Adenovirus vaccine vectors expressing hepatitis B surface antigen: Importance of regulatory elements in the adenovirus major late intron

Adenovirus types 4 and 7 are currently used as live oral vaccines for prevention of acute respiratory disease caused by these adenovirus serotypes. To investigate the concept of producing live recombinant vaccines using these serotypes, adenovirus types 4 (Ad4) and 7 (Ad7) were constructed that prod...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Virology (New York, N.Y.) N.Y.), 1990-08, Vol.177 (2), p.452-461
Hauptverfasser: Mason, Bruce B., Davis, Alan R., Brat, Bheem M., Chengalvala, Murty, Lubeck, Michael D., Zandle, Gordon, Kostek, Beverley, Cholodofsky, Stan, Dheer, Surendra, Molnar-Kimber, Katherine, Mizutani, Satoshi, Hung, Paul P.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 461
container_issue 2
container_start_page 452
container_title Virology (New York, N.Y.)
container_volume 177
creator Mason, Bruce B.
Davis, Alan R.
Brat, Bheem M.
Chengalvala, Murty
Lubeck, Michael D.
Zandle, Gordon
Kostek, Beverley
Cholodofsky, Stan
Dheer, Surendra
Molnar-Kimber, Katherine
Mizutani, Satoshi
Hung, Paul P.
description Adenovirus types 4 and 7 are currently used as live oral vaccines for prevention of acute respiratory disease caused by these adenovirus serotypes. To investigate the concept of producing live recombinant vaccines using these serotypes, adenovirus types 4 (Ad4) and 7 (Ad7) were constructed that produce HBsAg upon infection of cell cultures. Ad4 recombinants were constructed that express HBsAg from a cassette inserted 135 by from the right-hand terminus of the viral genome. The cassette contained the Ad4 major late promoter followed by leader 1 of the tripartite leader, the first intervening sequence between leaders 1 and 2, leaders 2 and 3, the HBsAg gene, and tandem polyadenylation signals from the Ad4 E3B and hexon genes. Using this same cassette, a series of Ad4 recombinants expressing HBsAg were constructed with deletions in the intervening sequence between leaders 1 and 2 to evaluate the contribution of the downstream control elements more precisely. Inclusion of regions located between +82 and +148 as well as +148 and +232 resulted in increases in expression levels of HBsAg in A549-infected cells by 22-fold and 44-fold, respectively, over the levels attained by an adenovirus recombinant retaining only sequences from +1 to +82, showing the importance of these elements in the activation of the major late promoter during the course of a natural Ad4 viral infection. Parallel increases were also observed in steady-state levels of cytoplasmic HBsAg-specific mRNA. When similar Ad7 recombinant viruses were constructed, these viruses also expressed 20-fold more HBsAg due to the presence of the intron. All Ad4 and Ad7 recombinants produced HBsAg particles containing gp27 and p24 which were secreted in the medium. When dogs were immunized intratracheally with one of these Ad7 recombinants, they seroconverted to both Ad7 and HBsAg to a high level.
