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Verardi S, Lombardi T, Stacchi C. Clinical and Radiographic Evaluation of Nanohydroxyapatite Powder in Combination with Polylactic Acid/Polyglycolic Acid Copolymer as Bone Replacement Graft in the Surgical Treatment of Intrabony Periodontal Defects: A Retrospective Case Series Study. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E269. [PMID: 31936143 PMCID: PMC7014298 DOI: 10.3390/ma13020269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 01/25/2023]
Abstract
The aim of this retrospective case series was to evaluate the clinical efficacy of nanohydroxyapatite powder (NHA) in combination with polylactic acid/polyglycolic acid copolymer (PLGA) as a bone replacement graft in the surgical treatment of intrabony periodontal defects. Medical charts were screened following inclusion and exclusion criteria. Periodontal parameters and periapical radiographs taken before surgery and at 12-month follow-up were collected. Intra-group comparisons were performed using a two-tailed Wilcoxon signed-rank test. Twenty-five patients (13 males, 12 females, mean age 55.1 ± 10.5 years) were included in the final analysis. Mean probing depth (PD) and clinical attachment level (CAL) at baseline were 8.32 ± 1.41 mm and 9.96 ± 1.69 mm, respectively. Twelve months after surgery, mean PD was 4.04 ± 0.84 mm and CAL was 6.24 ± 1.71 mm. Both PD and CAL variations gave statistically significant results (p < 0.00001). The mean radiographic defect depth was 5.54 ± 1.55 mm and 1.48 ± 1.38 mm at baseline and at 12-month follow-up, respectively (p < 0.0001). This case series, with the limitations inherent in the study design, showed that the combination of NHA and PLGA, used as bone replacement graft in intrabony periodontal defects, may give significant improvements of periodontal parameters at 12-month follow-up.
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Affiliation(s)
- Simone Verardi
- Department of Periodontics, University of Washington, Seattle, WA 98195, USA;
| | - Teresa Lombardi
- Department of Health Sciences, University of “Magna Græcia”, 88100 Catanzaro, Italy;
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy
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Karatas O, Balci Yuce H, Aydemir Turkal H. Dental hypofunction alters subgingival microorganisms: a pilot study. MINERVA STOMATOLOGICA 2019; 68:183-191. [PMID: 31357852 DOI: 10.23736/s0026-4970.19.04245-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to evaluate dental plaque compositions, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF) 1-alpha levels in gingival crevicular fluid (GCF) at hypofunctional and normofunctional teeth in healthy individuals and chronic periodontitis patients. METHODS Sixty systemically healthy individuals were enrolled. Study groups were: group 1 hypofunctional healthy group (group 1, N.=15); group 2 hypofunctional periodontitis group (group 2, N.=15); group 3 normofunctional healthy group (group 3, N.=15); and group 4 normofunctional periodontitis group (group 4, N.=15). Clinical periodontal measurements (plaque index, gingival index and clinical attachment level) were recorded. Dental plaque and GCF samples were taken. VEGF and HIF 1-alpha levels in GCF were determined. Subgingival plaque samples were evaluated for 11 different bacterial species as, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens and Capnocytophaga species. RESULTS Tannerella forsythia, Peptostreptococcus micros, Eubacterium nodatum levels decreased in hypofunctional healthy and periodontitis groups (P<0.05). Porphyromonas gingivalis levels increased in hypofunctional healthy group and decreased in hypofunctional periodontitis group (P<0.05). There was also a decrease in Eikenella corrodens levels in hypofunctional periodontitis group (P<0.05). There were no difference regarding the Aggregatibacter actinomycetemcomitans, Capnocytophaga spp., Prevotella intermedia and Fusobacterium nucleatum levels among the groups (P>0.05). VEGF and HIF-1α levels in both GCF and serum samples were also similar (P>0.05). CONCLUSIONS Within the limits of this study, the authors found that the levels of four significant bacterial strains were decreased in both hypofunctional healthy and hypofunctional periodontitis groups compared to normofunctional equivalents. Though not evaluated in this study, this situation could be due to periodontal ligament atrophy and related physiological alterations.
