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Alquria TA, Alfirdous RA, Gupta S, Santamaria MP, Santamaria IF, Gomes APM, Tiradentes N, Silva EG, Martinho FC. Comparison of conventional and contemporary root canal disinfection protocols against bacteria, lipoteichoic acid (LTA), and lipopolysaccharide (LPS). Sci Rep 2023; 13:1206. [PMID: 36681702 PMCID: PMC9867776 DOI: 10.1038/s41598-022-26855-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023] Open
Abstract
This study devised a dual-species biofilm model to investigate bacteria, lipoteichoic acid (LTA), and lipopolysaccharide (LPS) simultaneously, and compared the efficacy of conventional and contemporary disinfection protocols. Seventy single-rooted mandibular premolars were included. Fourteen teeth were negative control, and 56 teeth were infected with 3-week-old E. faecalis and E. coli GFP biofilm. Fourteen/56 teeth were positive control, with seven teeth processed for CLSM analysis and seven teeth sampled with paper points (PPs) and cryogenically ground for bacterial, LTA, and LPS analyses. Forty-two teeth were randomly divided into three groups: GWS (GentleWave system) + MIT (minimally invasive technique), PUI (passive ultrasonic irrigation) + CIT (conventional instrumentation technique), and XP-EF (XP-endo Finisher) + CIT (All, n = 14). Samples were collected before (s1) and after disinfection (s2) with PPs and after cryogenically ground (s3). CFUs were counted, and LTA and LPS were quantified with LTA-ELISA and LAL assay, respectively. XP-EF was as effective as PUI (p > 0.05). GWS + MIT was the most effective disinfection protocol against bacteria, LTA, and LPS (p < 0.05). In conclusion, PUI, XP-EF, and GWS were highly effective against bacteria, LTA, and LPS, with GWS being the most effective.
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Affiliation(s)
- Theeb A Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
- Department of Restorative Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rayyan A Alfirdous
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
- Prince Abdulrahman Advanced Dental Institute, Riyadh, Kingdom of Saudi Arabia
| | - Swati Gupta
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | | | - Ingrid F Santamaria
- Department of General Dentistry, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Ana P M Gomes
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Naiara Tiradentes
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Eduardo G Silva
- Department of Social and Pediatric Dentistry, Institute of Science and Technology, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA.
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Al-Amad SH, Al Bayatti S, Alshamsi HA. Stylohyoid Ligament Calcification and Its Association With Dental Diseases. Int Dent J 2022; 73:151-156. [PMID: 35902309 PMCID: PMC9875230 DOI: 10.1016/j.identj.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES This research aimed at investigating the relationship between calcification of the stylohyoid ligaments (SHLs) and odontogenic inflammatory events. METHODS Cone-beam computed tomography scans of 175 patients were retrospectively assessed for presence of SHL calcifications. Frequencies of 4 types of odontogenic inflammatory events were assessed using the same scans, namely dental extractions, root canal treatments, furcation lesions, and periapical lesions. Patients were telephone-interviewed and asked about histories of tonsillectomy and head and neck trauma. Mann-Whitney U and binary logistic regression tests were used to assess associations between SHL calcification and mean ranks of odontogenic inflammatory events. RESULTS Calcification of SHLs was detected in 71 (41%) and 58 (33%) patients on the right and left sides, respectively. Tonsillectomy and trauma were reported in 14% and 10% of the sample, respectively. Amongst all inflammatory events, root canal treatments were significantly associated with SHL calcification (U = 2755; Z = -2.1; P = .035). This association was independent from patient age, tonsillectomy, trauma, and other inflammatory events (odds ratio, 1.2; 95% confidence interval, 1.0-1.4; P = .036). CONCLUSIONS This study presents new evidence that intra-oral inflammatory events, particularly related to root canal treatments, have a stronger association with SHL dystrophic calcification than that associated with traditional predisposing factors (ie, old age, tonsillectomy, and trauma).
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Affiliation(s)
- Suhail H. Al-Amad
- Corresponding author. College of Dental Medicine, University of Sharjah, PO Box 27272, Room M28-132, Sharjah, UAE.