doi_str_mv 10.1016/0042-6822(90)90509-P
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79882293</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>004268229090509P</els_id><sourcerecordid>15813980</sourcerecordid><originalsourceid>FETCH-LOGICAL-c418t-9bf033806fb30e817358e858e379dda217d558e4d7981d5298ac8802c6e523633</originalsourceid><addsrcrecordid>eNqFkctuFDEQRS0ECpPAH4DkDSgsGux2P-wskELEI1IksoC15bGrJ4667cblHpE_4LPxZEbJDhaWVa57b1l1CHnF2XvOePeBsaauOlnXp4q9U6xlqrp-Qlacqa5iouFPyepB8pwcI96yUvc9OyJHteh533Ur8ufcQYhbnxakW2OtD0C3YHNMSOH3nADRhw29gdlknz3STxSXNBgL1ITsNxDO6OU0x5RNKG9xoAk2y2hKwB2FESYIGakPNN8Ux-OsydzGRIsOSjOnGF6QZ4MZEV4e7hPy88vnHxffqqvvXy8vzq8q23CZK7UemBCSdcNaMJC8F60EWY7olXOm5r1rS9W4Xknu2lpJY6Vkte2grUUnxAl5u8-dU_y1AGY9ebQwjiZAXFAXX9mX-r-Qt5ILJVkRNnuhTRExwaDn5CeT7jRnekdK7zDoHQatmL4npa-L7fUhf1lP4B5MBzSl_-bQN2jNOKSyYI-P2arlsr3XfdzroGxt6yFptB4KDOdTAald9P_-yF8bN7Fr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>15813980</pqid></control><display><type>article</type><title>Adenovirus vaccine vectors expressing hepatitis B surface antigen: Importance of regulatory elements in the adenovirus major late intron</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Mason, Bruce B. ; Davis, Alan R. ; Brat, Bheem M. ; Chengalvala, Murty ; Lubeck, Michael D. ; Zandle, Gordon ; Kostek, Beverley ; Cholodofsky, Stan ; Dheer, Surendra ; Molnar-Kimber, Katherine ; Mizutani, Satoshi ; Hung, Paul P.</creator><creatorcontrib>Mason, Bruce B. ; Davis, Alan R. ; Brat, Bheem M. ; Chengalvala, Murty ; Lubeck, Michael D. ; Zandle, Gordon ; Kostek, Beverley ; Cholodofsky, Stan ; Dheer, Surendra ; Molnar-Kimber, Katherine ; Mizutani, Satoshi ; Hung, Paul P.</creatorcontrib><description>Adenovirus types 4 and 7 are currently used as live oral vaccines for prevention of acute respiratory disease caused by these adenovirus serotypes. To investigate the concept of producing live recombinant vaccines using these serotypes, adenovirus types 4 (Ad4) and 7 (Ad7) were constructed that produce HBsAg upon infection of cell cultures. Ad4 recombinants were constructed that express HBsAg from a cassette inserted 135 by from the right-hand terminus of the viral genome. The cassette contained the Ad4 major late promoter followed by leader 1 of the tripartite leader, the first intervening sequence between leaders 1 and 2, leaders 2 and 3, the HBsAg gene, and tandem polyadenylation signals from the Ad4 E3B and hexon genes. Using this same cassette, a series of Ad4 recombinants expressing HBsAg were constructed with deletions in the intervening sequence between leaders 1 and 2 to evaluate the contribution of the downstream control elements more precisely. Inclusion of regions located between +82 and +148 as well as +148 and +232 resulted in increases in expression levels of HBsAg in A549-infected cells by 22-fold and 44-fold, respectively, over the levels attained by an adenovirus recombinant retaining only sequences from +1 to +82, showing the importance of these elements in the activation of the major late promoter during the course of a natural Ad4 viral infection. Parallel increases were also observed in steady-state levels of cytoplasmic HBsAg-specific mRNA. When similar Ad7 recombinant viruses were constructed, these viruses also expressed 20-fold more HBsAg due to the presence of the intron. All Ad4 and Ad7 recombinants produced HBsAg particles containing gp27 and p24 which were secreted in the medium. When dogs were immunized intratracheally with one of these Ad7 recombinants, they seroconverted to both Ad7 and HBsAg to a high level.