Jan Gryczynski

Jan Gryczynski, Ph. D.

Founding Partner/Senior Research Scientist

Ph.D., Public Policy, University of Maryland, Baltimore County
M.A., Applied Sociology, University of Maryland, Baltimore County
jgrycz1@umbc.edu

Research Interests

Dr. Gryczynski’s research focuses on the intersection of medical care and behavioral health, particularly with respect to identifying approaches to service delivery that improve programmatic efficiencies as well as patients’ access, engagement, and outcomes. Much of Dr. Gryczynski’s work has emphasized practical strategies for service improvement in vulnerable and underserved populations. Within this context, his research has focused on the development, application, and scientific evaluation of novel technologies and approaches in the healthcare and specialty substance use disorder service systems.

Selected Publications

Lounsbury DW, Mitchell SG, Dusek K, Li Z, Kirk AS, Oros M, Hosler C, Schwartz RP, Gryczynski J, Monico LB & Brown BS (in press). Application of System Dynamics Modeling to Inform Implementation of Adolescent SBIRT in Primary Care Settings. Journal of Behavioral Health Services & Research.
Gryczynski J, Nichols H, Schwartz RP, Mitchell SG, Hill P, Wireman K (in press). Fentanyl exposure and preferences among individuals starting treatment for opioid use disorder. Drug and Alcohol Dependence. 2019 Aug 30; 204:107515. doi: 10.1016/j.drugalcdep.2019.06.017. [Epub ahead of print] PMID: 31525569.
Schwartz RP, Mitchell MM, O’Grady KE, Kelly SM, Gryczynski J, Mitchell SG, Gordon MS, Jaffe JH (in press). Pharmacotherapy for Opioid Addiction in Community Corrections. International Review of Psychiatry. 2018 Dec 6:1-19. doi: 10.1080/09540261.2018.1524373. [Epub ahead of print] PMID: 30522370.
Sanchez, K., Gryczynski, J., Carswell, S.B., & Schwartz, R.P. (2021). Development and feasibility of a Spanish language version of the Tobacco, Alcohol, Prescription Drug, and Illicit Substance Use (TAPS) Tool. Journal of Addiction Medicine. 15(1),61–67.
Monico LB, Mitchell SG, Dusek K, Gryczynski J, Schwartz RP, Oros M, Hosler C, O’Grady KE, Brown BS (2019). A Comparison of Screening Practices for Adolescents in Primary Care After Implementation of Screening, Brief Intervention, and Referral to Treatment. Journal of Adolescent Health. Journal of Adolescent Health. 65(1):46-50. doi: 10.1016/j.jadohealth.2018.12.005. Epub 2019 Mar 6. PMID: 30850312.
Gryczynski J, Mitchell SG, Schwartz RP, Kelly SM, Dušek K, Monico L, O’Grady KE, Brown BS, Oros M, Hosler C (2019). Disclosure of Adolescent Substance Use in Primary Care: Comparison of Routine Clinical Screening and Anonymous Research Interviews. Journal of Adolescent Health. 64(4):541-543. doi: 10.1016/j.jadohealth.2018.10.009. Epub 2018 Dec 18. PMID: 30578116.
Schwartz RP, Kelly SM, Mitchell SG, Gryczynski J, O’Grady KE, Jaffe JH (2019). Initiating methadone in jail and in the community: Patient differences and implications of methadone treatment for reducing arrests. Journal of Substance Abuse Treatment. 97:7-13. doi: 10.1016/j.jsat.2018.11.006. Epub 2018 Nov 19. PMID:30577902.
Mitchell SG, Gryczynski J, Schwartz RP (2018). Commentary on "The More Things Change: Buprenorphine/Naloxone Diversion Continues While Treatment is Inaccessible". Journal of Addiction Medicine. 12(6):424-425. doi: 10.1097/ADM.0000000000000437. PMID:30095564.
Mitchell SG, Monico LB, Lertch E, Kelly SM, Gryczynski J, Jaffe J, O’Grady KE, & Schwartz RP (2018). Counseling staff's views of patient-centered methadone treatment: Changing program rules and staff roles. The Journal of Behavioral Health Services and Research. 45(3):506-515. doi: 10.1007/s11414-018-9603-1. PMID: 29536342.