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Lima AR, Herrera DR, Francisco PA, Pereira AC, Lemos J, Abranches J, Gomes BPFA. Detection of Streptococcus mutans in symptomatic and asymptomatic infected root canals. Clin Oral Investig 2021; 25:3535-3542. [PMID: 33170373 PMCID: PMC8152374 DOI: 10.1007/s00784-020-03676-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate the presence of Streptococcus mutans in root canals of symptomatic necrotic teeth (SNT) and their associated acute apical abscesses (AAA) and in the root canals of asymptomatic necrotic teeth (ANT). It also aimed to investigate the presence of the cnm and cbm genes in specimens that harbored S. mutans. MATERIALS AND METHODS DNA was extracted from samples collected from 10 patients presenting pulpal necrosis associated with radiographic evidence of apical periodontitis (ANT) and from 10 patients in need of endodontic therapy due to the presence of pulpal necrosis (SNT) and AAA. The control group consisted of 10 patients with teeth with normal vital pulp and requiring endodontic treatment for prosthetic reasons. The presence of S. mutans was detected by quantitative real-time-PCR (qPCR) using species-specific primers. Samples harboring S. mutans were further evaluated for the presence of CBP genes by qPCR as well. RESULTS All studied sites showed a high prevalence of S. mutans, except the control group. Specifically, 60% of ANT and 70% of AAA/SNT paired samples were positive for S. mutans. The cnm gene was detected positive for S. mutans only in ANT samples (66.6%). The cbm gene was not detected in any of the investigated sites. CONCLUSIONS S. mutans was found in high prevalence in both asymptomatic and symptomatic endodontic infections, including in abscesses, but it was not detected in the root canals of teeth with normal vital pulp. Interestingly, cnm+ S. mutans was only detected in asymptomatic/chronic primary endodontic infections associated with apical lesion. Therefore, it appears that cnm, and possibly other CBPs, may play an underestimated role in chronic endodontic infections. CLINICAL RELEVANCE A high prevalence of Streptococcus mutans cnm+ gene was detected only in asymptomatic primary endodontic infections associated with apical lesion. Therefore, it appears that this collagen-binding protein gene plays an underestimated role in asymptomatic/chronic endodontic infections.
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Affiliation(s)
- Augusto Rodrigues Lima
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA
| | - Daniel Rodrigo Herrera
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
- Department of Endodontics, Fluminense Federal University - UFF, Niteroi, RJ, Brazil
| | - Priscila Amanda Francisco
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
| | - Andrea Cardoso Pereira
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA
| | - Jose Lemos
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA
| | - Jacqueline Abranches
- Department of Oral Biology, University of Florida, UF. College of Dentistry, 1395 Center Drive, Box 100424, Gainesville, FL, 32610-0424, USA.
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, University of Campinas-UNICAMP, Av Limeira, 901, Bairro Areião, Piracicaba, SP, 13414-903, Brazil.
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Nascimento GG, Rabello DGD, Corazza BJM, Gomes APM, Silva EG, Martinho FC. Comparison of the effectiveness of single- and multiple-sessions disinfection protocols against endotoxins in root canal infections: systematic review and meta-analysis. Sci Rep 2021; 11:1226. [PMID: 33441646 PMCID: PMC7806761 DOI: 10.1038/s41598-020-79300-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/07/2020] [Indexed: 12/29/2022] Open
Abstract
This systematic review (SR) addressed the following common clinical question: What is more effective in reducing or eliminating endotoxin in endodontic infections—single or multiple-session treatments using calcium hydroxide medications? Literature searches of Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge, Scopus, and Google Scholar databases. Two reviewers independently assessed the eligibility for inclusion, extracted data, and evaluated the quality of the studies using the risk of bias tools. Electronic searches resulted in 358 articles, of which 32 studies were included for full-text assessment, and nine were included in this review. Meta-analysis pooling all the nine studies revealed lower levels of endotoxin for multiple-session treatment (P < 0.001). The sub-group analysis indicated no difference between single-session and 7 days of Ca(OH)2 medication (SMD − 0.32; P = 0.22). However, 14-days (I2 = 80.5%, P < 0.001) and 30-days (I2 = 78.9%, P < 0.01) of Ca(OH)2 medication was more effective than single-session treatment (both, p < 0.001). Overall, Overall, this SR provides evidence to support that multiple-session disinfection protocols with the placement of Ca(OH)2 medications are more effective in reducing the levels of endotoxin from root canal infections compared to single-session when applied for 14 and 30 days.
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Affiliation(s)
- Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Diego G D Rabello
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University, São José dos Campos, São Paulo, Brazil
| | - Bruna J M Corazza
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University, São José dos Campos, São Paulo, Brazil
| | - Ana P M Gomes
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University, São José dos Campos, São Paulo, Brazil
| | - Eduardo G Silva
- Department of Social and Pediatric Dentistry, Institute of Science and Technology, São Paulo State University, São José dos Campos, São Paulo, Brazil
| | - Frederico C Martinho
- Endodontic Division, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA.