</description><identifier>ISSN: 0042-6822</identifier><identifier>EISSN: 1096-0341</identifier><identifier>DOI: 10.1016/0042-6822(90)90509-P</identifier><identifier>PMID: 2371766</identifier><identifier>CODEN: VIRLAX</identifier><language>eng</language><publisher>San Diego, CA: Elsevier Inc</publisher><subject>Adenoviruses, Human - genetics ; Base Sequence ; Biological and medical sciences ; Cell Line ; Cloning, Molecular ; Fundamental and applied biological sciences. Psychology ; Gene Expression ; Genes, Viral ; Hepatitis B Surface Antigens - genetics ; Humans ; Introns ; Microbiology ; Molecular Sequence Data ; Oligonucleotide Probes ; Recombination, Genetic ; Regulatory Sequences, Nucleic Acid ; Restriction Mapping ; RNA, Messenger - genetics ; Sequence Homology, Nucleic Acid ; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies ; Viral Vaccines ; Virology</subject><ispartof>Virology (New York, N.Y.), 1990-08, Vol.177 (2), p.452-461</ispartof><rights>1990</rights><rights>1991 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-9bf033806fb30e817358e858e379dda217d558e4d7981d5298ac8802c6e523633</citedby><cites>FETCH-LOGICAL-c418t-9bf033806fb30e817358e858e379dda217d558e4d7981d5298ac8802c6e523633</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/004268229090509P$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=19518566$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2371766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mason, Bruce B.</creatorcontrib><creatorcontrib>Davis, Alan R.</creatorcontrib><creatorcontrib>Brat, Bheem M.</creatorcontrib><creatorcontrib>Chengalvala, Murty</creatorcontrib><creatorcontrib>Lubeck, Michael D.</creatorcontrib><creatorcontrib>Zandle, Gordon</creatorcontrib><creatorcontrib>Kostek, Beverley</creatorcontrib><creatorcontrib>Cholodofsky, Stan</creatorcontrib><creatorcontrib>Dheer, Surendra</creatorcontrib><creatorcontrib>Molnar-Kimber, Katherine</creatorcontrib><creatorcontrib>Mizutani, Satoshi</creatorcontrib><creatorcontrib>Hung, Paul P.</creatorcontrib><title>Adenovirus vaccine vectors expressing hepatitis B surface antigen: Importance of regulatory elements in the adenovirus major late intron</title><title>Virology (New York, N.Y.)</title><addtitle>Virology</addtitle><description>Adenovirus types 4 and 7 are currently used as live oral vaccines for prevention of acute respiratory disease caused by these adenovirus serotypes. To investigate the concept of producing live recombinant vaccines using these serotypes, adenovirus types 4 (Ad4) and 7 (Ad7) were constructed that produce HBsAg upon infection of cell cultures. Ad4 recombinants were constructed that express HBsAg from a cassette inserted 135 by from the right-hand terminus of the viral genome. The cassette contained the Ad4 major late promoter followed by leader 1 of the tripartite leader, the first intervening sequence between leaders 1 and 2, leaders 2 and 3, the HBsAg gene, and tandem polyadenylation signals from the Ad4 E3B and hexon genes. Using this same cassette, a series of Ad4 recombinants expressing HBsAg were constructed with deletions in the intervening sequence between leaders 1 and 2 to evaluate the contribution of the downstream control elements more precisely. Inclusion of regions located between +82 and +148 as well as +148 and +232 resulted in increases in expression levels of HBsAg in A549-infected cells by 22-fold and 44-fold, respectively, over the levels attained by an adenovirus recombinant retaining only sequences from +1 to +82, showing the importance of these elements in the activation of the major late promoter during the course of a natural Ad4 viral infection. Parallel increases were also observed in steady-state levels of cytoplasmic HBsAg-specific mRNA. When similar Ad7 recombinant viruses were constructed, these viruses also expressed 20-fold more HBsAg due to the presence of the intron. All Ad4 and Ad7 recombinants produced HBsAg particles containing gp27 and p24 which were secreted in the medium. When dogs were immunized intratracheally with one of these Ad7 recombinants, they seroconverted to both Ad7 and HBsAg to a high level.