Hormonal profiles and biochemical indices of bone turnover in Indian women
The study establishes Indian referent database for bone turnover markers. The levels of markers decreased across the four quartiles of BMD showing a negative correlation with BMD. The study depicts that levels of hormones and bone turnover makers can aid in identifying women at risk for osteoporosis...
Gespeichert in:
Veröffentlicht in: | Osteoporosis international 2007-07, Vol.18 (7), p.923-929 |
---|---|
Hauptverfasser: | , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 929 |
---|---|
container_issue | 7 |
container_start_page | 923 |
container_title | Osteoporosis international |
container_volume | 18 |
creator | DESAI MEENA, P KHATKHATAY, M. I BHANU PRAKASH, K. V SAVARDEKAR, L. S SHAH, R. S ANSARI, Z |
description | The study establishes Indian referent database for bone turnover markers. The levels of markers decreased across the four quartiles of BMD showing a negative correlation with BMD. The study depicts that levels of hormones and bone turnover makers can aid in identifying women at risk for osteoporosis.
Biochemical markers of bone turnover reflect changes in bone metabolism earlier and aid in the management of osteoporosis. Since a referent database for Indian women is lacking, the study was initiated to establish the same and suggest that hormonal profiles and markers of bone turnover can aid in identifying women at risk for osteoporosis.
Osteocalcin (OC), bone specific alkaline phosphatase ((BSAP), C-terminal crosslinking telopeptide of type-I collagen (CTX-I), deoxypyridinoline (DPD), follicle-stimulating hormone (FSH) and estrone glucuronide (E(1)G) were measured in 365 Indian women (20-70 years) and correlated with BMD measurements by dual energy absorptiometry (DXA) using one way analysis of variance (ANOVA).
The mean levels of bone resorption markers; CTX-I and DPD increased significantly across the age showing a negative correlation with BMD. The increase in levels of CTX-I and DPD was significantly higher (p < 0.0001) as compared to the femoral and spinal BMD, which dropped only 30-36%. The levels of bone turnover markers and FSH decreased across the four quartiles of spinal and femoral BMD showing a negative correlation whereas E(1)G levels increased across the four quartiles.
The bone turnover markers were comparatively low in cohort of Indian women studied. |
doi_str_mv | 10.1007/s00198-006-0318-4 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70605552</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70605552</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-eeb260f4075c3c70028c1214e8ced384d787dcd3a811562ad327ec99b6ae56fb3</originalsourceid><addsrcrecordid>eNp1kU-LFTEQxIMo7nP1A3iRQdHbaHcy-XeURd2VBS8K3kIm04OzzCRr8p7it7eX92BB8BRI_aopqoR4jvAWAey7BoDe9QCmB4WuHx6IHQ5K9dIb_VDswCvb-wG_n4knrd0Ae7y3j8UZWik1OrcTny9L3UqOa3dby7ys1LqYp25cSvpB25JYWPK0JP4vczeWTN3-UHP5RZWF7oq1mLvfZaP8VDya49ro2ek9F98-fvh6cdlff_l0dfH-uk_KDfueaJQG5gGsTipZAOkSShzIJZqYmKyzU5pUdIjayDgpaSl5P5pI2syjOhdvjnc58c8DtX3YlpZoXWOmcmjBggGttWTw1T_gTeHsnC1IY7Sy4FEx9fK_FFeEgAYYwiOUammt0hxu67LF-icghLstwnGLwFuEuy3CwJ4Xp8OHcaPp3nEqn4HXJyA2LnquMael3XPOaYWDVX8BiNqPtg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>218810160</pqid></control><display><type>article</type><title>Hormonal profiles and biochemical indices of bone turnover in Indian women</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>DESAI MEENA, P ; KHATKHATAY, M. I ; BHANU PRAKASH, K. V ; SAVARDEKAR, L. S ; SHAH, R. S ; ANSARI, Z</creator><creatorcontrib>DESAI MEENA, P ; KHATKHATAY, M. I ; BHANU PRAKASH, K. V ; SAVARDEKAR, L. S ; SHAH, R. S ; ANSARI, Z</creatorcontrib><description>The study establishes Indian referent database for bone turnover markers. The levels of markers decreased across the four quartiles of BMD showing a negative correlation with BMD. The study depicts that levels of hormones and bone turnover makers can aid in identifying women at risk for osteoporosis.
Biochemical markers of bone turnover reflect changes in bone metabolism earlier and aid in the management of osteoporosis. Since a referent database for Indian women is lacking, the study was initiated to establish the same and suggest that hormonal profiles and markers of bone turnover can aid in identifying women at risk for osteoporosis.