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Affiliation(s)
- Ozkan Karatas
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey -
| | - Hatice Balci Yuce
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Humeyra Aydemir Turkal
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
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Al-Rekabi Z, Fura AM, Juhlin I, Yassin A, Popowics TE, Sniadecki NJ. Hyaluronan-CD44 interactions mediate contractility and migration in periodontal ligament cells. Cell Adh Migr 2019; 13:138-150. [PMID: 30676222 PMCID: PMC6527381 DOI: 10.1080/19336918.2019.1568140] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The role of hyaluronan (HA) in periodontal healing has been speculated via its interaction with the CD44 receptor. While HA-CD44 interactions have previously been implicated in numerous cell types; effect and mechanism of exogenous HA on periodontal ligament (PDL) cells is less clear. Herein, we examine the effect of exogenous HA on contractility and migration in human and murine PDL cells using arrays of microposts and time-lapse microscopy. Our findings observed HA-treated human PDL cells as more contractile and less migratory than untreated cells. Moreover, the effect of HA on contractility and focal adhesion area was abrogated when PDL cells were treated with Y27632, an inhibitor of rho-dependent kinase, but not when these cells were treated with ML-7, an inhibitor of myosin light chain kinase. Our results provide insight into the mechanobiology of PDL cells, which may contribute towards the development of therapeutic strategies for periodontal healing and tissue regeneration.
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Affiliation(s)
- Zeinab Al-Rekabi
- a Department of Mechanical Engineering , University of Washington , Seattle , WA , USA
| | - Adriane M Fura
- b Department of Bioengineering , University of Washington , Seattle , WA , USA
| | - Ilsa Juhlin
- a Department of Mechanical Engineering , University of Washington , Seattle , WA , USA
| | - Alaa Yassin
- c Department of Periodontics , University of Washington , Seattle , WA , USA
| | - Tracy E Popowics
- d Department of Oral Health Sciences , University of Washington , Seattle , WA , USA
| | - Nathan J Sniadecki
- a Department of Mechanical Engineering , University of Washington , Seattle , WA , USA.,b Department of Bioengineering , University of Washington , Seattle , WA , USA.,e Institute for Stem Cell and Regenerative Medicine , University of Washington , Seattle , WA , USA
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Buskermolen JK, Roffel S, Gibbs S. Stimulation of oral fibroblast chemokine receptors identifies CCR3 and CCR4 as potential wound healing targets. J Cell Physiol 2017; 232:2996-3005. [PMID: 28387445 PMCID: PMC5575500 DOI: 10.1002/jcp.25946] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/05/2017] [Indexed: 02/02/2023]
Abstract
The focus of this study was to determine which chemokine receptors are present on oral fibroblasts and whether these receptors influence proliferation, migration, and/or the release of wound healing mediators. This information may provide insight into the superior wound healing characteristics of the oral mucosa. The gingiva fibroblasts expressed 12 different chemokine receptors (CCR3, CCR4, CCR6, CCR9, CCR10, CXCR1, CXCR2, CXCR4, CXCR5, CXCR7, CX3CR1, and XCR1), as analyzed by flow cytometry. Fourteen corresponding chemokines (CCL5, CCL15, CCL20, CCL22, CCL25, CCL27, CCL28, CXCL1, CXCL8, CXCL11, CXCL12, CXCL13, CX3CL1, and XCL1) were used to study the activation of these receptors on gingiva fibroblasts. Twelve of these fourteen chemokines stimulated gingiva fibroblast migration (all except for CXCL8 and CXCL12). Five of the chemokines stimulated proliferation (CCL5/CCR3, CCL15/CCR3, CCL22/CCR4, CCL28/CCR3/CCR10, and XCL1/XCR1). Furthermore, CCL28/CCR3/CCR10 and CCL22/CCR4 stimulation increased IL-6 secretion and CCL28/CCR3/CCR10 together with CCL27/CCR10 upregulated HGF secretion. Moreover, TIMP-1 secretion was reduced by CCL15/CCR3. In conclusion, this in-vitro study identifies chemokine receptor-ligand pairs which may be used in future targeted wound healing strategies. In particular, we identified the chemokine receptors CCR3 and CCR4, and the mucosa specific chemokine CCL28, as having an predominant role in oral wound healing by increasing human gingiva fibroblast proliferation, migration, and the secretion of IL-6 and HGF and reducing the secretion of TIMP-1.