Gryczynski J, Carswell SB, (2018). Gender and ethnic differences in primary care patients' response to computerized vs. in-person brief intervention for illicit drug misuse. Journal of Substance Abuse Treatment. 84:50-56. doi: 10.1016/j.jsat.2017.10.009. Epub 2017 Nov 7. PMID: 29195593.
Gryczynski J, Schwartz RP, Fishman MJ, Nordeck CD, Grant J, Nidich S, Rothenberg S, O’Grady KE (2018). Integration of Transcendental Meditation® (TM) into alcohol use disorder (AUD) treatment. Journal of Substance Abuse Treatment. 87:23-30. doi: 10.1016/j.jsat.2018.01.009. Epub 2018 Jan 16. PMID:29471923.
Dunlap LJ, Zarkin GA, Orme S, Meinhofer A, Kelly SM, O’Grady KE, Gryczynski J, Mitchell SG, Schwartz RP (2018). Re-engineering methadone-Cost-effectiveness analysis of a patient-centered approach to methadone treatment. Journal of Substance Abuse Treatment. 94:81-90. doi: 10.1016/j.jsat.2018.07.014. Epub 2018 Jul 31. PMID: 30243422.
Nordeck CD, Welsh C, Schwartz RP, Mitchell SG, Cohen A, O’Grady KE, Gryczynski J (2018). Rehospitalization and substance use disorder (SUD) treatment entry among patients seen by a hospital SUD consultation-liaison service. Drug and Alcohol Dependence. 186:23-28. doi: 10.1016/j.drugalcdep.2017.12.043. Epub 2018 Mar 2. PMID: 29529456.
Carswell SB, Gordon MS, Gryczynski J, and Tangires S (2018). The daily progress system: A proof of concept pilot study of a recovery support technology tool for outpatient substance abuse treatment. The American Journal of Drug and Alcohol Abuse. Published online: 30 May 2018.
Monico LB, Gryczynski J, Schwartz RP, Jaffe JH, O’Grady KE, & Mitchell SG (2018). Treatment outcomes among a cohort of African American buprenorphine patients: Follow-up at 12-months. The American Journal of Drug and Alcohol Abuse. 44(6):604-610. doi: 10.1080/00952990.2018.1461877. Epub 2018 May 2. PMID: 29718715.
Schwartz RP, McNeely J, Wu LT, Sharma G, Wahle A, Cushing C, Nordeck CD, Sharma A, O’Grady KE, Gryczynski J, Mitchell SG, Ali RL, Marsden J, Subramaniam G (2017). Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST. Journal of Substance Abuse Treatment. 76, 69-76.
Schwartz RP, Kelly SM, Mitchell SG, Gryczynski J, O’Grady KE, Gandhi D, Olsen Y, Jaffe JH (2017). Patient‐centered methadone treatment: a randomized clinical trial. Addiction. 112(3):454-64.
Gryczynski J, Nordeck CD, Mitchell SG, Page KR, Johnsen LL, O’Grady KE, Schwartz RP (2017). Pilot Studies Examining Feasibility of Substance Use Disorder Screening and Treatment Linkage at Urban Sexually Transmitted Disease Clinics. Journal of Addiction Medicine. 11(5):350-356. doi: 10.1097/ADM.0000000000000327. PMID: 28590392.
Mark K, Gryczynski J, Axenfeld E, Schwartz RP, Terplan M (2017). Pregnant Women's Current and Intended Cannabis Use in Relation to Their Views Toward Legalization and Knowledge of Potential Harm. Journal of Addiction Medicine. 11(3):211-216. doi: 10.1097/ADM.0000000000000299. PMID:28252456.
Sharma A, Kelly SM, Mitchell SG, Gryczynski J, O’Grady KE, Schwartz RP (2017). Update on Barriers to Pharmacotherapy for Opioid Use Disorders. Current Psychiatry Reports. 19(6):35. doi: 10.1007/s11920-017-0783-9. Review. PMID: 28526967.
Gryczynski J, McNeely J, Wu LT, Subramaniam GA, Svikis DS, Cathers LA, Sharma G, King J, Jelstrom E, Nordeck CD, Sharma A, Mitchell SG, O’Grady KE, Schwartz RP (2017). Validation of the TAPS-1: A Four-Item Screening Tool to Identify Unhealthy Substance Use in Primary Care. Journal of General Internal Medicine. 32(9):990-996. doi: 10.1007/s11606-017-4079-x. Epub 2017 May 26. PMID: 28550609.
