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Grant Details

Grant Number: 1R01CA136726-01A1 Interpret this number
Primary Investigator: Li, Li
Organization: Case Western Reserve University
Project Title: Obesity-Related Insulin Resistance Signaling Pathway Factors and Colon Cancer
Fiscal Year: 2009


Abstract

DESCRIPTION (provided by applicant): Obesity is now established as a potential cause for colon cancer. While the underlying mechanisms mediating the obesity-colon cancer link are not well understood, increasing evidence supports that Insulin resistance resulting from long-term energy imbalance and subsequent perturbation of metabolic homeostasis and insulin signaling pathways form the core of obesity-related colon carcinogenesis. Genetic variations within genes in key insulin and growth factor signaling pathways may, or in combination with obesity, drive the development of colon cancer, but have been little studied. The fact that obesity is escalating as an epidemic worldwide makes the exploration of the mechanistic connections between obesity and colon cancer a pressing public health and research priority. Therefore, we propose a genetic epidemiologic study of the relation of colon cancer with obesity and candidate genes in four critical insulin and related growth factor signaling pathways: 1) phosphatidylinositol-3 Kinase/protein kinase B (PI3K/AKT) signaling cascade; 2) AMP-activated protein kinase (AMPK) pathway; 3) mitogen-activated protein (MAP) kinase pathway; and 4) peroxisome proliferators-activated receptors (PPARs). Each of these pathways plays an important role linking increased adiposity to colon carcinogenesis and model systems indicate that crosstalk occurs among them. We will use both conventional statistical approaches and a novel hierarchical model to comprehensively evaluate obesity and adult weight gain, candidate gene polymorphisms and haplotypes, and their potential joint and interactive effects on colon cancer. The unifying theme of this proposal is that obesity and candidate gene variants within these pathways may act alone or jointly to drive colon carcinogenesis. This study builds upon an ongoing population-based case-control study where epidemiologic data and DNA samples from 1,250 incident colon cancer cases and 1,500 population controls has already being collected. This relatively large study population will be readily available and allow us to dissect complex gene-gene and gene-obesity interactions to gain in- depth understanding of mechanistic link between obesity and colon carcinogenesis. PUBLIC HEALTH RELEVANCE: This study builds upon an ongoing population-based case-control study where epidemiologic data and DNA samples from 1,250 incident colon cancer cases and 1,500 population controls have already being collected. This relatively large study population will be readily available and allow us to dissect complex gene-gene and gene-obesity interactions to gain in-depth understanding of mechanistic link between obesity and colon carcinogenesis.



Publications

Sex hormones and risk of lung and colorectal cancers in women: a Mendelian randomization study.
Authors: Denos M. , Sun Y.Q. , Brumpton B. , Li Y. , Albanes D. , Burnett-Hartman A. , Campbell P.T. , Küry S. , Li C.I. , White E. , et al. .
Source: Research Square, 2024-04-10 00:00:00.0; , .
EPub date: 2024-04-10 00:00:00.0.
PMID: 38659935
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Genome-Wide Gene-Environment Interaction Analyses to Understand the Relationship between Red Meat and Processed Meat Intake and Colorectal Cancer Risk.
Authors: Stern M.C. , Sanchez Mendez J. , Kim A.E. , Obón-Santacana M. , Moratalla-Navarro F. , Martín V. , Moreno V. , Lin Y. , Bien S.A. , Qu C. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2024-03-01 00:00:00.0; 33(3), p. 400-410.
PMID: 38112776
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Association between circulating inflammatory markers and adult cancer risk: a Mendelian randomization analysis.
Authors: Yarmolinsky J. , Robinson J.W. , Mariosa D. , Karhunen V. , Huang J. , Dimou N. , Murphy N. , Burrows K. , Bouras E. , Smith-Byrne K. , et al. .
Source: Ebiomedicine, 2024 Feb; 100, p. 104991.
EPub date: 2024-02-01 00:00:00.0.
PMID: 38301482
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Elucidating the Risk of Colorectal Cancer for Variants in Hereditary Colorectal Cancer Genes.
