Initial metabolic state and exercise-induced endotoxaemia are unrelated to gastrointestinal symptoms during exercise
The aim of the study was to investigate the association between the initial metabolic state and exercise-induced endotoxaemia on the appearance of gastrointestinal symptoms (GIS) during exercise. Eleven males (36.6 ± 4.9 yrs, 1.7 ± 0.1 m, 74.5 ± 7.7 kg, DEXA body fat % 17.2 ± 6.6, VO2max 57.4 ± 7.4...
Gespeichert in:
Veröffentlicht in: | Journal of sports science & medicine 2009-06, Vol.8 (2), p.252-258 |
---|---|
Hauptverfasser: | , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 258 |
---|---|
container_issue | 2 |
container_start_page | 252 |
container_title | Journal of sports science & medicine |
container_volume | 8 |
creator | Moncada-Jimènez, José Plaisance, Eric P Mestek, Michael L Araya-Ramirez, Felipe Ratcliff, Lance Taylor, James K Grandjean, Peter W Aragonvargas, Luis F |
description | The aim of the study was to investigate the association between the initial metabolic state and exercise-induced endotoxaemia on the appearance of gastrointestinal symptoms (GIS) during exercise. Eleven males (36.6 ± 4.9 yrs, 1.7 ± 0.1 m, 74.5 ± 7.7 kg, DEXA body fat % 17.2 ± 6.6, VO2max 57.4 ± 7.4 ml·kg(-1)·min(-1)) underwent two isoenergetic diets designed to change their initial metabolic status by either depleting or maintaining their hepatic and muscular glycogen content. These diets and accompanying exercise sessions were performed by each participant in the days before completing a laboratory-based duathlon (5-km run, 30-km cycling, 10-km run). Blood samples were obtained before, immediately and 1- and 2-h following the duathlon for determination of insulin (IN), glucagon (GL), endotoxin, aspartic aminotransferase (AST), and alanine aminotransferase (ALT) markers. GIS were assessed by survey before and after exercise. Diet content produced a different energy status as determined by macronutrient content and the IN/GL ratio (p < 0.05), and mild exercise-induced endotoxaemia was observed in both experimental duathlons. Regardless of the diet, the AST/ALT ratio following exercise and in the recovery phase indicated hepatocyte and liver parenchyma structural damage. In spite of GIS, no significant correlations between endotoxin levels and GIS were found. In conclusion, increased markers of endotoxaemia observed with the high-intensity exercise were unrelated to hepatic function and/or GIS before and after exercise. Key pointsGastrointestinal symptoms before, during, and after a competition are reported by approximately 20%-50% of the athletes participating in endurance events such as marathon, cycling and triathlon.Energy status, exercise-induced endotoxaemia and liver structural damage might be related to gastrointestinal symptoms.In this study, gastrointestinal symptoms observed before and after endurance exercise were unrelated to endotoxin levels or hepatic structural damage. |
format | Article |
fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3761474</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A201944812</galeid><sourcerecordid>A201944812</sourcerecordid><originalsourceid>FETCH-LOGICAL-g501t-59ee7cc09b43ff69ad7bdefa0a372ecc356819958d5ea1eb6fdd26388f35746e3</originalsourceid><addsrcrecordid>eNqNkt9rFDEQgBdRbK3-C7IgFPuwspsfu8mLUA6tB4d9UJ_DXDK7l5JNzk22XP97U1rLrYhIHhIm33xJZvKsOG1oTSsiW_H8aH1SvIrxpq4J50S8LE4Ia5jklJ0Wae1tsuDKERNsg7O6jAkSluBNiQectI1YWW9mjTngTUjhADhaKGHCcvYTuoybMoVygJimYH3CmKzPzng37lMYY2nmyfrhyfe6eNGDi_jmcT4rfnz-9H31pdpcX61Xl5tq4HWTKi4RO61ruWW071sJptsa7KEG2hHUmvJWNFJyYThCg9u2N4a0VIie8o61SM-Kjw_e_bwd0Wj0aQKn9pMdYbpTAaxa7ni7U0O4VbRrG9axLDh_FEzh55yfpUYbNToHHsMcFckVFlyIDL7_J9gwxgSXrZQZffcHehPmKZcr64jkXDBe35_84YEawKGyvg_5gjoPk2uvg8fe5vglqRuZzQ3JCReLhMwkPKQB5hjV-tvX_2bF1WbJVn9jdXAOB1S5X6vrJX9-xO8QXNrF4OZkg49L8O1xc5668vtv0l8AL-Ci</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2295584504</pqid></control><display><type>article</type><title>Initial