Osteocalcin (OC), bone specific alkaline phosphatase ((BSAP), C-terminal crosslinking telopeptide of type-I collagen (CTX-I), deoxypyridinoline (DPD), follicle-stimulating hormone (FSH) and estrone glucuronide (E(1)G) were measured in 365 Indian women (20-70 years) and correlated with BMD measurements by dual energy absorptiometry (DXA) using one way analysis of variance (ANOVA).
The mean levels of bone resorption markers; CTX-I and DPD increased significantly across the age showing a negative correlation with BMD. The increase in levels of CTX-I and DPD was significantly higher (p < 0.0001) as compared to the femoral and spinal BMD, which dropped only 30-36%. The levels of bone turnover markers and FSH decreased across the four quartiles of spinal and femoral BMD showing a negative correlation whereas E(1)G levels increased across the four quartiles.
The bone turnover markers were comparatively low in cohort of Indian women studied.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-006-0318-4</identifier><identifier>PMID: 17225188</identifier><language>eng</language><publisher>London: Springer</publisher><subject>Adult ; Age Distribution ; Aged ; Alkaline phosphatase ; Amino Acids - blood ; Biochemical markers ; Biochemistry ; Biological and medical sciences ; Biomarkers - blood ; Bone and Bones - metabolism ; Bone density ; Bone resorption ; Bone turnover ; Collagen ; Collagen Type I - blood ; Databases, Factual ; Deoxypyridinoline ; Diseases of the osteoarticular system ; Dual energy X-ray absorptiometry ; Estrone ; Estrone - blood ; Female ; Femur ; Follicle Stimulating Hormone - blood ; Follicle-stimulating hormone ; Fundamental and applied biological sciences. Psychology ; Hormones ; Hormones - blood ; Humans ; India - epidemiology ; Medical sciences ; Middle Aged ; Osteocalcin ; Osteocalcin - blood ; Osteoporosis ; Osteoporosis - ethnology ; Osteoporosis - metabolism ; Osteoporosis. Osteomalacia. Paget disease ; Parathyroid Hormone - blood ; PAX5 Transcription Factor - blood ; Peptides - blood ; Prospective Studies ; Risk Factors ; Skeleton and joints ; Variance analysis ; Vertebrates: osteoarticular system, musculoskeletal system ; Women</subject><ispartof>Osteoporosis international, 2007-07, Vol.18 (7), p.923-929</ispartof><rights>2007 INIST-CNRS</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2007</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2007.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-eeb260f4075c3c70028c1214e8ced384d787dcd3a811562ad327ec99b6ae56fb3</citedby><cites>FETCH-LOGICAL-c384t-eeb260f4075c3c70028c1214e8ced384d787dcd3a811562ad327ec99b6ae56fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18853147$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17225188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DESAI MEENA, P</creatorcontrib><creatorcontrib>KHATKHATAY, M. I</creatorcontrib><creatorcontrib>BHANU PRAKASH, K. V</creatorcontrib><creatorcontrib>SAVARDEKAR, L. S</creatorcontrib><creatorcontrib>SHAH, R. S</creatorcontrib><creatorcontrib>ANSARI, Z</creatorcontrib><title>Hormonal profiles and biochemical indices of bone turnover in Indian women</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><description>The study establishes Indian referent database for bone turnover markers. The levels of markers decreased across the four quartiles of BMD showing a negative correlation with BMD. The study depicts that levels of hormones and bone turnover makers can aid in identifying women at risk for osteoporosis.
Biochemical markers of bone turnover reflect changes in bone metabolism earlier and aid in the management of osteoporosis. Since a referent database for Indian women is lacking, the study was initiated to establish the same and suggest that hormonal profiles and markers of bone turnover can aid in identifying women at risk for osteoporosis.
Osteocalcin (OC), bone specific alkaline phosphatase ((BSAP), C-terminal crosslinking telopeptide of type-I collagen (CTX-I), deoxypyridinoline (DPD), follicle-stimulating hormone (FSH) and estrone glucuronide (E(1)G) were measured in 365 Indian women (20-70 years) and correlated with BMD measurements by dual energy absorptiometry (DXA) using one way analysis of variance (ANOVA).
The mean levels of bone resorption markers; CTX-I and DPD increased significantly across the age showing a negative correlation with BMD. The increase in levels of CTX-I and DPD was significantly higher (p < 0.0001) as compared to the femoral and spinal BMD, which dropped only 30-36%. The levels of bone turnover markers and FSH decreased across the four quartiles of spinal and femoral BMD showing a negative correlation whereas E(1)G levels increased across the four quartiles.
