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Gualdoni GS, Barril C, Jacobo PV, Pacheco Rodríguez LN, Cebral E. Involvement of metalloproteinase and nitric oxide synthase/nitric oxide mechanisms in early decidual angiogenesis-vascularization of normal and experimental pathological mouse placenta related to maternal alcohol exposure. Front Cell Dev Biol 2023; 11:1207671. [PMID: 37670932 PMCID: PMC10476144 DOI: 10.3389/fcell.2023.1207671] [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: 04/17/2023] [Accepted: 07/28/2023] [Indexed: 09/07/2023] Open
Abstract
Successful pregnancy for optimal fetal growth requires adequate early angiogenesis and remodeling of decidual spiral arterioles during placentation. Prior to the initiation of invasion and endothelial replacement by trophoblasts, interactions between decidual stromal cells and maternal leukocytes, such as uterine natural killer cells and macrophages, play crucial roles in the processes of early maternal vascularization, such as proliferation, apoptosis, migration, differentiation, and matrix and vessel remodeling. These placental angiogenic events are highly dependent on the coordination of several mechanisms at the early maternal-fetal interface, and one of them is the expression and activity of matrix metalloproteinases (MMPs) and endothelial nitric oxide synthases (NOSs). Inadequate balances of MMPs and nitric oxide (NO) are involved in several placentopathies and pregnancy complications. Since alcohol consumption during gestation can affect fetal growth associated with abnormal placental development, recently, we showed, in a mouse model, that perigestational alcohol consumption up to organogenesis induces fetal malformations related to deficient growth and vascular morphogenesis of the placenta at term. In this review, we summarize the current knowledge of the early processes of maternal vascularization that lead to the formation of the definitive placenta and the roles of angiogenic MMP and NOS/NO mechanisms during normal and altered early gestation in mice. Then, we propose hypothetical defective decidual cellular and MMP and NOS/NO mechanisms involved in abnormal decidual vascularization induced by perigestational alcohol consumption in an experimental mouse model. This review highlights the important roles of decidual cells and their MMP and NOS balances in the physiological and pathophysiological early maternal angiogenesis-vascularization during placentation in mice.
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Affiliation(s)
| | | | | | | | - Elisa Cebral
- Laboratorio de Reproducción y Fisiología Materno-Embrionaria, Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Departamento de Biodiversidad y Biología Experimental (DBBE), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
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Gualdoni GS, Pérez-Tito L, Barril C, Sobarzo C, Cebral E. Abnormal growth and morphogenesis of placenta at term is linked to adverse fetal development after perigestational alcohol consumption up to early gestation in mouse. Birth Defects Res 2022; 114:611-630. [PMID: 35775613 DOI: 10.1002/bdr2.2063] [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: 08/24/2021] [Revised: 05/20/2022] [Accepted: 06/13/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Gestation alcohol consumption produces fetal growth restriction and malformations by affecting the embryo-fetal development. Recently a relationship between abnormal placentation and fetal malformation and intrauterine growth retardation has been suggested. However, the effects of perigestational alcohol ingestion up to early pregnancy on the placenta at term and its association with fetal abnormalities are little known. METHODS In female mice, ethanol 10% in water was administered for 15 days previous and up to days 4 (D4), 8 (D8), or 10 (D10) of gestation (TF), and gestation continues without ethanol exposure. Control females (CF) received ethanol-free water. At day 18, feto-placental units and implantation sites were studied. RESULTS TF had increased resorptions and only fetuses from D8-TF and D10-TF had significantly increased weights versus CF. D4 and D10-TF-placentas had significantly reduced weights. All TF had increased junctional zone (JZ) and reduced labyrinth (Lab) areas (PAS-histology and morphometry) compared with CF. Fetuses with mainly with craniofacial abnormalities and skeletal defects (Alizarin red staining), significantly increase; while the fetal bone density (alizarin color intensity, ImageJ) was reduced in D4, D8 and D10-TF versus CF. Although all TF-placentas were histo-structural affected, TF-abnormal fetuses had the most severe placental anomalies, with junctional abundant glycogenic cells into the labyrinth, disorganized labyrinthine vascularization with signs of leukocyte infiltrates and feto-maternal blood mix. CONCLUSIONS Perigestational alcohol consumption up to early gestation induces at term fetal growth alterations, dysmorphology and defective skeleton, linked to deficient growth and abnormal morphogenesis of placenta, highlighting insight into the prenatal etiology of FASD.