Schwartz RP, Kelly SM, Mitchell SG, Gryczynski J, O’Grady KE, Jaffe JH (2017). When does methadone treatment reduce arrest and severity of arrest charges? An analysis of arrest records. Drug and Alcohol Dependence. 180:385-390. doi: 10.1016/j.drugalcdep.2017.08.025. Epub 2017 Sep 14. PMID: 28961545.
Gryczynski J, O’Grady KE, Mitchell SG, Ondersma SJ, Schwartz RP (2016). Immediate Versus Delayed Computerized Brief Intervention for Illicit Drug Misuse. Journal of Addiction Medicine. 10(5):344-51. doi: 10.1097/ADM.0000000000000248. PMID: 27504925.
Schwartz RP, Kelly SM, Mitchell SG, Gryczynski J, O’Grady KE, Gandhi D, Olsen Y, Jaffe JH (2016). Patient-centered methadone treatment: a randomized clinical trial. Addiction. doi: 10.1111/add.13622. [Epub ahead of print]. PMID: 27661788.
Ondersma SJ, Gryczynski J, Mitchell SG, O’Grady KE, Schwartz RP (2016). Process evaluation of a technology-delivered screening and brief intervention for substance use in primary care. Internet Interventions. 4(Pt 1):11-16. PMID: 27110494PMCID: PMC4836054. DOI: 10.1016/j.invent.2016.01.004.
Monico LB, Schwartz RP, Gryczynski J, O’Grady KE, Mitchell SG (2016). Two models of integrating buprenorphine treatment and medical staff within formerly "drug-free" outpatient programs. Journal of Psychoactive Drugs. 48(2):101-8. doi: 10.1080/02791072.2015.1130884. PMID: 26940870.
Gryczynski J, Schwartz RP, O’Grady KE, Restivo LL, Mitchell SG, Jaffe JH (2016). Understanding patterns of high-cost health care use across different substance user groups. Health Affairs. (Millwood). 35(1):12-9. doi: 10.1377/hlthaff.2015.0618. PMID: 26733696 PMCID: PMC4936480 DOI: 10.1377/hlthaff.2015.0618.
Gryczynski J, Mitchell SG, Gonzales A, Moseley A, Peterson TR, Ondersma SJ, O’Grady KE, Schwartz RP (2015). A randomized trial of computerized vs. in-person brief intervention for illicit drug use in primary care: outcomes through 12 months. Journal of Substance Abuse Treatment. 50, 3-10. doi: 10.1016/j.jsat.2014.09.002. Epub 2014 Sep 16. PMID: 25282578.
Monico LB, Gryczynski J, Mitchell SG, Schwartz RP, O’Grady KE, Jaffe JH (2015). Buprenorphine treatment and 12-step meeting attendance: conflicts, compatibilities, and patient outcomes. Journal of Substance Abuse Treatment.   57:89-95. doi: 10.1016/j.jsat.2015.05.005. Epub 2015 May 12. PMID: 25986647.
Mitchell SG, Gryczynski J, Schwartz RP, Myers CP, O’Grady KE, Olsen YK, Jaffe JH (2015). Changes in Quality of Life following Buprenorphine Treatment: Relationship with Treatment Retention and Illicit Opioid Use. Journal of Psychoactive Drugs. 47(2):149-57.
Schwartz RP, Kelly SM, Gryczynski J, Mitchell SG, O’Grady KE, Jaffe JH (2015). Heroin use, HIV-risk, and criminal behavior in Baltimore: Findings from Clinical Research. Journal of Addictive Diseases. 34(2-3):151-61. doi: 10.1080/10550887.2015.1059222. PMID: 26079104.
Gryczynski J, Mitchell SG, Jaffe JH, O’Grady KE, Olsen YK, Schwartz RP (2015). Leaving buprenorphine treatment: patients' reasons for cessation of care. Journal of Substance Abuse Treatment. 46(3):356-61. PubMed PMID: 24238714; PubMed Central PMCID: PMC3947058.