The bone turnover markers were comparatively low in cohort of Indian women studied.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Alkaline phosphatase</subject><subject>Amino Acids - blood</subject><subject>Biochemical markers</subject><subject>Biochemistry</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Bone and Bones - metabolism</subject><subject>Bone density</subject><subject>Bone resorption</subject><subject>Bone turnover</subject><subject>Collagen</subject><subject>Collagen Type I - blood</subject><subject>Databases, Factual</subject><subject>Deoxypyridinoline</subject><subject>Diseases of the osteoarticular system</subject><subject>Dual energy X-ray absorptiometry</subject><subject>Estrone</subject><subject>Estrone - blood</subject><subject>Female</subject><subject>Femur</subject><subject>Follicle Stimulating Hormone - blood</subject><subject>Follicle-stimulating hormone</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hormones</subject><subject>Hormones - blood</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Osteocalcin</subject><subject>Osteocalcin - blood</subject><subject>Osteoporosis</subject><subject>Osteoporosis - ethnology</subject><subject>Osteoporosis - metabolism</subject><subject>Osteoporosis. Osteomalacia. Paget disease</subject><subject>Parathyroid Hormone - blood</subject><subject>PAX5 Transcription Factor - blood</subject><subject>Peptides - blood</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Skeleton and joints</subject><subject>Variance analysis</subject><subject>Vertebrates: osteoarticular system, musculoskeletal system</subject><subject>Women</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU-LFTEQxIMo7nP1A3iRQdHbaHcy-XeURd2VBS8K3kIm04OzzCRr8p7it7eX92BB8BRI_aopqoR4jvAWAey7BoDe9QCmB4WuHx6IHQ5K9dIb_VDswCvb-wG_n4knrd0Ae7y3j8UZWik1OrcTny9L3UqOa3dby7ys1LqYp25cSvpB25JYWPK0JP4vczeWTN3-UHP5RZWF7oq1mLvfZaP8VDya49ro2ek9F98-fvh6cdlff_l0dfH-uk_KDfueaJQG5gGsTipZAOkSShzIJZqYmKyzU5pUdIjayDgpaSl5P5pI2syjOhdvjnc58c8DtX3YlpZoXWOmcmjBggGttWTw1T_gTeHsnC1IY7Sy4FEx9fK_FFeEgAYYwiOUammt0hxu67LF-icghLstwnGLwFuEuy3CwJ4Xp8OHcaPp3nEqn4HXJyA2LnquMael3XPOaYWDVX8BiNqPtg</recordid><startdate>20070701</startdate><enddate>20070701</enddate><creator>DESAI MEENA, P</creator><creator>KHATKHATAY, M. I</creator><creator>BHANU PRAKASH, K. V</creator><creator>SAVARDEKAR, L. S</creator><creator>SHAH, R. S</creator><creator>ANSARI, Z</creator><general>Springer</general><general>Springer Nature B.V</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>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20070701</creationdate><title>Hormonal profiles and biochemical indices of bone turnover in Indian women</title><author>DESAI MEENA, P ; KHATKHATAY, M. I ; BHANU PRAKASH, K. V ; SAVARDEKAR, L. S ; SHAH, R. S ; ANSARI, Z</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-eeb260f4075c3c70028c1214e8ced384d787dcd3a811562ad327ec99b6ae56fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Alkaline phosphatase</topic><topic>Amino Acids - blood</topic><topic>Biochemical markers</topic><topic>Biochemistry</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Bone and Bones - metabolism</topic><topic>Bone density</topic><topic>Bone resorption</topic><topic>Bone turnover</topic><topic>Collagen</topic><topic>Collagen Type I - blood</topic><topic>Databases, Factual</topic><topic>Deoxypyridinoline</topic><topic>Diseases of the osteoarticular system</topic><topic>Dual energy X-ray absorptiometry</topic><topic>Estrone</topic><topic>Estrone - blood</topic><topic>Female</topic><topic>Femur</topic><topic>Follicle Stimulating Hormone - blood</topic><topic>Follicle-stimulating hormone</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hormones</topic><topic>Hormones - blood</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Osteocalcin</topic><topic>Osteocalcin - blood</topic><topic>Osteoporosis</topic><topic>Osteoporosis - ethnology</topic><topic>Osteoporosis - metabolism</topic><topic>Osteoporosis. Osteomalacia. Paget disease</topic><topic>Parathyroid Hormone - blood</topic><topic>PAX5 Transcription Factor - blood</topic><topic>Peptides - blood</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Skeleton and joints</topic><topic>Variance analysis</topic><topic>Vertebrates: osteoarticular system, musculoskeletal system</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DESAI MEENA, P</creatorcontrib><creatorcontrib>KHATKHATAY, M. I</creatorcontrib><creatorcontrib>BHANU PRAKASH, K. V</creatorcontrib><creatorcontrib>SAVARDEKAR, L. S</creatorcontrib><creatorcontrib>SHAH, R. S</creatorcontrib><creatorcontrib>ANSARI, Z</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>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & 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>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DESAI MEENA, P</au><au>KHATKHATAY, M. I</au><au>BHANU PRAKASH, K. V</au><au>SAVARDEKAR, L. S</au><au>SHAH, R. S</au><au>ANSARI, Z</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hormonal profiles and biochemical indices of bone turnover in Indian women</atitle><jtitle>Osteoporosis international</jtitle><addtitle>Osteoporos Int</addtitle><date>2007-07-01</date><risdate>2007</risdate><volume>18</volume><issue>7</issue><spage>923</spage><epage>929</epage><pages>923-929</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>The study establishes Indian referent database for bone turnover markers. The levels of markers decreased across the four quartiles of BMD showing a negative correlation with BMD. The study depicts that levels of hormones and bone turnover makers can aid in identifying women at risk for osteoporosis.
