Targeting the heat shock factor 1 by RNA interference : A potent tool to enhance hyperthermochemotherapy efficacy in cervical cancer
Carcinoma of the uterine cervix is one of the highest causes of mortality in female cancer patients worldwide, and improved treatment options for this type of malignancy are highly needed. Local hyperthermia has been successfully used in combination with systemic administration of cisplatin-based ch...
Gespeichert in:
Veröffentlicht in: | Cancer research (Chicago, Ill.) Ill.), 2006-08, Vol.66 (15), p.7678-7685 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 7685 |
---|---|
container_issue | 15 |
container_start_page | 7678 |
container_title | Cancer research (Chicago, Ill.) |
container_volume | 66 |
creator | ROSSI, Antonio CIAFRE, Stefania BALSAMO, Mirna PIERIMARCHI, Pasquale SANTORO, M. Gabriella |
description | Carcinoma of the uterine cervix is one of the highest causes of mortality in female cancer patients worldwide, and improved treatment options for this type of malignancy are highly needed. Local hyperthermia has been successfully used in combination with systemic administration of cisplatin-based chemotherapy in phase I/II clinical studies. Heat-induced expression of cytoprotective and antiapoptotic heat shock proteins (HSP) is a known complication of hyperthermia, resulting in thermotolerance and chemoresistance and hindering the efficacy of the combination therapy. Heat shock transcription factor 1 (HSF1) is the master regulator of heat-induced HSP expression. In the present report, we used small interfering RNA (siRNA) to silence HSF1 and to examine the effect of HSF1 loss of function on the response to hyperthermia and cisplatin-based chemotherapy in HeLa cervical carcinoma. We have identified the 322-nucleotide to 340-nucleotide HSF1 sequence as an ideal target for siRNA-mediated HSF1 silencing, have created a pSUPER-HSF1 vector able to potently suppress the HSF1 gene, and have generated for the first time human cancer cell lines with stable loss of HSF1 function. We report that, although it surprisingly does not affect cancer cell sensitivity to cisplatin or elevated temperatures up to 43 degrees C when administered separately, loss of HSF1 function causes a dramatic increase in sensitivity to hyperthermochemotherapy, leading to massive (>95%) apoptosis of cancer cells. These findings indicate that disruption of HSF1-induced cytoprotection during hyperthermochemotherapy may represent a powerful strategy to selectively amplify the damage in cancer cells and identify HSF1 as a promising therapeutic target in cervical carcinoma. |
doi_str_mv | 10.1158/0008-5472.CAN-05-4282 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68712153</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>19365647</sourcerecordid><originalsourceid>FETCH-LOGICAL-c515t-75315b2fd255cb4b877536149d7303a8349ea32e64a6dc99246bbc0faed58d0f3</originalsourceid><addsrcrecordid>eNqFkUtv1DAUhS0EokPhJ4C8gV1av-OwG43KQ6paCZW15TjXTSCJg-1Byp4fXkcd0WU3tq_9nWPpHITeU3JBqdSXhBBdSVGzi8P-piKyEkyzF2hHJddVLYR8iXb_mTP0JqVfZZSUyNfojCqtJVfNDv27s_Ee8jDf49wD7sFmnPrgfmNvXQ4RU9yu-MfNHg9zhughwuwAf8Z7vIQMc8Y5hLEsGObebk_9ukAsXnEKrocpbEe7rBi8H5x1azHCDuLfMozYbZL4Fr3ydkzw7rSfo59fru4O36rr26_fD_vrykkqc1VLTmXLfMekdK1odV1uFBVNV3PCreaiAcsZKGFV55qGCdW2jngLndQd8fwcfXr0XWL4c4SUzTQkB-NoZwjHZJSuKSsBPgvShiupRF1A-Qi6GFKK4M0Sh8nG1VBitp7M1oHZOjClJ0Ok2Xoqug-nD47tBN2T6lRMAT6eAJtKUD6WoIb0xGlCmaoVfwCvaZwu</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>19365647</pqid></control><display><type>article</type><title>Targeting the heat shock factor 1 by RNA interference : A potent tool to enhance hyperthermochemotherapy efficacy in cervical cancer</title><source>MEDLINE</source><source>American Association for Cancer Research</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>ROSSI, Antonio ; CIAFRE, Stefania ; BALSAMO, Mirna ; PIERIMARCHI, Pasquale ; SANTORO, M. Gabriella</creator><creatorcontrib>ROSSI, Antonio ; CIAFRE, Stefania ; BALSAMO, Mirna ; PIERIMARCHI, Pasquale ; SANTORO, M. Gabriella</creatorcontrib><description>Carcinoma of the uterine cervix is one of the highest causes of mortality in female cancer patients worldwide, and improved treatment options for this type of malignancy are highly needed. Local hyperthermia has been successfully used in combination with systemic administration of cisplatin-based chemotherapy in phase I/II clinical studies. Heat-induced expression of cytoprotective and antiapoptotic heat shock proteins (HSP) is a known complication of hyperthermia, resulting in thermotolerance and chemoresistance and hindering the efficacy of the combination therapy. Heat shock transcription factor 1 (HSF1) is the master regulator of heat-induced HSP expression. In the present report, we used small interfering RNA (siRNA) to silence HSF1 and to examine the effect of HSF1 loss of function on the response to hyperthermia and cisplatin-based chemotherapy in HeLa cervical carcinoma. We have identified the 322-nucleotide to 340-nucleotide HSF1 sequence as an ideal target for siRNA-mediated HSF1 silencing, have created a pSUPER-HSF1 vector able to potently suppress the HSF1 gene, and have generated for the first time human cancer cell lines with stable loss of HSF1 function. We report that, although it surprisingly does not affect cancer cell sensitivity to cisplatin or elevated temperatures up to 43 degrees C when administered separately, loss of HSF1 function causes a dramatic increase in sensitivity to hyperthermochemotherapy, leading to massive (>95%) apoptosis of cancer cells. These findings indicate that disruption of HSF1-induced cytoprotection during hyperthermochemotherapy may represent a powerful strategy to selectively amplify the damage in cancer cells and identify HSF1 as a promising therapeutic target in cervical carcinoma.</description><identifier>ISSN: 0008-5472</identifier><identifier>EISSN: 1538-7445</identifier><identifier>DOI: 10.1158/0008-5472.CAN-05-4282</identifier><identifier>PMID: 16885369</identifier><identifier>CODEN: CNREA8</identifier><language>eng</language><publisher>Philadelphia, PA: American Association for Cancer Research</publisher><subject>Antineoplastic agents ; Apoptosis - drug effects ; Apoptosis - physiology ; Biological and medical sciences ; Cisplatin ; Combined Modality Therapy ; DNA-Binding Proteins - antagonists & inhibitors ; DNA-Binding Proteins - biosynthesis ; DNA-Binding Proteins - genetics ; Female ; Female genital diseases ; Gene Silencing ; Gynecology. Andrology. Obstetrics ; Heat Shock Transcription Factors ; Heat-Shock Proteins - biosynthesis ; Heat-Shock Proteins - genetics ; HeLa Cells ; HSP27 Heat-Shock Proteins ; HSP70 Heat-Shock Proteins - biosynthesis ; HSP70 Heat-Shock Proteins - genetics ; HSP90 Heat-Shock Proteins - biosynthesis ; HSP90 Heat-Shock Proteins - genetics ; Humans ; Hyperthermia, Induced - methods ; Medical sciences ; Neoplasm Proteins - biosynthesis ; Neoplasm Proteins - genetics ; Pharmacology. Drug treatments ; RNA Interference ; RNA, Small Interfering - genetics ; Transcription Factors - antagonists & inhibitors ; Transcription Factors - biosynthesis ; Transcription Factors - genetics ; Transfection ; Tumors ; Uterine Cervical Neoplasms - drug therapy ; Uterine Cervical Neoplasms - genetics ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - therapy</subject><ispartof>Cancer research (Chicago, Ill.), 2006-08, Vol.66 (15), p.7678-7685</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-75315b2fd255cb4b877536149d7303a8349ea32e64a6dc99246bbc0faed58d0f3</citedby><cites>FETCH-LOGICAL-c515t-75315b2fd255cb4b877536149d7303a8349ea32e64a6dc99246bbc0faed58d0f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3354,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18012676$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16885369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ROSSI, Antonio</creatorcontrib><creatorcontrib>CIAFRE, Stefania</creatorcontrib><creatorcontrib>BALSAMO, Mirna</creatorcontrib><creatorcontrib>PIERIMARCHI, Pasquale</creatorcontrib><creatorcontrib>SANTORO, M. Gabriella</creatorcontrib><title>Targeting the heat shock factor 1 by RNA interference : A potent tool to enhance hyperthermochemotherapy efficacy in cervical cancer</title><title>Cancer research (Chicago, Ill.)