A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology
Objective To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women. Design Prospective, comparative study. Setting Obstetrics and Gynecology Departmen...
Gespeichert in:
| Veröffentlicht in: | Fertility and sterility 2010-12, Vol.94 (7), p.2720-2725 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2725 |
|---|---|
| container_issue | 7 |
| container_start_page | 2720 |
| container_title | Fertility and sterility |
| container_volume | 94 |
| creator | Grimbizis, Grigoris F., M.D., Ph.D Tsolakidis, Dimitrios, M.D., Ph.D Mikos, Themistoklis, M.Sc., M.D., Ph.D Anagnostou, Eftychia, M.D., Ph.D Asimakopoulos, Efstratios, M.D., Ph.D Stamatopoulos, Panagiotis, M.D., Ph.D Tarlatzis, Basil C., M.D., Ph.D |
| description | Objective To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women. Design Prospective, comparative study. Setting Obstetrics and Gynecology Department of a tertiary academic hospital. Patient(s) A total of 105 consecutive women presenting in an outpatient clinic with symptoms of menorrhagia, postmenopausal bleeding, and infertility. Intervention(s) Each patient had TVS, SIS, and DH. Main Outcome Measure(s) The sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for TVS, SIS, and DH were determined for the diagnosis of endometrial pathology. More specifically, the diagnostic performance of each of these three methods was compared after receiver operating characteristic analysis. Result(s) By comparative analysis of the area under the curve, DH was found to have a significantly better diagnostic performance compared to SIS and TVS. In addition, after comparing the receiver operating characteristic curves, DH was found to be significantly more precise in the diagnosis of intracavitary masses than TVS and SIS. However, SIS was more accurate compared to TVS. Conclusion(s) Saline infusion sonohysterography appears to be more valuable than TVS in the diagnosis of intracavitary masses (both polyps and myomas). |
| doi_str_mv | 10.1016/j.fertnstert.2010.03.047 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_814464141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S001502821000508X</els_id><sourcerecordid>814464141</sourcerecordid><originalsourceid>FETCH-LOGICAL-c574t-9476ba832761a0fbb4bc5ef4b4d0d46a36c1a660148a0cf312a4c3ce7704624b3</originalsourceid><addsrcrecordid>eNqNksFu1DAQhiMEotvCKyBfEJdmsRPHCRekUkFBqsQBkLhZE2ey6yWxg8dZKS_Ds-JoFypx4mLL9jfzj-efLGOCbwUX6vVh22OIjmJatwVP17zcclk_yjaiqlReqap8nG04F1XOi6a4yC6JDpxzJeriaXZRcKmKqq432a8bNgVPE5poj8iMHycIlrxjvmcxgKMj7KyDgc1DOpKfXXfNCAbrkFnXz2QTm3i_X9Zy_C7AtF-uGbiOdRZ2zlO0hp1fyfhpSXEs7pHhEYYZoj2Joev8iDHYpDVB3PvB75Zn2ZMeBsLn5_0q-_bh_dfbj_n957tPtzf3ualqGfM3slYtNGVRKwG8b1vZmgp72cqOd1JBqYwApbiQDXDTl6IAaUqDdb02QrblVfbqlDc14-eMFPVoyeAwgEM_k26ElEoKKRLZnEiTfkMBez0FO0JYtOB6NUcf9IM5ejVH81Inc1Loi7PI3I7Y_Q3840YCXp4BIANDn9pvLD1wpWpqwZvEvTtxmFpytBg0GYvOYGdDMlJ33v5PNW__SWKSqTbp_sAF6eDnkGwnLTQVmusv6zCtsyTSGFW8-V7-Bm5uzUs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>814464141</pqid></control><display><type>article</type><title>A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Grimbizis, Grigoris F., M.D., Ph.D ; Tsolakidis, Dimitrios, M.D., Ph.D ; Mikos, Themistoklis, M.Sc., M.D., Ph.D ; Anagnostou, Eftychia, M.D., Ph.D ; Asimakopoulos, Efstratios, M.D., Ph.D ; Stamatopoulos, Panagiotis, M.D., Ph.D ; Tarlatzis, Basil C., M.D., Ph.D</creator><creatorcontrib>Grimbizis, Grigoris F., M.D., Ph.D ; Tsolakidis, Dimitrios, M.D., Ph.D ; Mikos, Themistoklis, M.Sc., M.D., Ph.D ; Anagnostou, Eftychia, M.D., Ph.D ; Asimakopoulos, Efstratios, M.D., Ph.D ; Stamatopoulos, Panagiotis, M.D., Ph.D ; Tarlatzis, Basil C., M.D., Ph.D</creatorcontrib><description>Objective To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women. Design Prospective, comparative study. Setting Obstetrics and Gynecology Department of a tertiary academic hospital. Patient(s) A total of 105 consecutive women presenting in an outpatient clinic with symptoms of menorrhagia, postmenopausal bleeding, and infertility. Intervention(s) Each patient had TVS, SIS, and DH. Main Outcome Measure(s) The sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for