A Pilot Study Evaluating Real-Time Shear Wave Ultrasound Elastography of Miscellaneous Non-Nodal Neck Masses in a Routine Head and Neck Ultrasound Clinic
Abstract A pilot study was performed to evaluate shear wave ultrasound elastography (SWE) for miscellaneous non-nodal/salivary/thyroid neck lesions. Forty-six lesions undergoing conventional sonography also underwent SWE. Elastic moduli from the stiffest areas in lesions were correlated with diagnos...
Gespeichert in:
| Veröffentlicht in: | Ultrasound in medicine & biology 2012-06, Vol.38 (6), p.933-942 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 942 |
|---|---|
| container_issue | 6 |
| container_start_page | 933 |
| container_title | Ultrasound in medicine & biology |
| container_volume | 38 |
| creator | Bhatia, Kunwar S.S Yuen, Edmund H.Y Cho, Carmen C.M Tong, Cina S.L Lee, Yolanda Y.P Ahuja, Anil T |
| description | Abstract A pilot study was performed to evaluate shear wave ultrasound elastography (SWE) for miscellaneous non-nodal/salivary/thyroid neck lesions. Forty-six lesions undergoing conventional sonography also underwent SWE. Elastic moduli from the stiffest areas in lesions were correlated with diagnosis. Forty lesions were benign (9 lipomas, 8 lymphatic/venous vascular malformations, 7 thyroglossal duct cysts, 4 branchial cleft cysts, 4 abscesses/phlegmons, 3 neurogenic tumors and 1 each of paraganglioma, sebaceous cyst, pseudotumor, hypertrophic scar, ranula) and 6 were malignant (1 malignant fibrous histiocytoma, 2 primary squamous cell carcinomas and 3 intramuscular metastases [2 squamous cell carcinomas, 1 malignant melanoma]).Median stiffness of malignant lesions (226.4 kPa, range 55.6 to 300.0) was higher than benign lesions (28.3 kPa, range 4.0 to 300.0) ( p |
| doi_str_mv | 10.1016/j.ultrasmedbio.2012.02.034 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1034814153</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0301562912001470</els_id><sourcerecordid>1011539227</sourcerecordid><originalsourceid>FETCH-LOGICAL-c498t-889d1f41b81f71923376b7afe42598e03660c475a7986a8f6bc023cab7de033c3</originalsourceid><addsrcrecordid>eNqNkttuEzEQhlcIREPhFZCFhNSbDT7syVwgVSFQpDagphXcWbPe2dapsw72bqQ8Cm-LcwAiriqN5Iv55p_x_JMkbxgdM8qKd4vxYHsPYYlNbdyYU8bHNIbIniQjVpUy5ZL9eJqMqKAszQsuT5IXISwopWUhyufJCec55ZVko-TXOflmrOvJvB-aDZmuwQ7Qm-6OXCPY9MYskczvETz5Dmskt7vGbugaMrUQenfnYXW_Ia4lVyZotBY6dEMgM9elM9eAJTPUD-QKQsBATEeAXLshNkBygdAQiEo74kh5Yk1n9MvkWQs24KvDe5rcfpreTC7Sy6-fv0zOL1OdyapPq0o2rM1YXbG2ZJILURZ1CS1mPJcVUlEUVGdlDqWsCqjaotaUCw112cSk0OI0Odvrrrz7OWDo1fL4J4rFvVYsY7l4BMoiJjkvI_p-j2rvQvDYqpU3S_CbCG25Qi3UsYtq66KiMUQWi18f-gx1TP8t_WNbBN4eAAgabOuh0yb843LJOJcych_3HMYFrg16FbTBTmNjPOpeNc48bp4P_8nonUVgH3CDYeEG30WLFFMhFqj59u62Z8c4pSwrqfgNXBTW8A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1011539227</pqid></control><display><type>article</type><title>A Pilot Study Evaluating Real-Time Shear Wave Ultrasound Elastography of Miscellaneous Non-Nodal Neck Masses in a Routine Head and Neck Ultrasound Clinic</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Bhatia, Kunwar S.S ; Yuen, Edmund H.Y ; Cho, Carmen C.M ; Tong, Cina S.L ; Lee, Yolanda Y.P ; Ahuja, Anil T</creator><creatorcontrib>Bhatia, Kunwar S.S ; Yuen, Edmund H.Y ; Cho, Carmen C.M ; Tong, Cina S.L ; Lee, Yolanda Y.P ; Ahuja, Anil T</creatorcontrib><description>Abstract A pilot study was performed to evaluate shear wave ultrasound elastography (SWE) for miscellaneous non-nodal/salivary/thyroid neck lesions. Forty-six lesions undergoing conventional sonography also underwent SWE. Elastic moduli from the stiffest areas in lesions were correlated with diagnosis. Forty lesions were benign (9 lipomas, 8 lymphatic/venous vascular malformations, 7 thyroglossal duct cysts, 4 branchial cleft cysts, 4 abscesses/phlegmons, 3 neurogenic tumors and 1 each of paraganglioma, sebaceous cyst, pseudotumor, hypertrophic scar, ranula) and 6 were malignant (1 malignant fibrous histiocytoma, 2 primary squamous cell carcinomas and 3 intramuscular metastases [2 squamous cell carcinomas, 1 malignant melanoma]).Median stiffness of malignant lesions (226.4 kPa, range 55.6 to 300.0) was higher than benign lesions (28.3 kPa, range 4.0 to 300.0) ( p < 0.001). SWE cut-off with highest accuracy (174.4 kPa) achieved 83.3% sensitivity and 97.5% specificity, and the cut-off with 100% sensitivity (55.6kPa) achieved 75% specificity. All malignant lesions were suspected on conventional sonography. The preliminary data indicate that SWE is feasible for miscellaneous neck lesions. SWE would not have altered management in terms of detecting undisclosed malignancies, although as a quantitative technique, it may increase the diagnostic confidence of less experienced operators performing head and neck ultrasound.