metabolic state and exercise-induced endotoxaemia are unrelated to gastrointestinal symptoms during exercise</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Moncada-Jimènez, José ; Plaisance, Eric P ; Mestek, Michael L ; Araya-Ramirez, Felipe ; Ratcliff, Lance ; Taylor, James K ; Grandjean, Peter W ; Aragonvargas, Luis F</creator><creatorcontrib>Moncada-Jimènez, José ; Plaisance, Eric P ; Mestek, Michael L ; Araya-Ramirez, Felipe ; Ratcliff, Lance ; Taylor, James K ; Grandjean, Peter W ; Aragonvargas, Luis F</creatorcontrib><description>The aim of the study was to investigate the association between the initial metabolic state and exercise-induced endotoxaemia on the appearance of gastrointestinal symptoms (GIS) during exercise. Eleven males (36.6 ± 4.9 yrs, 1.7 ± 0.1 m, 74.5 ± 7.7 kg, DEXA body fat % 17.2 ± 6.6, VO2max 57.4 ± 7.4 ml·kg(-1)·min(-1)) underwent two isoenergetic diets designed to change their initial metabolic status by either depleting or maintaining their hepatic and muscular glycogen content. These diets and accompanying exercise sessions were performed by each participant in the days before completing a laboratory-based duathlon (5-km run, 30-km cycling, 10-km run). Blood samples were obtained before, immediately and 1- and 2-h following the duathlon for determination of insulin (IN), glucagon (GL), endotoxin, aspartic aminotransferase (AST), and alanine aminotransferase (ALT) markers. GIS were assessed by survey before and after exercise. Diet content produced a different energy status as determined by macronutrient content and the IN/GL ratio (p < 0.05), and mild exercise-induced endotoxaemia was observed in both experimental duathlons. Regardless of the diet, the AST/ALT ratio following exercise and in the recovery phase indicated hepatocyte and liver parenchyma structural damage. In spite of GIS, no significant correlations between endotoxin levels and GIS were found. In conclusion, increased markers of endotoxaemia observed with the high-intensity exercise were unrelated to hepatic function and/or GIS before and after exercise. Key pointsGastrointestinal symptoms before, during, and after a competition are reported by approximately 20%-50% of the athletes participating in endurance events such as marathon, cycling and triathlon.Energy status, exercise-induced endotoxaemia and liver structural damage might be related to gastrointestinal symptoms.In this study, gastrointestinal symptoms observed before and after endurance exercise were unrelated to endotoxin levels or hepatic structural damage.</description><identifier>ISSN: 1303-2968</identifier><identifier>EISSN: 1303-2968</identifier><identifier>PMID: 24149534</identifier><language>eng</language><publisher>Turkey: Journal of Sports Science and Medicine</publisher><subject>Athletes ; Care and treatment ; Diagnosis ; Employment ; Energy ; Exercise ; Fitness equipment ; Food ; Gastrointestinal diseases ; Glycogen ; Graduate students ; Health aspects ; Laboratories ; Liver ; Marathons ; Metabolism ; Nonsteroidal anti-inflammatory drugs ; Nutrition research ; Physical education ; Physical fitness ; Physiology ; Proteins ; Sports medicine ; Triathlon</subject><ispartof>Journal of sports science & medicine, 2009-06, Vol.8 (2), p.252-258</ispartof><rights>COPYRIGHT 2009 Journal of Sports Science and Medicine</rights><rights>COPYRIGHT 2009 Journal of Sports Science and Medicine</rights><rights>2009. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Journal of Sports Science and Medicine 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761474/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761474/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24149534$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moncada-Jimènez, José</creatorcontrib><creatorcontrib>Plaisance, Eric P</creatorcontrib><creatorcontrib>Mestek, Michael L</creatorcontrib><creatorcontrib>Araya-Ramirez, Felipe</creatorcontrib><creatorcontrib>Ratcliff, Lance</creatorcontrib><creatorcontrib>Taylor, James K</creatorcontrib><creatorcontrib>Grandjean, Peter W</creatorcontrib><creatorcontrib>Aragonvargas, Luis F</creatorcontrib><title>Initial metabolic state and exercise-induced endotoxaemia are unrelated to gastrointestinal symptoms during exercise</title><title>Journal of sports science & medicine</title><addtitle>J Sports Sci Med</addtitle><description>The aim of the study was to investigate the association between the initial metabolic state and exercise-induced endotoxaemia on the appearance of gastrointestinal symptoms (GIS) during exercise. Eleven males (36.6 ± 4.9 yrs, 1.7 ± 0.1 m, 74.5 ± 7.7 kg, DEXA body fat % 17.2 ± 6.6, VO2max 57.4 ± 7.4 ml·kg(-1)·min(-1)) underwent two isoenergetic diets designed to change their initial metabolic status by either depleting or maintaining their hepatic and muscular glycogen content. These diets and accompanying exercise sessions were performed by each participant in the days before completing a laboratory-based duathlon (5-km run, 30-km cycling, 10-km run). Blood samples were obtained before, immediately and 1- and 2-h following the duathlon for determination of insulin (IN), glucagon (GL), endotoxin, aspartic aminotransferase (AST), and alanine aminotransferase (ALT) markers. GIS were assessed by survey before and after exercise. Diet content produced a different energy status as determined by macronutrient content and the IN/GL ratio (p < 0.05), and mild exercise-induced endotoxaemia was observed in both experimental duathlons. Regardless of the diet, the AST/ALT ratio following exercise and in the recovery phase indicated hepatocyte and liver parenchyma structural damage. In spite of GIS, no significant correlations between endotoxin levels and GIS were found. In conclusion, increased markers of endotoxaemia observed with the high-intensity exercise were unrelated to hepatic function and/or GIS before and after exercise. Key pointsGastrointestinal symptoms before, during, and after a competition are reported by approximately 20%-50% of the athletes participating in endurance events such as marathon, cycling and triathlon.Energy status, exercise-induced endotoxaemia and liver structural damage might be related to gastrointestinal symptoms.In this study, gastrointestinal symptoms observed before and after endurance exercise were unrelated to endotoxin levels or hepatic structural damage.</description><subject>Athletes</subject><subject>Care and treatment</subject><subject>Diagnosis</subject><subject>Employment</subject><subject>Energy</subject><subject>Exercise</subject><subject>Fitness equipment</subject><subject>Food</subject><subject>Gastrointestinal diseases</subject><subject>Glycogen</subject><subject>Graduate students</subject><subject>Health aspects</subject><subject>Laboratories</subject><subject>Liver</subject><subject>Marathons</subject><subject>Metabolism</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Nutrition research</subject><subject>Physical education</subject><subject>Physical fitness</subject><subject>Physiology</subject><subject>Proteins</subject><subject>Sports