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Koller G, Foschi F, Mitchell P, Witherden E, Bruce K, Mannocci F. Amoebae in Chronic, Polymicrobial Endodontic Infections Are Associated with Altered Microbial Communities of Increased Virulence. J Clin Med 2020; 9:jcm9113700. [PMID: 33218015 PMCID: PMC7698792 DOI: 10.3390/jcm9113700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Infections of the root canal space involve polymicrobial biofilms and lead to chronic, low grade inflammatory responses arising from the seeding of microbes and by-products. Acute exacerbation and/or disseminating infections occur when established microbial communities undergo sudden changes in phenotypic behaviour. METHODS Within clinical endodontic infections, we assessedcategorical determinants comprising, and changing microbial composition of, chronic polymicrobial infections and their association with amoebae. After standardised assessment, primary or secondary infections underwent sampling and DNA processing, targeting bacteria, fungi and amoebae, including 16S high-throughput sequencing. After taxonomic assignment, community composition was correlated with clinical signs and symptoms. Diversity and abundance analyses were carried out in relation to the presence of non-bacterial amplicons. RESULTS Clinical specimens revealed two distinct community clusters, where specific changes correlated with clinical signs. An association between the compositions of microbiomes was found between these groups and the presence of Entamoeba gingivalis in 44% of cases. When amoebae were present in endodontic infections, we demonstrate changes in microbial community structure that mirror those observed in treatment-resistant or recurrent infections. CONCLUSIONS Amoeba are present in endodontic infections at a high prevalence, and may promote increased virulence by enrichment for phagocytosis-resistant bacteria.
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Affiliation(s)
- Garrit Koller
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (G.K.); (P.M.); (F.M.)
- Centre for Host Microbiome Interactions, King’s College London Dental Institute at Guy’s Hospital, King’s Health Partners, London SE1 9RT, UK;
- LCN—London Centre for Nanotechnology, 19 Gordon St, Bloomsbury, London WC1H 0AH, UK
| | - Federico Foschi
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (G.K.); (P.M.); (F.M.)
- Centre for Oral, Clinical and Translational Sciences, Floor 25, Tower Wing, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9RT, UK
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
- Correspondence: ; Tel.: +44-(0)207-188-1573
| | - Philip Mitchell
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (G.K.); (P.M.); (F.M.)
| | - Elizabeth Witherden
- Centre for Host Microbiome Interactions, King’s College London Dental Institute at Guy’s Hospital, King’s Health Partners, London SE1 9RT, UK;
| | - Kenneth Bruce
- King’s College London, Institute of Pharmaceutical Science, Franklin-Wilkins Building, London SE1 9NN, UK;
| | - Francesco Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, Floor 22 Tower Wing, Guy’s Dental Hospital, London SE1 9RT, UK; (G.K.); (P.M.); (F.M.)
- Centre for Oral, Clinical and Translational Sciences, Floor 25, Tower Wing, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9RT, UK
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Effectiveness of calcium hydroxide-based intracanal medication on infectious/inflammatory contents in teeth with post-treatment apical periodontitis. Clin Oral Investig 2018; 23:2759-2766. [DOI: 10.1007/s00784-018-2719-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/17/2018] [Indexed: 02/07/2023]
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Gomes BPFDA, Herrera DR. Etiologic role of root canal infection in apical periodontitis and its relationship with clinical symptomatology. Braz Oral Res 2018; 32:e69. [PMID: 30365610 DOI: 10.1590/1807-3107bor-2018.vol32.0069] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 12/16/2022] Open
Abstract
Evidence shows the polymicrobial etiology of endodontic infections, in which bacteria and their products are the main agents for the development, progression, and dissemination of apical periodontitis. Microbial factors in necrotic root canals (e.g., endotoxin) may spread into apical tissue, evoking and supporting a chronic inflammatory load. Thus, apical periodontitis is the result of the complex interplay between microbial factors and host defense against invasion of periradicular tissues. This review of the literature aims to discuss the complex network between endodontic infectious content and host immune response in apical periodontitis. A better understanding of the relationship of microbial factors with clinical symptomatology is important to establish appropriate therapeutic procedures for a more predictable outcome of endodontic treatment.