TVS, SIS, and DH were determined for the diagnosis of endometrial pathology. More specifically, the diagnostic performance of each of these three methods was compared after receiver operating characteristic analysis. Result(s) By comparative analysis of the area under the curve, DH was found to have a significantly better diagnostic performance compared to SIS and TVS. In addition, after comparing the receiver operating characteristic curves, DH was found to be significantly more precise in the diagnosis of intracavitary masses than TVS and SIS. However, SIS was more accurate compared to TVS. Conclusion(s) Saline infusion sonohysterography appears to be more valuable than TVS in the diagnosis of intracavitary masses (both polyps and myomas).</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2010.03.047</identifier><identifier>PMID: 20462577</identifier><identifier>CODEN: FESTAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Area Under Curve ; Biological and medical sciences ; Diagnostic hysteroscopy ; endometrial cancer ; endometrial hyperplasia ; endometrial pathology ; endometrial polyp ; Female ; Female genital diseases ; Gynecology. Andrology. Obstetrics ; Humans ; Hysterosalpingography - adverse effects ; Hysterosalpingography - methods ; Hysteroscopy - adverse effects ; Hysteroscopy - methods ; Internal Medicine ; Medical sciences ; Middle Aged ; myoma ; Obstetrics and Gynecology ; ROC Curve ; saline infusion sonohysterography ; Sensitivity and Specificity ; Single-Blind Method ; Sodium Chloride - administration & dosage ; structural uterine anomalies ; transvaginal ultrasound ; Tumors ; Ultrasonography ; Uterine Diseases - diagnostic imaging ; Uterus - diagnostic imaging ; Vagina - diagnostic imaging</subject><ispartof>Fertility and sterility, 2010-12, Vol.94 (7), p.2720-2725</ispartof><rights>American Society for Reproductive Medicine</rights><rights>2010 American Society for Reproductive Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c574t-9476ba832761a0fbb4bc5ef4b4d0d46a36c1a660148a0cf312a4c3ce7704624b3</citedby><cites>FETCH-LOGICAL-c574t-9476ba832761a0fbb4bc5ef4b4d0d46a36c1a660148a0cf312a4c3ce7704624b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.fertnstert.2010.03.047$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23687108$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20462577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grimbizis, Grigoris F., M.D., Ph.D</creatorcontrib><creatorcontrib>Tsolakidis, Dimitrios, M.D., Ph.D</creatorcontrib><creatorcontrib>Mikos, Themistoklis, M.Sc., M.D., Ph.D</creatorcontrib><creatorcontrib>Anagnostou, Eftychia, M.D., Ph.D</creatorcontrib><creatorcontrib>Asimakopoulos, Efstratios, M.D., Ph.D</creatorcontrib><creatorcontrib>Stamatopoulos, Panagiotis, M.D., Ph.D</creatorcontrib><creatorcontrib>Tarlatzis, Basil C., M.D., Ph.D</creatorcontrib><title>A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Objective To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women. Design Prospective, comparative study. Setting Obstetrics and Gynecology Department of a tertiary academic hospital. Patient(s) A total of 105 consecutive women presenting in an outpatient clinic with symptoms of menorrhagia, postmenopausal bleeding, and infertility. Intervention(s) Each patient had TVS, SIS, and DH. Main Outcome Measure(s) The sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for TVS, SIS, and DH were determined for the diagnosis of endometrial pathology. More specifically, the diagnostic performance of each of these three methods was compared after receiver operating characteristic analysis. Result(s) By comparative analysis of the area under the curve, DH was found to have a significantly better diagnostic performance compared to SIS and TVS. In addition, after comparing the receiver operating characteristic curves, DH was found to be significantly more precise in the diagnosis of intracavitary masses than TVS and SIS. However, SIS was more accurate compared to TVS. Conclusion(s) Saline infusion sonohysterography appears to be more valuable than TVS in the diagnosis of intracavitary masses (both polyps and myomas).