Distribution and Diversity of Escherichia coli Populations in the South Nation River Drainage Basin, Eastern Ontario, Canada

We investigated the prevalence and diversity of Escherichia coli strains isolated from surface waters from multiple watersheds within the South Nation River basin in eastern Ontario, Canada. The basin is composed of mixed but primarily agricultural land uses. From March 2004 to November 2007, a tota...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Applied and Environmental Microbiology 2010-03, Vol.76 (5), p.1486-1496
Hauptverfasser: Lyautey, Emilie, Lu, Zexun, Lapen, David R, Wilkes, Graham, Scott, Andrew, Berkers, Tanya, Edge, Thomas A, Topp, Edward
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1496
container_issue 5
container_start_page 1486
container_title Applied and Environmental Microbiology
container_volume 76
creator Lyautey, Emilie
Lu, Zexun
Lapen, David R
Wilkes, Graham
Scott, Andrew
Berkers, Tanya
Edge, Thomas A
Topp, Edward
description We investigated the prevalence and diversity of Escherichia coli strains isolated from surface waters from multiple watersheds within the South Nation River basin in eastern Ontario, Canada. The basin is composed of mixed but primarily agricultural land uses. From March 2004 to November 2007, a total of 2,004 surface water samples were collected from 24 sampling sites. E. coli densities ranged from undetectable to 1.64 x 10⁵ CFU 100 ml⁻¹ and were correlated with stream order and proximity to livestock production systems. The diversity of 21,307 E. coli isolates was characterized using repetitive extragenic palindromic PCR (rep-PCR), allowing for the identification of as many as 7,325 distinct genotypes, without capturing all of the diversity. The community was temporally and spatially dominated by a few dominant genotypes (clusters of more than 500 isolates) and several genotypes of intermediary abundance (clustering between 10 and 499 isolates). Simpson diversity indices, assessed on a normalized number of isolates per sample, ranged from 0.050 to 0.668. Simpson indices could be statistically discriminated on the basis of year and stream order, but land use, discharge, weather, and water physical-chemical properties were not statistically important discriminators. The detection of Campylobacter species was associated with statistically lower Simpson indices (greater diversity; P < 0.05). Waterborne E. coli isolates from genotypes of dominant and intermediary abundance were clustered with isolates obtained from fecal samples collected in the study area over the same period, and 90% of the isolates tested proved to share genotypes with fecal isolates. Overall, our data indicated that the densities and distribution of E. coli in these mixed-use watersheds were linked to stream order and livestock-based land uses. Waterborne E. coli populations that were distinct from fecal isolates were detected and, on this basis, were possibly naturalized E. coli strains.
doi_str_mv 10.1128/AEM.02288-09
format Article
fullrecord <record><control><sourceid>proquest_pasca</sourceid><recordid>TN_cdi_proquest_miscellaneous_733532030</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1972957091</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490t-8b28c9929dd2439df76adfa71007a32d10006cb13abd41609817e027681b20a73</originalsourceid><addsrcrecordid>eNpd0d9v0zAQB_AIgVgpvPEMHhLipRlnO43tF6TRlh_SYIixZ-uSOI2n1C52MjSJPx53LePH00n2x6fzfbPsKYUTSpl8fbr6dAKMSZmDupdNKCiZzzkv72cTAKVyxgo4yh7FeAUABZTyYXbEALgsFZ9kP5c2DsFW42C9I-gasrTXJkQ73BDfklWsOxNs3Vkkte8t-eK3Y487HIl1ZOgMufDj0JHPt4fk6-41WQa0DteGvMVo3YysMA4mOHLuBgzWz8gCHTb4OHvQYh_Nk0OdZpfvVt8WH_Kz8_cfF6dneV0oGHJZMVkrxVTTsIKrphUlNi0KCiCQsyZVKOuKcqyagpZpAVQYYKKUtGKAgk-zN_u-27HamKY2bgjY622wGww32qPV_9442-m1v9ZMcsbTMqfZq0OD4L-PJg56Y2Nt-h6d8WPUgifFgEOSL_6TV34MLv1OM5grIUqQCc32qA4-xmDau1Eo6F2oOoWqb0PVoBJ_9vf4d_h3igm8PACMNfZtQFfb-MexQopS7Nzx3nV23f2wwWiMG41mo0Wp55oWskzm-d606DWuQ-pzecGAcqASZME5_wXdKb4F</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>205977608</pqid></control><display><type>article</type><title>Distribution