Involvement of the NF-κB signaling pathway in the renoprotective effects of isorhamnetin in a type 2 diabetic rat model
The aim of the present study was to investigate the renoprotective effects of isorhamnetin (ISO) in type 2 diabetic rats and its effects on the nuclear factor-κB (NF-κB) signaling pathway, which is associated with diabetic nephropathy. The type 2 diabetic rat model was established by a high-fat diet...
Gespeichert in:
Veröffentlicht in: | Biomedical reports 2016-05, Vol.4 (5), p.628-634 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 634 |
---|---|
container_issue | 5 |
container_start_page | 628 |
container_title | Biomedical reports |
container_volume | 4 |
creator | QIU, SHUJUAN SUN, GUILING ZHANG, YUNXIA LI, XIANGLING WANG, RONG |
description | The aim of the present study was to investigate the renoprotective effects of isorhamnetin (ISO) in type 2 diabetic rats and its effects on the nuclear factor-κB (NF-κB) signaling pathway, which is associated with diabetic nephropathy. The type 2 diabetic rat model was established by a high-fat diet plus streptozocin injection and the rats were subsequently treated with two dosages of ISO, respectively. The levels of blood glucose were determined. Urinary osteopontin, kidney injury molecule-1 (KIM-1) and albumin were measured to evaluate the renal function of the rats. Renal NF-κB signaling activity was assessed by measuring the levels of NF-κB p65, phospho-NF-κB p65, inhibitor of NF-κB (IκBα) and phospho-IκBα, and the NF-κB p65 DNA-binding activity. Downstream inflammatory mediators [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, intercellular adhesion molecule-1 (ICAM-1) and transforming growth factor-β1 (TGF-β1)] of the NF-κB signaling pathway were investigated to evaluate the renal inflammatory response. Renal levels of malondialdehyde and total superoxide dismutase were detected to access the oxidative stress. Furthermore, glomerular mesangial cells (GMCs) were treated with lipopolysaccharide and ISO. In the cellular experiment, the NF-κB signaling activity, levels of TNF-α, IL-1β, IL-6, ICAM-1 and TGF-β1, and oxidative stress were also investigated. The results showed that ISO decreased the levels of urinary osteopontin, KIM-1 and albumin. ISO also inhibited the NF-κB signaling activity, decreased the production of inflammatory mediators and attenuated oxidative stress in diabetic rats and GMCs. The present investigations revealed that ISO had ameliorative effects on diabetes-induced renal damage and the activity may be associated with the negative regulation of NF-κB signaling pathway. |
doi_str_mv | 10.3892/br.2016.636 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4840710</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826681015</sourcerecordid><originalsourceid>FETCH-LOGICAL-c437t-c9a10401dd508e6a981601836733906db1d6afe786098ab00cefa531c3537ddd3</originalsourceid><addsrcrecordid>eNpdkd9uFCEUxidGY5vaK-8NiTcmZtYDzDBwY2Ibq00aTYxeE2Y406WZgRHYrftqPoTPJGvr-gdIOOH8zseBr6qeUlhxqdirPq4YULESXDyojhk0qlZNwx4eYt4cVacp3UAZqgPWysfVEeso46xVx9W3S78N0xZn9JmEkeQ1kg8X9Y_vZyS5a28m56_JYvL61uyI87_yEX1YYsg4ZLdFguNYorSvdinEtZk95oKWZUjeLUgYsc705XAg0WQyB4vTk-rRaKaEp_f7SfXl4u3n8_f11cd3l-dvruqh4V2uB2UoNECtbUGiMEpSAVRy0XGuQNieWmFG7KQAJU0PMOBoWk4H3vLOWstPqtd3usumn9EO5Z3RTHqJbjZxp4Nx-t-Md2t9Hba6kQ10FIrAi3uBGL5uMGU9uzTgNBmPYZM0lUwISYG2BX3-H3oTNrF8YqEUB8UUp6JQL--oIYaUIo6HZijovam6j3pvqi6mFvrZ3_0f2N8W_rk0LcZbZ0M6MGefaihzL_MTHuqpxw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1930929316</pqid></control><display><type>article</type><title>Involvement of the NF-κB signaling pathway in the renoprotective effects of isorhamnetin in a type 2 diabetic rat model</title><source>Spandidos Publications Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>QIU, SHUJUAN ; SUN, GUILING ; ZHANG, YUNXIA ; LI, XIANGLING ; WANG, RONG</creator><creatorcontrib>QIU, SHUJUAN ; SUN, GUILING ; ZHANG, YUNXIA ; LI, XIANGLING ; WANG, RONG</creatorcontrib><description>The aim of the present study was to investigate the renoprotective effects of isorhamnetin (ISO) in type 2 diabetic rats and its effects on the nuclear factor-κB (NF-κB) signaling pathway, which is associated with diabetic nephropathy. The type 2 diabetic rat model was established by a high-fat diet plus streptozocin injection and the rats were subsequently treated with two dosages of ISO, respectively. The levels of blood glucose were determined. Urinary osteopontin, kidney injury molecule-1 (KIM-1) and albumin were measured to evaluate the renal function of the