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Eker F, Akdaşçi E, Duman H, Yalçıntaş YM, Canbolat AA, Kalkan AE, Karav S, Šamec D. Antimicrobial Properties of Colostrum and Milk. Antibiotics (Basel) 2024; 13:251. [PMID: 38534686 DOI: 10.3390/antibiotics13030251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
The growing number of antibiotic resistance genes is putting a strain on the ecosystem and harming human health. In addition, consumers have developed a cautious attitude towards chemical preservatives. Colostrum and milk are excellent sources of antibacterial components that help to strengthen the immunity of the offspring and accelerate the maturation of the immune system. It is possible to study these important defenses of milk and colostrum, such as lactoferrin, lysozyme, immunoglobulins, oligosaccharides, etc., as biotherapeutic agents for the prevention and treatment of numerous infections caused by microbes. Each of these components has different mechanisms and interactions in various places. The compound's mechanisms of action determine where the antibacterial activity appears. The activation of the antibacterial activity of milk and colostrum compounds can start in the infant's mouth during lactation and continue in the gastrointestinal regions. These antibacterial properties possess potential for therapeutic uses. In order to discover new perspectives and methods for the treatment of bacterial infections, additional investigations of the mechanisms of action and potential complexes are required.
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Affiliation(s)
- Furkan Eker
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Emir Akdaşçi
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Hatice Duman
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Yalçın Mert Yalçıntaş
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Ahmet Alperen Canbolat
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Arda Erkan Kalkan
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University, Çanakkale 17000, Turkey
| | - Dunja Šamec
- Department of Food Technology, University North, Trg Dr. Žarka Dolinara 1, 48000 Koprivnica, Croatia
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Wang H, Li QF, Xu XF, Hu XL. Effects of Sublingual Colostrum Application on Oral and Intestinal Flora of Extremely Low Birth Weight Infants. Endocr Metab Immune Disord Drug Targets 2024; 24:489-494. [PMID: 37711000 DOI: 10.2174/1871530323666230913105820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The aim of this study is to analyze the effects of colostrum application on the establishment of normal flora in the intestinal tracts and oral cavities of extremely low birth weight infants (ELBWI). METHODS A prospective cohort study design was adopted following the STROBE guidelines (Supplementary File 1). Colostrum was administered immediately after obtaining maternal breast milk using a special sterile cotton swab. There were no specific treatments for infants who did not receive colostrum. This experiment was completed on day 5 post-birth and the patients were divided into the colostrum and control groups, corresponding to whether or not colostrum was administered. Throat swabs and stool samples were collected on days 1 and 5 post-birth. RESULTS Using the conventional bacteria cultivation technique, the detection rate of bacteria in 98 cases of meconium at birth was 15.31%. On day 5, the detection rates of Staphylococcus in the colostrum and control groups were 36.54% and 34.78%, with no significant difference between them (P = 0.856), and that of Enterococcus was 26.92% and 13.04%, respectively, with no statistically significant difference (P = 0.089). Likewise, at birth, the detection rate of bacteria in 98 cases of throat swabs was 27.55%. On day 5, the detection rate of Streptococcus in the colostrum and control groups was 78.85% and 50.00%, respectively, recording a statistically significant difference this time (P = 0.003). CONCLUSION Colostrum application had limited effects on intestinal flora colonization but contributes to physiological oral flora colonization.
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Affiliation(s)
- Hua Wang
- Department of NICU, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Qiu-Fang Li
- Department of nursing, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Xin-Fen Xu
- Department of nursing, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Xiao-Li Hu
- Department of obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
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Rio-Aige K, Azagra-Boronat I, Castell M, Selma-Royo M, Collado MC, Rodríguez-Lagunas MJ, Pérez-Cano FJ. The Breast Milk Immunoglobulinome. Nutrients 2021; 13:nu13061810. [PMID: 34073540 PMCID: PMC8230140 DOI: 10.3390/nu13061810] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 12/24/2022] Open
Abstract
Breast milk components contribute to the infant’s immune development and protection, and among other immune factors, immunoglobulins (Igs) are the most studied. The presence of IgA in milk has been known for a long time; however, less information is available about the presence of other Igs such as IgM, IgG, and their subtypes (IgG1, IgG2, IgG3, and IgG4) or even IgE or IgD. The total Ig concentration and profile will change during the course of lactation; however, there is a great variability among studies due to several variables that limit establishing a clear pattern. In this context, the aim of this review was firstly to shed light on the Ig concentration in breast milk based on scientific evidence and secondly to study the main factors contributing to such variability. A search strategy provided only 75 studies with the prespecified eligibility criteria. The concentrations and proportions found have been established based on the intrinsic factors of the study—such as the sampling time and quantification technique—as well as participant-dependent factors, such as lifestyle and environment. All these factors contribute to the variability of the immunoglobulinome described in the literature and should be carefully addressed for further well-designed studies and data interpretation.