Authors: Mahmood K. , Thomas M. , Qu C. , Gecco-Ccfr Consortium , Hsu L. , Buchanan D.D. , Peters U. .
Source: Gastroenterology, 2023 Oct; 165(4), p. 1070-1076.e3.
EPub date: 2023-07-14 00:00:00.0.
PMID: 37453563
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A Genetic Locus within the FMN1/GREM1 Gene Region Interacts with Body Mass Index in Colorectal Cancer Risk.
Authors: Aglago E.K. , Kim A. , Lin Y. , Qu C. , Evangelou M. , Ren Y. , Morrison J. , Albanes D. , Arndt V. , Barry E.L. , et al. .
Source: Cancer Research, 2023-08-01 00:00:00.0; 83(15), p. 2572-2583.
PMID: 37249599
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Identifying metabolic features of colorectal cancer liability using Mendelian randomization.
Authors: Bull C.J. , Hazelwood E. , Bell J.A. , Tan V.Y. , Constantinescu A.E. , Borges M.C. , Legge D.N. , Burrows K. , Huyghe J.R. , Brenner H. , et al. .
Source: Medrxiv : The Preprint Server For Health Sciences, 2023-07-17 00:00:00.0; , .
EPub date: 2023-07-17 00:00:00.0.
PMID: 36945480
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Probing the diabetes and colorectal cancer relationship using gene - environment interaction analyses.
Authors: Dimou N. , Kim A.E. , Flanagan O. , Murphy N. , Diez-Obrero V. , Shcherbina A. , Aglago E.K. , Bouras E. , Campbell P.T. , Casey G. , et al. .
Source: British Journal Of Cancer, 2023-06-26 00:00:00.0; , .
EPub date: 2023-06-26 00:00:00.0.
PMID: 37365285
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Association between circulating inflammatory markers and adult cancer risk: a Mendelian randomization analysis.
Authors: Yarmolinsky J. , Robinson J.W. , Mariosa D. , Karhunen V. , Huang J. , Dimou N. , Murphy N. , Burrows K. , Bouras E. , Smith-Byrne K. , et al. .
Source: Medrxiv : The Preprint Server For Health Sciences, 2023-05-05 00:00:00.0; , .
EPub date: 2023-05-05 00:00:00.0.
PMID: 37205426
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Genome-wide interaction study with smoking for colorectal cancer risk identifies novel genetic loci related to tumor suppression, inflammation and immune response.
Authors: Carreras-Torres R. , Kim A.E. , Lin Y. , Díez-Obrero V. , Bien S.A. , Qu C. , Wang J. , Dimou N. , Aglago E.K. , Albanes D. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2022-12-28 00:00:00.0; , .
EPub date: 2022-12-28 00:00:00.0.
PMID: 36576985
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Genetic Predictors for Fecal Propionate and Butyrate-Producing Microbiome Pathway are Not Associated with Colorectal Cancer Risk: A Mendelian Randomization Analysis.
Authors: Lu Y. , Zhao Y.C. , Chang-Claude J. , Gruber S.B. , Gsur A. , Offit K. , Vodickova L. , Woods M.O. , Nguyen L.H. , Wade K.H. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2022-12-13 00:00:00.0; , .
EPub date: 2022-12-13 00:00:00.0.
PMID: 36512731
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Interactions between folate intake and genetic predictors of gene expression levels associated with colorectal cancer risk.
Authors: Haas C.B. , Su Y.R. , Petersen P. , Wang X. , Bien S.A. , Lin Y. , Albanes D. , Weinstein S.J. , Jenkins M.A. , Figueiredo J.C. , et al. .
Source: Scientific Reports, 2022-11-07 00:00:00.0; 12(1), p. 18852.
EPub date: 2022-11-07 00:00:00.0.
PMID: 36344807
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Disease consequences of higher adiposity uncoupled from its adverse metabolic effects using Mendelian randomisation.
