Assessment of age at death by microscopy: Unbiased quantification of secondary osteons in femoral cross sections

The microscopic method of age at death determination was introduced by Kerley in 1965 [E.R. Kerley, The microscopic determination of age in human bone, Am. J. Phys. Anthropol, 23 (1965) 149–163.]. However, even though the method has been revised several times, there remain some fundamental issues co...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Forensic science international 2006-05, Vol.159 (1), p.S100-S103
Hauptverfasser: Lynnerup, Niels, Frohlich, Bruno, Thomsen, Jørgen L.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page S103
container_issue 1
container_start_page S100
container_title Forensic science international
container_volume 159
creator Lynnerup, Niels
Frohlich, Bruno
Thomsen, Jørgen L.
description The microscopic method of age at death determination was introduced by Kerley in 1965 [E.R. Kerley, The microscopic determination of age in human bone, Am. J. Phys. Anthropol, 23 (1965) 149–163.]. However, even though the method has been revised several times, there remain some fundamental issues concerning the reliability of the methods. This is because several basic histological features seen in a cross section of a bone have to be quantified according to the method, but the definition, and hence quantification, of these features leaves room for subjectivity. In a previous study we found that some of these features (osteon fragments and Haversian canals) could not be identified reliably. Only secondary osteons could be identified with a low inter and intra observer error. Furthermore, since the histological features are quantified in only parts of an entire bone cross section, the selection of these parts or areas is a potential source of bias. Finally, unless an unbiased method is used for addressing features on the borders of the selected areas, this will also introduce error. These issues have not been addressed specifically in previous studies. In this study, we used the methods of stereology to choose the regions of interest, as well as for dealing with border phenomena, and we only counted secondary osteons. Our results show a statistically significant increase in the median number of osteons per area unit with increasing age at death. However, this was after exclusion of one outlier. This result is probably due to the limited sample size ( N = 24). As such, this study is preliminary, but does warrant applying the described techniques to a larger sample.
doi_str_mv 10.1016/j.forsciint.2006.02.023
format Article
fullrecord <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_67862238</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A145982899</galeid><els_id>S037907380600082X</els_id><sourcerecordid>A145982899</sourcerecordid><originalsourceid>FETCH-LOGICAL-c532t-51932a659d5a228cc3fc7cadb54eeae20d2d846d4303861b3b4bde674035f8c93</originalsourceid><addsrcrecordid>eNqFktuK2zAQhk1p6Wa3fYVWULp3dnWwZLl3YekJFnrTvRayNEoVbCkrOQt5-8pNaGgJFA0IxPfPjP6ZqnpLcEMwER-2jYspG-_D3FCMRYNpCfasWhHZ0VpQyZ5XK8y6vsYdk1fVdc5bjDHnVLysrojgtJd9u6p265wh5wnCjKJDegNIz8iCnn-i4YAmb1LMJu4OH9FDGLzOYNHjXofZO2_07GNYZBlMDFanA4p5hhgy8gE5mGLSI1oy5AVZ6PyqeuH0mOH16b6pHj5_-nH3tb7__uXb3fq-NpzRueakZ1QL3luuKZXGMGc6o-3AWwANFFtqZStsyzCTggxsaAcLomsx406ant1Ut8e8uxQf95BnNflsYBx1gLjPSnRSUMpkAd_9A27jPoXSmyKYtZy3uMdnaqNHUD64OCdtlpRqTVreSyr7pWh9gdpAgGJEDOB8ef6Lby7w5Vgozl8UdEfBb1MTOLVLfirGl17Vshlqq_5shlo2Q2FaghXlm9M398ME9qw7rUIB3p8AnY0eXdLB-Hzmuo5zRkTh1kcOyvSePCRVqkEwYH0qM1Y2-v828wvy5Nq_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1034554090</pqid></control><display><type>article</type><title>Assessment of age at death by microscopy: Unbiased quantification of secondary osteons in femoral cross sections</title><source>Elsevier ScienceDirect Journals Complete - AutoHoldings</source><source>MEDLINE</source><source>ProQuest Central UK/Ireland</source><creator>Lynnerup, Niels ; Frohlich, Bruno ; Thomsen, Jørgen L.</creator><creatorcontrib>Lynnerup, Niels ; Frohlich, Bruno ; Thomsen, Jørgen L.</creatorcontrib><description>The microscopic method of age at death determination was introduced by Kerley in 1965 [E.R. Kerley, The microscopic determination of age in human bone, Am. J. Phys. Anthropol, 23 (1965) 149–163.]