</description><subject>Adenoviruses, Human - genetics</subject><subject>Base Sequence</subject><subject>Biological and medical sciences</subject><subject>Cell Line</subject><subject>Cloning, Molecular</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gene Expression</subject><subject>Genes, Viral</subject><subject>Hepatitis B Surface Antigens - genetics</subject><subject>Humans</subject><subject>Introns</subject><subject>Microbiology</subject><subject>Molecular Sequence Data</subject><subject>Oligonucleotide Probes</subject><subject>Recombination, Genetic</subject><subject>Regulatory Sequences, Nucleic Acid</subject><subject>Restriction Mapping</subject><subject>RNA, Messenger - genetics</subject><subject>Sequence Homology, Nucleic Acid</subject><subject>Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies</subject><subject>Viral Vaccines</subject><subject>Virology</subject><issn>0042-6822</issn><issn>1096-0341</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1990</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctuFDEQRS0ECpPAH4DkDSgsGux2P-wskELEI1IksoC15bGrJ4667cblHpE_4LPxZEbJDhaWVa57b1l1CHnF2XvOePeBsaauOlnXp4q9U6xlqrp-Qlacqa5iouFPyepB8pwcI96yUvc9OyJHteh533Ur8ufcQYhbnxakW2OtD0C3YHNMSOH3nADRhw29gdlknz3STxSXNBgL1ITsNxDO6OU0x5RNKG9xoAk2y2hKwB2FESYIGakPNN8Ux-OsydzGRIsOSjOnGF6QZ4MZEV4e7hPy88vnHxffqqvvXy8vzq8q23CZK7UemBCSdcNaMJC8F60EWY7olXOm5r1rS9W4Xknu2lpJY6Vkte2grUUnxAl5u8-dU_y1AGY9ebQwjiZAXFAXX9mX-r-Qt5ILJVkRNnuhTRExwaDn5CeT7jRnekdK7zDoHQatmL4npa-L7fUhf1lP4B5MBzSl_-bQN2jNOKSyYI-P2arlsr3XfdzroGxt6yFptB4KDOdTAald9P_-yF8bN7Fr</recordid><startdate>19900801</startdate><enddate>19900801</enddate><creator>Mason, Bruce B.</creator><creator>Davis, Alan R.</creator><creator>Brat, Bheem M.</creator><creator>Chengalvala, Murty</creator><creator>Lubeck, Michael D.</creator><creator>Zandle, Gordon</creator><creator>Kostek, Beverley</creator><creator>Cholodofsky, Stan</creator><creator>Dheer, Surendra</creator><creator>Molnar-Kimber, Katherine</creator><creator>Mizutani, Satoshi</creator><creator>Hung, Paul P.</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>7TM</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>19900801</creationdate><title>Adenovirus vaccine vectors expressing hepatitis B surface antigen: Importance of regulatory elements in the adenovirus major late intron</title><author>Mason, Bruce B. ; Davis, Alan R. ; Brat, Bheem M. ; Chengalvala, Murty ; Lubeck, Michael D. ; Zandle, Gordon ; Kostek, Beverley ; Cholodofsky, Stan ; Dheer, Surendra ; Molnar-Kimber, Katherine ; Mizutani, Satoshi ; Hung, Paul P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-9bf033806fb30e817358e858e379dda217d558e4d7981d5298ac8802c6e523633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1990</creationdate><topic>Adenoviruses, Human - genetics</topic><topic>Base Sequence</topic><topic>Biological and medical sciences</topic><topic>Cell Line</topic><topic>Cloning, Molecular</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gene Expression</topic><topic>Genes, Viral</topic><topic>Hepatitis B Surface Antigens - genetics</topic><topic>Humans</topic><topic>Introns</topic><topic>Microbiology</topic><topic>Molecular Sequence Data</topic><topic>Oligonucleotide Probes</topic><topic>Recombination, Genetic</topic><topic>Regulatory Sequences, Nucleic Acid</topic><topic>Restriction Mapping</topic><topic>RNA, Messenger - genetics</topic><topic>Sequence Homology, Nucleic Acid</topic><topic>Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies</topic><topic>Viral Vaccines</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mason, Bruce B.</creatorcontrib><creatorcontrib>Davis, Alan R.</creatorcontrib><creatorcontrib>Brat, Bheem M.</creatorcontrib><creatorcontrib>Chengalvala, Murty</creatorcontrib><creatorcontrib>Lubeck, Michael D.</creatorcontrib><creatorcontrib>Zandle, Gordon</creatorcontrib><creatorcontrib>Kostek, Beverley</creatorcontrib><creatorcontrib>Cholodofsky, Stan</creatorcontrib><creatorcontrib>Dheer, Surendra</creatorcontrib><creatorcontrib>Molnar-Kimber, Katherine</creatorcontrib><creatorcontrib>Mizutani, Satoshi</creatorcontrib><creatorcontrib>Hung, Paul P.</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>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Virology (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mason, Bruce B.</au><au>Davis, Alan R.</au><au>Brat, Bheem M.</au><au>Chengalvala, Murty</au><au>Lubeck, Michael D.</au><au>Zandle, Gordon</au><au>Kostek, Beverley</au><au>Cholodofsky, Stan</au><au>Dheer, Surendra</au><au>Molnar-Kimber, Katherine</au><au>Mizutani, Satoshi</au><au>Hung, Paul P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adenovirus vaccine vectors expressing hepatitis B surface antigen: Importance of regulatory elements in the adenovirus major late intron</atitle><jtitle>Virology (New York, N.Y.)