Authors: Martin S. , Tyrrell J. , Thomas E.L. , Bown M.J. , Wood A.R. , Beaumont R.N. , Tsoi L.C. , Stuart P.E. , Elder J.T. , Law P. , et al. .
Source: Elife, 2022-01-25 00:00:00.0; 11, .
EPub date: 2022-01-25 00:00:00.0.
PMID: 35074047
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Circulating Levels of Testosterone, Sex Hormone Binding Globulin and Colorectal Cancer Risk: Observational and Mendelian Randomization Analyses.
Authors: Dimou N. , Mori N. , Harlid S. , Harbs J. , Martin R.M. , Smith-Byrne K. , Papadimitriou N. , Bishop D.T. , Casey G. , Colorado-Yohar S.M. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2021 07; 30(7), p. 1336-1348.
EPub date: 2021-04-20 00:00:00.0.
PMID: 33879453
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Nongenetic Determinants of Risk for Early-Onset Colorectal Cancer.
Authors: Archambault A.N. , Lin Y. , Jeon J. , Harrison T.A. , Bishop D.T. , Brenner H. , Casey G. , Chan A.T. , Chang-Claude J. , Figueiredo J.C. , et al. .
Source: Jnci Cancer Spectrum, 2021 Jun; 5(3), p. pkab029.
EPub date: 2021-05-20 00:00:00.0.
PMID: 34041438
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Causal Effects of Lifetime Smoking on Breast and Colorectal Cancer Risk: Mendelian Randomization Study.
Authors: Dimou N. , Yarmolinsky J. , Bouras E. , Tsilidis K.K. , Martin R.M. , Lewis S.J. , Gram I.T. , Bakker M.F. , Brenner H. , Figueiredo J.C. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2021 May; 30(5), p. 953-964.
EPub date: 2021-03-02 00:00:00.0.
PMID: 33653810
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A Combined Proteomics and Mendelian Randomization Approach to Investigate the Effects of Aspirin-Targeted Proteins on Colorectal Cancer.
Authors: Nounu A. , Greenhough A. , Heesom K.J. , Richmond R.C. , Zheng J. , Weinstein S.J. , Albanes D. , Baron J.A. , Hopper J.L. , Figueiredo J.C. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2020-12-14 00:00:00.0; , .
EPub date: 2020-12-14 00:00:00.0.
PMID: 33318029
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Identifying novel susceptibility genes for colorectal cancer risk from a transcriptome-wide association study of 125,478 subjects.
Authors: Guo X. , Lin W. , Wen W. , Huyghe J. , Bien S. , Cai Q. , Harrison T. , Chen Z. , Qu C. , Bao J. , et al. .
Source: Gastroenterology, 2020-10-12 00:00:00.0; , .
EPub date: 2020-10-12 00:00:00.0.
PMID: 33058866
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Circulating adipokine concentrations and risk of five obesity-related cancers: A Mendelian randomization study.
Authors: Dimou N.L. , Papadimitriou N. , Mariosa D. , Johansson M. , Brennan P. , Peters U. , Chanock S.J. , Purdue M. , Bishop D.T. , Gago-Dominquez M. , et al. .
Source: International Journal Of Cancer, 2020-10-10 00:00:00.0; , .
EPub date: 2020-10-10 00:00:00.0.
PMID: 33038280
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Exploratory genome-wide interaction analysis of non-steroidal anti-inflammatory drugs and predicted gene expression on colorectal cancer risk.
Authors: Wang X. , Su Y.R. , Petersen P.S. , Bien S. , Schmit S.L. , Drew D.A. , Albanes D. , Berndt S.I. , Brenner H. , Campbell P.T. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2020-07-10 00:00:00.0; , .
EPub date: 2020-07-10 00:00:00.0.
PMID: 32651213
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Circulating Levels of Insulin-like Growth Factor 1 and Insulin-like Growth Factor Binding Protein 3 Associate With Risk of Colorectal Cancer Based on Serologic and Mendelian Randomization Analyses.
Authors: Murphy N. , Carreras-Torres R. , Song M. , Chan A.T. , Martin R.M. , Papadimitriou N. , Dimou N. , Tsilidis K.K. , Banbury B. , Bradbury K.E. , et al. .