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Affiliation(s)
- Gisela Soledad Gualdoni
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Leticia Pérez-Tito
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Camila Barril
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Cristian Sobarzo
- Facultad de Medicina, CONICET, Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Buenos Aires, Argentina
| | - Elisa Cebral
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires, Buenos Aires, Argentina
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Gualdoni GS, Jacobo PV, Barril C, Ventureira MR, Cebral E. Early Abnormal Placentation and Evidence of Vascular Endothelial Growth Factor System Dysregulation at the Feto-Maternal Interface After Periconceptional Alcohol Consumption. Front Physiol 2022; 12:815760. [PMID: 35185604 PMCID: PMC8847216 DOI: 10.3389/fphys.2021.815760] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/28/2021] [Indexed: 01/16/2023] Open
Abstract
Adequate placentation, placental tissue remodeling and vascularization is essential for the success of gestation and optimal fetal growth. Recently, it was suggested that abnormal placenta induced by maternal alcohol consumption may participate in fetal growth restriction and relevant clinical manifestations of the Fetal Alcohol Spectrum Disorders (FASD). Particularly, periconceptional alcohol consumption up to early gestation can alter placentation and angiogenesis that persists in pregnancy beyond the exposure period. Experimental evidence suggests that abnormal placenta following maternal alcohol intake is associated with insufficient vascularization and defective trophoblast development, growth and function in early gestation. Accumulated data indicate that impaired vascular endothelial growth factor (VEGF) system, including their downstream effectors, the nitric oxide (NO) and metalloproteinases (MMPs), is a pivotal spatio-temporal altered mechanism underlying the early placental vascular alterations induced by maternal alcohol consumption. In this review we propose that the periconceptional alcohol intake up to early organogenesis (first trimester) alters the VEGF-NO-MMPs system in trophoblastic-decidual tissues, generating imbalances in the trophoblastic proliferation/apoptosis, insufficient trophoblastic development, differentiation and migration, deficient labyrinthine vascularization, and uncompleted remodelation and transformation of decidual spiral arterioles. Consequently, abnormal placenta with insufficiency blood perfusion, vasoconstriction and reduced labyrinthine blood exchange can be generated. Herein, we review emerging knowledge of abnormal placenta linked to pregnancy complications and FASD produced by gestational alcohol ingestion and provide evidence of the early abnormal placental angiogenesis-vascularization and growth associated to decidual-trophoblastic dysregulation of VEGF system after periconceptional alcohol consumption up to mid-gestation, in a mouse model.
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Perigestational alcohol consumption induces altered early placentation and organogenic embryo growth restriction by disruption of trophoblast angiogenic factors. Reprod Biomed Online 2020; 42:481-504. [PMID: 33549483 DOI: 10.1016/j.rbmo.2020.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/10/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
RESEARCH QUESTION Maternal alcohol consumption produces fetal retardation and malformations, probably associated with placental defects. Does perigestational alcohol consumption up to organogenesis lead to abnormal placentation and embryo growth restriction by disrupting the vascular endothelial growth factor (VEGF) system in embryo-placental development? DESIGN Female mice were treated with 10% ethanol in drinking water before and up to day 10 of gestation. Control mice received ethanol-free water. After treatment, the trophoblastic tissue, embryo growth and the angiogenic VEGF pathway were analysed. RESULTS Female mice who had received treatment had resorbed and delayed implantation sites with poor ectoplacental cone development. Reduced trophoblastic area tissue from female mice who had received treatment had abnormal junctional zone and diminished labyrinthine vascularization. After treatment, the labyrinth had increased chorionic trophoblast proliferation, hypoxia inducible factor-1α immunoexpression but reduced apoptosis. The embryo growth was reduced concomitantly with low VEGF immunostaining but high endothelial nitric oxide synthase (eNOS) expression. In junctional and labyrinth of treated female mice, gene and protein immunoexpression of VEGF was reduced and the protein expression of FLT-1 increased compared with controls. Increased activation of kinase insert domain receptor receptor (phosphorylated KDR) and expression of eNOS were observed in placenta of treated female mice. Immunoexpression of metalloproteinase-9, however, was reduced in junctional zone but increased in labyrinth, compared with controls. CONCLUSIONS These data reveal inadequate expression of VEGF/receptors and angiogenic eNOS and metalloproteinase factors related to abnormal early placentation after perigestational alcohol ingestion, providing insight into aetiological factors underlying early placentopathy associated with intrauterine growth restriction caused by maternal alcohol consumption.