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Affiliation(s)
- Jeroen K. Buskermolen
- Department of Oral Cell BiologyAcademic Centre for Dentistry (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Sanne Roffel
- Department of Oral Cell BiologyAcademic Centre for Dentistry (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Susan Gibbs
- Department of Oral Cell BiologyAcademic Centre for Dentistry (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of DermatologyVU University Medical CenterAmsterdamThe Netherlands
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Vistejnova L, Safrankova B, Nesporova K, Slavkovsky R, Hermannova M, Hosek P, Velebny V, Kubala L. Low molecular weight hyaluronan mediated CD44 dependent induction of IL-6 and chemokines in human dermal fibroblasts potentiates innate immune response. Cytokine 2014; 70:97-103. [PMID: 25126764 DOI: 10.1016/j.cyto.2014.07.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/26/2014] [Accepted: 07/18/2014] [Indexed: 01/09/2023]
Abstract
Complex regulation of the wound healing process involves multiple interactions among stromal tissue cells, inflammatory cells, and the extracellular matrix. Low molecular weight hyaluronan (LMW HA) derived from the degradation of high molecular weight hyaluronan (HMW HA) is suggested to activate cells involved in wound healing through interaction with HA receptors. In particular, receptor CD44 is suggested to mediate cell response to HA of different MW, being the main cell surface HA receptor in stromal tissue and immune cells. However, the response of dermal fibroblasts, the key players in granulation tissue formation within the wound healing process, to LMW HA and their importance for the activation of immune cells is unclear. In this study we show that LMW HA (4.3kDa) induced pro-inflammatory cytokine IL-6 and chemokines IL-8, CXCL1, CXCL2, CXCL6 and CCL8 gene expression in normal human dermal fibroblasts (NHDF) that was further confirmed by increased levels of IL-6 and IL-8 in cell culture supernatants. Conversely, NHDF treated by HMW HA revealed a tendency to decrease the gene expression of these cytokine and chemokines when compared to untreated control. The blockage of CD44 expression by siRNA resulted in the attenuation of IL-6 and chemokines expression in LMW HA treated NHDF suggesting the involvement of CD44 in LMW HA mediated NHDF activation. The importance of pro-inflammatory mediators produced by LMW HA triggered NHDF was evaluated by significant activation of blood leukocytes exhibited as increased production of IL-6 and TNF-α. Conclusively, we demonstrated a pro-inflammatory response of dermal fibroblasts to LMW HA that was transferred to leukocytes indicating the significance of LMW HA in the inflammatory process development during the wound healing process.
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Affiliation(s)
- Lucie Vistejnova
- Contipro Biotech spol. s.r.o., Dolni Dobrouc, Czech Republic; Institute of Experimental Biology, Department of Physiology and Immunology of Animals, Faculty of Science, Masaryk University, Brno, Czech Republic; Biomedical Center, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Barbora Safrankova
- Contipro Biotech spol. s.r.o., Dolni Dobrouc, Czech Republic; Institute of Experimental Biology, Department of Physiology and Immunology of Animals, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Kristina Nesporova
- Contipro Biotech spol. s.r.o., Dolni Dobrouc, Czech Republic; Institute of Experimental Biology, Department of Physiology and Immunology of Animals, Faculty of Science, Masaryk University, Brno, Czech Republic
| | | | | | - Petr Hosek
- Biomedical Center, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | | | - Lukas Kubala
- Institute of Biophysics, Academy of Science of the Czech Republic v.v.i., Czech Republic; International Clinical Research Center - Center of Biomolecular and Cellular Engineering, St. Anne's University Hospital Brno, Brno, Czech Republic.