and Diversity of Escherichia coli Populations in the South Nation River Drainage Basin, Eastern Ontario, Canada</title><source>American Society for Microbiology</source><source>MEDLINE</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Lyautey, Emilie ; Lu, Zexun ; Lapen, David R ; Wilkes, Graham ; Scott, Andrew ; Berkers, Tanya ; Edge, Thomas A ; Topp, Edward</creator><creatorcontrib>Lyautey, Emilie ; Lu, Zexun ; Lapen, David R ; Wilkes, Graham ; Scott, Andrew ; Berkers, Tanya ; Edge, Thomas A ; Topp, Edward</creatorcontrib><description>We investigated the prevalence and diversity of Escherichia coli strains isolated from surface waters from multiple watersheds within the South Nation River basin in eastern Ontario, Canada. The basin is composed of mixed but primarily agricultural land uses. From March 2004 to November 2007, a total of 2,004 surface water samples were collected from 24 sampling sites. E. coli densities ranged from undetectable to 1.64 x 10⁵ CFU 100 ml⁻¹ and were correlated with stream order and proximity to livestock production systems. The diversity of 21,307 E. coli isolates was characterized using repetitive extragenic palindromic PCR (rep-PCR), allowing for the identification of as many as 7,325 distinct genotypes, without capturing all of the diversity. The community was temporally and spatially dominated by a few dominant genotypes (clusters of more than 500 isolates) and several genotypes of intermediary abundance (clustering between 10 and 499 isolates). Simpson diversity indices, assessed on a normalized number of isolates per sample, ranged from 0.050 to 0.668. Simpson indices could be statistically discriminated on the basis of year and stream order, but land use, discharge, weather, and water physical-chemical properties were not statistically important discriminators. The detection of Campylobacter species was associated with statistically lower Simpson indices (greater diversity; P &lt; 0.05). Waterborne E. coli isolates from genotypes of dominant and intermediary abundance were clustered with isolates obtained from fecal samples collected in the study area over the same period, and 90% of the isolates tested proved to share genotypes with fecal isolates. Overall, our data indicated that the densities and distribution of E. coli in these mixed-use watersheds were linked to stream order and livestock-based land uses. Waterborne E. coli populations that were distinct from fecal isolates were detected and, on this basis, were possibly naturalized E. coli strains.</description><identifier>ISSN: 0099-2240</identifier><identifier>EISSN: 1098-5336</identifier><identifier>DOI: 10.1128/AEM.02288-09</identifier><identifier>PMID: 20038693</identifier><identifier>CODEN: AEMIDF</identifier><language>eng</language><publisher>Washington, DC: American Society for Microbiology</publisher><subject>Animal Husbandry ; Animals ; Animals, Domestic ; Bacterial Typing Techniques ; Biological and medical sciences ; Campylobacter - isolation &amp; purification ; Cluster Analysis ; Colony Count, Microbial ; DNA Fingerprinting ; DNA, Bacterial - genetics ; E coli ; Environmental Microbiology ; Escherichia coli - classification ; Escherichia coli - isolation &amp; purification ; Fresh Water - microbiology ; Fundamental and applied biological sciences. Psychology ; Genetic diversity ; Genetic Variation ; Genotype ; Genotype &amp; phenotype ; Land use ; Microbiology ; Ontario ; Polymerase Chain Reaction ; Rivers ; Surface water ; Watersheds</subject><ispartof>Applied and Environmental Microbiology, 2010-03, Vol.76 (5), p.1486-1496</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright American Society for Microbiology Mar 2010</rights><rights>Copyright © 2010, American Society for Microbiology 