Gryczynski J, Mitchell SG, Ondersma SJ, O’Grady KE, Schwartz RP (2015). Potential radiating effects of misusing substances among medical patients receiving brief intervention. Journal of Substance Abuse Treatment. 55:39-44.
Gryczynski J, Schwartz RP, Mitchell SG, Dzirasa L, Dušek K, O’Grady K, and Cowell A (2015). Preliminary research in preparation for a randomized trial of brief intervention strategies for adolescents in school-based health centers. Addiction Science and Clinical Practice. 10 (Suppl 2), O20. http://doi.org/10.1186/1940-0640-10-S2-O20.
Monico LB, Mitchell SG, Gryczynski J, Schwartz RP, O’Grady KE, Olsen YK, Jaffe JH (2015). Prior experience with non-prescribed buprenorphine: Role in treatment entry and retention. Journal of Substance Abuse Treatment. 57:57-62. doi: 10.1016/j.jsat.2015.04.010. Epub 2015 May 7. PMID: 25980599.
Gryczynski J, Nordeck C, Mitchell SG, O’Grady KE, McNeely J, Wu L-T, Schwartz RP (2015). Reference periods in retrospective behavioral self-report: A qualitative investigation. American Journal on Addictions. 24(8): 744-747.
Mitchell SG, Monico LB, Gryczynski J, O’Grady KE, Schwartz RP (2015). Staff Views of Acceptability and Appropriateness of a Computer-Delivered Brief Intervention for Moderate Drug and Alcohol Use. Journal of Psychoactive Drugs. 47(4):301-7. doi: 10.1080/02791072.2015.1075631. Epub 2015 Sep 16. PMID: 26375411.
Barbosa C, Dunlap LJ, Wedehase B, Mitchell SG, Schwartz RP, Dušek K, Kirk AS, Oros M, Hosler C, Gryczynski J, Brown BS (2015). Start-up costs of implementing Screening and Brief Intervention (SBI) for Adolescents (part of Economics of SBI symposium). Addiction Science and Clinical Practice. 10 (Suppl 2), O5.
Gryczynski J, Kelly SM, Mitchell SG, Kirk A, O’Grady KE, Schwartz RP (2015). Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients. Addiction. 110(2):240-7. doi: 10.1111/add.12767. Epub 2014 Nov 20. PMID: 25311148.
Schwartz RP, Gryczynski J, Mitchell SG, Gonzales A, Moseley A, Peterson TR, Ondersma SJ, O’Grady KE (2014). Computerized versus in-person brief intervention for drug misuse: a randomized clinical trial. Addiction. 109(7):1091-8. doi: 10.1111/add.12502. Epub 2014 Mar 10. PMID: 24520906. PMCID: PMC4086904.
Kelly SM, Gryczynski J, Mitchell SG, Kirk A, O’Grady KE, Schwartz RP (2014). Concordance between DSM-5 and DSM-IV nicotine, alcohol, and cannabis use disorder diagnoses among pediatric patients. Drug and Alcohol Dependence. 140:213-6. PubMed PMID: 24793367; PubMed Central PMCID: PMC4070874.
Gryczynski J, Schwartz RP, Mitchell SG, O’Grady KE, Ondersma SJ (2014). Hair drug testing results and self-reported drug use among primary care patients with moderate-risk illicit drug use. Drug and Alcohol Dependence. 141:44-50. doi: 10.1016/j.drugalcdep.2014.05.001. Epub 2014 May 17. PMID: 24932945. PMCID: PMC4080811.
Schwartz RP, Alexandre PK, Kelly SM, O’Grady KE, Gryczynski J, Jaffe JH (2014). Interim versus standard methadone treatment: a benefit-cost analysis. Journal of Substance Abuse Treatment. 46(3):306-14. doi: 10.1016/j.jsat.2013.10.003. Epub 2013 Oct 14.PMID:24239030.
Mitchell SG, Kelly SM, Gryczynski J, Myers CP, O’Grady KE, Kirk AS, Schwartz RP (2014). The CRAFFT Cut-Points and DSM-5 Criteria for Alcohol and Other Drugs: A Reevaluation and Reexamination. Substance Abuse. 35(4):376-80. PubMed PMID: 25036144; PubMed Central PMCID: PMC4268117.