medicine</subject><subject>Triathlon</subject><issn>1303-2968</issn><issn>1303-2968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNqNkt9rFDEQgBdRbK3-C7IgFPuwspsfu8mLUA6tB4d9UJ_DXDK7l5JNzk22XP97U1rLrYhIHhIm33xJZvKsOG1oTSsiW_H8aH1SvIrxpq4J50S8LE4Ia5jklJ0Wae1tsuDKERNsg7O6jAkSluBNiQectI1YWW9mjTngTUjhADhaKGHCcvYTuoybMoVygJimYH3CmKzPzng37lMYY2nmyfrhyfe6eNGDi_jmcT4rfnz-9H31pdpcX61Xl5tq4HWTKi4RO61ruWW071sJptsa7KEG2hHUmvJWNFJyYThCg9u2N4a0VIie8o61SM-Kjw_e_bwd0Wj0aQKn9pMdYbpTAaxa7ni7U0O4VbRrG9axLDh_FEzh55yfpUYbNToHHsMcFckVFlyIDL7_J9gwxgSXrZQZffcHehPmKZcr64jkXDBe35_84YEawKGyvg_5gjoPk2uvg8fe5vglqRuZzQ3JCReLhMwkPKQB5hjV-tvX_2bF1WbJVn9jdXAOB1S5X6vrJX9-xO8QXNrF4OZkg49L8O1xc5668vtv0l8AL-Ci</recordid><startdate>20090601</startdate><enddate>20090601</enddate><creator>Moncada-Jimènez, José</creator><creator>Plaisance, Eric P</creator><creator>Mestek, Michael L</creator><creator>Araya-Ramirez, Felipe</creator><creator>Ratcliff, Lance</creator><creator>Taylor, James K</creator><creator>Grandjean, Peter W</creator><creator>Aragonvargas, Luis F</creator><general>Journal of Sports Science and Medicine</general><general>Asist Group</general><scope>NPM</scope><scope>8GL</scope><scope>ISN</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20090601</creationdate><title>Initial metabolic state and exercise-induced endotoxaemia are unrelated to gastrointestinal symptoms during exercise</title><author>Moncada-Jimènez, José ; Plaisance, Eric P ; Mestek, Michael L ; Araya-Ramirez, Felipe ; Ratcliff, Lance ; Taylor, James K ; Grandjean, Peter W ; Aragonvargas, Luis F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g501t-59ee7cc09b43ff69ad7bdefa0a372ecc356819958d5ea1eb6fdd26388f35746e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Athletes</topic><topic>Care and treatment</topic><topic>Diagnosis</topic><topic>Employment</topic><topic>Energy</topic><topic>Exercise</topic><topic>Fitness equipment</topic><topic>Food</topic><topic>Gastrointestinal diseases</topic><topic>Glycogen</topic><topic>Graduate students</topic><topic>Health aspects</topic><topic>Laboratories</topic><topic>Liver</topic><topic>Marathons</topic><topic>Metabolism</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Nutrition research</topic><topic>Physical education</topic><topic>Physical fitness</topic><topic>Physiology</topic><topic>Proteins</topic><topic>Sports medicine</topic><topic>Triathlon</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moncada-Jimènez, José</creatorcontrib><creatorcontrib>Plaisance, Eric P</creatorcontrib><creatorcontrib>Mestek, Michael L</creatorcontrib><creatorcontrib>Araya-Ramirez, Felipe</creatorcontrib><creatorcontrib>Ratcliff, Lance</creatorcontrib><creatorcontrib>Taylor, James K</creatorcontrib><creatorcontrib>Grandjean, Peter W</creatorcontrib><creatorcontrib>Aragonvargas, Luis F</creatorcontrib><collection>PubMed</collection><collection>Gale In Context: High School</collection><collection>Gale In Context: Canada</collection><collection>ProQuest Central (Corporate)</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>Science Database (Alumni Edition)</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 Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of sports science & medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moncada-Jimènez, José</au><au>Plaisance, Eric P</au><au>Mestek, Michael L</au><au>Araya-Ramirez, Felipe</au><au>Ratcliff, Lance</au><au>Taylor, James K</au><au>Grandjean, Peter W</au><au>Aragonvargas, Luis F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Initial metabolic state and exercise-induced endotoxaemia are unrelated to gastrointestinal symptoms during exercise</atitle><jtitle>Journal of sports science & medicine</jtitle><addtitle>J Sports Sci