</description><identifier>ISSN: 0301-5629</identifier><identifier>EISSN: 1879-291X</identifier><identifier>DOI: 10.1016/j.ultrasmedbio.2012.02.034</identifier><identifier>PMID: 22502891</identifier><identifier>CODEN: USMBA3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abscesses ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Benign ; Biological and medical sciences ; Cellulitis ; Cysts ; Data processing ; Diagnosis ; Elasticity Imaging Techniques - methods ; Elastography ; Female ; Head - diagnostic imaging ; Head - pathology ; Head and neck ; histiocytoma ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; lipoma ; Male ; Malignancy ; Masses ; Medical sciences ; Metastases ; Middle Aged ; Miscellaneous. Technology ; Neck ; Neck - diagnostic imaging ; Neck - pathology ; Paraganglioma ; Pilot Projects ; Prospective Studies ; Pseudotumors ; Radiology ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; ROC Curve ; Sensitivity and Specificity ; squamous cell carcinoma ; Thyroid ; Tumors ; Ultrasonic investigative techniques ; Ultrasound ; Waves</subject><ispartof>Ultrasound in medicine & biology, 2012-06, Vol.38 (6), p.933-942</ispartof><rights>World Federation for Ultrasound in Medicine & Biology</rights><rights>2012 World Federation for Ultrasound in Medicine & Biology</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-889d1f41b81f71923376b7afe42598e03660c475a7986a8f6bc023cab7de033c3</citedby><cites>FETCH-LOGICAL-c498t-889d1f41b81f71923376b7afe42598e03660c475a7986a8f6bc023cab7de033c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0301562912001470$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25912299$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22502891$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhatia, Kunwar S.S</creatorcontrib><creatorcontrib>Yuen, Edmund H.Y</creatorcontrib><creatorcontrib>Cho, Carmen C.M</creatorcontrib><creatorcontrib>Tong, Cina S.L</creatorcontrib><creatorcontrib>Lee, Yolanda Y.P</creatorcontrib><creatorcontrib>Ahuja, Anil T</creatorcontrib><title>A Pilot Study Evaluating Real-Time Shear Wave Ultrasound Elastography of Miscellaneous Non-Nodal Neck Masses in a Routine Head and Neck Ultrasound Clinic</title><title>Ultrasound in medicine & biology</title><addtitle>Ultrasound Med Biol</addtitle><description>Abstract A pilot study was performed to evaluate shear wave ultrasound elastography (SWE) for miscellaneous non-nodal/salivary/thyroid neck lesions. Forty-six lesions undergoing conventional sonography also underwent SWE. Elastic moduli from the stiffest areas in lesions were correlated with diagnosis. Forty lesions were benign (9 lipomas, 8 lymphatic/venous vascular malformations, 7 thyroglossal duct cysts, 4 branchial cleft cysts, 4 abscesses/phlegmons, 3 neurogenic tumors and 1 each of paraganglioma, sebaceous cyst, pseudotumor, hypertrophic scar, ranula) and 6 were malignant (1 malignant fibrous histiocytoma, 2 primary squamous cell carcinomas and 3 intramuscular metastases [2 squamous cell carcinomas, 1 malignant melanoma]).Median stiffness of malignant lesions (226.4 kPa, range 55.6 to 300.0) was higher than benign lesions (28.3 kPa, range 4.0 to 300.0) ( p < 0.001). SWE cut-off with highest accuracy (174.4 kPa) achieved 83.3% sensitivity and 97.5% specificity, and the cut-off with 100% sensitivity (55.6kPa) achieved 75% specificity. All malignant lesions were suspected on conventional sonography. The preliminary data indicate that SWE is feasible for miscellaneous neck lesions. SWE would not have altered management in terms of detecting undisclosed malignancies, although as a quantitative technique, it may increase the diagnostic confidence of less experienced operators performing head and neck ultrasound.