</title><addtitle>Cancer Res</addtitle><description>Carcinoma of the uterine cervix is one of the highest causes of mortality in female cancer patients worldwide, and improved treatment options for this type of malignancy are highly needed. Local hyperthermia has been successfully used in combination with systemic administration of cisplatin-based chemotherapy in phase I/II clinical studies. Heat-induced expression of cytoprotective and antiapoptotic heat shock proteins (HSP) is a known complication of hyperthermia, resulting in thermotolerance and chemoresistance and hindering the efficacy of the combination therapy. Heat shock transcription factor 1 (HSF1) is the master regulator of heat-induced HSP expression. In the present report, we used small interfering RNA (siRNA) to silence HSF1 and to examine the effect of HSF1 loss of function on the response to hyperthermia and cisplatin-based chemotherapy in HeLa cervical carcinoma. We have identified the 322-nucleotide to 340-nucleotide HSF1 sequence as an ideal target for siRNA-mediated HSF1 silencing, have created a pSUPER-HSF1 vector able to potently suppress the HSF1 gene, and have generated for the first time human cancer cell lines with stable loss of HSF1 function. We report that, although it surprisingly does not affect cancer cell sensitivity to cisplatin or elevated temperatures up to 43 degrees C when administered separately, loss of HSF1 function causes a dramatic increase in sensitivity to hyperthermochemotherapy, leading to massive (>95%) apoptosis of cancer cells. These findings indicate that disruption of HSF1-induced cytoprotection during hyperthermochemotherapy may represent a powerful strategy to selectively amplify the damage in cancer cells and identify HSF1 as a promising therapeutic target in cervical carcinoma.</description><subject>Antineoplastic agents</subject><subject>Apoptosis - drug effects</subject><subject>Apoptosis - physiology</subject><subject>Biological and medical sciences</subject><subject>Cisplatin</subject><subject>Combined Modality Therapy</subject><subject>DNA-Binding Proteins - antagonists & inhibitors</subject><subject>DNA-Binding Proteins - biosynthesis</subject><subject>DNA-Binding Proteins - genetics</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gene Silencing</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Heat Shock Transcription Factors</subject><subject>Heat-Shock Proteins - biosynthesis</subject><subject>Heat-Shock Proteins - genetics</subject><subject>HeLa Cells</subject><subject>HSP27 Heat-Shock Proteins</subject><subject>HSP70 Heat-Shock Proteins - biosynthesis</subject><subject>HSP70 Heat-Shock Proteins - genetics</subject><subject>HSP90 Heat-Shock Proteins - biosynthesis</subject><subject>HSP90 Heat-Shock Proteins - genetics</subject><subject>Humans</subject><subject>Hyperthermia, Induced - methods</subject><subject>Medical sciences</subject><subject>Neoplasm Proteins - biosynthesis</subject><subject>Neoplasm Proteins - genetics</subject><subject>Pharmacology. Drug treatments</subject><subject>RNA Interference</subject><subject>RNA, Small Interfering - genetics</subject><subject>Transcription Factors - antagonists & inhibitors</subject><subject>Transcription Factors - biosynthesis</subject><subject>Transcription Factors - genetics</subject><subject>Transfection</subject><subject>Tumors</subject><subject>Uterine Cervical Neoplasms - drug therapy</subject><subject>Uterine Cervical Neoplasms - genetics</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - therapy</subject><issn>0008-5472</issn><issn>1538-7445</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EokPhJ4C8gV1av-OwG43KQ6paCZW15TjXTSCJg-1Byp4fXkcd0WU3tq_9nWPpHITeU3JBqdSXhBBdSVGzi8P-piKyEkyzF2hHJddVLYR8iXb_mTP0JqVfZZSUyNfojCqtJVfNDv27s_Ee8jDf49wD7sFmnPrgfmNvXQ4RU9yu-MfNHg9zhughwuwAf8Z7vIQMc8Y5hLEsGObebk_9ukAsXnEKrocpbEe7rBi8H5x1azHCDuLfMozYbZL4Fr3ydkzw7rSfo59fru4O36rr26_fD_vrykkqc1VLTmXLfMekdK1odV1uFBVNV3PCreaiAcsZKGFV55qGCdW2jngLndQd8fwcfXr0XWL4c4SUzTQkB-NoZwjHZJSuKSsBPgvShiupRF1A-Qi6GFKK4M0Sh8nG1VBitp7M1oHZOjClJ0Ok2Xoqug-nD47tBN2T6lRMAT6eAJtKUD6WoIb0xGlCmaoVfwCvaZwu</recordid><startdate>20060801</startdate><enddate>20060801</enddate><creator>ROSSI, Antonio</creator><creator>CIAFRE, Stefania</creator><creator>BALSAMO, Mirna</creator><creator>PIERIMARCHI, Pasquale</creator><creator>SANTORO, M. Gabriella</creator><general>American Association for Cancer Research</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>7TM</scope><scope>7X8</scope></search><sort><creationdate>20060801</creationdate><title>Targeting the heat shock factor 1 by RNA interference : A potent tool to enhance hyperthermochemotherapy efficacy in cervical cancer</title><author>ROSSI, Antonio ; CIAFRE, Stefania ; BALSAMO, Mirna ; PIERIMARCHI, Pasquale ; SANTORO, M. Gabriella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c515t-75315b2fd255cb4b877536149d7303a8349ea32e64a6dc99246bbc0faed58d0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Antineoplastic agents</topic><topic>Apoptosis - drug effects</topic><topic>Apoptosis - physiology</topic><topic>Biological and medical sciences</topic><topic>Cisplatin</topic><topic>Combined Modality Therapy</topic><topic>DNA-Binding Proteins - antagonists & inhibitors</topic><topic>DNA-Binding Proteins - biosynthesis</topic><topic>DNA-Binding Proteins - genetics</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Gene Silencing</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Heat Shock Transcription Factors</topic><topic>Heat-Shock Proteins - biosynthesis</topic><topic>Heat-Shock Proteins - genetics</topic><topic>HeLa Cells</topic><topic>HSP27 Heat-Shock Proteins</topic><topic>HSP70 Heat-Shock Proteins - biosynthesis</topic><topic>HSP70 Heat-Shock Proteins - genetics</topic><topic>HSP90 Heat-Shock Proteins - biosynthesis</topic><topic>HSP90 Heat-Shock Proteins - genetics</topic><topic>Humans</topic><topic>Hyperthermia, Induced - methods</topic><topic>Medical sciences</topic><topic>Neoplasm Proteins - biosynthesis</topic><topic>Neoplasm Proteins - genetics</topic><topic>Pharmacology. Drug treatments</topic><topic>RNA Interference</topic><topic>RNA, Small Interfering - genetics</topic><topic>Transcription Factors - antagonists & inhibitors</topic><topic>Transcription Factors - biosynthesis</topic><topic>Transcription Factors - genetics</topic><topic>Transfection</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - drug therapy</topic><topic>Uterine Cervical Neoplasms - genetics</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ROSSI, Antonio</creatorcontrib><creatorcontrib>CIAFRE, Stefania</creatorcontrib><creatorcontrib>BALSAMO, Mirna</creatorcontrib><creatorcontrib>PIERIMARCHI, Pasquale</creatorcontrib><creatorcontrib>SANTORO, M. Gabriella</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>Nucleic Acids Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer research (Chicago, Ill.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ROSSI, Antonio</au><au>CIAFRE, Stefania</au><au>BALSAMO, Mirna</au><au>PIERIMARCHI, Pasquale</au><au>SANTORO, M. Gabriella</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Targeting the heat shock factor 1 by RNA interference : A potent tool to enhance hyperthermochemotherapy efficacy in cervical cancer</atitle><jtitle>Cancer research (Chicago, Ill.)