Med</addtitle><date>2009-06-01</date><risdate>2009</risdate><volume>8</volume><issue>2</issue><spage>252</spage><epage>258</epage><pages>252-258</pages><issn>1303-2968</issn><eissn>1303-2968</eissn><abstract>The aim of the study was to investigate the association between the initial metabolic state and exercise-induced endotoxaemia on the appearance of gastrointestinal symptoms (GIS) during exercise. Eleven males (36.6 ± 4.9 yrs, 1.7 ± 0.1 m, 74.5 ± 7.7 kg, DEXA body fat % 17.2 ± 6.6, VO2max 57.4 ± 7.4 ml·kg(-1)·min(-1)) underwent two isoenergetic diets designed to change their initial metabolic status by either depleting or maintaining their hepatic and muscular glycogen content. These diets and accompanying exercise sessions were performed by each participant in the days before completing a laboratory-based duathlon (5-km run, 30-km cycling, 10-km run). Blood samples were obtained before, immediately and 1- and 2-h following the duathlon for determination of insulin (IN), glucagon (GL), endotoxin, aspartic aminotransferase (AST), and alanine aminotransferase (ALT) markers. GIS were assessed by survey before and after exercise. Diet content produced a different energy status as determined by macronutrient content and the IN/GL ratio (p < 0.05), and mild exercise-induced endotoxaemia was observed in both experimental duathlons. Regardless of the diet, the AST/ALT ratio following exercise and in the recovery phase indicated hepatocyte and liver parenchyma structural damage. In spite of GIS, no significant correlations between endotoxin levels and GIS were found. In conclusion, increased markers of endotoxaemia observed with the high-intensity exercise were unrelated to hepatic function and/or GIS before and after exercise. Key pointsGastrointestinal symptoms before, during, and after a competition are reported by approximately 20%-50% of the athletes participating in endurance events such as marathon, cycling and triathlon.Energy status, exercise-induced endotoxaemia and liver structural damage might be related to gastrointestinal symptoms.In this study, gastrointestinal symptoms observed before and after endurance exercise were unrelated to endotoxin levels or hepatic structural damage.</abstract><cop>Turkey</cop><pub>Journal of Sports Science and Medicine</pub><pmid>24149534</pmid><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1303-2968 |
ispartof | Journal of sports science & medicine, 2009-06, Vol.8 (2), p.252-258 |
issn | 1303-2968 1303-2968 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3761474 |
source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
subjects | Athletes Care and treatment Diagnosis Employment Energy Exercise Fitness equipment Food Gastrointestinal diseases Glycogen Graduate students Health aspects Laboratories Liver Marathons Metabolism Nonsteroidal anti-inflammatory drugs Nutrition research Physical education Physical fitness Physiology Proteins Sports medicine Triathlon |
title | Initial metabolic state and exercise-induced endotoxaemia are unrelated to gastrointestinal symptoms during exercise |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T05%3A25%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Initial%20metabolic%20state%20and%20exercise-induced%20endotoxaemia%20are%20unrelated%20to%20gastrointestinal%20symptoms%20during%20exercise&rft.jtitle=Journal%20of%20sports%20science%20&%20medicine&rft.au=Moncada-Jim%C3%A8nez,%20Jos%C3%A9&rft.date=2009-06-01&rft.volume=8&rft.issue=2&rft.spage=252&rft.epage=258&rft.pages=252-258&rft.issn=1303-2968&rft.eissn=1303-2968&rft_id=info:doi/&rft_dat=%3Cgale_pubme%3EA201944812%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2295584504&rft_id=info:pmid/24149534&rft_galeid=A201944812&rfr_iscdi=true |