection limits (MDL) of the ELISA and Endopep MS were 260pg/mL and 21pg/mL of BoNT/A complex toxin, respectively. Since toxin could be present in water samples at highly dilute concentrations, large volume (100-L) samples of municipal tap water from five US municipalities having distinct water compositions were dechlorinated, spiked with 5μg BoNT/A, and subjected to tangential-flow ultrafiltration (UF) using hollow fiber dialyzers. The recovery efficiency of BoNT/A using UF and quantified by ELISA ranged from 11% to 36% while efficiencies quantified by MS ranged from 26% to 55%. BoNT/A was shown to be stable in dechlorinated municipal tap water stored at 4°C for up to four weeks. In addition, toxin present in UF-concentrated water samples was also shown to be stable at 4°C for up to four weeks, allowing holding of samples prior to analysis. Finally, UF was used to concentrate a level of toxin (7pg/mL) which is below the MDL for direct analysis by both ELISA and Endopep MS. Following UF, toxin was detectable in these samples using both in vitro analysis methods. These data demonstrate that UF-concentration of toxin from large volume water samples followed by use of existing analytical methods for detection of BoNT/A can be used in support of a monitoring program for contaminants in drinking water. ► ELISA and MS methods were adapted for quantification of botulinum toxin type A in water. ► Toxin in highly dilute water samples was concentrated using ultrafiltration. ► Recovered toxin was stable up to 4weeks at 4°C. ► Various water quality parameters are correlated with toxin recovery.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>22677607</pmid><doi>10.1016/j.mimet.2012.05.020</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0167-7012
ispartof Journal of microbiological methods, 2012-09, Vol.90 (3), p.267-272
issn 0167-7012
1872-8359
1872-8359
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11302440
source Elsevier
subjects analytical methods
Animals
Biological and medical sciences
botulinum toxin
Botulinum Toxins, Type A - analysis
Botulinum Toxins, Type A - chemistry
Botulism
Calibration
Detection
detection limit
Drinking Water - analysis
ELISA
Enzyme Assays
Enzyme Stability
enzyme-linked immunosorbent assay
Enzyme-Linked Immunosorbent Assay - standards
Fundamental and applied biological sciences. Psychology
Limit of Detection
Linear Models
Mass Spectrometry
Mice
Mice, Inbred ICR
Microbiology
monitoring
Reference Standards
tap water
Toxin
Ultrafiltration
Water Microbiology
Water quality
title Ultrafiltration improves ELISA and Endopep MS analysis of botulinum neurotoxin type A in drinking water
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T21%3A10%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ultrafiltration%20improves%20ELISA%20and%20Endopep%20MS%20analysis%20of%20botulinum%20neurotoxin%20type%20A%20in%20drinking%20water&rft.jtitle=Journal%20of%20microbiological%20methods&rft.au=Raphael,%20Brian%20H.&rft.date=2012-09-01&rft.volume=90&rft.issue=3&rft.spage=267&rft.epage=272&rft.pages=267-272&rft.issn=0167-7012&rft.eissn=1872-8359&rft.coden=JMIMDQ&rft_id=info:doi/10.1016/j.mimet.2012.05.020&rft_dat=%3Cproquest_pubme%3E1027836635%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c514t-4ffbee5594efb4de7f8413eaae7c6d6ea22feda1d0b2c64eee21cce4272ccbc23%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1027836635&rft_id=info:pmid/22677607&rfr_iscdi=true