</description><subject>Adult</subject><subject>Aged</subject><subject>Area Under Curve</subject><subject>Biological and medical sciences</subject><subject>Diagnostic hysteroscopy</subject><subject>endometrial cancer</subject><subject>endometrial hyperplasia</subject><subject>endometrial pathology</subject><subject>endometrial polyp</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hysterosalpingography - adverse effects</subject><subject>Hysterosalpingography - methods</subject><subject>Hysteroscopy - adverse effects</subject><subject>Hysteroscopy - methods</subject><subject>Internal Medicine</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>myoma</subject><subject>Obstetrics and Gynecology</subject><subject>ROC Curve</subject><subject>saline infusion sonohysterography</subject><subject>Sensitivity and Specificity</subject><subject>Single-Blind Method</subject><subject>Sodium Chloride - administration & dosage</subject><subject>structural uterine anomalies</subject><subject>transvaginal ultrasound</subject><subject>Tumors</subject><subject>Ultrasonography</subject><subject>Uterine Diseases - diagnostic imaging</subject><subject>Uterus - diagnostic imaging</subject><subject>Vagina - diagnostic imaging</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNksFu1DAQhiMEotvCKyBfEJdmsRPHCRekUkFBqsQBkLhZE2ey6yWxg8dZKS_Ds-JoFypx4mLL9jfzj-efLGOCbwUX6vVh22OIjmJatwVP17zcclk_yjaiqlReqap8nG04F1XOi6a4yC6JDpxzJeriaXZRcKmKqq432a8bNgVPE5poj8iMHycIlrxjvmcxgKMj7KyDgc1DOpKfXXfNCAbrkFnXz2QTm3i_X9Zy_C7AtF-uGbiOdRZ2zlO0hp1fyfhpSXEs7pHhEYYZoj2Joev8iDHYpDVB3PvB75Zn2ZMeBsLn5_0q-_bh_dfbj_n957tPtzf3ualqGfM3slYtNGVRKwG8b1vZmgp72cqOd1JBqYwApbiQDXDTl6IAaUqDdb02QrblVfbqlDc14-eMFPVoyeAwgEM_k26ElEoKKRLZnEiTfkMBez0FO0JYtOB6NUcf9IM5ejVH81Inc1Loi7PI3I7Y_Q3840YCXp4BIANDn9pvLD1wpWpqwZvEvTtxmFpytBg0GYvOYGdDMlJ33v5PNW__SWKSqTbp_sAF6eDnkGwnLTQVmusv6zCtsyTSGFW8-V7-Bm5uzUs</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Grimbizis, Grigoris F., M.D., Ph.D</creator><creator>Tsolakidis, Dimitrios, M.D., Ph.D</creator><creator>Mikos, Themistoklis, M.Sc., M.D., Ph.D</creator><creator>Anagnostou, Eftychia, M.D., Ph.D</creator><creator>Asimakopoulos, Efstratios, M.D., Ph.D</creator><creator>Stamatopoulos, Panagiotis, M.D., Ph.D</creator><creator>Tarlatzis, Basil C., M.D., Ph.D</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>7X8</scope></search><sort><creationdate>20101201</creationdate><title>A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology</title><author>Grimbizis, Grigoris F., M.D., Ph.D ; Tsolakidis, Dimitrios, M.D., Ph.D ; Mikos, Themistoklis, M.Sc., M.D., Ph.D ; Anagnostou, Eftychia, M.D., Ph.D ; Asimakopoulos, Efstratios, M.D., Ph.D ; Stamatopoulos, Panagiotis, M.D., Ph.D ; Tarlatzis, Basil C., M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c574t-9476ba832761a0fbb4bc5ef4b4d0d46a36c1a660148a0cf312a4c3ce7704624b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Area Under Curve</topic><topic>Biological and medical sciences</topic><topic>Diagnostic hysteroscopy</topic><topic>endometrial cancer</topic><topic>endometrial hyperplasia</topic><topic>endometrial pathology</topic><topic>endometrial polyp</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hysterosalpingography - adverse effects</topic><topic>Hysterosalpingography - methods</topic><topic>Hysteroscopy - adverse effects</topic><topic>Hysteroscopy - methods</topic><topic>Internal Medicine</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>myoma</topic><topic>Obstetrics and Gynecology</topic><topic>ROC Curve</topic><topic>saline infusion sonohysterography</topic><topic>Sensitivity and Specificity</topic><topic>Single-Blind Method</topic><topic>Sodium Chloride - administration & dosage</topic><topic>structural uterine anomalies</topic><topic>transvaginal ultrasound</topic><topic>Tumors</topic><topic>Ultrasonography</topic><topic>Uterine Diseases - diagnostic imaging</topic><topic>Uterus - diagnostic imaging</topic><topic>Vagina - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grimbizis, Grigoris F., M.D., Ph.D</creatorcontrib><creatorcontrib>Tsolakidis, Dimitrios, M.D., Ph.D</creatorcontrib><creatorcontrib>Mikos, Themistoklis, M.Sc., M.D., Ph.D</creatorcontrib><creatorcontrib>Anagnostou, Eftychia, M.D., Ph.D</creatorcontrib><creatorcontrib>Asimakopoulos, Efstratios, M.D., Ph.D</creatorcontrib><creatorcontrib>Stamatopoulos, Panagiotis, M.D., Ph.D</creatorcontrib><creatorcontrib>Tarlatzis, Basil