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Affiliation(s)
- Karla Rio-Aige
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Ignasi Azagra-Boronat
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Margarida Castell
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Marta Selma-Royo
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), 46890 Paterna, Valencia, Spain; (M.S.-R.); (M.C.C.)
| | - María Carmen Collado
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), 46890 Paterna, Valencia, Spain; (M.S.-R.); (M.C.C.)
| | - María J. Rodríguez-Lagunas
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Francisco J. Pérez-Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain; (K.R.-A.); (I.A.-B.); (M.C.); (M.J.R.-L.)
- Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
- Correspondence: ; Tel.: +34-934-024-505
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Faria JB, Santiago MB, Silva CB, Geraldo-Martins VR, Nogueira RD. Development of Streptococcus mutans biofilm in the presence of human colostrum and 3'-sialyllactose. J Matern Fetal Neonatal Med 2020; 35:630-635. [PMID: 32164475 DOI: 10.1080/14767058.2020.1730321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: To evaluate the initial adhesion and formation of Streptococcus mutans biofilm in vitro in the presence of saliva, human colostrum and 3'-sialyllactose. Methods: Human colostrum and salivas were collected from 30 mothers and newborn postpartum. Eighteen hours culture of S. mutans was treated with colostrum or 3'-sialyllactose in three different moments: before, during, and after 24 h from the microbial inoculation. Salivas were also tested in conjunction with colostrum. The assays were realized in sterile 96-well flat-bottom microtiter plates for 24 h. The biofilms were fixed, washed, stained with crystal violet, and extracted. Absorbance was measured to evaluate biofilm growth mass. Results: Colostrum applied after and during the inoculation decreased biofilm formation when compared with the control (p < .05). The presence of saliva increased the biofilm biomass (p < .05). The application of 3'-sialyllactose reduced biofilm formation independently of moments of application (p < .05). Conclusion: Saliva contributed to the proliferation of biofilm and colostrum did not prevent the initial adhesion, but interfered in the accumulation and development of microorganisms in biofilms. 3'-sialyllactose significantly decreased biofilm formation. This information expands the importance of colostrum as a potent oral antimicrobial biofluid.
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Sánchez-Salguero E, Mondragón-Ramírez GK, Alcántara-Montiel JC, Cérbulo-Vázquez A, Villegas-Domínguez X, Contreras-Vargas VM, Thompson-Bonilla MDR, Romero-Ramírez H, Santos-Argumedo L. Infectious episodes during pregnancy, at particular mucosal sites, increase specific IgA1 or IgA2 subtype levels in human colostrum. Matern Health Neonatol Perinatol 2019; 5:9. [PMID: 31205733 PMCID: PMC6558797 DOI: 10.1186/s40748-019-0104-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 05/12/2019] [Indexed: 12/14/2022] Open
Abstract
Background Colostrum is the primary source of maternal immunoglobulin A (IgA) for the newborn. IgA participates in protection and regulation mechanisms of the immune response at the neonate’s mucosa. Several studies have evaluated infectious diseases and vaccine protocols effects during pregnancy on maternal milk IgA levels, with the aim to understand lactation protecting effect on newborn. However, most of their results demonstrated that there were no differences in the total IgA levels. In humans, IgA has two subclasses (IgA1 and IgA2), they have an anatomical distribution among mucosal compartments, their levels vary after antigen stimulation and are also seen to describe differential affinities in colostrum. Although there are differences between IgA subclasses in several compartments, these studies have excluded specific colostrum IgA1 and IgA2 determination. Methods We analyzed data from 900 women in Mexico City. With Pearson correlation, we compared the number of infectious episodes during their pregnancy that was associated with mucosal compartments (skin, respiratory and gastrointestinal tracts) and colostrum IgA subclasses. Results We show a correlation between increased colostrum IgA1 levels and the number of infectious episodes at respiratory tract and the skin. In contrast, infections at the gastrointestinal tract correlated with increased IgA2 amounts. Conclusions Infections present during pregnancy at certain mucosal site increase specific IgA subclasses levels in human colostrum. These results will help in understanding infections and immunizations effects on maternal IgA at the mammary gland, and their impact on the development and protection of the newborn. Electronic supplementary material The online version of this article (10.1186/s40748-019-0104-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erick Sánchez-Salguero
- 1Department of Molecular Biomedicine, Center for Research and Advanced Studies (CINVESTAV), National Polytechnic Institute (IPN), Mexico City, Mexico
| | - Geovanni Kaleb Mondragón-Ramírez