Mitchell SG, Gryczynski J, Kelly SM, O’Grady KE, Jaffe JH, Olsen YK, Schwartz RP (2014). Treatment Outcomes of African American Buprenorphine Patients by Parole and Probation Status. Journal of Drug Issues. 44(1):69-82. PMID:25364037.
Kelly SM, Gryczynski J, Mitchell SG, Kirk A, O’Grady KE, Schwartz RP (2014). Validity of brief screening instrument for adolescent tobacco, alcohol, and drug use. Pediatrics. 133(5):819-26. PubMed PMID: 24753528; PubMed Central PMCID: PMC4006430.
Mitchell SG, Gryczynski J, Schwartz RP, O’Grady KE, Olsen YK, Jaffe JH (2013). A randomized trial of intensive outpatient (IOP) vs. standard outpatient (OP) buprenorphine treatment for African Americans. Drug and Alcohol Dependence. 128 (3), 222-229.
Serpelloni G, Gomma M, Genetti B, Zermiani M, Rimondo C, Mollica R, Gryczynski J, O’Grady KE, Schwartz RP (2013). Italy’s electronic health record system for opioid agonist treatment. Journal of Substance Abuse Treatment. 45(2):190-5.
Schwartz RP, Gryczynski J, O’Grady KE, Sharfstein JM, Warren G, Olsen Y, Mitchell SG, Jaffe JH (2013). Opioid agonist treatments and heroin overdose deaths in Baltimore, Maryland, 1995-2009. American Journal of Public Health.  103(5):917-22.
Gryczynski J, Jaffe JH, Schwartz RP, Dušek KA, Gugsa N, Monroe CL, O’Grady KE, Olsen YK, Mitchell SG (2013). Patient perspectives on choosing buprenorphine over methadone in an urban, equal-access system. American Journal on Addictions. 22(3):285-91.
Gryczynski J, Mitchell SG, Jaffe JH, Kelly SM, Myers CP, O’Grady KE, Olsen YK, Schwartz RP (2013). Retention in methadone and buprenorphine treatment among African Americans. Journal of Substance Abuse Treatment. 45(3):287-92.
Mitchell SG, Gryczynski J, O’Grady KE, Schwartz RP (2013). SBIRT for adolescent drug and alcohol use: current status and future directions. Journal of Substance Abuse Treatment. 44 (5), 463-472.
Schwartz RP, Gryczynski J, O’Grady KE, Sharfstein JM, Warren G, Olsen YK, Mitchell SG, Jaffe JH (2013). Schwartz et al. respond. American Journal of Public Health. 2013 103(8):e2-3..Epub 2013 Jun 13.
Mitchell SG, Kelly SM, Gryczynski J, Myers CP, Jaffe JH, O’Grady KE, Olson YK, Schwartz RP (2012). African-American patients seeking treatment in the public sector: Characteristics of buprenorphine v. methadone patients. Drug and Alcohol Dependence. 122, 55-60. [PMCID: PMC3251709].
Caldwell D, Gryczynski J (2012). Computerized assessment facilitates disclosure of sensitive HIV risk behaviors among African Americans entering substance abuse treatment. American Journal of Drug and Alcohol Abuse. 38 (4), 365-369.
Wiechelt SA, Gryczynski J, Johnson JL, Caldwell D (2012). Historical trauma among urban American Indians: Impact on substance abuse and family cohesion. Journal of Loss and Trauma. 17 (4), 319-336.
Gonzales A, Westerberg VS, Peterson TR, Moseley A, Gryczynski J, Mitchell SG, Buff G, Schwartz RP (2012). Implementing a statewide Screening, Brief Intervention, and Referral to Treatment (SBIRT) service in rural health settings: New Mexico SBIRT. Substance Abuse. 33 (2), 114-123. [PMCID: PMC3325793].
Gryczynski J, Kinlock TW, Kelly SM, O’Grady KE, Gordon MS, Schwartz RP (2012). Opioid agonist maintenance for probationers: Patient-level predictors of treatment retention, drug use, and crime. Substance Abuse. 33 (1), 30-39.
Gryczynski J, Ward BW (2012). Religiosity, heavy alcohol use, and vicarious learning networks among adolescents in the United States. Health Education and Behavior. 39 (3), 341-351.