Source: Gastroenterology, 2020 04; 158(5), p. 1300-1312.e20.
EPub date: 2019-12-27 00:00:00.0.
PMID: 31884074
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Mendelian Randomization of Circulating Polyunsaturated Fatty Acids and Colorectal Cancer Risk.
Authors: Khankari N.K. , Banbury B.L. , Borges M.C. , Haycock P. , Albanes D. , Arndt V. , Berndt S.I. , Bézieau S. , Brenner H. , Campbell P.T. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2020 Apr; 29(4), p. 860-870.
EPub date: 2020-02-12 00:00:00.0.
PMID: 32051193
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Functional informed genome-wide interaction analysis of body mass index, diabetes and colorectal cancer risk.
Authors: Xia Z. , Su Y.R. , Petersen P. , Qi L. , Kim A.E. , Figueiredo J.C. , Lin Y. , Nan H. , Sakoda L.C. , Albanes D. , et al. .
Source: Cancer Medicine, 2020-03-24 00:00:00.0; , .
EPub date: 2020-03-24 00:00:00.0.
PMID: 32207560
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Identification of Novel Loci and New Risk Variant in Known Loci for Colorectal Cancer Risk in East Asians.
Authors: Lu Y. , Kweon S.S. , Cai Q. , Tanikawa C. , Shu X.O. , Jia W.H. , Xiang Y.B. , Huyghe J.R. , Harrison T.A. , Kim J. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2020 02; 29(2), p. 477-486.
EPub date: 2019-12-11 00:00:00.0.
PMID: 31826910
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Cumulative Burden of Colorectal Cancer-Associated Genetic Variants is More Strongly Associated With Early-onset vs Late-onset Cancer.
Authors: Archambault A.N. , Su Y.R. , Jeon J. , Thomas M. , Lin Y. , Conti D.V. , Win A.K. , Sakoda L.C. , Lansdorp-Vogelaar I. , Peterse E.F. , et al. .
Source: Gastroenterology, 2019-12-19 00:00:00.0; , .
EPub date: 2019-12-19 00:00:00.0.
PMID: 31866242
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Meta-analysis of 16 studies of the association of alcohol with colorectal cancer.
Authors: McNabb S. , Harrison T.A. , Albanes D. , Berndt S.I. , Brenner H. , Caan B.J. , Campbell P.T. , Cao Y. , Chang-Claude J. , Chan A. , et al. .
Source: International Journal Of Cancer, 2019-04-29 00:00:00.0; , .
EPub date: 2019-04-29 00:00:00.0.
PMID: 31037736
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Mendelian randomization analysis of C-reactive protein on colorectal cancer risk.
Authors: Wang X. , Dai J.Y. , Albanes D. , Arndt V. , Berndt S.I. , Bézieau S. , Brenner H. , Buchanan D.D. , Butterbach K. , Caan B. , et al. .
Source: International Journal Of Epidemiology, 2018-11-21 00:00:00.0; , .
EPub date: 2018-11-21 00:00:00.0.
PMID: 30476131
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The Potential Role of Exercise and Nutrition in Harnessing the Immune System to Improve Colorectal Cancer Survival.
Authors: Song M. , Chan A.T. .
Source: Gastroenterology, 2018 09; 155(3), p. 596-600.
EPub date: 2018-08-01 00:00:00.0.
PMID: 30076837
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Determining Risk of Colorectal Cancer and Starting Age of Screening Based on Lifestyle, Environmental, and Genetic Factors.
Authors: Jeon J. , Du M. , Schoen R.E. , Hoffmeister M. , Newcomb P.A. , Berndt S.I. , Caan B. , Campbell P.T. , Chan A.T. , Chang-Claude J. , et al. .
Source: Gastroenterology, 2018-02-16 00:00:00.0; , .
EPub date: 2018-02-16 00:00:00.0.
PMID: 29458155
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Estimation of exposure distribution adjusting for association between exposure level and detection limit.