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-8b28c9929dd2439df76adfa71007a32d10006cb13abd41609817e027681b20a73</citedby><cites>FETCH-LOGICAL-c490t-8b28c9929dd2439df76adfa71007a32d10006cb13abd41609817e027681b20a73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832353/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832353/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,3188,3189,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=22487673$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20038693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lyautey, Emilie</creatorcontrib><creatorcontrib>Lu, Zexun</creatorcontrib><creatorcontrib>Lapen, David R</creatorcontrib><creatorcontrib>Wilkes, Graham</creatorcontrib><creatorcontrib>Scott, Andrew</creatorcontrib><creatorcontrib>Berkers, Tanya</creatorcontrib><creatorcontrib>Edge, Thomas A</creatorcontrib><creatorcontrib>Topp, Edward</creatorcontrib><title>Distribution and Diversity of Escherichia coli Populations in the South Nation River Drainage Basin, Eastern Ontario, Canada</title><title>Applied and Environmental Microbiology</title><addtitle>Appl Environ Microbiol</addtitle><description>We investigated the prevalence and diversity of Escherichia coli strains isolated from surface waters from multiple watersheds within the South Nation River basin in eastern Ontario, Canada. The basin is composed of mixed but primarily agricultural land uses. From March 2004 to November 2007, a total of 2,004 surface water samples were collected from 24 sampling sites. E. coli densities ranged from undetectable to 1.64 x 10⁵ CFU 100 ml⁻¹ and were correlated with stream order and proximity to livestock production systems. The diversity of 21,307 E. coli isolates was characterized using repetitive extragenic palindromic PCR (rep-PCR), allowing for the identification of as many as 7,325 distinct genotypes, without capturing all of the diversity. The community was temporally and spatially dominated by a few dominant genotypes (clusters of more than 500 isolates) and several genotypes of intermediary abundance (clustering between 10 and 499 isolates). Simpson diversity indices, assessed on a normalized number of isolates per sample, ranged from 0.050 to 0.668. Simpson indices could be statistically discriminated on the basis of year and stream order, but land use, discharge, weather, and water physical-chemical properties were not statistically important discriminators. The detection of Campylobacter species was associated with statistically lower Simpson indices (greater diversity; P &lt; 0.05). Waterborne E. coli isolates from genotypes of dominant and intermediary abundance were clustered with isolates obtained from fecal samples collected in the study area over the same period, and 90% of the isolates tested proved to share genotypes with fecal isolates. Overall, our data indicated that the densities and distribution of E. coli in these mixed-use watersheds were linked to stream order and livestock-based land uses. Waterborne E. coli populations that were distinct from fecal isolates were detected and, on this basis, were possibly naturalized E. coli strains.</description><subject>Animal Husbandry</subject><subject>Animals</subject><subject>Animals, Domestic</subject><subject>Bacterial Typing Techniques</subject><subject>Biological and medical sciences</subject><subject>Campylobacter - isolation &amp; purification</subject><subject>Cluster Analysis</subject><subject>Colony Count, Microbial</subject><subject>DNA Fingerprinting</subject><subject>DNA, Bacterial - genetics</subject><subject>E coli</subject><subject>Environmental Microbiology</subject><subject>Escherichia coli - classification</subject><subject>Escherichia coli - isolation &amp; purification</subject><subject>Fresh Water - microbiology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Genetic diversity</subject><subject>Genetic Variation</subject><subject>Genotype</subject><subject>Genotype &amp; phenotype</subject><subject>Land use</subject><subject>Microbiology</subject><subject>Ontario</subject><subject>Polymerase Chain Reaction</subject><subject>Rivers</subject><subject>Surface