Mitchell SG, Gryczynski J, Peterson T, Gonzales A, Moseley A, Schwartz RP (2012). Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use in a school-based program: Services and outcomes. American Journal on Addictions. 21 S5-S13.
Gryczynski J, Johnson JL (2011). Challenges in public health research with American Indians and other small ethnocultural minority populations. [Review]. Substance Use and Misuse. 46 (11), 1363-1371.
Wiechelt SA, Gryczynski J (2011). Cultural and historical trauma among Native Americans. In S. Ringel & J. R. Brandell (Eds.), . Trauma: Contemporary Directions in Theory, Practice, and Research.  (pp. 191-222). Thousand Oaks, CA: Sage.
Gryczynski J, Schwartz RP, Salkever DS, Mitchell SG, Jaffe JH (2011). Patterns in admission delays to outpatient methadone treatment in the United States. Journal of Substance Abuse Treatment. 41 (4), 431-439. [PMCID: PMC3205308].
Gryczynski J, Ward BW (2011). Social norms and the relationship between cigarette use and religiosity among adolescents in the United States. Health Education and Behavior. 38 (1), 39-48.
Gryczynski J, Johnson J (2011). Special issue on Native Americans and substance use. Substance Use and Misuse. 46 (11), 1359-1362.
Gryczynski J, Mitchell SG, Peterson TR, Gonzales A, Moseley A, Schwartz RP (2011). The relationship between services delivered and substance use outcomes in New Mexico's Screening, Brief Intervention, Referral and Treatment (SBIRT) Initiative. Drug and Alcohol Dependence. 118 (2-3), 152-157. [PMCID: PMC21482039].
Johnson JL, Gryczynski J, Moe J (2011). Treatment issues and interventions with young children and their substance-abusing parents. In SLA Straussner & CH Fewell (Eds.). Children of Substance Abusing Parents: Dynamics and Treatment. (pp. 101-125). New York: Springer.
Gryczynski J, Feldman R, Carter-Pokras O, Kanamori M, Chen L, Roth S (2010). Contexts of tobacco use and perspectives on smoking cessation among a sample of urban American Indians. Journal of Health Care for the Poor and Underserved. 21 (2), 544-558.
Johnson JL, Baldwin J, Gryczynski J, Wiechelt SA, Haring RC (2010). The Native American experience: From displacement and cultural trauma to resilience. In H. McCubbin, K. Ontai, L. Kehl, et al. (Eds.), . Multiethnicity and Multiethnic Families: Development, Identity, and Resilience.  (pp. 277-301). Honolulu, HI: Le’A Publications.
Wiechelt SA, Gryczynski J, Johnson JL (2009). Designing HIV preventative interventions for urban American Indians: Evolution of ‘The Don’t Forget Us’ program.  Health & Social Work. 34(4), 301-304.
Gryczynski J, Schwartz RP, O’Grady K, Jaffe JH (2009). Dropout from interim methadone and subsequent comprehensive methadone maintenance. American Journal of Drug and Alcohol Abuse. 35, 394-398.
Ward B, Gryczynski J (2009). Social learning theory and the effects of living arrangement on heavy alcohol use: Results from a national study of college students. Journal of Studies on Alcohol. 70, 364-372.
Gryczynski J, Schwartz RP, O’Grady K, Jaffe JH (2009). Treatment entry among individuals on a waiting list for methadone maintenance.  American Journal of Drug and Alcohol Abuse. 35(5), 290-294. Abstract.
Marsella A, Johnson J, Watson P, Gryczynski J, Eds (2008). Ethnocultural Perspectives on Disaster and Trauma: Foundations, Issues, and Applications. New York, Springer.
Ward B, Gryczynski J (2007). Alcohol use and participation in organized recreational sports among university undergraduates. Journal of American College Health. 56(3), 273-280. PMID: 18089509.
Johnson JL, Gryczynski J, and Wiechelt S (2007). HIV/AIDS, substance abuse, and hepatitis prevention needs of Native Americans living in Baltimore: In their own words. AIDS Education and Prevention. 19(6), 531-544. doi: 10.1521/aeap.2007.19.6.531. PMID: 18190277.
Gryczynski J, Johnson JL, and Coyhis D (2007). The healing forest metaphor revisited: The seen and unseen world of substance use. Substance Use and Misuse. 42(2-3), 475-484. PMID: 17558945.