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Coll TA, Chaufan G, Pérez-Tito LG, Ventureira MR, Ríos de Molina MDC, Cebral E. Cellular and molecular oxidative stress-related effects in uterine myometrial and trophoblast-decidual tissues after perigestational alcohol intake up to early mouse organogenesis. Mol Cell Biochem 2017; 440:89-104. [PMID: 28822072 DOI: 10.1007/s11010-017-3158-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 08/05/2017] [Indexed: 12/18/2022]
Abstract
The placenta plays a major role in embryo-fetal defects and intrauterine growth retardation after maternal alcohol consumption. Our aims were to determine the oxidative status and cellular and molecular oxidative stress effects on uterine myometrium and trophoblast-decidual tissue following perigestational alcohol intake at early organogenesis. CF-1 female mice were administered with 10% alcohol in drinking water for 17 days prior to and up to day 10 of gestation. Control females received ethanol-free water. Treated mice had smaller implantation sites compared to controls (p < 0.05), diminished maternal vascular lumen, and irregular/discontinuous endothelium of decidual vessels. The trophoblast giant cell layer was disorganized and presented increased abnormal nuclear frequency. The myometrium of treated females had reduced nitrite content, increased superoxide dismutase activity, and reduced glutathione (GSH) content (p < 0.05). However, the trophoblast-decidual tissue of treated females had increased nitrite content (p < 0.05), increased GSH level (p < 0.001), increased thiobarbituric acid-reactive substance concentration (p < 0.001), higher 3-nitrotyrosine immunoreaction, and increased apoptotic index (p < 0.05) compared to controls. In summary, perigestational alcohol ingestion at organogenesis induced oxidative stress in the myometrium and trophoblast-decidual tissue, mainly affecting cells and macromolecules of trophoblast and decidual tissues around early organogenesis, in CF-1 mouse, and suggests that oxidative-induced abnormal early placental formation probably leads to risk of prematurity and fetal growth impairment at term.
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Affiliation(s)
- Tamara Anahí Coll
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Gabriela Chaufan
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Química Biológica, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Leticia Gabriela Pérez-Tito
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Martín Ricardo Ventureira
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - María Del Carmen Ríos de Molina
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Química Biológica, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Elisa Cebral
- Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina. .,Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina. .,IBBEA-UBA/CONICET, Intendente Güiraldes, 2620, Ciudad Universitaria, Pabellón 2, 4to. Piso, Lab 22. (CP: 1428EGA), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
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Coll TA, Chaufan G, Pérez-Tito L, Ventureira MR, Sobarzo CMA, Ríos de Molina MDC, Cebral E. Oxidative stress and cellular and tissue damage in organogenic outbred mouse embryos after moderate perigestational alcohol intake. Mol Reprod Dev 2017; 84:1086-1099. [DOI: 10.1002/mrd.22865] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/08/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Tamara A. Coll
- Universidad de Buenos Aires; Facultad de Ciencias Exactas y Naturales; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
- CONICET-Universidad de Buenos Aires; Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE); Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
| | - Gabriela Chaufan
- Universidad de Buenos Aires; Facultad de Ciencias Exactas y Naturales; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
- CONICET-Universidad de Buenos Aires, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN); Departamento de Química Biológica; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
| | - Leticia Pérez-Tito
- Universidad de Buenos Aires; Facultad de Ciencias Exactas y Naturales; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
- CONICET-Universidad de Buenos Aires; Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE); Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
| | - Martín R. Ventureira
- Universidad de Buenos Aires; Facultad de Ciencias Exactas y Naturales; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
- CONICET-Universidad de Buenos Aires; Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA-CONICET); Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
| | - Cristian M. A. Sobarzo
- Universidad de Buenos Aires, Facultad de Medicina, CONICET- Universidad de Buenos Aires; Instituto de Investigaciones Biomédicas (INBIOMED); Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
| | - María del Carmen Ríos de Molina
- Universidad de Buenos Aires; Facultad de Ciencias Exactas y Naturales; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
- CONICET-Universidad de Buenos Aires, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN); Departamento de Química Biológica; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
| | - Elisa Cebral
- Universidad de Buenos Aires; Facultad de Ciencias Exactas y Naturales; Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
- CONICET-Universidad de Buenos Aires; Instituto de Biodiversidad y Biología Experimental y Aplicada (IBBEA-CONICET); Ciudad Autonoma de Buenos Aires Buenos Aires Argentina
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Pérez-Tito L, Bevilacqua E, Cebral E. Peri-implantational in vivo and in vitro embryo-trophoblast development after perigestational alcohol exposure in the CD-1 mouse. Drug Chem Toxicol 2013; 37:184-97. [PMID: 24116715 DOI: 10.3109/01480545.2013.834358] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Long-term pregestational ethanol exposure induced altered fertilization and preimplantation embryogenesis. We evaluated preimplantational embryo-trophoblast differentiation, growth and invasiveness after perigestational ethanol 10% ingestion for 15 days preceding and up to day 4 (treated females [TF]: TF-D4 group) or 5 (TF-D5) of CD-1 gestation (control females [CF] with water). In TF-D4, expanded and hatched blastocyst numbers were significantly reduced (p < 0.05) versus CF-D4. Abnormal embryos and percentage of pyknotic nuclei were increased, and early blastocyst growth (nuclear number/embryo) and mitotic index was reduced (p < 0.05) versus CF-D4. On day 5 of gestation, TF-D5 presented significantly reduced total embryos and advanced embryo type 3 number versus CF-D5 (p < 0.05). During in vitro development, up to 72-hour culture, TF-D5 had reduced embryo type 1 (the least developed) and 3 percentages (p < 0.05) versus controls, whereas embryo type 2 percentage increased (p < 0.05) versus CF-D5. Embryo-trophoblast growth was studied during culture by morphometry. Embryo size ranges were classified as small, medium and large embryos. At 48-hour culture, small and medium embryos of TF had significantly increased mean area versus CF (p < 0.05), whereas large embryos had reduced mean area at 24-hour culture. Perigestational alcohol exposure up to days 4-5 induced embryo differentiation retardation, abnormal blastocyst growth and alterations of embryo-trophoblast growth and expansion during implantation, suggesting impaired regulation of trophoblast invasion and a relation with early pregnancy loss after mouse perigestational alcohol consumption.