water</subject><subject>Watersheds</subject><issn>0099-2240</issn><issn>1098-5336</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0d9v0zAQB_AIgVgpvPEMHhLipRlnO43tF6TRlh_SYIixZ-uSOI2n1C52MjSJPx53LePH00n2x6fzfbPsKYUTSpl8fbr6dAKMSZmDupdNKCiZzzkv72cTAKVyxgo4yh7FeAUABZTyYXbEALgsFZ9kP5c2DsFW42C9I-gasrTXJkQ73BDfklWsOxNs3Vkkte8t-eK3Y487HIl1ZOgMufDj0JHPt4fk6-41WQa0DteGvMVo3YysMA4mOHLuBgzWz8gCHTb4OHvQYh_Nk0OdZpfvVt8WH_Kz8_cfF6dneV0oGHJZMVkrxVTTsIKrphUlNi0KCiCQsyZVKOuKcqyagpZpAVQYYKKUtGKAgk-zN_u-27HamKY2bgjY622wGww32qPV_9442-m1v9ZMcsbTMqfZq0OD4L-PJg56Y2Nt-h6d8WPUgifFgEOSL_6TV34MLv1OM5grIUqQCc32qA4-xmDau1Eo6F2oOoWqb0PVoBJ_9vf4d_h3igm8PACMNfZtQFfb-MexQopS7Nzx3nV23f2wwWiMG41mo0Wp55oWskzm-d606DWuQ-pzecGAcqASZME5_wXdKb4F</recordid><startdate>20100301</startdate><enddate>20100301</enddate><creator>Lyautey, Emilie</creator><creator>Lu, Zexun</creator><creator>Lapen, David R</creator><creator>Wilkes, Graham</creator><creator>Scott, Andrew</creator><creator>Berkers, Tanya</creator><creator>Edge, Thomas A</creator><creator>Topp, Edward</creator><general>American Society for Microbiology</general><general>American Society for Microbiology (ASM)</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>7QL</scope><scope>7QO</scope><scope>7SN</scope><scope>7SS</scope><scope>7ST</scope><scope>7T7</scope><scope>7TM</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>SOI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100301</creationdate><title>Distribution and Diversity of Escherichia coli Populations in the South Nation River Drainage Basin, Eastern Ontario, Canada</title><author>Lyautey, Emilie ; Lu, Zexun ; Lapen, David R ; Wilkes, Graham ; Scott, Andrew ; Berkers, Tanya ; Edge, Thomas A ; Topp, Edward</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-8b28c9929dd2439df76adfa71007a32d10006cb13abd41609817e027681b20a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Animal Husbandry</topic><topic>Animals</topic><topic>Animals, Domestic</topic><topic>Bacterial Typing Techniques</topic><topic>Biological and medical sciences</topic><topic>Campylobacter - isolation &amp; purification</topic><topic>Cluster Analysis</topic><topic>Colony Count, Microbial</topic><topic>DNA Fingerprinting</topic><topic>DNA, Bacterial - genetics</topic><topic>E coli</topic><topic>Environmental Microbiology</topic><topic>Escherichia coli - classification</topic><topic>Escherichia coli - isolation &amp; purification</topic><topic>Fresh Water - microbiology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Genetic diversity</topic><topic>Genetic Variation</topic><topic>Genotype</topic><topic>Genotype &amp; phenotype</topic><topic>Land use</topic><topic>Microbiology</topic><topic>Ontario</topic><topic>Polymerase Chain Reaction</topic><topic>Rivers</topic><topic>Surface water</topic><topic>Watersheds</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lyautey, Emilie</creatorcontrib><creatorcontrib>Lu, Zexun</creatorcontrib><creatorcontrib>Lapen, David R</creatorcontrib><creatorcontrib>Wilkes, Graham</creatorcontrib><creatorcontrib>Scott, Andrew</creatorcontrib><creatorcontrib>Berkers, Tanya</creatorcontrib><creatorcontrib>Edge, Thomas A</creatorcontrib><creatorcontrib>Topp, Edward</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>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Environment Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>Environment Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Applied and Environmental Microbiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lyautey, Emilie</au><au>Lu, Zexun</au><au>Lapen, David R</au><au>Wilkes, Graham</au><au>Scott, Andrew</au><au>Berkers, Tanya</au><au>Edge, Thomas A</au><au>Topp, Edward</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distribution and Diversity of Escherichia coli Populations in the South Nation River Drainage Basin, Eastern Ontario, Canada</atitle><jtitle>Applied and Environmental Microbiology</jtitle><addtitle>Appl Environ Microbiol</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>76</volume><issue>5</issue><spage>1486</spage><epage>1496</epage><pages>1486-1496</pages><issn>0099-2240</issn><eissn>1098-5336</eissn><coden>AEMIDF</coden><abstract>We