rats. Renal NF-κB signaling activity was assessed by measuring the levels of NF-κB p65, phospho-NF-κB p65, inhibitor of NF-κB (IκBα) and phospho-IκBα, and the NF-κB p65 DNA-binding activity. Downstream inflammatory mediators [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, intercellular adhesion molecule-1 (ICAM-1) and transforming growth factor-β1 (TGF-β1)] of the NF-κB signaling pathway were investigated to evaluate the renal inflammatory response. Renal levels of malondialdehyde and total superoxide dismutase were detected to access the oxidative stress. Furthermore, glomerular mesangial cells (GMCs) were treated with lipopolysaccharide and ISO. In the cellular experiment, the NF-κB signaling activity, levels of TNF-α, IL-1β, IL-6, ICAM-1 and TGF-β1, and oxidative stress were also investigated. The results showed that ISO decreased the levels of urinary osteopontin, KIM-1 and albumin. ISO also inhibited the NF-κB signaling activity, decreased the production of inflammatory mediators and attenuated oxidative stress in diabetic rats and GMCs. The present investigations revealed that ISO had ameliorative effects on diabetes-induced renal damage and the activity may be associated with the negative regulation of NF-κB signaling pathway.</description><identifier>ISSN: 2049-9434</identifier><identifier>EISSN: 2049-9442</identifier><identifier>DOI: 10.3892/br.2016.636</identifier><identifier>PMID: 27123259</identifier><language>eng</language><publisher>England: D.A. Spandidos</publisher><subject>Albumin ; Animals ; Biocompatibility ; Biomedical materials ; Cell adhesion ; Cytokines ; Deoxyribonucleic acid ; Diabetes ; Diabetes mellitus ; DNA ; Growth factors ; High fat diet ; Inflammation ; Inflammatory response ; Intercellular adhesion molecule 1 ; Interleukin 6 ; isorhamnetin ; Lipopolysaccharides ; Malondialdehyde ; Mesangial cells ; Nephropathy ; nuclear factor-κB signaling pathway ; Osteopontin ; Oxidative stress ; Pathogenesis ; Proteins ; Rats ; Renal function ; renoprotective effects ; Signal transduction ; Standard deviation ; Streptozocin ; Superoxide dismutase ; Transforming growth factor ; Transforming growth factor-b1 ; Tumor necrosis factor-TNF ; Tumor necrosis factor-α ; Urine</subject><ispartof>Biomedical reports, 2016-05, Vol.4 (5), p.628-634</ispartof><rights>Copyright © 2016, Spandidos Publications</rights><rights>Copyright Spandidos Publications UK Ltd. 2016</rights><rights>Copyright © 2016, Spandidos Publications 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-c9a10401dd508e6a981601836733906db1d6afe786098ab00cefa531c3537ddd3</citedby><cites>FETCH-LOGICAL-c437t-c9a10401dd508e6a981601836733906db1d6afe786098ab00cefa531c3537ddd3</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/PMC4840710/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840710/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,5573,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27123259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>QIU, SHUJUAN</creatorcontrib><creatorcontrib>SUN, GUILING</creatorcontrib><creatorcontrib>ZHANG, YUNXIA</creatorcontrib><creatorcontrib>LI, XIANGLING</creatorcontrib><creatorcontrib>WANG, RONG</creatorcontrib><title>Involvement of the NF-κB signaling pathway in the renoprotective effects of isorhamnetin in a type 2 diabetic rat model</title><title>Biomedical reports</title><addtitle>Biomed Rep</addtitle><description>The aim of the present study was to investigate the renoprotective effects of isorhamnetin (ISO) in type 2 diabetic rats and its effects on the nuclear factor-κB (NF-κB) signaling pathway, which is associated with diabetic nephropathy. The type 2 diabetic rat model was established by a high-fat diet plus streptozocin injection and the rats were subsequently treated with two dosages of ISO, respectively. The levels of blood glucose were determined. Urinary osteopontin, kidney injury molecule-1 (KIM-1) and albumin were measured to evaluate the renal function of the rats. Renal NF-κB signaling activity was assessed by measuring the levels of NF-κB p65, phospho-NF-κB p65, inhibitor of NF-κB (IκBα) and phospho-IκBα, and the NF-κB p65 DNA-binding activity. Downstream inflammatory mediators [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, intercellular adhesion molecule-1 (ICAM-1) and transforming growth factor-β1 (TGF-β1)] of the NF-κB signaling pathway were investigated to evaluate the renal inflammatory response. Renal levels of malondialdehyde and total superoxide dismutase were detected to access the oxidative