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Affiliation(s)
- Leticia Pérez-Tito
- Laboratorio de Reproducción y Fisiopatología Materno-Embrionaria, Instituto de Fisiología, Biología sMolecular y Neurociencias (IFIBYNE-CONICET), Departamento de Biodiversidad y Biología Experimental (DBBE), Facultad de Ciencias Exactas y Naturales (FCEyN), Universidad de Buenos Aires (UBA) , Buenos Aires , Argentina and
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Coll TA, Tito LP, Sobarzo CMA, Cebral E. Embryo developmental disruption during organogenesis produced by CF-1 murine periconceptional alcohol consumption. ACTA ACUST UNITED AC 2011; 92:560-74. [PMID: 21922637 DOI: 10.1002/bdrb.20329] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 07/11/2011] [Indexed: 01/09/2023]
Abstract
The aim was to study the control females (CF)-1 mouse embryo differentiation, growth, morphology on embryonic E- and N-cadherin expression at midgestation after periconceptional moderate alcohol ingestion. Adult female mice were exposed to 10% ethanol in drinking water for 17 days previous to and up to day 10 of gestation (ethanol-exposed females, EF) and were compared with nonexposed CF. EF presented reduced quantities of E10 to E10.5 embryos, greater percentage of embryos at stages less than E7.5, reduced implantation site numbers/female, and increased resorptions compared with CF. EF-embryo growth was significantly affected as evidenced by reduced cephalic and body sizes of E10 and E10.5 embryos (scanning electron microscopy) and decreased protein content of E10.5 embryos vs. CF embryos. A significantly higher percentage of EF-E10-10.5 embryos presented abnormal neural tube (NT) closure vs. the percentage of CF. E10 embryos from EF presented elevated tissue disorganization, pyknosis and nuclear condensation in somites, mesenchymal and neuroepithelial tissue. Immunohistochemical E- and N-cadherin distribution patterns were similar in organic structures of E10 embryos between groups. However, western blot revealed that E- and N-cadherin expression levels were significantly increased in EF-derived embryos vs. controls. Perigestational ethanol consumption by CF-1 mice induced significant damage in the organogenic embryogenesis by producing delayed differentiation, growth deficiencies, and increasing the frequency of NT defects. Ethanol exposure may disrupt cell-cell adhesion leading to upregulation of E- and N-cadherin expression suggesting that deregulation of cell adhesion molecules could be involved in the disruption of embryo development at organogenesis in CF-1 mouse.
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Affiliation(s)
- Tamara A Coll
- Laboratorio de Reproducción y Fisiopatología Materno-Embrionaria, Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-CONICET), Departamento de Biodiversidad y Biología Experimental (DBBE), Universidad de Buenos Aires (UBA), Argentina
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Male and female reproductive toxicity induced by sub-chronic ethanol exposure in CF-1 mice. Cell Biol Toxicol 2011; 27:237-48. [DOI: 10.1007/s10565-011-9185-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 01/31/2011] [Indexed: 10/18/2022]
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Coyle P, Martin SA, Carey LC, Summers BL, Rofe AM. Ethanol-Mediated Fetal Dysmorphology and its Relationship to the Ontogeny of Maternal Liver Metallothionein. Alcohol Clin Exp Res 2009; 33:1051-8. [DOI: 10.1111/j.1530-0277.2009.00926.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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