Authors: Yang Y. , Shelton B.J. , Tucker T.T. , Li L. , Kryscio R. , Chen L. .
Source: Statistics In Medicine, 2017-05-16 00:00:00.0; , .
EPub date: 2017-05-16 00:00:00.0.
PMID: 28513091
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Genetic Variants In Epigenetic Pathways And Risks Of Multiple Cancers In The Game-on Consortium
Authors: Toth R. , Scherer D. , Kelemen L.E. , Risch A. , Hazra A. , Balavarca Y. , Issa J.J. , Moreno V. , Eeles R.A. , Ogino S. , et al. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2017-01-23 00:00:00.0; , .
PMID: 28115406
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A Germline Variant On Chromosome 4q31.1 Associates With Susceptibility To Developing Colon Cancer Metastasis
Authors: Markowitz S.D. , Nock N.L. , Schmit S.L. , Stadler Z.K. , Joseph V. , Zhang L. , Willis J.E. , Scacheri P. , Veigl M. , Adams M.D. , et al. .
Source: Plos One, 2016; 11(1), p. e0146435.
PMID: 26751797
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Is retinol binding protein 4 a link between adiposity and cancer?
Authors: Noy N. , Li L. , Abola M.V. , Berger N.A. .
Source: Hormone Molecular Biology And Clinical Investigation, 2015 Aug; 23(2), p. 39-46.
PMID: 26136304
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Serum levels of retinol-binding protein 4 and risk of colon adenoma.
Authors: Abola M.V. , Thompson C.L. , Chen Z. , Chak A. , Berger N.A. , Kirwan J.P. , Li L. .
Source: Endocrine-related Cancer, 2015 Apr; 22(2), p. L1-4.
PMID: 25712946
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Combined Use Of Vitamin D3 And Metformin Exhibits Synergistic Chemopreventive Effects On Colorectal Neoplasia In Rats And Mice
Authors: Li W. , Wang Q.L. , Liu X. , Dong S.H. , Li H.X. , Li C.Y. , Guo L.S. , Gao J.M. , Berger N.A. , Li L. , et al. .
Source: Cancer Prevention Research (philadelphia, Pa.), 2015 Feb; 8(2), p. 139-48.
PMID: 25416412
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Association Between Casp8 -652 6n Del Polymorphism (rs3834129) And Colorectal Cancer Risk: Results From A Multi-centric Study
Authors: Pardini B. , Verderio P. , Pizzamiglio S. , Nici C. , Maiorana M.V. , Naccarati A. , Vodickova L. , Vymetalkova V. , Veneroni S. , Daidone M.G. , et al. .
Source: Plos One, 2014; 9(1), p. e85538.
PMID: 24465592
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High Dietary Glycemic Load Is Associated With Increased Risk Of Colon Cancer
Authors: Zelenskiy S. , Thompson C.L. , Tucker T.C. , Li L. .
Source: Nutrition And Cancer, 2014; 66(3), p. 362-8.
PMID: 24611536
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Discovery Of Common Sequences Absent In The Human Reference Genome Using Pooled Samples From Next Generation Sequencing
Authors: Liu Y. , Koyutürk M. , Maxwell S. , Xiang M. , Veigl M. , Cooper R.S. , Tayo B.O. , Li L. , LaFramboise T. , Wang Z. , et al. .
Source: Bmc Genomics, 2014; 15, p. 685.
PMID: 25129063
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Towards Building A Disease-phenotype Knowledge Base: Extracting Disease-manifestation Relationship From Literature
Authors: Xu R. , Li L. , Wang Q. .
Source: Bioinformatics (oxford, England), 2013-09-01 00:00:00.0; 29(17), p. 2186-94.
PMID: 23828786
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Genetic Variation In 15-hydroxyprostaglandin Dehydrogenase And Colon Cancer Susceptibility
Authors: Thompson C.L. , Fink S.P. , Lutterbaugh J.D. , Elston R.C. , Veigl M.L. , Markowitz S.D. , Li L. .
Source: Plos One, 2013; 8(5), p. e64122.