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Liu J, Duan J, Wang Y, Ouyang X. Intracellular adhesion molecule-1 is regulated by porphyromonas gingivalis through nucleotide binding oligomerization domain-containing proteins 1 and 2 molecules in periodontal fibroblasts. J Periodontol 2013; 85:358-68. [PMID: 23688098 DOI: 10.1902/jop.2013.130152] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The mechanism by which Porphyromonas gingivalis regulates intracellular adhesion molecule 1 (ICAM-1) expression in human periodontal ligament cells (hPDLCs) and human gingival fibroblasts (hGFs) is unknown. The aim of this study is to investigate whether nucleotide binding oligomerization domain-containing protein (NOD) 1 and NOD2 are involved in this process and the clinical significance of ICAM-1 in periodontitis. METHODS hPDLCs and hGFs were treated with P. gingivalis, l-Ala-γ-d-glutamyl-mesodiaminopimelic acid (an agonist for NOD1), and muramyl dipeptide (an agonist for NOD2). Alternatively, cells transfected with small interfering RNA targeting NOD1and NOD2 were treated with P. gingivalis. ICAM-1, NOD1, and NOD2 were detected at mRNA and protein levels. In addition, clinical examinations were performed in 30 healthy controls and 40 patients with chronic periodontitis (CP) before and after treatment, and serum-soluble ICAM-1 (sICAM-1) levels in these individuals were detected by enzyme-linked immunosorbent assay. RESULTS This study shows that P. gingivalis caused an increase in ICAM-1, NOD1, and NOD2 expression in periodontal fibroblasts. There was a linear correlation between ICAM-1 and NOD1 and NOD2 levels. Activation of NOD1 and NOD2 by the specific agonist led to the upregulation of ICAM-1, whereas knocking down NOD1 and NOD2 caused a reduction in P. gingivalis-induced ICAM-1 production. Furthermore, sICAM-1 levels were higher in patients with CP than in healthy controls and were positively related to the clinical periodontal parameters. After periodontal treatment, sICAM-1 levels decreased significantly. CONCLUSIONS The present results indicate that sICAM-1 levels are correlated to the severity of periodontitis. NOD1 and NOD2 mediate P. gingivalis-induced ICAM-1 production in periodontal fibroblasts. NOD1 and NOD2 could be considered potential targets for periodontal therapy.
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Affiliation(s)
- Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
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Morandini ACF, Chaves Souza PP, Ramos-Junior ES, Brozoski DT, Sipert CR, Souza Costa CA, Santos CF. Toll-like receptor 2 knockdown modulates interleukin (IL)-6 and IL-8 but not stromal derived factor-1 (SDF-1/CXCL12) in human periodontal ligament and gingival fibroblasts. J Periodontol 2012; 84:535-44. [PMID: 22680301 DOI: 10.1902/jop.2012.120177] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Fibroblasts are now seen as active components of the immune response because these cells express Toll-like receptors (TLRs), recognize pathogen-associated molecular patterns, and mediate the production of cytokines and chemokines during inflammation. The innate host response to lipopolysaccharide (LPS) from Porphyromonas gingivalis is unusual inasmuch as different studies have reported that it can be an agonist for Toll-like receptor 2 (TLR2) and an antagonist or agonist for Toll-like receptor 4 (TLR4). This study investigates and compares whether signaling through TLR2 or TLR4 could affect the secretion of interleukin (IL)-6, IL-8, and stromal derived factor-1 (SDF-1/CXCL12) in both human gingival fibroblasts (HGF) and human periodontal ligament fibroblasts (HPDLF). METHODS After small interfering RNA-mediated silencing of TLR2 and TLR4, HGF and HPDLF from the same donors were stimulated with P. gingivalis LPS or with two synthetic ligands of TLR2, Pam2CSK4 and Pam3CSK4, for 6 hours. IL-6, IL-8, and CXCL12 mRNA expression and protein secretion were evaluated by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. RESULTS TLR2 mRNA expression was upregulated in HGF but not in HPDLF by all the stimuli applied. Knockdown of TLR2 decreased IL-6 and IL-8 in response to P. gingivalis LPS, or Pam2CSK4 and Pam3CSK4, in a similar manner in both fibroblasts subpopulations. Conversely, CXCL12 remained unchanged by TLR2 or TLR4 silencing. CONCLUSION These results suggest that signaling through TLR2 by gingival and periodontal ligament fibroblasts can control the secretion of IL-6 and IL-8, which contribute to periodontal pathogenesis, but do not interfere with CXCL12 levels, an important chemokine in the repair process.