stress. Furthermore, glomerular mesangial cells (GMCs) were treated with lipopolysaccharide and ISO. In the cellular experiment, the NF-κB signaling activity, levels of TNF-α, IL-1β, IL-6, ICAM-1 and TGF-β1, and oxidative stress were also investigated. The results showed that ISO decreased the levels of urinary osteopontin, KIM-1 and albumin. ISO also inhibited the NF-κB signaling activity, decreased the production of inflammatory mediators and attenuated oxidative stress in diabetic rats and GMCs. The present investigations revealed that ISO had ameliorative effects on diabetes-induced renal damage and the activity may be associated with the negative regulation of NF-κB signaling pathway.</description><subject>Albumin</subject><subject>Animals</subject><subject>Biocompatibility</subject><subject>Biomedical materials</subject><subject>Cell adhesion</subject><subject>Cytokines</subject><subject>Deoxyribonucleic acid</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>DNA</subject><subject>Growth factors</subject><subject>High fat diet</subject><subject>Inflammation</subject><subject>Inflammatory response</subject><subject>Intercellular adhesion molecule 1</subject><subject>Interleukin 6</subject><subject>isorhamnetin</subject><subject>Lipopolysaccharides</subject><subject>Malondialdehyde</subject><subject>Mesangial cells</subject><subject>Nephropathy</subject><subject>nuclear factor-κB signaling pathway</subject><subject>Osteopontin</subject><subject>Oxidative stress</subject><subject>Pathogenesis</subject><subject>Proteins</subject><subject>Rats</subject><subject>Renal function</subject><subject>renoprotective effects</subject><subject>Signal transduction</subject><subject>Standard deviation</subject><subject>Streptozocin</subject><subject>Superoxide dismutase</subject><subject>Transforming growth factor</subject><subject>Transforming growth factor-b1</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumor necrosis factor-α</subject><subject>Urine</subject><issn>2049-9434</issn><issn>2049-9442</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkd9uFCEUxidGY5vaK-8NiTcmZtYDzDBwY2Ibq00aTYxeE2Y406WZgRHYrftqPoTPJGvr-gdIOOH8zseBr6qeUlhxqdirPq4YULESXDyojhk0qlZNwx4eYt4cVacp3UAZqgPWysfVEeso46xVx9W3S78N0xZn9JmEkeQ1kg8X9Y_vZyS5a28m56_JYvL61uyI87_yEX1YYsg4ZLdFguNYorSvdinEtZk95oKWZUjeLUgYsc705XAg0WQyB4vTk-rRaKaEp_f7SfXl4u3n8_f11cd3l-dvruqh4V2uB2UoNECtbUGiMEpSAVRy0XGuQNieWmFG7KQAJU0PMOBoWk4H3vLOWstPqtd3usumn9EO5Z3RTHqJbjZxp4Nx-t-Md2t9Hba6kQ10FIrAi3uBGL5uMGU9uzTgNBmPYZM0lUwISYG2BX3-H3oTNrF8YqEUB8UUp6JQL--oIYaUIo6HZijovam6j3pvqi6mFvrZ3_0f2N8W_rk0LcZbZ0M6MGefaihzL_MTHuqpxw</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>QIU, SHUJUAN</creator><creator>SUN, GUILING</creator><creator>ZHANG, YUNXIA</creator><creator>LI, XIANGLING</creator><creator>WANG, RONG</creator><general>D.A. Spandidos</general><general>Spandidos Publications UK Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160501</creationdate><title>Involvement of the NF-κB signaling pathway in the renoprotective effects of isorhamnetin in a type 2 diabetic rat model</title><author>QIU, SHUJUAN ; SUN, GUILING ; ZHANG, YUNXIA ; LI, XIANGLING ; WANG, RONG</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-c9a10401dd508e6a981601836733906db1d6afe786098ab00cefa531c3537ddd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Albumin</topic><topic>Animals</topic><topic>Biocompatibility</topic><topic>Biomedical materials</topic><topic>Cell adhesion</topic><topic>Cytokines</topic><topic>Deoxyribonucleic acid</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>DNA</topic><topic>Growth factors</topic><topic>High fat diet</topic><topic>Inflammation</topic><topic>Inflammatory response</topic><topic>Intercellular adhesion molecule 1</topic><topic>Interleukin 6</topic><topic>isorhamnetin</topic><topic>Lipopolysaccharides</topic><topic>Malondialdehyde</topic><topic>Mesangial cells</topic><topic>Nephropathy</topic><topic>nuclear factor-κB signaling pathway</topic><topic>Osteopontin</topic><topic>Oxidative stress</topic><topic>Pathogenesis</topic><topic>Proteins</topic><topic>Rats</topic><topic>Renal function</topic><topic>renoprotective effects</topic><topic>Signal transduction</topic><topic>Standard deviation</topic><topic>Streptozocin</topic><topic>Superoxide dismutase</topic><topic>Transforming growth factor</topic><topic>Transforming growth factor-b1</topic><topic>Tumor necrosis factor-TNF</topic><topic>Tumor necrosis