- 1Department of Molecular Biomedicine, Center for Research and Advanced Studies (CINVESTAV), National Polytechnic Institute (IPN), Mexico City, Mexico.,2Interdisciplinary Center for Health Sciences, Milpa Alta Unit (CICSUMA), National Polytechnic Institute (IPN), Mexico City, Mexico
| | - Julio C Alcántara-Montiel
- School of Higher Studies Zaragoza, National Autonomous University of Mexico (UNAM), Regional Hospital of High Specialty of Ixtapaluca (HRAEI), Mexico City, Mexico
| | - Arturo Cérbulo-Vázquez
- 4Faculty of Medicine, Plan of Combined Studies in Medicine (PECEM), National Autonomous University of Mexico (UNAM), Mexico City, Mexico.,5Women's Hospital, Ministry of Health (SSA), Mexico City, Mexico
| | | | - Víctor Manuel Contreras-Vargas
- 6Departments of Gynecology and Genomic Medicine, Regional Hospital 1° de Octubre, Institute of Security and Social Services of State Workers (ISSSTE), Mexico City, Mexico
| | - María Del Rocío Thompson-Bonilla
- 6Departments of Gynecology and Genomic Medicine, Regional Hospital 1° de Octubre, Institute of Security and Social Services of State Workers (ISSSTE), Mexico City, Mexico
| | - Héctor Romero-Ramírez
- 1Department of Molecular Biomedicine, Center for Research and Advanced Studies (CINVESTAV), National Polytechnic Institute (IPN), Mexico City, Mexico
| | - Leopoldo Santos-Argumedo
- 1Department of Molecular Biomedicine, Center for Research and Advanced Studies (CINVESTAV), National Polytechnic Institute (IPN), Mexico City, Mexico
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Silva CBD, Mendes MM, Rodrigues BR, Pereira TL, Rodrigues DBR, Rodrigues Junior V, Ferriani VPL, Geraldo-Martins VR, Nogueira RD. Streptococcus mutans detection in saliva and colostrum samples. EINSTEIN-SAO PAULO 2019; 17:eAO4515. [PMID: 30726310 PMCID: PMC6438671 DOI: 10.31744/einstein_journal/2019ao4515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 08/17/2018] [Indexed: 01/15/2023] Open
Abstract
Objective To detect Streptococcus mutans in colostrum and saliva of neonates and compare with its detection in saliva of mothers. Methods Forty-three healthy women, full-term gestations with no complications, submitted to elective Cesarean section, and their newborns were included in the study. Samples were investigated by polymerase chain reaction to detect S. mutans in genetic material from the samples. Results Approximately 16% of colostrum samples showed S. mutans , but not correlated with the presence of the bacteria in both samples of saliva. S. mutans was detected in 49 and 30% of saliva samples of mothers and neonates, respectively. There was a positive correlation in S. mutans detection between types of saliva. The number of maternal samples of saliva with detectable S. mutans was smaller in women receiving dental treatment during pregnancy. Tooth brushing, three times a day, influenced the detection of S. mutans in both the saliva and the colostrum. Conclusion Although maternal saliva may present S. mutans , few samples of colostrum present the bacteria. The presence of bacteria in neonate saliva may be related to contact before birth. Dental treatment and hygiene habits seem to influence the detection of S. mutans in samples of maternal saliva and colostrum.
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Affiliation(s)
| | | | | | | | | | | | - Virginia Paes Leme Ferriani
- Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Ruchele Dias Nogueira
- Universidade de Uberaba, Uberaba, MG, Brazil.,Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Abuidhail J, Al-Shudiefat AAR, Darwish M. Alterations of immunoglobulin G and immunoglobulin M levels in the breast milk of mothers with exclusive breastfeeding compared to mothers with non-exclusive breastfeeding during 6 months postpartum: The Jordanian cohort study. Am J Hum Biol 2018; 31:e23197. [PMID: 30488618 DOI: 10.1002/ajhb.23197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/26/2018] [Accepted: 10/15/2018] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The purpose of this study was to measure changes in the concentration of immunoglobulin G (IgG) and immunoglobulin M (IgM) in the mature breast milk of Jordanian mothers during the first 6 months after giving birth between exclusively breastfeeding (EBF) mothers and non-exclusively breastfeeding (non-EBF) mothers. METHODS A longitudinal follow-up design was used to measure changes in the concentration of IgG and IgM in the mothers' mature milk during the first 6 months after giving birth. Sixty-nine lactating mothers were recruited in this study. Breast milk samples were collected by mothers themselves in the first, fourth, and sixth months of lactation to measure IgG and IgM concentrations using the enzyme-linked immunosorbent assay (ELISA) technique. RESULTS There was a significant difference in IgG and IgM concentrations between EBF and non-EBF mothers. IgG was higher in the EBF mothers' milk than in the milk of non-EBF mothers, whereas IgM was not affected by the type of baby feeding. CONCLUSION The concentration of immunoglobulins changes in human breast milk along with breastfeeding intervals. EBF enhances the concentration of IgG in breast milk compared to non-EBF.