PMID: 23717544
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Meta-analysis Of Mismatch Repair Polymorphisms Within The Cogent Consortium For Colorectal Cancer Susceptibility
Authors: Picelli S. , Lorenzo Bermejo J. , Chang-Claude J. , Hoffmeister M. , Fernández-Rozadilla C. , Carracedo A. , Castells A. , Castellví-Bel S. , Memebers of EPICOLON Consortium-Gastrointestinal Oncology Group of the Spanish Gastroenterological Association , Naccarati A. , et al. .
Source: Plos One, 2013; 8(9), p. e72091.
PMID: 24039736
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Red Meat-derived Heterocyclic Amines Increase Risk Of Colon Cancer: A Population-based Case-control Study
Authors: Helmus D.S. , Thompson C.L. , Zelenskiy S. , Tucker T.C. , Li L. .
Source: Nutrition And Cancer, 2013; 65(8), p. 1141-50.
PMID: 24168237
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Insulin resistance, central obesity, and risk of colorectal adenomas.
Authors: Ortiz A.P. , Thompson C.L. , Chak A. , Berger N.A. , Li L. .
Source: Cancer, 2012-04-01 00:00:00.0; 118(7), p. 1774-81.
EPub date: 2012-04-01 00:00:00.0.
PMID: 22009143
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Racial differences in measures of obesity and risk of colon adenoma.
Authors: Thompson C.L. , Berger N.A. , Chak A. , Li L. .
Source: Obesity (silver Spring, Md.), 2012 Mar; 20(3), p. 673-7.
PMID: 21996657
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Adult BMI Change and Risk of Colon Cancer in Postmenopausal Women.
Authors: Blake-Gumbs L. , Chen Z. , Thompson C.L. , Berger N.A. , Tucker T.C. , Li L. .
Source: Journal Of Obesity, 2012; 2012, p. 857510.
PMID: 22848798
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Higher bone mineral density is associated with a decreased risk of colorectal adenomas.
Authors: Nock N.L. , Patrick-Melin A. , Cook M. , Thompson C. , Kirwan J.P. , Li L. .
Source: International Journal Of Cancer, 2011-08-15 00:00:00.0; 129(4), p. 956-64.
EPub date: 2011-08-15 00:00:00.0.
PMID: 20949624
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FTO polymorphisms are associated with adult body mass index (BMI) and colorectal adenomas in African-Americans.
Authors: Nock N.L. , Plummer S.J. , Thompson C.L. , Casey G. , Li L. .
Source: Carcinogenesis, 2011 May; 32(5), p. 748-56.
PMID: 21317302
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Short duration of sleep increases risk of colorectal adenoma.
Authors: Thompson C.L. , Larkin E.K. , Patel S. , Berger N.A. , Redline S. , Li L. .
Source: Cancer, 2011-02-15 00:00:00.0; 117(4), p. 841-7.
EPub date: 2011-02-15 00:00:00.0.
PMID: 20936662
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Concentrations Of Arsenic, Chromium, And Nickel In Toenail Samples From Appalachian Kentucky Residents
Authors: Johnson N. , Shelton B.J. , Hopenhayn C. , Tucker T.T. , Unrine J.M. , Huang B. , Christian W. , Zhang Z. , Shi X. , Li L. .
Source: Journal Of Environmental Pathology, Toxicology And Oncology : Official Organ Of The International Society For Environmental Toxicology And Cancer, 2011; 30(3), p. 213-23.
PMID: 22126614
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Interleukin-22 genetic polymorphisms and risk of colon cancer.
Authors: Thompson C.L. , Plummer S.J. , Tucker T.C. , Casey G. , Li L. .
Source: Cancer Causes & Control : Ccc, 2010 Aug; 21(8), p. 1165-70.
PMID: 20339910
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Associations between obesity and changes in adult BMI over time and colon cancer risk.
Authors: Nock N.L. , Thompson C.L. , Tucker T.C. , Berger N.A. , Li L. .
Source: Obesity (silver Spring, Md.), 2008 May; 16(5), p. 1099-104.
PMID: 18356841
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