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Affiliation(s)
- Ana Carolina F Morandini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Oikonomopoulou K, Ricklin D, Ward PA, Lambris JD. Interactions between coagulation and complement--their role in inflammation. Semin Immunopathol 2011; 34:151-65. [PMID: 21811895 DOI: 10.1007/s00281-011-0280-x] [Citation(s) in RCA: 312] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 07/21/2011] [Indexed: 12/11/2022]
Abstract
The parallel expression of activation products of the coagulation, fibrinolysis, and complement systems has long been observed in both clinical and experimental settings. Several interconnections between the individual components of these cascades have also been described, and the list of shared regulators is expanding. The co-existence and interplay of hemostatic and inflammatory mediators in the same microenvironment typically ensures a successful host immune defense in compromised barrier settings. However, dysregulation of the cascade activities or functions of inhibitors in one or both systems can result in clinical manifestations of disease, such as sepsis, systemic lupus erythematosus, or ischemia-reperfusion injury, with critical thrombotic and/or inflammatory complications. An appreciation of the precise relationship between complement activation and thrombosis may facilitate the development of novel therapeutics, as well as improve the clinical management of patients with thrombotic conditions that are characterized by complement-associated inflammatory responses.
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Affiliation(s)
- Katerina Oikonomopoulou
- Department of Pathology & Laboratory Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6100, USA
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Jalili A, Marquez-Curtis L, Shirvaikar N, Wysoczynski M, Ratajczak M, Janowska-Wieczorek A. Complement C1q enhances homing-related responses of hematopoietic stem/progenitor cells. Transfusion 2010; 50:2002-10. [PMID: 20456695 DOI: 10.1111/j.1537-2995.2010.02664.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Previously, we reported that the complement cleavage fragments C3a and C5a are important modulators of trafficking of hematopoietic stem/progenitor cells (HSPCs). The aim of this study was to examine a possible role for complement component 1, subcomponent q (C1q) in HSPC migration. STUDY DESIGN AND METHODS CD34+ HSPCs isolated from cord blood (CB), bone marrow (BM), and granulocyte-colony-stimulating factor (G-CSF)-mobilized peripheral blood (mPB) were evaluated for the expression of C1q and its receptor for phagocytosis (C1qRp) using reverse transcription-polymerase chain reaction, Western blotting, and fluorescence-activated cell sorting. Chemotactic responses and chemoinvasiveness toward stromal cell-derived factor (SDF)-1 and expression of matrix metalloproteinase (MMP)-9 were also examined after C1q stimulation. Moreover, G-CSF- and zymosan-induced mobilization was evaluated in C1q-deficient mice. RESULTS C1q was expressed in CD34+ cells from mPB, but not from CB or steady-state BM; however, stimulation of the latter with G-CSF induced C1q expression. C1qRp receptor was found on BM, CB, and mPB CD34+ cells and more mature ex vivo expanded myeloid and megakaryocytic precursors. Although C1q itself was not a chemoattractant for HSPCs, it primed/enhanced the chemotactic response of CD34+ cells to a low SDF-1 gradient and their chemoinvasion across the reconstituted basement membrane Matrigel and increased secretion of MMP-9 by these cells. Moreover, in in vivo studies C1q-deficient mice were found to be easy G-CSF mobilizers compared to wild-type mice and normal zymosan mobilizers. CONCLUSION We demonstrated that C1q primes the responses of CD34+ HSPCs to an SDF-1 gradient, which may enhance their ability to stay within BM niches, suggesting that the C1q/C1qRp axis contributes to HSPC homing/retention in BM.
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Affiliation(s)
- Ali Jalili
- Canadian Blood Services, Research & Development, and the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Verardi S, Quaranta M, Bordin S. Peri-implantitis fibroblasts respond to host immune factor C1q. J Periodontal Res 2010; 46:134-40. [DOI: 10.1111/j.1600-0765.2010.01323.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Morandini ACF, Sipert CR, Gasparoto TH, Greghi SLA, Passanezi E, Rezende MLR, Sant'ana AP, Campanelli AP, Garlet GP, Santos CF. Differential Production of Macrophage Inflammatory Protein-1α, Stromal-Derived Factor-1, and IL-6 by Human Cultured Periodontal Ligament and Gingival Fibroblasts Challenged With Lipopolysaccharide FromP. gingivalis. J Periodontol 2010; 81:310-7. [DOI: 10.1902/jop.2009.090375] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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