</jtitle><addtitle>Virology</addtitle><date>1990-08-01</date><risdate>1990</risdate><volume>177</volume><issue>2</issue><spage>452</spage><epage>461</epage><pages>452-461</pages><issn>0042-6822</issn><eissn>1096-0341</eissn><coden>VIRLAX</coden><abstract>Adenovirus types 4 and 7 are currently used as live oral vaccines for prevention of acute respiratory disease caused by these adenovirus serotypes. To investigate the concept of producing live recombinant vaccines using these serotypes, adenovirus types 4 (Ad4) and 7 (Ad7) were constructed that produce HBsAg upon infection of cell cultures. Ad4 recombinants were constructed that express HBsAg from a cassette inserted 135 by from the right-hand terminus of the viral genome. The cassette contained the Ad4 major late promoter followed by leader 1 of the tripartite leader, the first intervening sequence between leaders 1 and 2, leaders 2 and 3, the HBsAg gene, and tandem polyadenylation signals from the Ad4 E3B and hexon genes. Using this same cassette, a series of Ad4 recombinants expressing HBsAg were constructed with deletions in the intervening sequence between leaders 1 and 2 to evaluate the contribution of the downstream control elements more precisely. Inclusion of regions located between +82 and +148 as well as +148 and +232 resulted in increases in expression levels of HBsAg in A549-infected cells by 22-fold and 44-fold, respectively, over the levels attained by an adenovirus recombinant retaining only sequences from +1 to +82, showing the importance of these elements in the activation of the major late promoter during the course of a natural Ad4 viral infection. Parallel increases were also observed in steady-state levels of cytoplasmic HBsAg-specific mRNA. When similar Ad7 recombinant viruses were constructed, these viruses also expressed 20-fold more HBsAg due to the presence of the intron. All Ad4 and Ad7 recombinants produced HBsAg particles containing gp27 and p24 which were secreted in the medium. When dogs were immunized intratracheally with one of these Ad7 recombinants, they seroconverted to both Ad7 and HBsAg to a high level.</abstract><cop>San Diego, CA</cop><pub>Elsevier Inc</pub><pmid>2371766</pmid><doi>10.1016/0042-6822(90)90509-P</doi><tpages>10</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0042-6822
ispartof Virology (New York, N.Y.), 1990-08, Vol.177 (2), p.452-461
issn 0042-6822
1096-0341
language eng
recordid cdi_proquest_miscellaneous_79882293
source MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
subjects Adenoviruses, Human - genetics
Base Sequence
Biological and medical sciences
Cell Line
Cloning, Molecular
Fundamental and applied biological sciences. Psychology
Gene Expression
Genes, Viral
Hepatitis B Surface Antigens - genetics
Humans
Introns
Microbiology
Molecular Sequence Data
Oligonucleotide Probes
Recombination, Genetic
Regulatory Sequences, Nucleic Acid
Restriction Mapping
RNA, Messenger - genetics
Sequence Homology, Nucleic Acid
Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies
Viral Vaccines
Virology
title Adenovirus vaccine vectors expressing hepatitis B surface antigen: Importance of regulatory elements in the adenovirus major late intron
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T01%3A46%3A28IST&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=Adenovirus%20vaccine%20vectors%20expressing%20hepatitis%20B%20surface%20antigen:%20Importance%20of%20regulatory%20elements%20in%20the%20adenovirus%20major%20late%20intron&rft.jtitle=Virology%20(New%20York,%20N.Y.)&rft.au=Mason,%20Bruce%20B.&rft.date=1990-08-01&rft.volume=177&rft.issue=2&rft.spage=452&rft.epage=461&rft.pages=452-461&rft.issn=0042-6822&rft.eissn=1096-0341&rft.coden=VIRLAX&rft_id=info:doi/10.1016/0042-6822(90)90509-P&rft_dat=%3Cproquest_cross%3E15813980%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=15813980&rft_id=info:pmid/2371766&rft_els_id=004268229090509P&rfr_iscdi=true