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Affiliation(s)
| | - Daniel Rodrigo Herrera
- Universidade Estadual de Campinas -Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
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Klimesova K, Jiraskova Zakostelska Z, Tlaskalova-Hogenova H. Oral Bacterial and Fungal Microbiome Impacts Colorectal Carcinogenesis. Front Microbiol 2018; 9:774. [PMID: 29731748 PMCID: PMC5920026 DOI: 10.3389/fmicb.2018.00774] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/05/2018] [Indexed: 12/31/2022] Open
Abstract
Host's physiology is significantly influenced by microbiota colonizing the epithelial surfaces. Complex microbial communities contribute to proper mucosal barrier function, immune response, and prevention of pathogen invasion and have many other crucial functions. The oral cavity and large intestine are distant parts of the digestive tract, both heavily colonized by commensal microbiota. Nevertheless, they feature different proportions of major bacterial and fungal phyla, mostly due to distinct epithelial layers organization and different oxygen levels. A few obligate anaerobic strains inhabiting the oral cavity are involved in the pathogenesis of oral diseases. Interestingly, these microbiota components are also enriched in gut inflammatory and tumor tissue. An altered microbiota composition - dysbiosis - and formation of polymicrobial biofilms seem to play important roles in the development of oral diseases and colorectal cancer. In this review, we describe the differences in composition of commensal microbiota in the oral cavity and large intestine and the mechanisms by which microbiota affect the inflammatory and carcinogenic response of the host.
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Affiliation(s)
- Klara Klimesova
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the CAS, Prague, Czechia
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Wang L, Jin H, Ye D, Wang J, Ao X, Dong M, Niu W. Enterococcus faecalis Lipoteichoic Acid-induced NLRP3 Inflammasome via the Activation of the Nuclear Factor Kappa B Pathway. J Endod 2017; 42:1093-100. [PMID: 27325457 DOI: 10.1016/j.joen.2016.04.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 04/11/2016] [Accepted: 04/28/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We wished to examine the effects of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome on periapical periodontitis induced by Enterococcus faecalis and to investigate the molecular mechanisms of lipoteichoic acid (LTA) derived from E. faecalis on the expression of the NLRP3 inflammasome. METHODS A model of periapical periodontitis by sealing E. faecalis into the pulp chambers of rats was established. We then examined the relationship between the expression, location, distribution, and concentration of NLRP3, caspase-1, and interleukin 1β with the inflammatory progression by immunohistochemistry and undertook correlation analyses. RAW264.7 cells were cultured in the absence or presence of LTA together with or without nuclear factor kappa B (NF-κB) inhibitor BAY 11-7082; NLRP3 inflammasome expression was measured by Western blotting, the enzyme-linked immunosorbent assay, and real-time quantitative polymerase chain reaction. An immunofluorescence study was conducted to further detect whether NF-κB can be completely inhibited by BAY 11-7082 or activated by LTA. RESULTS An animal model of periapical periodontitis was established successfully. Expression of NLRP3, caspase-1, and interleukin 1β protein was observed in the inflamed area. The expression of these 3 proteins had a significant positive correlation (P < .05). Overall, our results showed that, compared with the negative control group, LTA could directly activate expression of messenger RNA and protein of the NLRP3 inflammasome (P < .05), whereas BAY 11-7082 inhibited it (P < .05). CONCLUSIONS Our results suggested that LTA can act as a directly stimulating factor associated with expression of the NLRP3 inflammasome during periapical periodontitis, which is mainly linked with the NF-κB signaling activation pathway.
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Affiliation(s)
- Lina Wang
- Department of Endodontics and Periodontics, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China
| | - Haiwei Jin
- Department of Oral Basic Science, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China
| | - Dandan Ye
- Department of Endodontics and Periodontics, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China
| | - Jiaojiao Wang
- Department of Endodontics and Periodontics, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China
| | - Xiang Ao
- Department of Endodontics and Periodontics, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China
| | - Ming Dong
- Department of Endodontics and Periodontics, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China
| | - Weidong Niu
- Department of Endodontics and Periodontics, College of Stomatology, Dalian Medical University, Dalian, Liaoning Province, China.
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Rabello DG, Corazza BJ, Ferreira LL, Santamaria MP, Gomes AP, Martinho FC. Does supplemental photodynamic therapy optimize the disinfection of bacteria and endotoxins in one-visit and two-visit root canal therapy? A randomized clinical trial. Photodiagnosis Photodyn Ther 2017; 19:205-211. [DOI: 10.1016/j.pdpdt.2017.06.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/24/2017] [Accepted: 06/11/2017] [Indexed: 11/27/2022]
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