</jtitle><addtitle>Cancer Res</addtitle><date>2006-08-01</date><risdate>2006</risdate><volume>66</volume><issue>15</issue><spage>7678</spage><epage>7685</epage><pages>7678-7685</pages><issn>0008-5472</issn><eissn>1538-7445</eissn><coden>CNREA8</coden><abstract>Carcinoma of the uterine cervix is one of the highest causes of mortality in female cancer patients worldwide, and improved treatment options for this type of malignancy are highly needed. Local hyperthermia has been successfully used in combination with systemic administration of cisplatin-based chemotherapy in phase I/II clinical studies. Heat-induced expression of cytoprotective and antiapoptotic heat shock proteins (HSP) is a known complication of hyperthermia, resulting in thermotolerance and chemoresistance and hindering the efficacy of the combination therapy. Heat shock transcription factor 1 (HSF1) is the master regulator of heat-induced HSP expression. In the present report, we used small interfering RNA (siRNA) to silence HSF1 and to examine the effect of HSF1 loss of function on the response to hyperthermia and cisplatin-based chemotherapy in HeLa cervical carcinoma. We have identified the 322-nucleotide to 340-nucleotide HSF1 sequence as an ideal target for siRNA-mediated HSF1 silencing, have created a pSUPER-HSF1 vector able to potently suppress the HSF1 gene, and have generated for the first time human cancer cell lines with stable loss of HSF1 function. We report that, although it surprisingly does not affect cancer cell sensitivity to cisplatin or elevated temperatures up to 43 degrees C when administered separately, loss of HSF1 function causes a dramatic increase in sensitivity to hyperthermochemotherapy, leading to massive (>95%) apoptosis of cancer cells. These findings indicate that disruption of HSF1-induced cytoprotection during hyperthermochemotherapy may represent a powerful strategy to selectively amplify the damage in cancer cells and identify HSF1 as a promising therapeutic target in cervical carcinoma.</abstract><cop>Philadelphia, PA</cop><pub>American Association for Cancer Research</pub><pmid>16885369</pmid><doi>10.1158/0008-5472.CAN-05-4282</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0008-5472 |
ispartof | Cancer research (Chicago, Ill.), 2006-08, Vol.66 (15), p.7678-7685 |
issn | 0008-5472 1538-7445 |
language | eng |
recordid | cdi_proquest_miscellaneous_68712153 |
source | MEDLINE; American Association for Cancer Research; EZB-FREE-00999 freely available EZB journals |
subjects | Antineoplastic agents Apoptosis - drug effects Apoptosis - physiology Biological and medical sciences Cisplatin Combined Modality Therapy DNA-Binding Proteins - antagonists & inhibitors DNA-Binding Proteins - biosynthesis DNA-Binding Proteins - genetics Female Female genital diseases Gene Silencing Gynecology. Andrology. Obstetrics Heat Shock Transcription Factors Heat-Shock Proteins - biosynthesis Heat-Shock Proteins - genetics HeLa Cells HSP27 Heat-Shock Proteins HSP70 Heat-Shock Proteins - biosynthesis HSP70 Heat-Shock Proteins - genetics HSP90 Heat-Shock Proteins - biosynthesis HSP90 Heat-Shock Proteins - genetics Humans Hyperthermia, Induced - methods Medical sciences Neoplasm Proteins - biosynthesis Neoplasm Proteins - genetics Pharmacology. Drug treatments RNA Interference RNA, Small Interfering - genetics Transcription Factors - antagonists & inhibitors Transcription Factors - biosynthesis Transcription Factors - genetics Transfection Tumors Uterine Cervical Neoplasms - drug therapy Uterine Cervical Neoplasms - genetics Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - therapy |
title | Targeting the heat shock factor 1 by RNA interference : A potent tool to enhance hyperthermochemotherapy efficacy in cervical cancer |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T01%3A32%3A20IST&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=Targeting%20the%20heat%20shock%20factor%201%20by%20RNA%20interference%20:%20A%20potent%20tool%20to%20enhance%20hyperthermochemotherapy%20efficacy%20in%20cervical%20cancer&rft.jtitle=Cancer%20research%20(Chicago,%20Ill.)&rft.au=ROSSI,%20Antonio&rft.date=2006-08-01&rft.volume=66&rft.issue=15&rft.spage=7678&rft.epage=7685&rft.pages=7678-7685&rft.issn=0008-5472&rft.eissn=1538-7445&rft.coden=CNREA8&rft_id=info:doi/10.1158/0008-5472.CAN-05-4282&rft_dat=%3Cproquest_cross%3E19365647%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=19365647&rft_id=info:pmid/16885369&rfr_iscdi=true |