</description><subject>Abscesses</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Benign</subject><subject>Biological and medical sciences</subject><subject>Cellulitis</subject><subject>Cysts</subject><subject>Data processing</subject><subject>Diagnosis</subject><subject>Elasticity Imaging Techniques - methods</subject><subject>Elastography</subject><subject>Female</subject><subject>Head - diagnostic imaging</subject><subject>Head - pathology</subject><subject>Head and neck</subject><subject>histiocytoma</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>lipoma</subject><subject>Male</subject><subject>Malignancy</subject><subject>Masses</subject><subject>Medical sciences</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Miscellaneous. Technology</subject><subject>Neck</subject><subject>Neck - diagnostic imaging</subject><subject>Neck - pathology</subject><subject>Paraganglioma</subject><subject>Pilot Projects</subject><subject>Prospective Studies</subject><subject>Pseudotumors</subject><subject>Radiology</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>squamous cell carcinoma</subject><subject>Thyroid</subject><subject>Tumors</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasound</subject><subject>Waves</subject><issn>0301-5629</issn><issn>1879-291X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkttuEzEQhlcIREPhFZCFhNSbDT7syVwgVSFQpDagphXcWbPe2dapsw72bqQ8Cm-LcwAiriqN5Iv55p_x_JMkbxgdM8qKd4vxYHsPYYlNbdyYU8bHNIbIniQjVpUy5ZL9eJqMqKAszQsuT5IXISwopWUhyufJCec55ZVko-TXOflmrOvJvB-aDZmuwQ7Qm-6OXCPY9MYskczvETz5Dmskt7vGbugaMrUQenfnYXW_Ia4lVyZotBY6dEMgM9elM9eAJTPUD-QKQsBATEeAXLshNkBygdAQiEo74kh5Yk1n9MvkWQs24KvDe5rcfpreTC7Sy6-fv0zOL1OdyapPq0o2rM1YXbG2ZJILURZ1CS1mPJcVUlEUVGdlDqWsCqjaotaUCw112cSk0OI0Odvrrrz7OWDo1fL4J4rFvVYsY7l4BMoiJjkvI_p-j2rvQvDYqpU3S_CbCG25Qi3UsYtq66KiMUQWi18f-gx1TP8t_WNbBN4eAAgabOuh0yb843LJOJcych_3HMYFrg16FbTBTmNjPOpeNc48bp4P_8nonUVgH3CDYeEG30WLFFMhFqj59u62Z8c4pSwrqfgNXBTW8A</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Bhatia, Kunwar S.S</creator><creator>Yuen, Edmund H.Y</creator><creator>Cho, Carmen C.M</creator><creator>Tong, Cina S.L</creator><creator>Lee, Yolanda Y.P</creator><creator>Ahuja, Anil T</creator><general>Elsevier Inc</general><general>Elsevier</general><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>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>20120601</creationdate><title>A Pilot Study Evaluating Real-Time Shear Wave Ultrasound Elastography of Miscellaneous Non-Nodal Neck Masses in a Routine Head and Neck Ultrasound Clinic</title><author>Bhatia, Kunwar S.S ; Yuen, Edmund H.Y ; Cho, Carmen C.M ; Tong, Cina S.L ; Lee, Yolanda Y.P ; Ahuja, Anil T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c498t-889d1f41b81f71923376b7afe42598e03660c475a7986a8f6bc023cab7de033c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abscesses</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Benign</topic><topic>Biological and medical sciences</topic><topic>Cellulitis</topic><topic>Cysts</topic><topic>Data processing</topic><topic>Diagnosis</topic><topic>Elasticity Imaging Techniques - methods</topic><topic>Elastography</topic><topic>Female</topic><topic>Head - diagnostic imaging</topic><topic>Head - pathology</topic><topic>Head and neck</topic><topic>histiocytoma</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>lipoma</topic><topic>Male</topic><topic>Malignancy</topic><topic>Masses</topic><topic>Medical sciences</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Miscellaneous. Technology</topic><topic>Neck</topic><topic>Neck - diagnostic imaging</topic><topic>Neck - pathology</topic><topic>Paraganglioma</topic><topic>Pilot Projects</topic><topic>Prospective Studies</topic><topic>Pseudotumors</topic><topic>Radiology</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>squamous cell carcinoma</topic><topic>Thyroid</topic><topic>Tumors</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasound</topic><topic>Waves</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhatia, Kunwar S.S</creatorcontrib><creatorcontrib>Yuen, Edmund H.Y</creatorcontrib><creatorcontrib>Cho, Carmen C.M</creatorcontrib><creatorcontrib>Tong, Cina S.L</creatorcontrib><creatorcontrib>Lee, Yolanda Y.P</creatorcontrib><creatorcontrib>Ahuja, Anil T</creatorcontrib><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>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Ultrasound