. However, even though the method has been revised several times, there remain some fundamental issues concerning the reliability of the methods. This is because several basic histological features seen in a cross section of a bone have to be quantified according to the method, but the definition, and hence quantification, of these features leaves room for subjectivity. In a previous study we found that some of these features (osteon fragments and Haversian canals) could not be identified reliably. Only secondary osteons could be identified with a low inter and intra observer error. Furthermore, since the histological features are quantified in only parts of an entire bone cross section, the selection of these parts or areas is a potential source of bias. Finally, unless an unbiased method is used for addressing features on the borders of the selected areas, this will also introduce error. These issues have not been addressed specifically in previous studies. In this study, we used the methods of stereology to choose the regions of interest, as well as for dealing with border phenomena, and we only counted secondary osteons. Our results show a statistically significant increase in the median number of osteons per area unit with increasing age at death. However, this was after exclusion of one outlier. This result is probably due to the limited sample size ( N = 24). As such, this study is preliminary, but does warrant applying the described techniques to a larger sample.</description><identifier>ISSN: 0379-0738</identifier><identifier>EISSN: 1872-6283</identifier><identifier>DOI: 10.1016/j.forsciint.2006.02.023</identifier><identifier>PMID: 16529894</identifier><identifier>CODEN: FSINDR</identifier><language>eng</language><publisher>Kidlington: Elsevier Ireland Ltd</publisher><subject>Adolescent ; Adult ; Age at death ; Age determination (Zoology) ; Age Determination by Skeleton - methods ; Aged ; Aged, 80 and over ; Bias ; Biological and medical sciences ; Bone microscopy ; Bone remodelling ; Bones ; Canals ; Female ; Femur - anatomy &amp; histology ; Femur - surgery ; Forensic anthropology ; Forensic Anthropology - methods ; Forensic medicine ; Forensic pathology ; Forensic sciences ; General aspects ; Haversian System - anatomy &amp; histology ; Humans ; Image Processing, Computer-Assisted ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Methods ; Microscope and microscopy ; Microscopy ; Middle Aged ; Necrosis ; Osteon ; Pilot Projects ; Population density ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Software ; Stereology ; Studies</subject><ispartof>Forensic science international, 2006-05, Vol.159 (1), p.S100-S103</ispartof><rights>2006 Elsevier Ireland Ltd</rights><rights>2006 INIST-CNRS</rights><rights>COPYRIGHT 2006 The Lancet Publishing Group, a division of Elsevier Science Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-51932a659d5a228cc3fc7cadb54eeae20d2d846d4303861b3b4bde674035f8c93</citedby><cites>FETCH-LOGICAL-c532t-51932a659d5a228cc3fc7cadb54eeae20d2d846d4303861b3b4bde674035f8c93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1034554090?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>309,310,314,778,782,787,788,3539,23917,23918,25127,27911,27912,45982,64370,64372,64374,72226</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=17755316$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16529894$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lynnerup, Niels</creatorcontrib><creatorcontrib>Frohlich, Bruno</creatorcontrib><creatorcontrib>Thomsen, Jørgen L.</creatorcontrib><title>Assessment of age at death by microscopy: Unbiased quantification of secondary osteons in femoral cross sections</title><title>Forensic science international</title><addtitle>Forensic Sci Int</addtitle><description>The microscopic method of age at death determination was introduced by Kerley in 1965 [E.R. Kerley, The microscopic determination of age in human bone, Am. J. Phys. Anthropol, 23 (1965) 149–163.]. However, even though the method has been revised several times, there remain some fundamental issues concerning the reliability of the methods. This is because several basic histological features seen in a cross section of a bone have to be quantified according to the method, but the definition, and hence quantification, of these features leaves room for subjectivity. In a previous study we found that some of these features (osteon fragments and Haversian canals) could not be identified reliably. Only secondary osteons could be identified with a low inter and intra observer error. Furthermore, since the histological features are quantified in only parts of an entire bone cross section, the selection of these parts or areas is a potential source of bias. Finally, unless an unbiased method is used for addressing features on the borders of the selected areas, this will also introduce error. These issues have not been addressed specifically in previous studies. In this study, we used the methods of stereology to choose the regions of interest, as well as for dealing with border phenomena, and we only counted secondary osteons. Our results show a statistically significant increase in the median number of osteons per area unit with increasing age at death. However, this was after exclusion of one outlier. This result is probably due to the limited sample size ( N = 24). As such, this study is preliminary, but does warrant applying the described techniques to a larger sample.