Biochemical markers of bone turnover reflect changes in bone metabolism earlier and aid in the management of osteoporosis. Since a referent database for Indian women is lacking, the study was initiated to establish the same and suggest that hormonal profiles and markers of bone turnover can aid in identifying women at risk for osteoporosis.
Osteocalcin (OC), bone specific alkaline phosphatase ((BSAP), C-terminal crosslinking telopeptide of type-I collagen (CTX-I), deoxypyridinoline (DPD), follicle-stimulating hormone (FSH) and estrone glucuronide (E(1)G) were measured in 365 Indian women (20-70 years) and correlated with BMD measurements by dual energy absorptiometry (DXA) using one way analysis of variance (ANOVA).
The mean levels of bone resorption markers; CTX-I and DPD increased significantly across the age showing a negative correlation with BMD. The increase in levels of CTX-I and DPD was significantly higher (p < 0.0001) as compared to the femoral and spinal BMD, which dropped only 30-36%. The levels of bone turnover markers and FSH decreased across the four quartiles of spinal and femoral BMD showing a negative correlation whereas E(1)G levels increased across the four quartiles.
The bone turnover markers were comparatively low in cohort of Indian women studied.</abstract><cop>London</cop><pub>Springer</pub><pmid>17225188</pmid><doi>10.1007/s00198-006-0318-4</doi><tpages>7</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0937-941X |
ispartof | Osteoporosis international, 2007-07, Vol.18 (7), p.923-929 |
issn | 0937-941X 1433-2965 |
language | eng |
recordid | cdi_proquest_miscellaneous_70605552 |
source | MEDLINE; SpringerLink Journals - AutoHoldings |
subjects | Adult Age Distribution Aged Alkaline phosphatase Amino Acids - blood Biochemical markers Biochemistry Biological and medical sciences Biomarkers - blood Bone and Bones - metabolism Bone density Bone resorption Bone turnover Collagen Collagen Type I - blood Databases, Factual Deoxypyridinoline Diseases of the osteoarticular system Dual energy X-ray absorptiometry Estrone Estrone - blood Female Femur Follicle Stimulating Hormone - blood Follicle-stimulating hormone Fundamental and applied biological sciences. Psychology Hormones Hormones - blood Humans India - epidemiology Medical sciences Middle Aged Osteocalcin Osteocalcin - blood Osteoporosis Osteoporosis - ethnology Osteoporosis - metabolism Osteoporosis. Osteomalacia. Paget disease Parathyroid Hormone - blood PAX5 Transcription Factor - blood Peptides - blood Prospective Studies Risk Factors Skeleton and joints Variance analysis Vertebrates: osteoarticular system, musculoskeletal system Women |
title | Hormonal profiles and biochemical indices of bone turnover in Indian women |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T22%3A12%3A38IST&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=Hormonal%20profiles%20and%20biochemical%20indices%20of%20bone%20turnover%20in%20Indian%20women&rft.jtitle=Osteoporosis%20international&rft.au=DESAI%20MEENA,%20P&rft.date=2007-07-01&rft.volume=18&rft.issue=7&rft.spage=923&rft.epage=929&rft.pages=923-929&rft.issn=0937-941X&rft.eissn=1433-2965&rft_id=info:doi/10.1007/s00198-006-0318-4&rft_dat=%3Cproquest_cross%3E70605552%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=218810160&rft_id=info:pmid/17225188&rfr_iscdi=true |