C., M.D., Ph.D</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>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grimbizis, Grigoris F., M.D., Ph.D</au><au>Tsolakidis, Dimitrios, M.D., Ph.D</au><au>Mikos, Themistoklis, M.Sc., M.D., Ph.D</au><au>Anagnostou, Eftychia, M.D., Ph.D</au><au>Asimakopoulos, Efstratios, M.D., Ph.D</au><au>Stamatopoulos, Panagiotis, M.D., Ph.D</au><au>Tarlatzis, Basil C., M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>94</volume><issue>7</issue><spage>2720</spage><epage>2725</epage><pages>2720-2725</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><coden>FESTAS</coden><abstract>Objective To compare the diagnostic performance of saline infusion sonohysterography (SIS), transvaginal ultrasound (TVS), and diagnostic hysteroscopy (DH) in the detection of endometrial lesions in symptomatic women. Design Prospective, comparative study. Setting Obstetrics and Gynecology Department of a tertiary academic hospital. Patient(s) A total of 105 consecutive women presenting in an outpatient clinic with symptoms of menorrhagia, postmenopausal bleeding, and infertility. Intervention(s) Each patient had TVS, SIS, and DH. Main Outcome Measure(s) The sensitivity, specificity, and positive and negative likelihood ratios (LR+ and LR-) for TVS, SIS, and DH were determined for the diagnosis of endometrial pathology. More specifically, the diagnostic performance of each of these three methods was compared after receiver operating characteristic analysis. Result(s) By comparative analysis of the area under the curve, DH was found to have a significantly better diagnostic performance compared to SIS and TVS. In addition, after comparing the receiver operating characteristic curves, DH was found to be significantly more precise in the diagnosis of intracavitary masses than TVS and SIS. However, SIS was more accurate compared to TVS. Conclusion(s) Saline infusion sonohysterography appears to be more valuable than TVS in the diagnosis of intracavitary masses (both polyps and myomas).</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20462577</pmid><doi>10.1016/j.fertnstert.2010.03.047</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0015-0282 |
| ispartof | Fertility and sterility, 2010-12, Vol.94 (7), p.2720-2725 |
| issn | 0015-0282 1556-5653 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_814464141 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Aged Area Under Curve Biological and medical sciences Diagnostic hysteroscopy endometrial cancer endometrial hyperplasia endometrial pathology endometrial polyp Female Female genital diseases Gynecology. Andrology. Obstetrics Humans Hysterosalpingography - adverse effects Hysterosalpingography - methods Hysteroscopy - adverse effects Hysteroscopy - methods Internal Medicine Medical sciences Middle Aged myoma Obstetrics and Gynecology ROC Curve saline infusion sonohysterography Sensitivity and Specificity Single-Blind Method Sodium Chloride - administration & dosage structural uterine anomalies transvaginal ultrasound Tumors Ultrasonography Uterine Diseases - diagnostic imaging Uterus - diagnostic imaging Vagina - diagnostic imaging |
| title | A prospective comparison of transvaginal ultrasound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T13%3A30%3A47IST&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=A%20prospective%20comparison%20of%20transvaginal%20ultrasound,%20saline%20infusion%20sonohysterography,%20and%20diagnostic%20hysteroscopy%20in%20the%20evaluation%20of%20endometrial%20pathology&rft.jtitle=Fertility%20and%20sterility&rft.au=Grimbizis,%20Grigoris%20F.,%20M.D.,%20Ph.D&rft.date=2010-12-01&rft.volume=94&rft.issue=7&rft.spage=2720&rft.epage=2725&rft.pages=2720-2725&rft.issn=0015-0282&rft.eissn=1556-5653&rft.coden=FESTAS&rft_id=info:doi/10.1016/j.fertnstert.2010.03.047&rft_dat=%3Cproquest_cross%3E814464141%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=814464141&rft_id=info:pmid/20462577&rft_els_id=S001502821000508X&rfr_iscdi=true |