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Affiliation(s)
- Jamila Abuidhail
- Maternal, Child, and Family Health Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | | | - Mona Darwish
- Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
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Mendes MM, da Silva CB, Rodrigues DBR, Rodrigues BR, Geraldo-Martins VR, Ferriani VPL, Rodrigues V, Nogueira RD. Streptococcus mutans in Umbilical Cord Blood, Peripheral Blood, and Saliva from Healthy Mothers. Curr Microbiol 2018; 75:1372-1377. [PMID: 29934881 DOI: 10.1007/s00284-018-1532-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 06/16/2018] [Indexed: 11/29/2022]
Abstract
The aims of this study were to analyze the presence of Streptococcus mutans (SM)-DNA in cord blood (CB), maternal peripheral blood (PB), and maternal saliva (SA) and compare with data collected in health surveys. Sixty-four healthy women with pregnancies to term and without complications attending for elective cesarean section in the Clinical Hospital of Ribeirao Preto, Sao Paulo were included. Samples of PB and unstimulated SA were obtained on the day of hospitalization and samples of CB were collected after the delivery section. Samples were investigated using polymerase chain reaction for the presence of SM-DNA using specific primers. The results show over 50% of the sample of PB and CB showed SM-DNA detectable. There was a positive correlation between the SM detection in PB/CB and SA (P < 0.05). Pregnant women, who reported tooth brushing more than three times a day, often showed detectable SM-DNA in PB and CB (P < 0.05). In conclusion, the majority of children can have contact with SM-DNA during the intrauterine life by the CB. SM probably transferred from salivary habitat to PB and CB. The tooth brushing can be associated to S. mutans detection in blood samples.
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Affiliation(s)
- Marcelly Milhomem Mendes
- Uberaba University, Av. Nenê Sabino, 1801 - Bairro Universitário, Uberaba, Minas Gerais, CEP: 38.055-500, Brazil
| | - Camilla Beatriz da Silva
- Uberaba University, Av. Nenê Sabino, 1801 - Bairro Universitário, Uberaba, Minas Gerais, CEP: 38.055-500, Brazil
| | | | - Barbara Rocha Rodrigues
- Uberaba University, Av. Nenê Sabino, 1801 - Bairro Universitário, Uberaba, Minas Gerais, CEP: 38.055-500, Brazil
| | | | | | | | - Ruchele Dias Nogueira
- Uberaba University, Av. Nenê Sabino, 1801 - Bairro Universitário, Uberaba, Minas Gerais, CEP: 38.055-500, Brazil. .,Department of Pediatrics, Medical School of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil.
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Dias EM, Rodrigues DBR, Geraldo-Martins VR, Nogueira RD. Analysis of colostrum IgA against bacteria involved in neonatal infections. EINSTEIN-SAO PAULO 2017; 15:256-261. [PMID: 29091144 PMCID: PMC5823036 DOI: 10.1590/s1679-45082017ao3958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 05/04/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe e compare the specificity of IgA antibodies against bacteria extract of Klebsiella pneumoniae , Staphylococcus aureus , Escherichia coli , and Salmonella enteritidis . METHODS Colostrum samples were aseptically collected in the first 12 hours after C-section delivery. The specificity of IgA against bacteria extracts was analyzed by the Western blot. RESULTS The findings showed proteins of high molecular weight frequently detectable in the samples. S. aureus was the most frequently found bacterium in the samples (p<0.05). Approximately 93.8, 56.3, 62.5 and 60.4% of samples presented IgA reactive to S. aureus , K. pneumoniae , S. enteritidis, and E. coli, respectively. Roughly 40% of samples showed no IgA reactive to K. pneumoniae, S. enteritidis and E. coli . CONCLUSION Clinical evidence of the importance of breastfeeding for the immune protection of neonates was consistent with the observed immunological findings, since most samples showed IgA reactive against the species tested. The application and development of immunotherapies during pregnancy, focused on frequently detected antigens, could be an important tool to enhance the presence of IgA in colostrum.
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BERTOLDO BB, SILVA CBD, RODRIGUES DBR, GERALDO-MARTINS VR, FERRIANI VPL, NOGUEIRA RD. Comparisons of IgA response in saliva and colostrum against oral streptococci species. Braz Oral Res 2017; 31:e39. [DOI: 10.1590/1807-3107bor-2017.vol31.0039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/10/2017] [Indexed: 11/22/2022] Open
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