in medicine & biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhatia, Kunwar S.S</au><au>Yuen, Edmund H.Y</au><au>Cho, Carmen C.M</au><au>Tong, Cina S.L</au><au>Lee, Yolanda Y.P</au><au>Ahuja, Anil T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Pilot Study Evaluating Real-Time Shear Wave Ultrasound Elastography of Miscellaneous Non-Nodal Neck Masses in a Routine Head and Neck Ultrasound Clinic</atitle><jtitle>Ultrasound in medicine & biology</jtitle><addtitle>Ultrasound Med Biol</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>38</volume><issue>6</issue><spage>933</spage><epage>942</epage><pages>933-942</pages><issn>0301-5629</issn><eissn>1879-291X</eissn><coden>USMBA3</coden><abstract>Abstract A pilot study was performed to evaluate shear wave ultrasound elastography (SWE) for miscellaneous non-nodal/salivary/thyroid neck lesions. Forty-six lesions undergoing conventional sonography also underwent SWE. Elastic moduli from the stiffest areas in lesions were correlated with diagnosis. Forty lesions were benign (9 lipomas, 8 lymphatic/venous vascular malformations, 7 thyroglossal duct cysts, 4 branchial cleft cysts, 4 abscesses/phlegmons, 3 neurogenic tumors and 1 each of paraganglioma, sebaceous cyst, pseudotumor, hypertrophic scar, ranula) and 6 were malignant (1 malignant fibrous histiocytoma, 2 primary squamous cell carcinomas and 3 intramuscular metastases [2 squamous cell carcinomas, 1 malignant melanoma]).Median stiffness of malignant lesions (226.4 kPa, range 55.6 to 300.0) was higher than benign lesions (28.3 kPa, range 4.0 to 300.0) ( p < 0.001). SWE cut-off with highest accuracy (174.4 kPa) achieved 83.3% sensitivity and 97.5% specificity, and the cut-off with 100% sensitivity (55.6kPa) achieved 75% specificity. All malignant lesions were suspected on conventional sonography. The preliminary data indicate that SWE is feasible for miscellaneous neck lesions. SWE would not have altered management in terms of detecting undisclosed malignancies, although as a quantitative technique, it may increase the diagnostic confidence of less experienced operators performing head and neck ultrasound.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22502891</pmid><doi>10.1016/j.ultrasmedbio.2012.02.034</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0301-5629 |
| ispartof | Ultrasound in medicine & biology, 2012-06, Vol.38 (6), p.933-942 |
| issn | 0301-5629 1879-291X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1034814153 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Abscesses Adolescent Adult Aged Aged, 80 and over Benign Biological and medical sciences Cellulitis Cysts Data processing Diagnosis Elasticity Imaging Techniques - methods Elastography Female Head - diagnostic imaging Head - pathology Head and neck histiocytoma Humans Investigative techniques, diagnostic techniques (general aspects) lipoma Male Malignancy Masses Medical sciences Metastases Middle Aged Miscellaneous. Technology Neck Neck - diagnostic imaging Neck - pathology Paraganglioma Pilot Projects Prospective Studies Pseudotumors Radiology Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ROC Curve Sensitivity and Specificity squamous cell carcinoma Thyroid Tumors Ultrasonic investigative techniques Ultrasound Waves |
| title | A Pilot Study Evaluating Real-Time Shear Wave Ultrasound Elastography of Miscellaneous Non-Nodal Neck Masses in a Routine Head and Neck Ultrasound Clinic |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T13%3A20%3A35IST&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=A%20Pilot%20Study%20Evaluating%20Real-Time%20Shear%20Wave%20Ultrasound%20Elastography%20of%20Miscellaneous%20Non-Nodal%20Neck%20Masses%20in%20a%20Routine%20Head%20and%20Neck%20Ultrasound%20Clinic&rft.jtitle=Ultrasound%20in%20medicine%20&%20biology&rft.au=Bhatia,%20Kunwar%20S.S&rft.date=2012-06-01&rft.volume=38&rft.issue=6&rft.spage=933&rft.epage=942&rft.pages=933-942&rft.issn=0301-5629&rft.eissn=1879-291X&rft.coden=USMBA3&rft_id=info:doi/10.1016/j.ultrasmedbio.2012.02.034&rft_dat=%3Cproquest_cross%3E1011539227%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1011539227&rft_id=info:pmid/22502891&rft_els_id=1_s2_0_S0301562912001470&rfr_iscdi=true |