factor-α</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>QIU, SHUJUAN</creatorcontrib><creatorcontrib>SUN, GUILING</creatorcontrib><creatorcontrib>ZHANG, YUNXIA</creatorcontrib><creatorcontrib>LI, XIANGLING</creatorcontrib><creatorcontrib>WANG, RONG</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Biological Science Database</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Biomedical reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>QIU, SHUJUAN</au><au>SUN, GUILING</au><au>ZHANG, YUNXIA</au><au>LI, XIANGLING</au><au>WANG, RONG</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Involvement of the NF-κB signaling pathway in the renoprotective effects of isorhamnetin in a type 2 diabetic rat model</atitle><jtitle>Biomedical reports</jtitle><addtitle>Biomed Rep</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>4</volume><issue>5</issue><spage>628</spage><epage>634</epage><pages>628-634</pages><issn>2049-9434</issn><eissn>2049-9442</eissn><abstract>The aim of the present study was to investigate the renoprotective effects of isorhamnetin (ISO) in type 2 diabetic rats and its effects on the nuclear factor-κB (NF-κB) signaling pathway, which is associated with diabetic nephropathy. The type 2 diabetic rat model was established by a high-fat diet plus streptozocin injection and the rats were subsequently treated with two dosages of ISO, respectively. The levels of blood glucose were determined. Urinary osteopontin, kidney injury molecule-1 (KIM-1) and albumin were measured to evaluate the renal function of the rats. Renal NF-κB signaling activity was assessed by measuring the levels of NF-κB p65, phospho-NF-κB p65, inhibitor of NF-κB (IκBα) and phospho-IκBα, and the NF-κB p65 DNA-binding activity. Downstream inflammatory mediators [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, intercellular adhesion molecule-1 (ICAM-1) and transforming growth factor-β1 (TGF-β1)] of the NF-κB signaling pathway were investigated to evaluate the renal inflammatory response. Renal levels of malondialdehyde and total superoxide dismutase were detected to access the oxidative stress. Furthermore, glomerular mesangial cells (GMCs) were treated with lipopolysaccharide and ISO. In the cellular experiment, the NF-κB signaling activity, levels of TNF-α, IL-1β, IL-6, ICAM-1 and TGF-β1, and oxidative stress were also investigated. The results showed that ISO decreased the levels of urinary osteopontin, KIM-1 and albumin. ISO also inhibited the NF-κB signaling activity, decreased the production of inflammatory mediators and attenuated oxidative stress in diabetic rats and GMCs. The present investigations revealed that ISO had ameliorative effects on diabetes-induced renal damage and the activity may be associated with the negative regulation of NF-κB signaling pathway.</abstract><cop>England</cop><pub>D.A. Spandidos</pub><pmid>27123259</pmid><doi>10.3892/br.2016.636</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 2049-9434 |
ispartof | Biomedical reports, 2016-05, Vol.4 (5), p.628-634 |
issn | 2049-9434 2049-9442 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4840710 |
source | Spandidos Publications Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
subjects | Albumin Animals Biocompatibility Biomedical materials Cell adhesion Cytokines Deoxyribonucleic acid Diabetes Diabetes mellitus DNA Growth factors High fat diet Inflammation Inflammatory response Intercellular adhesion molecule 1 Interleukin 6 isorhamnetin Lipopolysaccharides Malondialdehyde Mesangial cells Nephropathy nuclear factor-κB signaling pathway Osteopontin Oxidative stress Pathogenesis Proteins Rats Renal function renoprotective effects Signal transduction Standard deviation Streptozocin Superoxide dismutase Transforming growth factor Transforming growth factor-b1 Tumor necrosis factor-TNF Tumor necrosis factor-α Urine |
title | Involvement of the NF-κB signaling pathway in the renoprotective effects of isorhamnetin in a type 2 diabetic rat model |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-16T00%3A03%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Involvement%20of%20the%20NF-%CE%BAB%20signaling%20pathway%20in%20the%20renoprotective%20effects%20of%20isorhamnetin%20in%20a%20type%202%20diabetic%20rat%20model&rft.jtitle=Biomedical%20reports&rft.au=QIU,%20SHUJUAN&rft.date=2016-05-01&rft.volume=4&rft.issue=5&rft.spage=628&rft.epage=634&rft.pages=628-634&rft.issn=2049-9434&rft.eissn=2049-9442&rft_id=info:doi/10.3892/br.2016.636&rft_dat=%3Cproquest_pubme%3E1826681015%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1930929316&rft_id=info:pmid/27123259&rfr_iscdi=true |