investigated the prevalence and diversity of Escherichia coli strains isolated from surface waters from multiple watersheds within the South Nation River basin in eastern Ontario, Canada. The basin is composed of mixed but primarily agricultural land uses. From March 2004 to November 2007, a total of 2,004 surface water samples were collected from 24 sampling sites. E. coli densities ranged from undetectable to 1.64 x 10⁵ CFU 100 ml⁻¹ and were correlated with stream order and proximity to livestock production systems. The diversity of 21,307 E. coli isolates was characterized using repetitive extragenic palindromic PCR (rep-PCR), allowing for the identification of as many as 7,325 distinct genotypes, without capturing all of the diversity. The community was temporally and spatially dominated by a few dominant genotypes (clusters of more than 500 isolates) and several genotypes of intermediary abundance (clustering between 10 and 499 isolates). Simpson diversity indices, assessed on a normalized number of isolates per sample, ranged from 0.050 to 0.668. Simpson indices could be statistically discriminated on the basis of year and stream order, but land use, discharge, weather, and water physical-chemical properties were not statistically important discriminators. The detection of Campylobacter species was associated with statistically lower Simpson indices (greater diversity; P &lt; 0.05). Waterborne E. coli isolates from genotypes of dominant and intermediary abundance were clustered with isolates obtained from fecal samples collected in the study area over the same period, and 90% of the isolates tested proved to share genotypes with fecal isolates. Overall, our data indicated that the densities and distribution of E. coli in these mixed-use watersheds were linked to stream order and livestock-based land uses. Waterborne E. coli populations that were distinct from fecal isolates were detected and, on this basis, were possibly naturalized E. coli strains.</abstract><cop>Washington, DC</cop><pub>American Society for Microbiology</pub><pmid>20038693</pmid><doi>10.1128/AEM.02288-09</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0099-2240
ispartof Applied and Environmental Microbiology, 2010-03, Vol.76 (5), p.1486-1496
issn 0099-2240
1098-5336
language eng
recordid cdi_proquest_miscellaneous_733532030
source American Society for Microbiology; MEDLINE; PubMed Central; Alma/SFX Local Collection
subjects Animal Husbandry
Animals
Animals, Domestic
Bacterial Typing Techniques
Biological and medical sciences
Campylobacter - isolation & purification
Cluster Analysis
Colony Count, Microbial
DNA Fingerprinting
DNA, Bacterial - genetics
E coli
Environmental Microbiology
Escherichia coli - classification
Escherichia coli - isolation & purification
Fresh Water - microbiology
Fundamental and applied biological sciences. Psychology
Genetic diversity
Genetic Variation
Genotype
Genotype & phenotype
Land use
Microbiology
Ontario
Polymerase Chain Reaction
Rivers
Surface water
Watersheds
title Distribution and Diversity of Escherichia coli Populations in the South Nation River Drainage Basin, Eastern Ontario, Canada
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T23%3A00%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pasca&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Distribution%20and%20Diversity%20of%20Escherichia%20coli%20Populations%20in%20the%20South%20Nation%20River%20Drainage%20Basin,%20Eastern%20Ontario,%20Canada&rft.jtitle=Applied%20and%20Environmental%20Microbiology&rft.au=Lyautey,%20Emilie&rft.date=2010-03-01&rft.volume=76&rft.issue=5&rft.spage=1486&rft.epage=1496&rft.pages=1486-1496&rft.issn=0099-2240&rft.eissn=1098-5336&rft.coden=AEMIDF&rft_id=info:doi/10.1128/AEM.02288-09&rft_dat=%3Cproquest_pasca%3E1972957091%3C/proquest_pasca%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=205977608&rft_id=info:pmid/20038693&rfr_iscdi=true