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age at death</subject><subject>Age determination (Zoology)</subject><subject>Age Determination by Skeleton - methods</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bias</subject><subject>Biological and medical sciences</subject><subject>Bone microscopy</subject><subject>Bone remodelling</subject><subject>Bones</subject><subject>Canals</subject><subject>Female</subject><subject>Femur - anatomy &amp; histology</subject><subject>Femur - surgery</subject><subject>Forensic anthropology</subject><subject>Forensic Anthropology - methods</subject><subject>Forensic medicine</subject><subject>Forensic pathology</subject><subject>Forensic sciences</subject><subject>General aspects</subject><subject>Haversian System - anatomy &amp; histology</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Microscope and microscopy</subject><subject>Microscopy</subject><subject>Middle Aged</subject><subject>Necrosis</subject><subject>Osteon</subject><subject>Pilot Projects</subject><subject>Population density</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Software</subject><subject>Stereology</subject><subject>Studies</subject><issn>0379-0738</issn><issn>1872-6283</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFktuK2zAQhk1p6Wa3fYVWULp3dnWwZLl3YekJFnrTvRayNEoVbCkrOQt5-8pNaGgJFA0IxPfPjP6ZqnpLcEMwER-2jYspG-_D3FCMRYNpCfasWhHZ0VpQyZ5XK8y6vsYdk1fVdc5bjDHnVLysrojgtJd9u6p265wh5wnCjKJDegNIz8iCnn-i4YAmb1LMJu4OH9FDGLzOYNHjXofZO2_07GNYZBlMDFanA4p5hhgy8gE5mGLSI1oy5AVZ6PyqeuH0mOH16b6pHj5_-nH3tb7__uXb3fq-NpzRueakZ1QL3luuKZXGMGc6o-3AWwANFFtqZStsyzCTggxsaAcLomsx406ant1Ut8e8uxQf95BnNflsYBx1gLjPSnRSUMpkAd_9A27jPoXSmyKYtZy3uMdnaqNHUD64OCdtlpRqTVreSyr7pWh9gdpAgGJEDOB8ef6Lby7w5Vgozl8UdEfBb1MTOLVLfirGl17Vshlqq_5shlo2Q2FaghXlm9M398ME9qw7rUIB3p8AnY0eXdLB-Hzmuo5zRkTh1kcOyvSePCRVqkEwYH0qM1Y2-v828wvy5Nq_</recordid><startdate>20060515</startdate><enddate>20060515</enddate><creator>Lynnerup, Niels</creator><creator>Frohlich, Bruno</creator><creator>Thomsen, Jørgen L.</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><general>The Lancet Publishing Group, a division of Elsevier Science Ltd</general><general>Elsevier Limited</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>ILT</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</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>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20060515</creationdate><title>Assessment of age at death by microscopy: Unbiased quantification of secondary osteons in femoral cross sections</title><author>Lynnerup, Niels ; Frohlich, Bruno ; Thomsen, Jørgen L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-51932a659d5a228cc3fc7cadb54eeae20d2d846d4303861b3b4bde674035f8c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age at death</topic><topic>Age determination (Zoology)</topic><topic>Age Determination by Skeleton - methods</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bias</topic><topic>Biological and medical sciences</topic><topic>Bone microscopy</topic><topic>Bone remodelling</topic><topic>Bones</topic><topic>Canals</topic><topic>Female</topic><topic>Femur - anatomy &amp; histology</topic><topic>Femur - surgery</topic><topic>Forensic anthropology</topic><topic>Forensic Anthropology - methods</topic><topic>Forensic medicine</topic><topic>Forensic pathology</topic><topic>Forensic sciences</topic><topic>General aspects</topic><topic>Haversian System - anatomy &amp; histology</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Microscope and microscopy</topic><topic>Microscopy</topic><topic>Middle Aged</topic><topic>Necrosis</topic><topic>Osteon</topic><topic>Pilot Projects</topic><topic>Population density</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Software</topic><topic>Stereology</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lynnerup, Niels</creatorcontrib><creatorcontrib>Frohlich, Bruno</creatorcontrib><creatorcontrib>Thomsen, Jørgen L.</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>Gale OneFile: LegalTrac</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Toxicology Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</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>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Forensic science international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lynnerup, Niels</au><au>Frohlich, Bruno</au><au>Thomsen, Jørgen L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of age at death by microscopy: Unbiased quantification of secondary osteons in femoral cross sections</atitle><jtitle>Forensic science international</jtitle><addtitle>Forensic Sci Int</addtitle><date>2006-05-15</date><risdate>2006</risdate><volume>159</volume><issue>1</issue><spage>S100</spage><epage>S103</epage><pages>S100-S103</pages><issn>0379-0738</issn><eissn>1872-6283</eissn><coden>FSINDR</coden><abstract>The microscopic method of age at death determination was introduced by Kerley in 1965 [E.R. Kerley, The microscopic determination of age in human bone, Am. J. Phys. Anthropol, 23 (1965) 149–163.]. However, even though the method has been revised several times, there remain some fundamental issues concerning the reliability of the methods. This is because several basic histological features seen in a cross section of a bone have to be quantified according to the method, but the definition, and hence quantification, of these features leaves room for subjectivity. In a previous study we found that some of these features (osteon fragments and Haversian canals) could not be identified reliably. Only secondary osteons could be identified with a low inter and intra observer error. Furthermore, since the histological features are quantified in only parts of an entire bone cross section, the selection of these parts or areas is a potential source of bias. Finally, unless an unbiased method is used for addressing features on the borders of the selected areas, this will also introduce error. These issues have not been addressed specifically in previous studies. In this study, we used the methods of stereology to choose the regions of interest, as well as for dealing with border phenomena, and we only counted secondary osteons. Our results show a statistically significant increase in the median number of osteons per area unit with increasing age at death. However, this was after exclusion of one outlier. This result is probably due to the limited sample size ( N = 24). As such, this study is preliminary, but does warrant applying the described techniques to a larger sample.</abstract><cop>Kidlington</cop><pub>Elsevier Ireland Ltd</pub><pmid>16529894</pmid><doi>10.1016/j.forsciint.2006.02.023</doi></addata></record>
fulltext fulltext
identifier ISSN: 0379-0738
ispartof Forensic science international, 2006-05, Vol.159 (1), p.S100-S103
issn 0379-0738
1872-6283
language eng
recordid cdi_proquest_miscellaneous_67862238
source Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE; ProQuest Central UK/Ireland
subjects Adolescent
Adult
Age at death
Age determination (Zoology)
Age Determination by Skeleton - methods
Aged
Aged, 80 and over
Bias
Biological and medical sciences
Bone microscopy
Bone remodelling
Bones
Canals
Female
Femur - anatomy & histology
Femur - surgery
Forensic anthropology
Forensic Anthropology - methods
Forensic medicine
Forensic pathology
Forensic sciences
General aspects
Haversian System - anatomy & histology
Humans
Image Processing, Computer-Assisted
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Methods
Microscope and microscopy
Microscopy
Middle Aged
Necrosis
Osteon
Pilot Projects
Population density
Public health. Hygiene
Public health. Hygiene-occupational medicine
Software
Stereology
Studies
title Assessment of age at death by microscopy: Unbiased quantification of secondary osteons in femoral cross sections
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T11%3A39%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Assessment%20of%20age%20at%20death%20by%20microscopy:%20Unbiased%20quantification%20of%20secondary%20osteons%20in%20femoral%20cross%20sections&rft.jtitle=Forensic%20science%20international&rft.au=Lynnerup,%20Niels&rft.date=2006-05-15&rft.volume=159&rft.issue=1&rft.spage=S100&rft.epage=S103&rft.pages=S100-S103&rft.issn=0379-0738&rft.eissn=1872-6283&rft.coden=FSINDR&rft_id=info:doi/10.1016/j.forsciint.2006.02.023&rft_dat=%3Cgale_proqu%3EA145982899%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1034554090&rft_id=info:pmid/16529894&rft_galeid=A145982899&rft_els_id=S037907380600082X&rfr_iscdi=true